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029. Guidance on How to Support a Friend Dealing with Trauma

Our conversation today is with Rania Awaad, M.D.  She is a Clinical Associate Professor of Psychiatry at the Stanford University School of Medicine where she is the Director of the Muslim Mental Health Lab, Associate Chair of the Division of Public Mental Health and Population Sciences, and Chief of the Diversity Section in the Stanford Department of Psychiatry.

Her research and clinical work are focused on the mental health needs of Muslims. Her most recent academic publications include an edited volume on “Islamophobia and Psychiatry” (Springer, 2019) and Applying Islamic Principles to Clinical Mental Health Care (Routledge, 2020). She has also produced a toolkit, fact sheet, CME course, and is now editing a clinical textbook on Muslim mental health for the APA (American Psychiatric Association).

Through her outreach work at Stanford, she is also the Clinical Director of the San Francisco Bay Area branches of the Khalil Center, a spiritual wellness center pioneering the application of traditional Islamic spiritual healing methods to modern clinical psychology. Prior to studying medicine, she pursued classical Islamic studies in Damascus, Syria and holds certifications (ijaza) in Qur’an, Islamic Law and other branches of the Islamic Sciences. Dr. Awaad is a nationally recognized speaker, award-winning teacher, researcher and author in both the Islamic and medical sciences. 

In this day and age, with women choosing to bear children at a later age, it seems that infertility is on the rise. In this podcast, we discuss the perception vs reality of infertility, and how to navigate the journey. Everyone will enjoy this brief, but concise discussion because you or someone you know is trying to navigate infertility.

 
Episode Highlights with Dr. Rania Awaad: 
  • How to encourage people to seek help
  • Advice on how to navigate the relationship
To implement what you learn, join our Facebook Group: Wellness Surge Family.
 
Connect with Dr. Rania on Instagram @DrRaniaAwaad

Show Transcript

Introduction: [00:00:00] Welcome to the Wellness Surge Podcast with Dr. Adeola Oke. Each week we discuss our wellness journey with real people like you and me. We have conversations about food, fitness, mental health, financial wellness, and much more, so you can get back to the real you. To make sure that you’re up-to-date with this and other wellness topics, visit wellnesssurge.com. Information presented here is for educational purposes only and is not intended to diagnose or treat any disease. Please do not applying any of the information presented here without first speaking with your primary care provider. Now let’s head onto the show.

Dr. Adeola Oke: [00:00:36] Hello everybody! Welcome to the Wellness Surge Podcast. My name is Dr. Adeola Oke and today I have with me Dr. Rania Awaad.  Dr. Rania, say hello to everybody.

Dr. Rania Awaad: [00:00:47] Hello! It’s wonderful to be here with you.

Dr. Adeola Oke: [00:00:49] Awesome. Today, we’re going to talk about ‘The guidance on how to support a friend dealing with trauma’. 

All right. So let me introduce Dr. Rania with you. She’s very accomplished. Dr. Rania Awaad is a clinical associate professor of psychiatry at the Stanford University School of Medicine, where she is the director of the Muslim Mental Health Lab; Associate Chair of the Division of Public Mental Health and Population Sciences; and Chief of Diversity in the Stanford Department of Psychiatry.

Her research and clinical work are focused on the mental needs of Muslims. Her most recent academic publications include: an edited volume on Islamophobia and psychiatry, and Applying Islamic principles to clinical mental health care. She has also produced a toolkit: fuck shit, CME course. And is now editing a clinical textbook on Muslim mental health for the American Psychiatric Association. 

Through her outreach work at Stanford, she’s also the clinical director of the San Francisco Bay area branches of the Khalil center, a spiritual wellness center pioneering the application of traditional islamic spiritual healing methods to modern clinical psychology. So she’s blending, the Islamic spiritual aspect and modern psychology. And I think that’s just beautiful. 

Prior to studying medicine. She pursued classical Islamic studies in Damascus, Syria, and holds certifications in Qur’an, Islamic law, and other branches of Islamic sciences.

Dr. Awaad is a nationally recognized speaker, award winning teacher, researcher and author in book Islamic and medical sciences. You can follow her on Instagram after the show. 

So thank you so so much. I am hon- I’m so happy you’re here today. I’ve been trying to talk the doctor hour a long time now, so I’m so happy this is finally.

