We tend to have some cultural norms around things like if someone was in the hospital or had a family member die, but sometimes we get busy and overwhelmed and don’t know what to do or say.  Being that sometimes acute situations/ major transitions are what brings someone into psychotherapy, I’ve heard a lot about what’s helpful and not helpful from clients over the years, and I thought I’d pass some of those ideas along today.  I’d also like to encourage that we do the same for mental health and substance abuse related acute treatments as well, such as someone entering into or coming home from inpatient or intensive outpatient treatment, in situations where the person has disclosed this information to you. 

Offer practical and specific help when possible (versus “let me know if you need anything”):

Asking how you can help is good, or the very common “let me know if there’s anything I can do”, but offering specific things you feel willing to do is generally better.  Examples include things like:

• “I’d be happy to walk your dog when I take my morning walk”

• “I go to the grocery store on Sundays, I’d be happy to do your grocery shopping/ Is there anything I can get for you?” 

• “Would you like if I pick up the kids from school [on specific days]?”

• “ I can take your trash cans in and out each week until you tell me not to?”

• “I’m off on Fridays, if you have any MD appts I can take you to or errands I can run” 

• “Would it be okay with you if I coordinate a Mealtrain and, if so, What are any food allergies or restrictions or preferences?”

• “Can I send [insert spouse’s name or teenager’s name] over to take care of mowing your lawn this week?”

• “Is there anyone you’d like me to update?”

Provide physical items:

It can be helpful for some to have physical reminders that people care about them.  Bring over food, send flowers, send a greeting card, bring over treats.  If you live far away, you can mail such items or order local food delivery for them or coordinate a mealtrain.com. 

If you visit, be mindful of how long you stay:

Tell them how long you’ll stay, or ask them how long they’d like you to stay.  I learned by example of a friend whom when she had a baby said I could come over for half an hour to meet the baby.  I loved how specific that was to let people know what amount of time might be nice but not overwhelming, what with all the tasks of having a newborn baby.  Sometimes it’s best to say you’re dropping food off and will leave it on the porch, that way they don’t have to be dressed and ready to talk.  People are often overwhelmed in these more acute situations.  They may feel oversocialized, or alternatively they may feel undersocialized.  Sometimes offering to stay a longer time and do something that will be spending time together but not direct interaction – for example, watching a movie – can be comforting.  Other times, offering to get them out of the house such as to go on a walk together can be good.  Try to read the situation as best you can, ask when you’re not sure, and offer what you feel up to. 

Respect (and expect) boundaries:

There’s the Golden Rule, where you treat someone how you would like to be treated, and then there’s the Platinum Rule, where you treat someone how they would like to be treated.  I suggest a combination of both.  A good starting place is to recall what you have appreciated when in any similar situation yourself, and then offer those things that you had found helpful or wished someone had done for you.  Hold with that the fact that not everyone handles things the same way or grieves in the same way, and that they may want or need different things than you might in the situation.  When our dog died, I very much wanted to tell people, to talk about it, to put it on facebook, and to get that emotional support and encouragement.  My husband on the other hand felt very guarded, did not want to tell other people about it, did not want to talk about it, and wanted to grieve privately, not on facebook.  Sometimes it helps to say something like, “when [xyz] happened to me, I know I really wanted to talk about it, but I know not everyone is like that, What works for you?”  There is not a right or wrong way of doing things, and not everyone likes to handle things the same way.  It can help to keep in mind that people are generally very overwhelmed during these acute times, and it’s helpful and loving to respect their way of doing things, even if it’s counter to what you would like or need.    

Let go of expectations:

They may not call or text back [right away or ever], they may not write a thank you note.  In fact, it can be helpful to specifically say when you text or leave a voicemail, “you don’t have to reply/ I don’t expect a call or text back anytime soon or at all”.  Word your texts in such a way that don’t need a reply (eg, “I’m going to Safeway this afternoon, if you’d like me to pick you up anything, just let me know.”)  Give without expectations of reciprocation or a thank you.  A good guideline is that if you can’t give or offer a particular thing without feeling resentful, that may be a sign that you’re over extending yourself and may not want to do that.

Suggest professional help or outside support, when applicable or appropriate:

Professional help, such as counseling, may be helpful for themselves or their family member(s).  Support groups can also be great suggestions, and some groups have online versions which can be convenient.  It can be nice to offer to take them to a support group or meeting, either driving them there or going in with them.  Offer to do some research for them for these supports; it will likely be easier to follow through on counseling or group referrals when a list is narrowed down.  As a psychotherapist, I definitely get inquiry calls from folks calling on behalf of a loved one, and I can totally appreciate how the legwork of calling and finding out logistics and whether the therapist is taking new referrals, etc, can decrease overwhelm.

When you are on the receiving end of help:

• Try to let others know what you want or need.

• Ask those closest to you for things that may feel harder to ask for.

• Hire out when possible, to decrease your overwhelm – for example, a housecleaner, lawn mowing service, dog walker, grocery delivery, etc.  Money doesn’t solve everything, but it can solve some things.

• Do try to write thank you texts or notes when you’re done/ when you can. 

• Remind yourself that people are doing “their best”, even if that does not translate the best for you per se.

• Allow yourself technology breaks.   

• Reciprocate when you’re feeling better and when appropriate and/or pay it forward.