7 Things to Avoid Saying to People with PTSD – and What To Say Instead

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1. Get over it
Other variations on this are ‘why aren’t you better yet?’ and ‘But that was years ago.’ This is commonly said to abuse survivors, who often seem to be judged negatively compared to ‘wounded warriors’ who have PTSD as a result of military combat. Nobody chooses to have PTSD and it doesn’t disappear on demand, or when it becomes inconvenient for another person. Some people have PTSD for over 50 years despite working hard to heal, for others PTSD disappears by itself in a matter of months: even a trauma which seems ‘minor’ to another person, or happened decades ago can trigger severe PTSD symptoms. If a person could just ‘get over it’ in an instant, they would have already done so. Healing from PTSD doesn’t have a fixed timeframe, but support from others is known to help.

2. Everything happens for a reason
This view puts pressure on trauma survivors of find a positive reason behind their suffering, and can feel like the horror of the trauma is being minimized and was somehow ‘justified’. Some people do manage to find a positive outcome from the trauma, but it needs to be in their own time, and normally only happens late in the healing process. Healing PTSD involves dealing with loss, including the loss of a person’s former sense of safety, their former way of living (because PTSD symptoms often have a major impact on someone’s lifestyle), possibly losing their job or home, family, partner or friendships, and even sometimes their sense of identity. Would you say ‘everything happens for a reason’ to someone about bereavment? Then don’t suggest this to someone with PTSD.

3. It takes the same amount of effort to behappy as it does it be depressed
The exact opposite is true: lack of energy and lack of motivation are key symptoms of the depression, but a happy overall mood leaves you feeling energized and ready to face the world. Almost as bad is the phrase ‘If you act happy, you will become happy.’ The “persistent inability to experience positive emotions” affects many people with PTSD. Depression (and anxiety) often come as a result of PTSD, so rather than dealing with just one mental health disorder, a person can quickly find they are dealing with two or three. All people with PTSD regularly re-live the trauma, through flashbacks, nightmares or intrusive thoughts: with a mind that won’t stop replaying the worst moments of your life it would be hard to avoid feeling depressed. Severe depression makes it extremely difficult just to get out of bed, and willpower alone is not a known cure for depression. Disturbed sleep caused by PTSD or depression zaps energy levels further. Pressuring someone who is struggling to put on a fake smile or look on the ‘bright side’ in order to make you more comfortable isn’t helpful to them. Thinking or acting positively can help some people, but it can’t be forced. The pressure to ‘be positive’ can increase someone’s sense of isolation and any feelings of failure that depression brings.

4. All you need to do is…
‘You will feel better if you…’ is another version of this. There is no ‘quick fix’ or simple, easy solution to a complex condition like PTSD. It’s natural to want to help someone you care about, but unless you have been asked for advice, or have had a substantial battle with your own PTSD, resist any temptation you may have to offer solutions or well-being/mental health advice. Also be aware that news stories about new PTSD treatments are often misleading and not worth sharing: it is common to find out later they promote unavailable drugs, refer to clinical trials on mice rather than humans, involve a single study only, mention types of therapies which are not widely available, are only effective treatments for a different form of PTSD or PTSD caused by a different type of trauma – and they don’t mention risks (e.g., addiction and paranoia resulting from cannabis use, high drop-out rates, that it’s not advised for certain people, etc).
There is no single treatment or combination of treatments that everyone will respond to. Avoiding seeking professional help does not mean ‘not wanting to recover’ – it can simply be the result of the major PTSD symptom of ‘avoidance’ – which means avoiding anything that reminds the person of the trauma, including trauma professionals. Time does heal a proportion of people with PTSD, so a person’s mind may in fact already be healing by itself.

5. I know how you feel
It’s not possible to know exactly how another person feels, or what their thoughts are, unless you ask them. In PTSD symptoms often go from one extreme to another rapidly: from being emotionally numb to being anxious and ‘on edge’, or depressed and teary, then back again. One moment someone can be unable to stop talking about the trauma, and another time they will avoid conversations about PTSD or trauma and even the slightest reminder of it. Even after asking, you might not be aware of how strong particular feelings are.

6. Why didn’t you… during (or after) the trauma
You may want to keep your belief in a ‘just world’ where bad things don’t happen to good people – or if they do, good things later happen as a result – but trauma can affect anyone, and questioning someone’s actions or blaming them for a trauma is insensitive and judgemental. Unless you were in the same situation, at exactly the same time, and with the same personal history, you don’t know how you would reacted then – or how it would be impacting you now. Trauma responses are instinctive and biologically driven rather than logical decisions, and both ‘freeze’ responses and complying with (rather than resisting) a threatening person are common. Questioning someone’s actions, or rather reactions, during or after trauma is likely to feel like adding blame to someone who may not yet understand their own reactions.

7. It wasn’t that bad
Many people with PTSD will minimize their trauma, or may not mention the extent of what happened at that time (or shortly after the trauma). Some people have amnesia for some or most of the trauma’s details as well. This is the mind’s way of protecting itself from the full horror of the trauma, and the fact it could not be avoided or escaped. Don’t fall into the same trauma-related pattern of thinking and support their belief that ‘nothing really that bad happened’, ‘it was all my fault’ or ‘it was just an auto accident’, etc. The minimization (or even total denial) may later be followed by speaking out the reality of the trauma, which can sound contradictory, confusing and be judged as ‘exaggerating’ or ‘untrue’ because it doesn’t match the previous statements – or just because it sounds too horrible to accept. This pattern of minimizing (or denying) and then re-stating the trauma is not a measure of a person’s honesty, it can simply be the result of PTSD’s symptoms: either “distorted cognitions” about the trauma and/or an “inability to remember” major parts of the trauma (amnesia). A clearer picture of the trauma will emerge in time. If a person has developed PTSD that means the trauma has had a devastating impact and was too much for the mind to handle at the time. PTSD itself is a sign that the trauma was that bad, and even worse is the fact the person is reliving parts of the experience every day.

What To Say Instead
1. I’m here for you
But only say this if you really do mean it, over the longer term.

2. I’m sorry it happened to you
Nobody ‘deserves’ to be traumatized. Nobody makes that choice.

3. How can I help?

4. I can’t fix it, but I can listen.
Remember: listening doesn’t mean offering unsolicited advice.

5. Do you have the details of a helpline you can contact if you need to?
This shouldn’t be said as a way to avoid listening, but as a backup for when nobody is available or things are very hard. Helplines often offer text message or email help, some also offer online chat too.

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2 thoughts on “7 Things to Avoid Saying to People with PTSD – and What To Say Instead

  1. Pingback: 7 Things to avoid saying to people with PTSD what to say instead – Healing Veterans one step at a time

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