Dr. Rania Awaad: [00:02:49] It’s really my pleasure. Thank you so much for having me here. And I’m really happy to be with all the listeners and viewers. 

Dr. Adeola Oke: [00:02:56] Awesome. Alrighty. So we all know someone that is going through trauma or has gone through the trauma. Right. It’s not something that’s appealing to see. And we just always wonder, um, what do we say? What do we do? Sometimes these people start to avoid other people, but they even become delusional. And that’s what happened to me. Like I, I had a friend, I met somebody and the person I re- I was just like, okay, I know this person is going through something. What can I do? How can I say it? How can I approach it?

And so I’ve asked why I’m trying to figure out what to do, and hopefully we can all learn from this too. So! Big question. How do we interact with people like this without contributing to their isolation or delusion? 

Dr. Rania Awaad: [00:03:45] Hmm, that’s a really wonderful question. You’re absolutely right. We have so many people who in our lives have experienced some form of trauma and sometimes that trauma takes on a clinical aspect, right?

There’s actually a clinical diagnosis that might attach itself to the trauma. We might’ve all have heard of, you know, PTSD or post-traumatic stress disorder, which is probably one of the most common trauma disorders that we speak of, but not everybody who’s experienced trauma necessarily will have a clinical diagnosis.

It’ll go all the way. Sometimes, you know, you and I could have seen something or heard something or been at the site of something that was very traumatic. Do you know what I mean? I think it’s just really important to remember, because your question was, if you were the friend, the person who is the, you know, a confidant, a friend, a family member, a loved one of somebody who’s been through trauma, what do you do exactly without making things any worse?

Essentially. Yes. There’s a few things that I want to highlight. One is that it’s really important to hear the person out. This could be really hard sometimes. Um, like you mentioned, sometimes the trauma is so much, and what they’ve been through is so intense that, you know, it starts to be, um, you start to feel like it’s sounding like a broken record or it’s sounding even like you mentioned the word delusional. And well, the first thing we have to remember about trauma is no two people experienced trauma the same.

 Which is why- we always give this example for PTSD that you could have, you know, it’s very common, for example, in a war time settings where somebody, you know, soldiers who go off to war or the people who themselves experienced war. Right. And, but the interesting thing is let’s take the example of a soldier.

You can have two- while they have very similar family backgrounds, very similar histories, very similar education, very similar everything. And they both go out. They go to the same exact place. They see or encounter the same exact thing, but one comes back with PTSD and the other one doesn’t and the question is always, why, why is that the case?

And there’s a lot of theories that it’s not a, a solid science just yet, but there are a lot of theories on why this is. And often it’s because the issue of nature and nurture comes in to play. A lot to do with like how a person, what their….. how, how they are right there in nature, like who they are in their essence, right.

Plays a big role in this. But nurture also plays a role like how they were nurtured in their upbringing, how resilient they sort of become where they learn to become how much there they sort of crack under pressure. There’s a little bit of that also nature and nurture plays. And so does the theory that says you know, multiple steps. So for example, if there had been multiple traumas, so that’s why these two people can go to the same place and see the same thing; you and your friend both are at the same place doing the same thing, but maybe the friend has had multiple other little traumas in her life. 

And now this is like the straw that breaks the camel’s back. So as they say,  that statement, right? And for you, this might be the first time you’re experiencing a trauma. So it’s not as big of an impact necessarily as the other person there. The reason I give all of that explanation is because to remind us no two people, even if they’re from the same household, the same,  siblings, the same household that you grew up in, will not experience trauma  the same.

And so when you’re saying- people will say to other people, “Oh, you should get over this…” or “Come on, it’s been, it’s been a year now or two years. Like it’s been a while”. You know, and you’re wondering like, why is it not going away? Or why are they not getting better? Part of it could be you’re experiencing it very differently than they’re experiencing it. Which is why I give the advice of make sure to listen in tune in, really try to understand where they’re coming from.

Number two would be to be as supportive as possible and know that you have limits. To what those supports are. I think this is where especially loved ones, friends, family members go wrong a little bit. They worry about maybe becoming enablers of, you know, kind of like contributing to the problem rather than solving it.

