Advice to the Family Member

Feelings of shame and embarrassment about asking for help, appearing foolish, etc, often lead people with anxiety to hide their fears. However, at the same time they can expect others close to them to be "sensitive enough" to realize they are experiencing difficulties. Rarely does phobic anxiety manifest itself externally; therefore, anxious or phobic people must take resposibility for letting others know when they are having a problem.

Rather than passively waiting for a family member to initiate support and then becoming angry and disappointed when it is not given, the anxious person must say, "I am feeling anxious and would like your help". It is important for the anxious person to tell their support person exactly what is helpful and what is not. At times, the anxious person needs to be held or talked to; at other times, they want to do all the talking and, sometimes, they want to be left alone. The family member must understand and accept that inconsistencies in needs have to do with the nature of anxiety and trauma. They are not signs of personal rejection.

Much of the anxiety people with trauma experience is connected to fear of loss of control. To be able to enter into a difficult or triggering situation, they need to feel in control of themselves and their environment, including everyone around them. The more control the person feels over the situation, the less they feel trapped and thus less anxious. The support person might ask, "What would you like me to do to help you feel more comfortable?", and not act offended or put out by the reply.

The anxious person must tell the family member exactly what would be reassuring, even if the request seems irrational. For example, a young woman was afraid of going into high buildings for fear she would lose control and jump out the window. She asked her boyfriend to reassure her that if she did lose control, he would knock her out so she would not be in danger of hurting herself. They both knew how absurd this request was, but having this reassurance enabled the woman to go up to the high floors and remain there long enough to see that her feared reactions would not happen.

Anxious people need an "out" and it is helpful to decide with the family member what this will be, prior to entering the stressful situation. For example, if a person is hesitant to go into a crowded cinema for fear of panicking and having to leave, the family member might suggest, "Let's get tickets and go with the understanding that if you wish to leave at any time you may, even if it is in the middle of the performance, and that I will leave with you".

This can be difficult to say, because the support person is often afraid that this kind of "leniency" perpetuates the fear and avoidance. However, just knowing that a way out is an option enables the anxious person to enter stressful situations. Once they are confident that they are not trapped and trust that their family member will comply with their wishes without criticism, it becomes much easier to enter the feared situation.

As the anxious person improves, they may experience concern about heightened expectations, now that they have demonstrated an ability to do things which they were previously unable. It is helpful for them to express their concern to the support person. For example, the anxious person may ask:


"Since I did the shopping today, will you expect me to do it all the time?"

"If I drive to the party tonight, will I have to drive home as well?"

"If I go up in the elevator, can I walk down the steps if I want to?"


The family member should assure the anxious person that there are no additional expectations. This will help the anxious person focus on the present. When anxious people do not feel pressure to perform, they are more likely to enter and remain in feared situations.

Family members often cannot understand that the anxious person may be able to do something with a stranger, their therapist, or a fellow sufferer, and yet not be able to do the same thing with them. This can increase the family member's frustration and doubt regarding the intensity or legitimacy of the person's fear. Dwelling on this can cause the anxious person to become defensive and withdrawn. An expectation to perform, and the possibility of judgement if they do not, raises the person's anxiety level, perpetuating the fearful thinking, and decreasing willingness to confront fears and triggers.

It is common for the anxious person to do the same task several times with little or no discomfort and then suddenly feel paralyzed and unable to proceed. It is important for the family member to accept this as part of the illness, and not see it an indication of the person's inadequacy.

In order to be helpful, the supportive family member must maintain communication, keep an open and non-judgemental mind, and constantly reassure the anxious person that support will be provided irrespective of whether a task is completed or not.


Adapted from an article by Jerilyn Ross