Hesperian Health Guides
Helping Yourself and Helping Others
Every day 20,000 people visit the HealthWiki for lifesaving health information. Ifwe could translate 50 more chapters.
Make a gift to support this essential health information people depend on.
A person suffering from mental health problems can begin to feel better with treatment. Although most communities lack mental health services, there are things a woman can do on her own, with very few resources (personal coping skills). Or she can form a ‘helping relationship’ with another person or group.
The suggestions that follow are just a few of the many ways a person can work toward better mental health. These suggestions will be most effective if they are adapted to a community’s needs and traditions.
Personal coping skills
For severe problems, medicines may be necessary. Try to talk to a health worker who knows about medicines for mental health problems.
Women do not often take time out of their busy day to do something for themselves. But every woman needs to put her problems aside sometimes and do what she likes. Simple things that you may not do very often—like spending time alone, or shopping, gardening, or cooking with a friend—can all be helpful.
Activities to let your feelings out. If you are angry, do some hard physical work. Making up poems, songs, and stories can be helpful when you have trouble saying things to others. Or you can draw your feelings without using words—you do not have to be an artist.
Creating pleasing surroundings. Try to fix your living space so that it feels right to you. No matter how small it is, you will feel more order and control when it is arranged the way you like. Try to have as much light and fresh air as possible.
Try to have some beauty around you. This could mean putting some flowers in the room, playing music, or going where there is a nice view.
Practicing these traditions regularly can help a person cope better with stress and other difficulties in her life.
It is often easier to turn an existing group into a support group than to create a new one. But be careful when choosing helping relationships. Form relationships only with people who will respect your feelings and your privacy.
|Women often help each other by sharing and listening as they work.|
It helps to have someone to talk to. In a helping relationship, two or more people make a commitment to get to know and understand each other. This can happen in any relationship—between friends, family members, or women who work together, or in a group that already meets for another purpose. Or a new group may form because the people share a common problem. These are often called ‘support groups’.
Building a helping relationship
Even when two people know each other well, helping relationships develop slowly, because people usually hesitate to share their problems. It takes time to get over these worries and begin to trust one another. Here are some ways to build trust between people or members of a group:
- Try to be open to hearing everything another person says, without judging it.
- Try to understand how the other person feels. If you have had a similar experience, think about how you felt. But avoid seeing someone else’s experience as exactly like your own. If you do not understand her, do not pretend that you do.
- Do not tell another person what to do. You can help her understand how the pressures of her family, community, and work responsibilities affect her feelings, but she must make her own decisions.
No two people have exactly the same life experiences. There is always more to understand about another person.
- Never think of a woman as beyond help.
- Respect the woman’s privacy. Never tell others what she has told you unless it is necessary to protect her life. Always tell her if you plan to speak with someone else for her protection.
|Meeting together with others can help a woman:|
Sometimes we would arrive at the meeting in a bad way. We didn't have any wish to speak. We felt without energy. Then a hug from someone or the spirits of others would be catching. And all of us would feel more strength.
Some of us had been sexually abused in the past, but we had never been able to share it with others. It was only in the group that we could talk about these terrible things.
The group helped me to see others' points of view and to not get carried away by my feelings. This has helped me understand why other people react the way they do.
I often think poorly of myself and feel as if I am to blame for my family's situation. But it is not our fault that we are poor. Talking about this with others has helped me to understand why we women suffer the way we do.
There are things from our past that we have never discussed with our partners. In the group we talked about how to deal better with these things. We get strength from each other.
We all decided to have a ceremony and then accompany one of our members to get a death certificate for her partner and arrange the title of her land. If she had to do these things alone it would be very difficult.
Exercises for learning how to help
Most members of a group need to understand what a helping relationship is and what makes it work before they can really help one another with a mental health problem. These exercises can help:
These exercises are most often done in groups, but they can also be used by just 2 people.
- Sharing experiences of support. To become more aware of what support is, the leader can ask members to tell a personal story in which they have received or given support. Then the leader asks questions like: What kind of help was it? How did it help? What are the similarities and differences between the stories? This can help the group come up with general ideas about what it means to support and help another person.
Or the leader can pose a story of someone with a problem—for example, a woman whose husband drinks too much and beats her. She becomes withdrawn and pretends nothing is wrong, but no longer participates in the community. Then the group can discuss: How could we as a group help her? How can she help herself?
- Practicing active listening. In this exercise the group divides into pairs. One partner talks about a topic for about 5 to 10 minutes. The other partner listens, without interrupting or saying anything, except to encourage the speaker to say more. The listener shows that she is listening by her attitude and by the way she moves her body.
Some women may feel more comfortable listening as they work with their hands—for example, as they weave or sew.
Then the partners switch roles.
When the partners are finished, they think about how well it worked. They ask each other questions like: Did you feel listened to? What difficulties did you have? Then the leader begins a general discussion among everyone about the attitudes that best show listening and concern. The leader can also emphasize that listening sometimes means talking: asking questions, sharing experiences, or saying something that makes the other person feel understood. It may also mean admitting that you have tried but still do not understand.
Exercises for healing mental health problems
Once the group has learned how to help and support one another, they are ready to begin working on their mental health problems. Here are some ways for the group to help healing begin:
- Share experiences and feelings in the group. People who have mental health problems often feel very alone. Just being able to talk about a problem can be helpful. After one person has told her story, the leader can ask for other similar experiences. When everyone has listened to these, the group can discuss what the stories have in common, whether the problem was partly caused by social conditions, and if so, what the group might do to change these conditions.
