Listening with an open heart

Your book is a response to awareness campaigns that encourage people to talk about how they feel. It's for friends and family who want to help when a loved one discloses their struggles with anxiety. Do you think mental health awareness campaigns sometimes give the false impression that simply telling someone about your problems will make them go away?
Awareness campaigns tend to focus on the message that sharing is the first step to getting help, and of course that is an important message. But I am interested in the other side of that. What do you do if someone close to you opens up to you and you don't know how to respond in a helpful way? There is so much emphasis on talking; but talking is a two-way process, and it requires a listening ear. In my private practice, I am often approached by partners, friends, or parents of grown-up children who can see that the person close to them is struggling, but who feel completely helpless or unsure about how to help. I wanted to share the simple but powerful things we know to offer as therapists, to support those who find themselves in that 'listener' role.

What's the most important thing a friend or family member can do if someone discloses their mental health issues?
Near 15 years into my career as a Psychologist, I still believe that listening with an open heart is one of the most powerful and restorative things we can offer someone who is suffering or in distress. In the book, I share my step-by-step framework, called TURN, for helping someone who is struggling. The first, and most important, step is giving your time to the person you want to help, and taking your time to properly hear and understand what is going on for them. I think we put pressure on ourselves as helpers to 'fix' or 'solve' the problem when someone shares their distress. But often, finding a way to connect and listen is the most powerful antidote to suffering, and the isolation that can go with it. In the TURN framework, T stands for Time. Once you have given your time, you can develop Understanding, move into Reframing and Redirecting, and finally support your loved one to learn New Approaches for dealing with anxiety. I go into each of these areas in detail in the book.

Are there any common responses that are unhelpful?
When it comes to anxiety, it is entirely natural to get into a pattern of avoidance, because avoiding the source of anxiety can create the illusion that the anxiety has gone away. When we are in a helping role, there is a risk we can find ourselves facilitating or even encouraging avoidance because we want to do whatever we can to help the other person feel better. There is a balance between being caring and understanding, and supporting the person we want to help to gradually face and build tolerance to anxiety-provoking situations.

Another trap I am sure we all fall into from time to time is trying to keep conversations 'positive'. Responses like 'cheer up', 'it could be worse' or 'look on the bright side' are often given with the best of intentions, but can risk making the person who is sharing feel that their experience is not valid, or that they do not have a right to feel the way they feel. Making sure we take time to listen and validate each other is a great way to move trust to deeper level.

What steps should the friend or family member take to look after their own mental health in these situations?
I once heard someone say, 'boundaries are not there to PREVENT things from happening but to ALLOW things to happen'. That is never truer then when we are in a helping role! What I mean by boundaries is being aware of the extent to which our role as a helper is defining or taking over our time, identity or resources. If we are crossing these boundaries constantly, there is a chance that we will end up burnt out and struggling ourselves. To be able to help someone else, we need to be able to know our own limits, and respect those limits. I share some ways of managing these dynamics and boundaries in the book.

How do you cope with anxiety in your own life?
Anxiety is no stranger in my own life. I have been fortunate to receive well-timed help at various points in my life, but it is something I live with and will continue to live with. I personally know and appreciate how much good support can make a difference.

A major coping strategy for me is exposure. I have learned that if something feels challenging or anxiety-provoking, I should try and do it. I get a massive sense of accomplishment from overcoming my fear or self-doubt and doing something that my social anxiety tells me is beyond me. I regularly do things like teaching, training, and appearing on TV and radio. That is partly because I enjoy that side of my work and I like embracing opportunities to share psychological ideas with a broad audience. But it is also because that kind of exposure keeps my social anxiety at bay. Having said that, there are times when I need to step back and be kind to myself. So while I do use exposure a lot, there are some occasions where I know I need to take a break and just draw the line and say 'nope my social anxiety can't handle that today!'