How victim advocates support trauma survivors (and you can, too).

It was a disturbing video, tweeted under horrifying circumstances. Thousands of Twitter users with autoplay enabled had no choice but to watch. Thousands more clicked “play,” thinking it couldn’t be that bad. It was.

In a matter of seconds last week, tens of thousands of people experienced trauma by way of a Twitter video. (Link leads to a news story about a double homicide.) Tens of thousands more were called by friends a moment of crisis. Very few people are willing to really be there for someone experiencing trauma, and even fewer have been trained to do it well. I’m one of the lucky ones who spent hours in professional trauma support training, and I’d like to share some of it here.

Becoming what a complete stranger needs on the worst day of their life

I was a victim advocate for not quite two years, with not quite 2,000 hours spent on call. I wore a pager and could be summoned at any time during my overnight on-call shifts to a crime scene, where I would meet someone I’d never met before and try to help them get through something they never thought they’d have to survive. There might be a language barrier or a generational difference. They might be drunk and/or high. They might be in a hospital bed with severe injuries.

The only support process that can work for almost everyone is a process that listens to the trauma survivor as an individual. Here it is. It works on grandparents and on kids; on strangers and on best friends. It’s been used to train diplomats and disaster relief teams, as well as people like me who come to the door only when something really bad has happened.

Part One: SSVVPP

The National Organization for Victim Advocacy pioneered this method. I am simply parroting their generous and effective training. Proceed step-by-step, in order, and move on only when the other person is ready. (You may not get all the way through in one conversation.)

Safety & Security: Always start by confirming whether the traumatized person is in a safe place physically, and helping them get to a safe place if they are in danger. Try to help them feel safe emotionally, too. Help if you can with unmet safety needs — this could be something like giving your friend a ride home if they’re too shaken to drive, or helping them find a favorite stuffed animal. Ask them if they are afraid. They may not volunteer that they feel unsafe, but may admit it if you ask directly.

Ventilate & Validate: Reassure the traumatized person that their feelings are normal and typical. (All feelings are. Responses to trauma run the spectrum from crying fits to hysterical laughter and everything in between.) This isn’t a time to criticize or give a “well, actually…” answer. Validate whatever the other person says, within reason. Let them have a safe space to vent without fear of judgment or correction. If you give in to the temptation to criticize, correct, and give advice while a person is venting their raw emotions after a trauma, you may worsen their situation.

Important caveat: Call 911 if you hear a threat to harm any person, including a threat of suicide or self-harm.

Prepare & Predict: Lastly, help the traumatized person make a plan. For domestic violence survivors, this may look like a written safety plan and calling around for a shelter bed. For people traumatized by a horrific video, it might look more like planning ahead for how to fall asleep successfully after seeing the shock footage. Don’t do the planning for people — give them back their control of their lives by asking open-ended questions and letting them brainstorm their plans, next steps, and solutions.

If you just do these things, do them in the right order, and do them consistently when people experiencing trauma reach out to you, you’ll be an incredible friend already. If you’d like to take it to the next level, read on.

Part Two: Building on SSVVPP

The method above is useful in nearly any situation, but it only takes you part of the way, especially if you’re dealing with a person you’re close to and will see throughout their healing process. The following are brief tips — each of which could have been its own post — on taking that long journey with someone you care for.

Therapeutic Relationship vs. Mutual Friendship

Helping is about the person in need, not about the helper’s need for thanks or need to be right. If you choose to take up the mantle of trauma support with a friend, keep your own feelings and past traumas to yourself. Don’t say “I know how you feel, one time I…” or “I’ve walked in your shoes.” Say instead, “How do you feel?” In most cases, the friendship will return to being more mutual after the crisis is over.

Empowerment vs. Advice

Many types of trauma, from the death of a loved one to sexual assault, involve a person feeling powerless. The goal of trauma support, therefore, is to give people back a sense of power and independence. Avoid giving advice, especially if you are a convincing and persuasive advice-giver. It does nobody any good to go from being helpless in the face of trauma to helplessly obeying the well-meaning orders of a friend.

Remember also that what seems obvious to you may only be obvious to you because you’re missing key context. A battered spouse “should leave,” but in the complicated real world, leaving isn’t always a simple choice. (More on that specific case here.)

The role of a professional

Counseling is a good idea after any trauma. Victim advocates encourage everyone to consider therapy following a traumatic event. Not everyone has access to mental healthcare, but there are a few avenues you can try:

• If the trauma was a crime, the crime was reported to law enforcement, and the traumatized person was an innocent victim, ask law enforcement about victim’s compensation programs.
• Check with employers about an EAP (Employee Assistance Program) — many people who have and don’t use EAPs simply never knew their employer offered EAP benefits.
• Most major cities and many small towns have low-cost support group options; these are sometimes not ideal for people still in crisis immediately after a trauma, but can help in the mid to long term.
• Call 211. This little-used municipal resource is invaluable in connecting people to the kinds of helpful organizations that are incredibly hard to Google (or, gasp, not online at all).

Tetris time?

There’s some evidence that Tetris after a trauma might lower the incidence of PTSD. One theory as to why is that Tetris uses up all your visual processing capacity and holds your complete attention, so that your mind can’t focus on replaying traumatic visuals over and over. If you don’t think your friend will play Tetris, suggest something else highly visual that requires concentration. Knitting, painting, chess, or even Flappy Bird might fit the bill.

A note on “trigger warnings”

Trauma is painful and sad. It is also isolating and lonely. Ordinary places like a Facebook news feed or a place of work go from feeling like home to feeling inaccessible in an instant. If you have the opportunity to actively, warmly include a trauma surviving friend in your social life, workplace, or your social media presence, and all it costs you is the time it takes to type “Content advisory: This post contains a graphic description of sexual assault,” I suggest that you type the advisory language. You may be the next person who will need others to do the same for you.

Vicarious Trauma

Vicarious trauma is trauma that you receive from helping others who’ve experienced trauma. Nurses, EMTs, and even nonprofit workers are subject to it. Like direct trauma, it can turn into PTSD if you’re not careful. Pay attention to your body and to your emotions when helping others. If you notice changes for the worse in the stability of your mood, or if you notice physical symptoms like a racing heart and headaches, see a professional about vicarious trauma, and make some time for self-care. You deserve wellness, too.

An important caveat: I am not a professional, and this is not any sort of professional or medical or psychological advice. This is simply a blog post that might make you a better friend to those in crisis.

If you are interested in volunteering as a victim advocate, I highly recommend it and would be happy to answer questions.