At various points in How to Manage Stress, I have given you the advice to seek out help and support. This final chapter offers you some advice for when somebody comes to you for help and support. Having got this far in the book, you will already have a lot of resources, so this chapter is not about what advice to offer. Instead, it is about how to give your help and support effectively.
There are three sections in this chapter, which take you through advancing understanding of how to help, starting with listening well, then helping someone to regain control, and thirdly looking at one psychological model that will help you understand their need to apportion blame and how you can introduce reason into their thinking. Finally, because there is a limit to what you can achieve with goodwill and a few hours of reading, there is a list of resources at the end of the chapter, which sets out some of the places you can point them to for professional or highly experienced help, some of which specialise in particular life problems that result in stress.
Listening
The most valuable gift you can give someone who is struggling with stress is your total attention. There are three reasons: because we all want to be listened to, because it is important to let someone whose mind is in turmoil talk, and because you will be modelling the very opposite of what they are feeling – the ability to make a choice to do nothing but give your time to one very important thing. This can have a powerfully calming effect.
Making time
When somebody comes to you for help, it is a hard and uncomfortable thing they have done, so the most important response you can give is to be wholly respectful of this, and take it seriously. Even if you think that all is well, if, in their mind it is not, then it is not.
Look for an opportunity to listen to them, in a suitable place. The sooner the better; but it needs to be at a time when you can give them all of your attention. If they have caught you at a bad time then it is better to agree another time than to take time out and be stressed about this yourself. They will sense your stress and it will enhance theirs.
First response
It is tempting to say that your first response when you settle down to listen should be nothing. It is certainly true that you will need to work hard to suppress most of your reactions to what you hear: the temptation to probe, to judge, to give advice, to offer opinions, challenge or criticise, or even to tell your own story. None of these will help. Instead, your first response must be to show that you hear them and understand them.
Empathy is an understanding of another person’s feelings, and maybe starting to ‘feel for them’. We can do this because of a set of brain cells called ‘mirror neurons’ whose role is to spot movement, gesture and expression in the people around us and to mirror these. You can think of them as sending signals to your body to copy what you see, and the feedback from your body tells other parts of your brain about what those movements and expressions feel like. In this way, you can almost literally read a person’s mind and feel what they are feeling. You can empathise. This is a deep form of understanding, and just what someone in distress needs.
Listening
When we listen, we do so at different levels at different times. These levels range from shallow and superficial to deep and intense.
Pretending
Have you ever just pretended to be listening, because you knew it was expected of you, but you didn’t really care about what was being said? Of course you have – how recently? This is just a form of deceit and downright rude. It is no use to anyone.
Selecting
You will also certainly be familiar with your ability to take part in one conversation while subtly eavesdropping on a conversation nearby; perhaps a relative calls in the middle of a radio programme you were listening to. You are more than pretending to listen to them on the phone; your brain is paying some attention so that, when they say something important, you can phase out from the radio and into the phone conversation. You are selecting.
This is perhaps our default mode: we are selecting all the time. Even when we are only part of one conversation, we are selecting between it and that voice in our head that makes a running commentary on what we see and hear; it criticises and judges, it prepares our next statement or response. Consequently, we don’t always hear what the other person really says: we were listening to ourselves instead.
This is not good in many ways when listening to someone in distress. First, they will be able to tell that you are not paying full attention and, second, you will inevitably miss something important. But most essential, remember what we said about your first response: don’t judge or criticise, don’t offer advice, don’t probe. These are exactly what that voice in your head will do, instinctively, if you let it. We’ll examine how to shut that voice off soon.
Attending
At the next level of listening, you pay full attention to the other person. You focus on them and hear everything they say, giving appropriate and supportive feedback like eye contact, nods or an ‘aha’ at the right moment. When they finish what they are saying, you may ask another question, and sometimes you will make notes to help you remember things that are important. This is high-quality listening, it is good for gathering information, and is entirely appropriate to most workplace and business meetings and discussions. So what else could there be?
Empathising
When we listen to empathise, we don’t just hear what is said; we hear what is not said: we ‘listen between the lines’. Empathising is whole-body listening, where you pay total attention to the other person and start to feel a sense of what they are feeling. You will understand what they are saying in a way that goes far beyond the meaning of their words. This is particularly important for someone in distress, because that very emotional state means that they are unlikely to express themselves especially well in language: they may muddle and confuse words, and you need to follow what they are feeling rather than what they are saying.
