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Coping With Crises Close to Someone Else’s Heart

By HARRIET BROWN

Published: August 16, 2010

Over the last few years, my family has weathered our share of crises. First our younger daughter was hospitalized for a week with Kawasaki disease, a rare condition in children that involves inflammation of the blood vessels, and spent several months convalescing at home. Soon after she recovered, our older daughter landed in the hospital with anorexia, which proved to be the start of a yearlong fight for her life.

Somewhere in the middle of that process, my mother-in-law was given a diagnosis of advanced lung cancer, and died less than 11 months later.

So we’ve had plenty of opportunities to observe not only how we dealt with trauma but how our friends, family and community did, too. For the most part, we were blessed with support and love; friends ran errands for us, delivered meals, sat in hospital waiting rooms, walked, talked and cried with us.

But a couple of friends disappeared entirely. During the year we spent in eating-disorder hell, they called once or twice but otherwise behaved as though we had been transported to Mongolia with no telephones or e-mail.

At first, I barely noticed; I was overwhelmed with getting through each day. As the year wore on, though, and life settled in to a new if unpleasant version of normal, I began to wonder what had happened. Given our preoccupation with our daughter’s recovery and my husband’s mother’s illness, we were no doubt lousy company. Maybe we’d somehow offended our friends. Or maybe they were just sick of the disasters that now consumed our lives; just because we were stuck with them didn’t mean our friends had to go there, too.

Even if they were completely fed up with us, though, they had to know that my husband and I were going through the toughest year of our lives. I would have understood their defection if our friendship had been less close; as it was, I couldn’t stop wondering what had happened.

In the wake of 9/11, two wars and the seemingly ever-rising tide of natural disasters, we’ve come to understand the various ways in which people cope with crisis when it happens to them. But psychologists are just beginning to explore the ways we respond to other people’s traumas.

“We all live in some degree of terror of bad things happening to us,” said Barbara M. Sourkes, associate professor of pediatrics at the Stanford University School of Medicine. “When you’re confronted by someone else’s horror, there’s a sense that it’s close to home.”

Dr. Sourkes works with families confronted with the unfolding trauma of a child’s serious, and possibly fatal, illness. “Other people’s reactions are multifaceted,” she said. “There’s no formula, and it’ll change from person to person.” The only certainty is that traumatic events change relationships outside the family as well as within it.

Often the closer one feels to the family in crisis, the harder it is to cope. “Most people cannot tolerate the feeling of helplessness,” said Jackson Rainer, a professor of psychology at Georgia Southern University who has studied grief and relationships. “And in the presence of another’s crisis, there’s always the sense of helplessness.”

Feelings of vulnerability can lead to a kind of survivor’s guilt: People are grateful that the trauma didn’t happen to them, but they feel deeply ashamed of their reactions. Such emotional discomfort often leads them to avoid the family in crisis; as Dr. Sourkes put it, “They might, for instance, make sure they’re never in a situation where they have to talk to the family directly.”

Awkwardness is another common reaction — not knowing what to say or do. Some people say nothing; others, in a rush to relieve the feelings of awkwardness, blurt out well-intentioned but thoughtless comments, like telling the parent of a child with cancer, “My grandmother went through this, so I understand.”

“We have more of a societal framework for what to say and do around bereavement than we do when you’re in the midst of it,” Dr. Sourkes said. “Families say over and over, ‘It’s such a lonely time and I don’t have the energy to educate my friends and family, yet they don’t have a clue.’ ”

The more vulnerable people feel, the harder it may be to connect. A friend whose son suffered brain damage in an accident told me that the families who dropped them afterward had children the same age as her son. They could picture all too vividly the same thing happening to their children; they felt too much empathy rather than not enough.

That was true for us, too, I realized. The friends who had disappeared had daughters exactly the same age as ours.

Dr. Rainer describes this kind of distancing as “stiff-arming” — creating as much space as possible from the possibility of trauma. It’s magical thinking in the service of denial: If bad things are happening to you and I stay away from you, then I’ll be safe.

Such people often wind up offering what Dr. Rainer calls pseudo-care, asking vaguely if there’s anything they can do but never following up. Or they might say they’re praying for the family in crisis, a response he dismisses as ineffectual at best. “A more compassionate response,” he said, “is ‘I am praying for myself to have the courage to help you.’ ”

True empathy inspires what sociologists call instrumental aid. “There are any number of tasks to be done, and they’re as personal as your thumbprint,” Dr. Rainer said. If you really want to help a family in crisis, offer to do something specific: drive the carpool, weed the garden, bring a meal, do the laundry, go for a walk.

I tested that theory recently, when a friend’s mother went through a series of medical crises and moved to an assisted-living facility in our town. Normally, I might have been guilty of pseudo-care, asking if I could do anything but never really stepping up. Instead, I e-mailed her a list of tasks I could do, and asked if any of them would be helpful.

To my surprise, my friend responded by asking if I’d visit her mother on a day she couldn’t. Her mother was glad for the company, and my friend felt reassured, knowing that her mother wasn’t alone.

And I had the chance to do something truly useful for my friend, which in turn let me show her how much I cared about her. The time I spent with her mother turned out to be a gift for me.

Thinking back to my own years of crisis, I wondered why I’d focused on the friends who didn’t come through when so many others had. In retrospect, I wished I’d taken a slightly more Zen-like attitude.

“The human condition is that traumatic events occur,” said David B. Adams, a psychologist in private practice in Atlanta. “The reality is that we are equipped to deal with them. The challenge that lies before us is quite often more important than the disappointment that surrounds us.”

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