How to Care for Friends Who've Experienced Trauma

It’s likely that you will or already do know someone who will experience or has experienced trauma⁠ (trauma: A serious or critical physical and/or emotional injury or physically and/or emotionally painful experience.) of some form. As friends, it’s important that we understand the responsibilities and limitations of our role, so we can best support our friends who are survivors and maintain our boundaries. Has someone disclosed to you a traumatic experience they’ve had? How can you best support that person and yourself? Here’s some information about trauma, the role of friends, and what it means to really support survivors.

Trauma, defined.

Trauma is a biological and emotional response to a stressful experience. That biological and emotional response is triggered by the amygdala, one part of the limbic system in our brain. When the amygdala senses danger, it reacts one of four ways: fight, flight, freeze, or fawn – this is its way of protecting us. To focus on survival, our brain pauses memory storage, which is why our memories of traumatic experiences are often foggy. These responses aren’t something we choose. During a stressful experience, we don’t have control over what our body does because it is our instinctive brain that responds.

While all traumatic experiences are stressful, not all stressful experiences (like cramming for an exam) are traumatic. Traumatic experiences can happen to a person (like in a case of sexual violence), place (like a natural disaster), community (like in jails or neighborhoods), or a nation (like the COVID-19 pandemic). Many traumatic experiences build on one another and can cause more significant short- and long-term effects. The stress associated with the experience or experiences can range in severity and can have both immediate and long-term effects. Overall, trauma is complex, and scientists are still learning more about it every day. But what they do know is that trauma changes our brains and impacts the ways we connect and respond to others.

Trauma is different for every person.

Our reactions to stressful experiences are different because we are different. Everyone processes what happened to them in different ways and over different amounts of time. This is because the conditions of the stressful experience – or the location, type, point in our life (like our childhood), even our personalities and life histories – are different for every person¹. Sometimes a traumatic experience occurs at one moment in time (like a loss of a parent), for others, like those who’ve experienced child abuse⁠ (abuse: Purposeful harm or mistreatment of another person, which can be verbal, emotional, physical or sexual. An ongoing pattern or cycle of such mistreatment or harm can characterize an abusive relationship.) or neglect, traumatic experiences can happen over the course of years. Trauma is more about how each individual person navigates and feels through an experience that influences if they’ll have a stress response strong or severe enough to cause long-term effects.

Symptoms of trauma often fall on a spectrum and may last a lifetime, to varying degrees of intensity, meaning they ebb and flow, like waves, throughout our lives. Sometimes reactions to a traumatic experience seem weird or opposite from what we’d expect – like not crying when something very upsetting has happened. But every response possible has happened before and is normal.

Most people experience a collection of different symptoms:

• Symptoms may be physical² – fatigue, disturbed sleep/insomnia, headaches, decreased/increased appetite, weight gain/loss
• Symptoms may be emotional – guilt, sadness, panic, anger, sudden mood changes
• Symptoms may be behavioral or relational – withdrawal⁠ (withdrawal: A method of birth control which involves the person with the penis "pulling out" of a vagina well before ejaculation and ejaculating away from a partner's genitals.) from/over commitment to social interactions, increased substance use, increased/decreased sex⁠ (sex: Different things people choose to do to actively express or enact sexuality and sexual feelings; often this involves genitals, but not always. ) drive, difficulty opening up/trusting others, changes in diet/eating habits
• Some people have cognitive symptoms – delayed processing speed, difficulty focusing, suicidal thoughts/ideation, confusion, racing thoughts
• Others may have psychological symptoms – depression, anxiety, post-traumatic stress disorder

The trauma of folks with intersecting identities – like gender⁠ (gender: Characteristics that are seen or presented as distinguishing between male and female in a society. Gender may or may not include assigned or chosen: social roles, feelings, behaviors and/or presentation or appearance.) , race, or ability – is often combined with experiences like transphobia⁠ (transphobia: Prejudice against transgender individuals. Transphobia may also include prejudice against any kind of gender nonconformity or gender nonconforming people.) , racism⁠ (racism: Prejudice, discrimination and oppression based on race/ethnicity or perceived or assigned race/ethnicity.) , or ableism⁠ (ableism: The false belief that able-bodied people are what’s normal or superior.) (to name a few). As a result, getting help, finding support, and navigating the day-to-day may be even more difficult for these friends as the number of potentially activating situations is increased³.