How to listen deeply
Listening is a skill and, like all skills, if you follow a good process and practise it, you can get better. Try these six steps out with friends and family and notice what difference your better-quality listening makes to the way they regard you.
Open questions, supportive responses
Listening starts with good questions. These are questions that encourage people to talk about what is important to them, so make your questions open and avoid phrasing them in such a way that they imply the answer you want to hear. Examples of open questions are: ‘How do you feel?’ or ‘What would you like to talk about?’
There is one open question to avoid when you are listening to someone who is stressed: ‘Why… ?’ Whether you intend it to or not, a ‘why’ question will usually come across as critical or judgemental. If it is important for you to understand why I did something, for example, then find a way to ask your question without the provocative ‘why’ word; for example: ‘When you … what were your reasons?’ or ‘How did you make the decision to… ?’
Having asked a good question, listen to the answer and offer supportive responses. Keep eye contact, lean in appropriately, nod your head, and make small comments like ‘I understand,’ ‘Yes, I see’ or ‘Thank you.’
Avoid trying to tell the other person how they should feel: ‘Oh, that must have been awful.’ It seems like an empathetic way to respond, but you risk misreading their feelings. If your presumption is wrong, even slightly, you risk breaking your rapport or, worse, alienating them. It is far better to ask them how they feel or felt: ‘Oh, how did you feel about that?’
Put yourself out of the way
You are an independent thinker; you have your own ideas, beliefs, opinions, values, and even prejudices. If you want to listen respectfully, then none of these has a place in your listening. If you filter what you hear through your own values and beliefs, you will inevitably find yourself placing a value on what you hear as either: good or bad, right or wrong, sensible or stupid. What you hear is the other person’s reality and what you think of it should not be a part of your listening process.
Put all of your ideas, prejudices and opinions to one side. A good way to do this is to imagine them all encapsulated in a little version of you: your own ‘mini-me’. In your mind’s eye, imagine putting that little you right in the far corner of the room or, if you are outside, right to the edge of where you are. See them grow smaller, as they go off to that far place, where they are out of earshot and can’t judge what you hear.
Turn off the voice inside
Now you need to turn off that inner dialogue that constantly prepares the next thing you are going to say, thus drowning out what you should be hearing. Don’t worry about not being prepared with the right comment or next question: we’ll tackle that in a little bit. Imagine your inner voice being controlled by an electronic amplifier, with a big volume knob. In your mind, turn that dial down and down and down until that voice goes silen …
Become aware of your listening
As you listen, be aware of your listening; are you paying total attention? If that inner voice has started up, turn it down. If you feel yourself criticising or judging, push yourself further away. Is your body still? If you feel yourself fidgeting, then stop. If you are not turned completely towards the other person, turn to them.
To stop your hands fidgeting, use a meditation technique. If you are sitting, place your right hand in your lap, palm up, with your left hand on top, also palm up. If you are standing, place your right hand just in front of you or behind your back, and lightly hold your left hand. If you are left-handed, reverse this.
We tend to fidget most with our dominant hand, so, here, you are using your other hand to subdue it.
Match and mirror
To get that deep sense of rapport that allows you to really feel what the other person is saying, start to match their posture. Do not simply mimic every aspect, but, rather, match a few key aspects. If you do not have a close personal relationship, avoid mirroring them, so that your left side copies their right, so they see you as they would see themselves in a mirror. Instead, match their left with your left and their right with your right. Mirroring is far more intimate and will be unsettling if that intimacy is inappropriate. Matching facial expressions will give you the most direct insight into their emotions, so notice a frown and try it on, observe a closing of one eye and test it out. You may be amazed at how powerfully you can start to understand what is going on in someone’s head.
Reflect, not rephrase
Use the matching and mirroring process with words too, to show you really understand. Pick up on key phrases and play them back verbatim. Do not be tempted to paraphrase them, because your version may not mean exactly the same to them as theirs, and you will appear to them to have misunderstood.
If you know a phrase was important, but you are not sure exactly what it did mean, repeat it back and then test your understanding by rephrasing it in your words and asking if that is a good way to understand what they said. Here’s an example.
‘I feel like the whole thing is caving in on top of me.’
‘The whole thing is caving in on top of you.
Is it that your work feels out of control?’
‘Sort of, but it’s not just my work; it’s everything …
… it’s my home life too. It feels like it’s crushing me.’
‘Ah, everything.
You’re feeling crushed; is that like you can’t move under it all?’
‘Yes, that’s exactly it.’
