Helping A Friend Who Has PTSD

Reader’s Question

My best friend has recently told me that she was she was mentally, physically and sexually abused by her father as a child (her parents divorced when she was 13). As such, she suffers from PTSD and has flashbacks. She also is currently going through the legal systems in a case against her father and it’s been really hard on her. I’m just wondering what more I can do to help her. She’s told me what her usual triggers are and I do my best to keep her out of those situations and she always has a way to contact me if she has a nightmare or something. But, I want to know if there is anything more I can do to help her heal and deal with all of this.

Psychologist’s Reply

PTSD and flashbacks are related to “Emotional Memory“. When we experience abuse, the brain makes a strong memory that contains both the details and the mood of the experience. From that point, a variety of conditions in the environment can trigger the brain to remember and thus emotionally refeel/reexperience the event. My article on Emotional Memory has several techniques to help manage these traumatic memories.

As a best friend of someone with PTSD, there are several ways we can be of help:

• We can do our homework: read about emotional memory and PTSD, recognize how traumatic recollection works, and understand why flashbacks and triggers can intrude into their daily life.
• We can monitor them for triggers. What situations tend to produce more traumatic recollection? You’ll notice a change in their mood and facial expression when a past memory is triggered. If her reaction to a comment or situation seems inappropriate, it’s probably triggered a memory.
• When together, work as a team. Agree upon a few secret phrases and signs that can be used in public. As an example, a good friend of mine has PTSD from combat experience. When I notice that he’s dealing with an emotional memory I interrupt and say something like “My main concern in when we’re going fishing!” That’s the signal to change topics, laugh, and get out of the memory banks.
• Develop a nightmare or traumatic recollection ritual. Use strategies that help her calm and gain control. If we think about it, you’re probably saying almost the same thing each time she calls with a nightmare. Agree to use that approach each time. It might involve taking a series of calming physical activities, reorientation (“Where are you now? It’s a memory, not your life now.”), and discussions about how memory works. It’s often helpful to rate them (nightmares, recollections, etc.) on a light-hearted scale such as “nastiness”. Rating memories, hallucinations, etc. actually helps to decrease their impact by looking at them as objective brain processes.
• Encourage her to continue treatment. Be prepared for calls after treatment as treatment often stirs up traumatic memories.
• As I describe in my Emotional Memory article — purposefully add something verbally to each traumatic memory when they surface. Add your advice, your opinion, and your assurance that they are memories and not her current life. When we add information to a memory, it “waters down” the emotional part of the memory. If we have an exciting adventure, the first ten times we tell it we feel the excitement but after many years of telling the story, it’s just a story that we tell with little expression.

You’re on the right path. Do your homework and work as a team. She’s lucky to have a good friend like you.