Friendly reminder: Healing from trauma is not a linear process – there is no clear-cut timeline or response pattern. This may be hard for friends, because all we want is to see our friend happy or themselves again. Remember that any and all responses to trauma are normal, even if you struggle to understand it.

Supporting a friend in a healthy, realistic way.

As friends, it is really important to know what you can and cannot do. Just like how your friend has boundaries, you should have them, too. Boundary setting is essential both for you and for your friend to maintain a healthy relationship⁠ (relationship: An ongoing interaction or association with another person, place or thing.) and individual wellbeing.

As a friend, you CAN’T:

• Carry their trauma for them
• Make it all better/fix everything
• Change what happened
• Decide what happens next
• Speed the healing process

As a friend, you do not have the right to all the details of the traumatic experience. Regardless of our intentions, it is never appropriate to ask for them. Your friend holds the right to share or not share with you on their own terms. They may have various barriers to disclosing⁴ – from fearing stigma or shame to worries about getting in trouble. It’s also important to note that not everybody needs to tell their whole story to move forward and heal. Ultimately, it’s their story and their decision.

Something like this communicates support and understanding and reminds your friend that they are in control:

“As your friend, I am here to listen to whatever you need/want to talk about. I understand that you may not want to tell me everything and I respect your decision.”

As a friend, you CAN (and should):

• Listen and affirm your friend and their experience
• BE the reminder that good people exist
• Provide tissues, ice cream, laughs
• Connect your friend to other supports/resources (if that’s what they want/need)
• Create and share in new moments of joy

At the end of the day, your friend is in charge of what happens next – not you, not their parent, not their partner⁠ (partner: In a sexual context, a person with whom someone is having some kind of sex. The term "partner" can be used for all kinds of relationships, not just serious ones. "Partner" can also mean the person someone is with in a romantic or familial partnership.) – only they can decide. Your friend may not want to decide anything for a while, and that’s okay, too. As a good friend, it is essential that you acknowledge that and honor their boundaries, rights, and power.

Friendly reminder: Though it is heavy and significant, the trauma is only ONE part of your person’s life. Don’t let it overshadow other aspects of their personhood.

Trusting ourselves and knowing our limits.

How do we know what to do or say to a friend who is struggling with trauma?

First consideration: Who are you as a person and what can you offer? What are your strengths as a friend? Are you a good listener? Are you good at brainstorming fun activities? Are you good at picking out⁠ (out: Short for ‘out of the closet’. When someone’s LGBTQ+ identity is known to other people.) movies? Are you good at distracting? It is important to know what you are able to do and what you are willing to do before you ask what they need. Are you willing to go to a counseling appointment with them? Be there when they disclose to their parent/guardian/partner? Be on call for when they need company? When you identify your boundaries, it’s easier to maintain them and be a good friend.

Second consideration: Who are they as a person, and what is it that your friend wants and needs? Do they want to talk about what happened? Do they want to talk about literally anything else? Do they want to just sit and eat ice cream and watch rom coms? If you don’t know what your friend wants/needs, ASK. It’s important to practice assertive⁠ (assertive: To be self-assured, self-confident. To stand up for oneself in a positive, nonviolent way.) communication⁠ (communication: Various ways we express ourselves to others, such as through speech, written words or symbols, sign language, body language, touch or art.) .

Here are a couple examples of questions to ask to check in:

• “How can I support you?”
• “What do you need from me, as your friend? I can provide/do x, y, or z.”
• “Do you want a hug?” [Practicing consent⁠ (consent: To freely and actively agree to do a specific thing with someone else with all the information about what that thing is, and the right to change your mind.) !]
• “I want to support you the best I can. When you are ready for that, please let me know.”

