Kate Thieda

Kate Thieda MS, LPCA, NCC

Partnering in Mental Health

Six Steps to Relieve Emotional Pain

When your loved one says they are in pain, validate, validate, validate.

Posted Sep 17, 2014

After a period of dealing with a loved one’s mental illness, compassion fatigue can set in. Yes, you still love them. Yes, you still care that they are not feeling well. But it can become difficult to empathize after a while, and you may begin to wonder, “When is this going to end?”

While I can’t give you an answer on when–or if–the illness will abate, what I can tell you is that it is essential that if your loved one says they are in pain, believe them. The pain could be emotional or physical, and either way, it is valid.

Just because you can’t see something like a broken bone jutting through the skin doesn’t mean your loved one isn’t in distress. To go with the image, even if you could see a broken bone, what might be a “7″ on a Pain Scale of 1-10 for you might be a “25″ (on that same scale!) for your loved one. Every person has a different subjective experience of pain, and part of being a support person is recognizing and validating your loved one’s experience, even though you aren’t having the same internal experience yourself.

Validating someone else simply means that you are expressing to them, “Your feelings matter, and it’s okay to feel that way.” Validation does not mean you agree with another person’s experience.

Although validation is often associated with treating borderline personality disorder, the fact of the matter is that everyone deserves to be listened to, taken seriously, and believed.

The technique I am going to describe is identified by the acronym I-AM-MAD. This acronym was originally created by Bon Dobbs of Anything To Stop The Pain, a website dedicated to borderline personality disorder. I have modified it slightly to help you through appropriately validating your loved one’s experience, no matter what their diagnosis. (Perhaps a good way to remember the acronym is by reminding yourself that using this technique may eliminate the experience the acronym describes!)

I: Identify the emotions. As you listen to your loved one talk, note the emotion words they are using. Reply with statements that use the same emotion words that your loved one used, such as, “You sound really frustrated,” “You look angry about that,” or “I can hear how worried you are about this” (note the emotion words in italics).

A: Ask a validating question. Open-ended questions (as in, those that require more than a “yes” or “no”) show that you are listening and want to know more. Some examples include, “Tell me more about your [insert emotion word here],” “How can I help you with your [insert emotion word here]?”, or “What else can you tell me about your [insert emotion word here]?”

M: Make a validating statement about your loved one’s pain. Having listened carefully to your loved one’s answer to your question, say something that shows you were listening and care about their feelings. Statements like, “I can see why you are upset,” “I understand how that would be frustrating for you,” and “It must have been upsetting to have that happen,” are some appropriate responses.

M: Make a normalizing statement about your loved one’s pain. Sometimes people get upset because they feel they are the only ones who are experiencing their situation. So, yes, while I did say every person’s experience of a mental illness is subjective and unique, the experience of having emotions can often be generalized. In this case, try a statement such as, “I would have been upset if that had happened to me as well,” or “I think most people would be angry if that happened.”

A: Ask how you can be helpful to your loved one. Keep it short and sweet: “What can I do to help?” (However, see the next step!)

D: Do not solve the problem for your loved one. The “solution” to the problem may be obvious to you, but that doesn’t mean it’s time to jump in and take care of it for your loved one, however tempting that might be. Some further questions, such as “What thoughts do you have about what to do next?” and “If I was the one coming to you with this, what advice would you have for me?” empowers your loved one to come up with their own answers. Since self-esteem is often an issue for people with mental illnesses, being a supportive listener, instead of a hero, can help your loved one think about ways to solve not only the immediate problem, but future issues as well.