Social Support and Connection. Do It.
Written by: Ron Acierno, PhD
It probably doesn’t take a million dollar research study to tell us that social support is good for people in psychotherapy, especially people who have experienced a potentially traumatic event like combat, interpersonal violence, or severe disaster or accident. In fact, it probably doesn’t take a research study for us to know that social support before, during, and especially after a potentially traumatic event can help to sustain resilience and effective coping strategies. Of course, we did do these research studies (just to be sure our hunches were correct) and we found that, not only does social support help people deal with trauma, it might even help prevent some forms of trauma in the first place.
For example, in the large National Elder Mistreatment Study, the most consistent risk factor for experiencing elder abuse was low social support. In fact, people with the lowest social support were 2-3 times more likely to report elder abuse than people with higher social support. It seems that connection to others, particularly for older adults, is important for preventing bad things from happening. But as noted earlier, if something bad does happen, social support and connection can make it easier to deal with.
In the elder abuse example above, we followed up with people who reported being abused 8 years later and asked about their mental health. The abused older adults who also reported low social support showed much higher levels of depression and anxiety after abuse than people who were not abused. This was not a surprise. However, the abused older adults who reported that they had high social support over the years reported no more depression and anxiety than the people who were not abused! Their mental health levels were as good as if the abuse did not happen. It seems social support and connection completely buffered against the damaging effects of abuse.
Social support is good for people. Particularly older adults. A phone or zoom call. A quick visit. A check in to help with chores. Do it.
Elder abuse is not the only area that shows the positive aspects of social support and connection, and for older adults in particular. In 2004, Florida experienced 4 hurricanes in rapid succession. Some people were hit 3 times. The devastation and impact of repeated evacuations and subsequent property destruction and personal injury was tough on everyone. Not unexpectedly, people who were directly affected by the hurricane, either by being present or by experiencing significant financial losses, were more likely to report increased depression and anxiety. Except…..guess who? Yup. Those older adults who reported social support and connection immediately before and after the hurricanes showed no more symptoms of depression and anxiety than those Floridians who were not at all affected by the hurricanes. Once again, social support completely ‘inoculated’ people against negative mental health outcomes.
There is something to the good neighbor approach. Check on your older relatives and older people who live nearby. You have something to give to them in the form of a brief gift of your time, and they have wisdom from lived experience that they may well impart to you. Do it.
We started this blog talking about social support in psychotherapy, so let’s go there. People who have experienced the trauma of violence and combat often bear the consequences of such experiences, including a combination of anxiety and depression symptoms known as post traumatic stress disorder. During trauma, your fight or flight response kicks in. Fight or flight is that state of near panic and energy that allows you to run away from a bear faster than you’ve ever run, or that allows a mother to lift a car off her child. The only problem is that, after trauma, reminders of the traumatic event found in everyday things, like a fourth of July firecracker or a noisy crowd at the department store, can set off the fight or flight response. There is no attacker, but your body reacts this way in the middle of Walmart.
The treatment for this problem is exposure. Like it or not, the best way to reset the fight or flight response is to repeatedly expose yourself to anxiety provoking (but realistically safe) situations, starting small (like going to the parking lot of the department store and staying there a little while) and then gradually pushing yourself to go further and further (like going into the store, first during times when its empty, then gradually when its more crowded). You know the saying ‘no pain no gain’…that’s true here as well. But you know the saying ‘misery loves company’….well, that might fit here too. Our research shows that people going through exposure therapy for PTSD are more likely to stick with treatment, and are more likely to benefit from treatment if they have high social support during treatment. A battle buddy on the field of battle makes sense, and so does a therapy partner (spouse, friend, family cheerleader) encouraging you to stick with the program.
Social support and connection helps people get into, stay with, and effectively engage in evidence based psychotherapy. It makes a good thing better. If you know someone in therapy, or who has experienced trauma, support them. Call, encourage, talk about the weather. Its time and connection that matter, not what you talk about. Do it.
As a clinical psychologist who works in the field of interpersonal violence and other trauma, people are often surprised when I tell them the most important thing to make available to people going through tough times is social support and connection. They ask me, what about therapy? Well, for one thing, if you have social support and connection, your resilience will be increased and you may not need therapy. And for another, if you are in therapy, if you have social support and connection the therapy will work better. So, yes, social support and connection is the first step.
Social support and connection. The evening walk to visit an older neighbor or relative. The group zoom call to grandma or a friend who has recently returned from combat. The lunch invite when it would be easier to just eat alone. Invest the time in your social network. Make the connection. Do it.