Sometimes, the right move is saying kind, affirming, and validating words:

• “Thank you for being vulnerable with me.”
• “I believe you.”
• “I care about you.”
• “This wasn’t your fault.”
• “I can see that you’re doing what is best for you right now, and that is awesome.”

Sometimes, the right move is just being there. They may need you to check in, make plans, or give them some space, and that’s okay, too.

Being a good friend has its challenges, too.

As friends who are working hard to support friends with trauma, we will have our own feelings. We may often feel heavy with sadness, anger, or fear over what has happened.

We may feel guilty that this happened to them instead of us – this is called survivors guilt and it is a normal reaction. Survivors guilt comes from our human need to connect and take on others’ pain. Hearing about a friend’s trauma may change the way we see the world and people around us.

We may start to feel fearful, jumpy, or worried – this is called secondary traumatic stress and it is also normal. This comes from our human tendency to feel with people. While the experience didn’t happen to us, our closeness to our survivor friend may pull in some of their symptoms, like sympathy pains.

We also may feel exhausted by the care we are giving – this is called compassion fatigue and it is normal, too. Compassion fatigue can include emotional, physical, and even spiritual distress and develops over time, often taking weeks or months to appear.

If you have trauma of your own, it can be difficult to support other friends with trauma. Hearing another person’s experience with violence or loss may bring up upsetting memories or experiences from your past – this is called retraumatization and is normal for survivors. Retraumatization refers to the reemergence of trauma symptoms as a result of exposure to others’ trauma⁵. If this happens, often new boundaries are needed so that both you and your friend can stay well. You can care for yourself, be honest about what you’re feeling, AND still be a good friend and ally⁠ (ally: Someone who is on your side. Is often used to describe someone who takes a stand against discrimination when they are not a part of the group being discriminated against.) . Try saying something like this:

“I care about you and what you are going through. Right now, I need to take some time to care for myself so that I can be a better support for you. While that happens, I am able to [text, hang out, or check-in from time-to-time as we support each other] OR I need some space.”

Self-care helps you manage the challenges that come with supporting others, maintain healthy boundaries with your friend and others, and achieve more balance in your life. Self-care can mean a lot of things – sleep, good food, exercise, being in nature, quality time with friends or family, meditation – the list goes on and on. If you are having difficulty coping with caring for your friend or for yourself, seeking professional support might be a good idea to help you get back on track.

Friendly reminder: You can’t care for others if you can’t care for you.

Is it ever okay to get professional help for my friend without their permission?

Your friend may ask you to help them find help. If it is within your capacity to help here, use the tools above to do so effectively.

However, there are two scenarios when you may validly consider seeking help without their permission: 1) if you believe your friend is at risk of hurting themselves, or 2) if they are at risk of hurting someone else.

The first move is to talk to your friend about your concerns and offer solutions, and this should happen before you contact a professional or trusted adult on their behalf. This professional or adult could be a counselor, crisis center advocate, close relative, or parent. Hotlines are also helpful resources for a friend in crisis and are anonymous. Assertive communication allows you to honor the choice and desires of your person, and also be upfront about your worries about their safety. Saying something like this prioritizes consent, care, and concern:

“I am hearing you [threaten a harmful behavior] or seeing [harmful behavior] and I am worried for your safety. I care about you and don’t want to see you hurt more – what if we [texted the crisis hotline/talked to your parent/went to the local crisis center] together?”

If you are worried that your friend may hurt themselves or another person, and they are resistant to seeking help about this, it is essential that you seek a professional or trusted adult to intervene. Your first instinct may be to call 911 or the police. Police officers are not trained mental health providers. Police are mandated reporters which means they will file a report and require that your friend tells their story over and over again to different people⁶. Many find the police interrogation/reporting process to be traumatic in its own way, at minimum it can be upsetting⁷.

A better option is to contact an advocate from a local crisis center or a national hotline – the folks that will answer are specifically trained to respond and are knowledgeable about the process for getting help, whether that be justice-related or mental health-related. If you are unsure about what to do as a friend, a crisis advocate can help you decide what to do, too. As for calling a parent, it is important to know whether or not your friend has a good, trusting relationship with their parent before you call them. The parent may not be aware of the traumatic experience or the parent may not be a safe person. Consider other relatives in your friend’s life who may respond better.