So there’s a limit to how much, you know, first of all, some people don’t give enough support. Other people give too much support and don’t ever allow the person to get the help they actually need. Right. And that’s where we try to remind friends and family members that you have a limit too, after which it’s time to refer that person potentially to a professional and to say, I really think you need to go talk to somebody about this, who’s trained in this. You know what I mean in this field. And thirdly is exactly that point, which is refer to the professionals. And I think that’s going to be really important. Um, and sometimes it’s friends and family. We have to know that we are, we are the front line. We are the first people, our friends and family will come to our loved ones will come to when they’re struggling. Not the doctor, not the therapist, you know, not even a community leader, a religious leader.

It’s usually the friends and family first. 

Dr. Adeola Oke: [00:08:36] Okay. So that’s the big, big, big question because a lot of people, sometimes when they’re going through trauma and they just, they don’t know that something is that they’re acting different. The, and so that’s the big question. How do you break it- how do you say it?

Like, okay. I don’t think what you’re saying is right. Um, you’re starting to act a little different. Um, do you think you’d like to seek help? How do you go about that?

Dr. Rania Awaad: [00:09:03] Yeah. I mean the way you’ve prefaced, the first part, the first couple of statements, there are good. What we say is basically: ask for insight- which means do they see for themselves that something’s wrong?

Some people have insight and say: Oh yes, this is- I know I need to, I know this needs to get better. And so they have an insight into the issu. And others are like: no, what are you talking about? I’m not acting any differently than before. And that’s a cue to you. That’s a very important cue because depending on their answer, So then you know what to do next, right?

Because the person who has insight, it’s going to be a lot easier to say, can I be of assistance to you to help you kind of connect you to that care? Can I help you look for that person? You know, what are the barriers, right. And you start to understand, is it financial? Is it access? Is it not knowing who to go to? Right. And so you try to be of help.

 The person who does not have insight. This is a really, really, really key point that we always teach in mental health: which is for you as the loved one to know you cannot help. Someone who does not want to be helped. And that’s really hard for people to hear, especially when we’re talking about their loved ones, right.

They want to do something they want to help, but it’s a really key point here. You can only help the one who wants to get help. And so if there’s no insight and I totally blocking you and it’s time to take a step back. And to allow things to kind of maybe work themselves out a bit. And if they don’t, we always say this it’s really, really hard.

I’m selling this- and I know it’s really hard to say this, but sometimes it almost has to be the, the person, um, falls down before they’re willing to be helped to be picked back up again. It may sound mean, and I don’t mean in any way to say that, but how else will you help someone who’s refusing help?

Dr. Adeola Oke: [00:10:45] I’ve heard that before. And I guess I refuse to listen. That’s the thing it’s really hard. Like what do you mean I can-I can’t help. What do you mean by that? Like, it’s really hard. Like. You still supposed to be your brother’s keeper, your sister’s keeper. What do you mean I can’t help? So they have to fall and do something terrible before…. .

Okay. That’s hard.

Dr. Rania Awaad: [00:11:11] It’s really hard. And that’s why I say that. And I prefaced it so many times before I said it. Because then- because think about the others, like let’s turn the table for a minute and look at the other side of the story, because right now, when a person says that’s really hard, I want to do something it’s about you and it’s not about you.

It’s actually about. Them. And that’s really hard for people because it’s about, you know, but I want to do something, but this isn’t about you here, right? This is about the other person. And when they’re ready to take that step….. I love when you said earlier, how do we make sure we don’t let them isolate more?

So if you are your brother or sister’s keeper, part of it is even if you need to take a step back, you don’t cut off. Hmm, you actually take a step back and you are still there so that when it is ready and they’re ready to take that step forward, you’re there to help and assist, you know what I mean? Okay.

Dr. Adeola Oke: [00:12:01] Alrighty. Okay. Now I’ve heard, I have heard, I have lists. I’ve heard. It has stuck, so, okay. That’s hard. Okay. That’s really hard. Okay. Alrighty. Um, So, yes. Um, that’s my– That was the big question. Is there any advice you can give to people on how to heal from trauma? So you found this friend that, okay, I’m ready to take that step, or how can before even like, approaching like a counselor or somebody, are there any steps or tips or tricks people can possibly implement?

Dr. Rania Awaad: [00:12:37] Definitely. I mean, so we’re talking now about the friend or family member, you know, a loved one who is ready to take a step. Is that what you’re-..?

Dr. Adeola Oke: [00:12:45] Is yes, yes, yes. That’s right.

Dr. Rania Awaad: [00:12:49] Even when a person says, okay, I’ve heard I’m listening, let me do this. Right. So then comes this whole slew of barriers in the plan and the way to really get that help.