- Learn to relax. This exercise is particularly helpful for people who are suffering from stress. In a quiet place where everyone can sit down, the leader asks the group to follow these instructions:
- Close your eyes and imagine a safe, peaceful place where you would like to be. This might be on a mountain, by a lake or ocean, or in a field.
- Keep thinking about this place as you breathe deeply in through your nose and then out through your mouth.
- If it helps, think of a positive thought, such as “I am at peace,” or “I am safe.”
- Keep breathing, focusing either on the safe place or the thought. Do this for about 20 minutes (as long as it takes to boil rice).
A woman can also practice this exercise at home whenever she has difficulty sleeping, or feels tense and afraid. Breathing deeply helps calm nervous feelings.
If you tell a story about a problem, it is important to also talk as a group about ways to overcome the problem.
If a group has lived through a trauma and enough time has passed, they can analyze their own experiences rather than creating a story.
- Creating a story, drama, or painting. The group can make up a story about a situation similar to those experienced by members of the group. The leader starts the story, and then another member continues to tell another part—and so on until everyone has contributed something and the story is complete. (The group can also act out the story as it is told or paint a picture of the story.)
Then the group analyzes the different ideas that have been developed. These questions can help people begin to talk:
- What feelings or experiences are most important in this story?
- Why did these feelings occur?
- How is the person coping with these feelings?
- What can help her develop a new balance in her life?
- What can the community do to help?
- Creating a picture of your community. This exercise works best after the group has been meeting together for a while. The leader first asks the group to draw a picture of their community. (It may help for the leader to draw a simple picture to get things started.) Then the group adds to the picture, drawing in those parts of the community that contribute to good mental health, and those that cause mental health problems.
More InformationOrganizing to Solve Community Health Problems
Then the group studies the picture and starts to think about ways to improve the community’s mental health. The leader can ask questions like these:
- How can we strengthen those parts of the community that now contribute to good mental health?
- What new things need to be done?
- How can the group help bring about these changes?
If you start to feel uncomfortable or frightened at any time during this relaxation exercise, open your eyes and breathe deeply.
In El Salvador, a group of women from an urban squatters’ community decided to form a support group. They had lived through the civil war and now worked with victims of the war through their church. One member tells how the group began and how it has helped her:
“One day, all of us felt sad without knowing why. It wasn’t as though anything special had happened that day, but all of us were feeling this way. Then one of us realized that it was the anniversary of the war that all of us had lived through. That was when we decided to form this group. We needed to feel close, to understand the things we had experienced, and to cope with how we felt about losing our sons, daughters, husbands, and neighbors to the war—and for what?
“We spoke, cried, and laughed, but this time we did it together. The group supported us, helped us to change, and helped us see new directions for our lives. We were able to bring new energy and strength to our work.Now we help victims of the war—not just to rebuild their homes and health, but also to overcome their fears and hopelessness. This way they can create a new future for themselves and for their community.
“Even though we all lost so much to the war—and peace has not delivered on its promises—we feel as though we have given birth to something new. And like a new baby, this group brings new spirit into the world and gives us the strength to go on.”
Helping women with reactions to trauma
Once a woman understands her reactions, the feelings usually have less control over her.
- The most important way to help someone suffering from trauma is to help her learn to trust others again. Let her control how fast the relationship between you develops. She needs to know you are willing to listen, but that she can wait until she feels ready to talk. Doing everyday activities together may be best at first.
|Massage can help|
relieve painful feelings.
- It may help a woman to talk about her life before the trauma as well as her current experiences. This may help her realize that although life has changed a lot, in many ways she is the same person as before. If it seems right, encourage her to do some of the same activities she enjoyed before or that were part of her daily routine.
- Some painful things may be too difficult to talk about, or may be ‘buried’ away where they cannot be remembered. Exercises like drawing or painting, or a physical activity like massage, can help a person express or relieve these painful feelings.
- If a woman dreams of the trauma, she can put an object from her new life next to her as she sleeps. This helps her remember, when she wakes from a bad dream, that she is safe now.
- If reminders of the trauma make a woman react in fearful ways, help her make a plan for those reminders that cannot be avoided. For example, a woman might tell herself: “His face is like the man who attacked me, but he is a different person and does not wish to hurt me.”
- If a person was tortured or raped, remind her that she is not responsible for what she said or did while being tortured. All responsibility lies with those who tortured her. Help her understand that one aim of torture is to make a person feel she can never feel whole again, but that this is not true.
Helping someone who wants to kill herself
|If a woman has made a plan for killing herself, she needs help right away.|
Anyone who suffers from serious depression is at risk for suicide. A woman may not readily talk about thoughts of suicide, but she will often admit them if asked. If she does, then try to find out:
- Does she have a plan about how to kill herself?
- Does she have a way to carry out the plan? Is she planning to kill others as well (for example, her children)?
- Has she ever tried suicide before?
- Is her judgment affected by alcohol or drugs?
- Is she isolated from family or friends?
- Has she lost the desire to live?
- Does she have a serious health problem?
- Is she young and going through a serious life problem?
If the answer to any of these questions is ‘yes’, she is at a greater risk for attempting suicide than other people. To help, first try talking with her. Some people may begin to feel better simply by telling you about their problems. If so, or if she still feels bad but is more in control of her feelings than before, ask her to promise that she will not hurt herself without talking to you first.
If talking about her problems does not help, or if she cannot promise to talk to you, then she needs to be watched closely. Always tell the person considering suicide that you plan to talk with others to help protect her. Talk to her family and friends, encouraging someone to be with her at all times. Ask them to remove dangerous objects from her surroundings.
If there are mental health services in her community, find out if someone can talk with her regularly. Medicine for depression may also be helpful.