The power of silence
If you turn off your inner voice, you won’t be able to prepare your next question or response in advance, because you will be listening. This is good. To prepare your response, you will need to wait until they have stopped speaking and then take a moment to do so. This silence is phenomenally powerful and, when you feel comfortable with it, you will become a far better listener and helper.
First, the silence indicates that you are thinking and therefore tells the other person that what they said is important to you – it is respectful. Secondly, silence is uncomfortable, so they may just fill it. By this time they have said what they consciously wanted to say, and with their guard a little lower they may just tell you something more. This might be really important.
Learn to cultivate silences, because in them lies the truth.
Helping someone to regain control
People need to find their own solutions, so helping is not always about having the answers or offering to do things. Sometimes it is entirely about letting them think through their problem and see it from a new perspective, and then endorsing their own solutions. Remember the essence of this book: any solution that I find allows me to do something for myself and so it gives me back some control.
This section is not about training you to be a coach, a counsellor or a therapist. But there is a simple five-stage questioning process that will help you to challenge somebody’s faulty thinking and restore a sense of control over their life. It’s as simple as ABCDE, in fact. We saw Albert Ellis’s ABC model towards the end of Chapter 6. We are going to revisit it, and extend it.
A: Activating event
First, enquire into what thing (or things) triggered the feelings of stress. Remember to use the terms that they use for their stress, such as ‘overwhelmed’, ‘stuck’, or ‘can’t cope’. Listen to their description and focus in on some of the things they appear to believe are true, which may not be.
B: Beliefs
Next, actually ask about the beliefs they have about the event, which set off their stress, fears and subsequent responses.
C: Consequences
Then look at the consequences those beliefs had for them. How did they react and what happened next? What you need to help them recognise is that it is their beliefs that have led to the stress response, rather than the activating event itself.
D: Dispute
Now is the time to challenge their beliefs – the faulty thinking that has led them to feel stress in their situation. What is the evidence for their interpretations? What alternative interpretations are possible? How would the alternatives change the way they see the world? And how would things turn out differently, if they act in the future on new beliefs?
E: Energise
The final step is to energise them to do something different: to seize control. In the more conventional therapeutic language, they will exchange old behaviours for new, more empowering ones. This is where you need to be firm, and hold them in some way to account for making at least one small change. This is the first step to taking control and with it will come a sense of victory that will further energise them – especially if you are able to acknowledge it and congratulate them.
Ways to challenge faulty thinking
The D for Dispute step is where the change really starts to take place, so it is worth cataloguing some of the typical ways people can pick up and then articulate false beliefs, and therefore how you can challenge them by asking good-quality questions.
Assigning cause
One of the commonest types of faulty thinking – and one that we are almost compelled to do – is to assign a cause to every event: ‘This happened because of that, because of him, because of you.’ Rarely is life as easy. Certainly things do happen for a reason, but encourage the person you are helping to challenge evidence that their reasoning is correct and either find a new, more helpful reason or, perhaps more useful, accept that things just happen and deal with the consequences, rather than worrying about a reason they cannot change.
Assigning meaning
‘When she says this, it means she thinks …’ or ‘When this happens it means that I am …’ How can they know what she thinks and what does an external event really tell us about ourselves? Meaning is another thing our brains desperately seek and, again, you need to help the person see that the evidence for their faulty thinking is either absent or flimsy at best.
Reading minds
We all think things like: ‘He doesn’t think I can cope with this,’ but when we are stressed, we can’t just set those thoughts aside as idle speculation. Where is the evidence that he thinks that? What else might he think?
Value judgements
‘I’ll never be good enough unless I …’ is an example of one of the dangerous attitudes we saw in Chapter 5. But who says so? This kind of faulty thinking sets up expectations of ourselves that nobody has expressed. Another thing you may hear is: ‘They say I’ll never be good enough unless I …’ Here, there is a mysterious they, but no more evidence that the value judgement is valid.
Must, Mustn’t and Can’t
All of these injunctions and assessments of ourselves are mere generalisations. Ask the person whom you are helping to justify their assertions, by testing them out: ‘What if you did, or didn’t or could?’ ‘How do you know you must, or mustn’t or can’t?’ ‘What compels you, what prevents you?’ Look for what is causing these beliefs and find counter evidence to free them from the straitjacket of compulsion or inability.
More or less
‘I need to work harder’ or ‘I want less pressure’ are examples of comparisons with an unspecified standard. It will give them more control to set absolute levels of performance, like ‘I need to put in eight good solid work hours each day next week’ or ‘I want to be able to leave work and feel I can go out with friends on a Friday night, rather than worry about my workload.’