Disclaimer: If your person is a minor (under 18) and is seeking support through a hotline or agency, it is important to note that each agency has different procedures for reporting an incident of child abuse or violence. And in the case that a report is filed, every person, including minors, have the right to have an advocate present.

Final advice

Being a good friend is really important and doing so takes serious work and practice. You may not always get it right, but all you can do is your very best and ask for help when needed. Recovery and healing are easier when survivors are met with compassion and care, when they are in control of what happens next (check out this interview with survivor Chanel Miller), and when they have access to options and resources. A solid, affirming, and empowering network of friends can make a life-changing difference. Your action matters!

References included in this article:

1. Yuan, N. P., Koss, M. P., & Stone, M. (2006). The psychological consequences of sexual⁠ (sexual: About or relating in some way to sex or sexuality.) trauma. National Online Resource Center on Violence Against Women: Applied Research.
2. Flynn, C. (2020, August 19). PTSD physical symptoms can be confounding for sexual assault⁠ (sexual assault: When someone is attacked, or attacks someone else, in a sexual way.) survivors. Teen Vogue.
3. Calton, J. M., Bennett-Cattaneo, L., & Gebhard, J. M. (2015). Barriers to help seeking for LGBTQ⁠ (LGBTQ: L = lesbian, G = gay, B = bisexual, T = transgender, Q = queer or questioning. Additional letters sometimes added include U = unsure, I = intersex, P = pansexual, A= asexual, S = straight allies.) survivors of intimate partner violence. Trauma, Violence, and Abuse, 17(5), 585-600. https://doi.org/10.1177/1524838015585318
   1. Donovan, C., & Barnes, R. (2020). Help-seeking among lesbian⁠ (lesbian: Describes the sexual orientation of a woman who is sexually and emotionally attracted only or mostly to other women.) , gay⁠ (gay: A man who is attracted to other men, or a person of any sex or gender who is sexually and emotionally attracted to people of the same or a similar sex or gender. Often used alongside lesbian.) , bisexual⁠ (bisexual: A term for sexual orientation which either describes a person who can be sexually and emotionally attracted to people of more than one gender.) and/or transgender⁠ (transgender: Describes people who find that the gender applied to them because of the sex they were assigned at birth is incorrect.) victims/survivors of domestic violence and abuse: The impacts of cisgendered heteronormativity⁠ (heteronormativity: A system of beliefs, attitudes, and structures that assume everyone is heterosexual (straight) until “proven” otherwise and that heterosexuality is the “default” or norm. Heteronormativity delegitimizes the experiences of people that aren’t heterosexual.) and invisibility. Journal of Sociology, 56(4), 554-570.
   2. Kirkner, A., Plummer, S., Findley, P. A., & McMahon, S. (2020). Campus sexual violence victims with disabilities: Disclosure and help seeking. Journal of Interpersonal Violence, 1-22.
   3. Christensen, M. C., Caswell, C., & Hernandez, M. F. (2021). Contextualizing barriers to help-seeking after sexual violence: A critical feminist study with Latinx college women. Affilia, 36(1), 97-112.
4. Overstreet, N. M., & Quinn, D. M. (2013). The Intimate Partner Violence Stigmatization Model and barriers to help seeking. Basic and Applied Social Psychology, 35(1), 109-122.
5. Alexander, P. C. (2012). Retraumatization and revictimization: An attachment perspective. In M. P. Duckworth & V. M. Follette (Eds.), Retraumatization: Assessment, treatment, and prevention (pp. 191–220). Routledge/Taylor & Francis Group.
6. Sullivan, C. M., & Hagen, L. A. (2005). Survivors’ opinions about mandatory reporting of domestic violence and sexual assault by medical professionals. Affilia, 20(3), 346-361.
7. Berry, M. (2020, June 6). Feminism requires abolition: Police aren’t an adequate response to sexual violence. Ms. Magazine.