Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
a friend lost his entire family 23 years ago and never had counseling. he says no counselor can help him because no one has gone thru this. He is 60 years old and says he cant sleep unless numb from alcohol. he holds a job and does charity work but still feels guilty for killing his family. How can i help this man? my heart breaks for him.
He lives in Malham Tarn, England (a small village).
This is a very difficult situation, and to be honest, there is no simple solution.
Until someone with a problem accepts that there is a problem, they won’t do anything about solving it. That’s the first hurdle. The second is convincing them that help is available, and that the should accept it.
At the moment, the best you can do is support him, and mobilize anyone else close to him to join the effort.
Sustained gentle persuasion is at least part of the answer. Just being there to listen, and letting the person know that you are there for them may let them build up enough trust inside themselves to begin to deal with it.
You may not to be able to solve their problem, or for that matter understand how they feel, but just listening and letting them talk can be really helpful.
Getting people to open up can be difficult. It has to be done sensitively so that the person does not feel put down or alienated. A gentle approach like ‘It must be difficult feeling as you do. Perhaps we could talk about it? is often the best start.
Choose your time and place carefully if possible so that the person feels as safe and as comfortable as possible.
Try to make sure that the person feels that you are on their side, and try to use ‘open questions’ – ones that don’t allow a simple “Yes” or “No” answer.
Don’t try to give them solutions, because as they open up and talk, the person begins to find their own solutions.
Good beginnings are:
Where – 'Where did that happen?'
When – 'When did you find out……?'
What – 'What else was happening?'
How – 'How did you feel?'
Can you tell me…….
How are you feeling? This helps to get past the bare facts of a situation, and lets people begin to look at their inner turmoil.
Don’t push hard or try to tell them what they MUST do – give them space and time to talk.
There are some things you can do, and here are some tips:
What you can say that helps:
I’m here for you – you’re not alone.
What causes these thoughts and feelings is a real illness, and it can be treated..
You may not believe it now, but someday, this will pass and you’ll feel differently.
I care about you and want to help, even if I don’t really understand what you are going through right now, how you feel, and what you’re thinking
Don’t ever give up – just hang on one more minute or hour – whatever you can.
You are important to me. Your life is important to me, and to everybody who knows you
I’d like you to tell me what I can do now to help you.
We can get through this together
Cheer up- it could be worse
Quit worrying about it – you’ll be fine
Your just imagining it, it’s all in your head.
Everybody feels like this sometimes
You’ll just have to help yourself
I’d have thought you would be better by now.
Get over it and snap out of it.
Grow up and act like an adult.
What’s the matter with you anyway?
Also the Samaritan’s web site in the UK here is a mine of useful information which will help you if he becomes suicidal.
One cannot diagnose at a distance, but from what you say, he may be suffering from mixed anxiety and depression - depression is causing him to feel bad, and the other part is that his negative thinking about his life situation is just adding to that.
Both these things can be dealt with by a combination of proper medication and a course of Cognitive Behavioral Therapy. It is a form of therapy that addresses problems in a direct and targeted way and is brief compared with most other therapies.
The first thing he needs to do is to see his Doctor – he will give he a full diagnosis and if appropriate, start him on a suitable anti-depressant medication. He will also want to rule out any physical cause of what he is experiencing.
Depression is seen as a chemical imbalance in the brain, just as diabetes is a chemical imbalance in the body. Diabetics take medication to stay well, why shouldn’t he?
He should not be afraid of taking medication – it could really help turn his whole life around
Two important issues about this - when he is on medication, he must take it at the correct dose and as prescribed. It is no use missing doses or messing around with the dose.
Secondly, he should know that anti-depressants can take up to 8 weeks from the start of therapy before they begin to show beneficial effects, so it's no use quitting after two weeks.
I mentioned CBT - is based on the fact that what we think in any given situation generates beliefs about, and reactions to that situation, and also cause the behaviour and feelings which flow from those beliefs and reactions.
These ‘automatic thoughts’ are so fast that generally, we are unaware that we have even had them. We call them ANTS (automatic negative thoughts) for short.
If the pattern of thinking we use, or our beliefs about our situation are even slightly distorted, the resulting emotions and actions that flow from them can be extremely negative and unhelpful. The object of CBT is to identify these ‘automatic thoughts’ then to re-adjust our thoughts and beliefs so that they are entirely realistic and correspond to the realities of our lives, and that therefore, the resulting emotions, feelings and actions we have will be more useful and helpful.
Cognitive therapists do not usually interpret or seek for unconscious motivations but bring cognitions and beliefs into the current focus of attention and through guided discovery encourage clients to gently re-evaluate their thinking.
Therapy is not seen as something “done to” the client. CBT is not about trying to prove a client wrong and the therapist right, or getting into unhelpful debates. Through collaboration, questioning and re-evaluating their views, clients come to see for themselves that there are alternatives and that they can change.
Clients try things out in between therapy sessions, putting what has been learned into practice, learning how therapy translates into real life improvement.
Please visit this website for much more detailed information on CBT:
If he cannot afford to see a therapist, there are good free CBT based self-help resources here:
Make the first step NOW – get him if you can an appointment with his Doc, and he can start to get better.
You’ll also find some very good help here:
He can be helped, really, but he does have to accept the help that is out there for him
I told him I wasn't a therapist and couldnt possibly advise him, but i did have empathy and told him i was there for him no matter what. I believe i left the door open for him to discuss his innermost feelings. I will follow your advise and make the recommendations, but i honestly feel that the 23 years of suffering may have taken its toll, along with the heart diagnosis, that he still may not be willing to get counseling. I can only nudge him along that path. I just cannot give up on him.
Thank you for your time in answering. I knew it was a difficult situation, but I feel Dr. Phil and his foundation is the only place i could turn to.
Thank you again.