Accentuating the negative
As the song says, it always helps to eliminate the negative and accentuate the positive, but we do precisely the opposite when we feel down, so your job is to help them focus on what is good, what resources they have, and how things can turn out positively. This has a close relative …
The end is nigh
When we are stressed and unable to think clearly, the smallest things appear to have the greatest consequence. ‘If I don’t get this done, she’ll … hate me, sack me, leave me.’ Help explore the likely real consequences, so that things can be assigned a realistic priority, and some things can be neglected safely and without remorse.
A related form of faulty thinking – and the opposite of assigning cause – is fortune-telling, seeing a future based on little or no evidence and a lot of faulty beliefs and false inferences. Once again, uncovering the source of these predictions can lead to better assessments of what the real evidence indicates.
My fault
The last of our examples of faulty thinking is to accept blame and feel excessive remorse for things – even when there is no blame at all. Tread carefully here, because stressed people do make mistakes. What is important is not the fault, but the remedy. ‘It may be your fault, it may not. If it is, you must apologise. Either way, let’s think through what needs to be done and what is the first thing you can do to start to put it right.’
Blame and reason
‘My fault’ is one start of the blame game, which turns the blame in on ourself. Another start is to turn the blame on someone else. Now, when we are stressed, we can start to build a whole fantasy on this faulty belief. The psychological field of Transactional Analysis (or TA) has a powerful model that can help you understand what is going on. It is called The Drama Triangle and was developed by Stephen Karpman.
Figure 10.1 The drama triangle
In this triangle, there are three roles: the victim, the persecutor and the rescuer. You are likely to observe two sides of the triangle in place: the person you are helping as the victim and the person they blame as the persecutor. The most important thing to know is this: the drama triangle represents faulty thinking. Victim, persecutor and rescuer roles are perceptions only.
Therefore, you are not there to become their rescuer. If you do, you become part of the drama and risk making the situation worse for them and for you. Let me give you an example of how easily this can happen.
It would be easy to go on, but you get the drift. These switches around the triangle give us a psychological pay-off, as we shed blame from ourselves and hand it to someone else. We feel good when we rescue and, strangely, feel less responsible when we are victim. When we consciously persecute, we feel in control.
Break the triangle – refuse to get involved in the drama. This is difficult and requires that you can sense a trap and not fall into it. But even then, we saw Rene spot the rescuer trap and still end up feeling persecuted. There are seven ways that can help you avoid stepping on to the drama triangle.
- Stick to asking questions to uncover facts. With facts, the drama starts to weaken.
- Invite the other player to take responsibility for themselves.
- Do nothing to endorse another player’s perceptions of themself or of other players.
- Remain courteous and calm at all times, and pause so you can analyse the perceptions before making a response. Use the SCOPE process.
- Break the cycle by declaring what is happening. Encourage other players to analyse the drama.
- Step out of the play. If all else fails, walk away.
- Refuse to feel bad about how the other player perceives you. Be confident of your own motivations and accept that, if you did not play the situation as you would have wished, then at least you tried in good faith.
Expert help
Pointing someone towards the right professional or expert help is the ultimate way you can help them. Often a GP is a good first port of call, and an appointment will never be the wrong thing for someone whose health is in danger. GPs can help access the full range of social or medical care resources available locally. They will be able to weigh up a full range of options from counselling to therapy to medical help and treatment with prescription drugs.
Here are a few further sources of help you might refer to.
Sources of professional help
- If you have alcohol-related problems, Alcoholics Anonymous is a good source of help: www.alcoholics-anonymous.org.uk
- British Association for Counselling & Psychotherapy (BACP): www.bacp.co.uk
- For practical help with legal, financial or other problems, the Citizens’ Advice Bureau, CAB: www.citizensadvice.org.uk
- Gamblers Anonymous: www.gamblersanonymous.org.uk
- International Stress Management Association (ISMA): www.isma.org.uk
- For advice relating to mental health, Mind: www.mind.org.uk
- For stress with relationships, Relate: www.relate.org.uk
- For someone to listen, The Samaritans: www.samaritans.org
- There are four levels of listening and we help best when we commit to the deepest level: empathising.
- Good listening is a learnable skill, so turn off your inner voice, refrain from criticising, and give me your full attention.
- Use Albert Ellis’s ABCDE process to help restore a sense of control.
- Don’t encourage or allow yourself to get caught up in the blame game. It is futile and destructive.