And I think this is where it’s really useful to think about, you know, this, especially if you’re the one in the, in the role of being the helper. Right, because for many it’s actually, I have no idea where to look. I don’t know who to go to. What kind of, what kind of professional does this work that I’m looking for?

Right. And today we’ve been talking about trauma and there are, you know, therapists and psychiatrists who are specifically trained in trauma. So it’s actually like a specialty within the field of mental health. So not every therapist per se is trained in trauma. Most have some amount of training because they do that regularly in their schooling,  but there are others who are specialized in trauma. 

And I think that would be very useful to figure it out. Usually if you go to a website like psychology today. That lists out all the therapists that are in your area, or some of the other databases that are out there, usually they’ll have a list of the different specialties that therapist or psychiatrist specializes in.

And if trauma is on there, that’s great. Cause then, you know, you’re kind of in the right… direction. Do you know what I mean?

Dr. Adeola Oke: [00:14:01] Okay. Okay. Okay. Alrighty. Alrighty. So that’s good. Okay. Wow. Alrighty. So that’s what we wanted to learn today. And I hope people have learned from this, because sometimes hearing it the first time, you’re like, no, it’s not.

No, that’s not what I want to hear and hearing it a second time -okay. There must be some truth to this. So all, so we’ve said a lot today, right? We’ve said a lot today. What is one thing that you want to make sure that people take away from this discussion before you leave? 

Dr. Rania Awaad: [00:14:31] Yes, I, if there’s one thing that I can say and thank you for the opportunity to say this is really talking about how we all, all of us. Have something that we probably need to tune in more about. I did not say that all of us have mental health issues. That’s not what I said today, but I did say as all of us have something, even if it does not reach the threshold of a clinical diagnosis. So this is really key because people think, okay, only if I have depression or only if I have anxiety or PTSD, then do I need to go to a mental health specialist.

But the reality is all of us are dealing with, look at the pandemic we’re in. Look at the fact that we are in, you know, literally a global crisis mode, right. And nationally we’ve been through a really rough week just recently. Right. And ongoing and, and, and it keeps on stacking everything from distance learning to balancing your life and studies at home and your kids.

And if you have children and, and the finances, I mean, that’s, it’s a ton of stress, probably more than we have ever felt in our life. And the take home message I want to say today is it does not mean that you have to reach a clinical diagnosis to get help. All of us are in need of health. And if that, if that statement was ever true, it’s more true today than ever before.

And so I really wanna encourage all the listeners and all the viewers to really take stock of how life is going right now, how heavily you’re breathing or lighter you’re breathing at the moment. And it also how difficult this time is really has been, and be honest with ourselves because it may be the time to reach out to a friend or confidant.

And if it’s beyond the pail of what they can help with. Then it’s probably time to also speak to professionals. A therapist, a counselor, you know, and it does not mean that you have to be diagnosed with something to get that kind of help. So that’s the message that I hope to give today. 

Dr. Adeola Oke: [00:16:21] Thank you. Thank you.

I realized that on the show, I’ve brought in a lot of mental, mental health providers, because I think I’d probably in my subconscious, I realized there’s. A lot of people are dealing with a lot of stuff right now. And this whole show was started during this pandemic. So the more reason why we need to talk about this and it’s okay, it’s hard.

It’s really hard to accept that something is like, huh, I don’t want them to think I’m that person, you know, that person and know it’s really hard, but. Sometimes we in denial, it happens personally and you’re like, okay, you know what? We just need to take this next step before it escalates to the next level.

And sometimes when your skull escalates, it’s really hard to forget. And so yes, before we get to that level, I think we should all accept it and just seek the help we need. So thank you for that. Thank you. Thank you so much. Alrighty. So it said you can get ahold of her on Instagram at Dr. Rania Awaad, right?

Yeah. That’s her. If you want to follow her on there, lots of resourceful information over there. So very good. So thank you so much, Dr. Awaad for being here. We really appreciate your time. And so everybody makes sure you turn on your notifications and subscribe to our channel. So you don’t miss a show. Do you have any last words?

Dr. Rania Awaad: [00:17:42] Really. My thanks and appreciation to everyone in my last words would be here is, you know, we’re all in this together. 

Ending: [00:17:49] Absolutely. We’re all in this together. Thank you so much. Have a wonderful week, everybody. Bye-bye.

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Have an awesome week. Best wishes to see you thrive.