The act of asking an open-ended question shows that you care. “What does that feel like?” or “What has been on your mind as you’re going through this?” Then, listen non-judgmentally to their response without interrupting or offering your opinion.

Asking about feelings

If someone, for instance, has received a new medical diagnosis, you can say, "It sounds like you're worried about the side effects of the treatment. Is that right?"You can also express kindness by saying, “You’re in such a tough situation.” A facial expression is also a powerful way to show support.

Willingness to understand

Not every person feels comforted in the same way. Acknowledge that by asking "How can I support you?"It expresses a desire to assist without jumping in to problem-solve.

Offering support

Emotional pain can feel unbearable at times, especially if people lack support. It may sometimes lead to harming thoughts.If someone you care about is going through a tough time and had suicidal thoughts in the past, ask them directly if they are thinking of hurting themselves. Research shows that upfront questions may benefit them.

Negative thoughts

Statements like "Everything will be fine," or "It could be worse," rarely help. Instead, try saying things like, "There's help available; we'll find it together," or “I’ve seen you get through extremely challenging times in the past, I believe in you.”

Reassurance

<div>
<figure> <img src="https://cdn.vox-cdn.com/thumbor/mz724gWM87Ghv0JCCQWfYJSEsBU=/0x0:5472x3648/1200x800/filters:focal(2299x1387:3173x2261)/cdn.vox-cdn.com/uploads/chorus_image/image/65861851/shutterstock_1384084307.0.jpg"></figure><h2>This story is part of a group of stories called <a href="https://www.vox.com/first-person"> <img src="https://cdn.vox-cdn.com/uploads/chorus_asset/file/12868843/first-person.0.0.png"></a></h2>
First-person essays and interviews with unique perspectives on complicated issues.

Science supports what we intuitively understand: Strong relationships enhance <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480897/">the quality of our lives</a>. We have all felt our outlook brighten after a meaningful conversation and our mood sour after conflict. We have all had a bad day turn around after an afternoon of laughter and story-swapping with good friends. That's because having social support not only boosts our mental health, <a href="https://www.ncbi.nlm.nih.gov/pubmed/27504934">research</a> has found, it also softens the impact of stress.
Our desire to belong is so universal that psychologists have labeled it a <a href="https://psycnet.apa.org/buy/1995-29052-001">fundamental motivational drive</a>. Social isolation is linked to a variety of problems, including attempting <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165032713000888">suicide</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/25910392">premature death</a>. Loneliness, in other words, is finally being recognized as <a href="https://www.washingtonpost.com/news/on-leadership/wp/2017/10/04/this-former-surgeon-general-says-theres-a-loneliness-epidemic-and-work-is-partly-to-blame/">a public health issue</a>. 
As a clinical psychologist, I provide therapy to people who have been through heart-wrenching experiences that can leave them feeling deeply alone - the death of a family member, sexual assault, domestic violence, unemployment, and other hardships. One of my top priorities as a therapist is working with patients to increase their sources of social support. Many have loved ones who are eager to help. The problem is, they may not know how to. 
When we are not equipped to support loved ones through a hard time, our discomfort can compel us to point out a bright side or offer a simple solution, which may come across as dismissive. Sometimes, my patients say they walk away feeling judged or burdensome. While putting ourselves in other people's shoes and treating people how we want to be treated are generally useful principles, they are not always the most effective ways to cultivate compassion. It is hard to imagine being in a situation that you have not actually been in, and people differ in what they find comforting. 
Through years of working with therapy patients and conducting mental health research, I have found some useful approaches for comforting people in pain. These are the most effective:
<h3>Ask them how they are feeling. Then, listen non-judgmentally to their response. </h3>
The simple act of asking someone how they're doing, with an open-ended question, shows that you care. Listen attentively rather than interrupting or offering your opinion. Ask simple follow-up questions like, "What does that feel like?" or "What has been on your mind as you're going through this?" This communicates that you genuinely want to know how they're doing and feel comfortable hearing the truth.
<h3>Show them that you want to understand and express sympathy. </h3>
For example, if someone is struggling with a new medical diagnosis, you can say, "It sounds like you're most worried about the side effects of the treatment. Is that right?" If you're speaking in person, nonverbal communication, like a concerned facial expression, is a powerful way to convey support. You can also express kindness and validation through statements such as, "I'm sad that you're in so much pain right now," or "You're in such a tough situation."
<h3>Ask how you can support them and resist jumping in to problem-solve. </h3>
As a therapist, I help patients assert their requests for emotional support to friends and family members. You can't be expected to mindread and know what will comfort every person in every situation. Acknowledging that and asking, "How can I support you?" or "What can I do to help?" expresses a desire to assist without presuming you know what is best for them.
<h3>Check in to see if they are suicidal. </h3>
Emotional pain can feel unbearable at times, especially for people lacking support and resources. Sometimes, this leads to suicidal thoughts. If someone you care about is going through a hard time, especially if they've had suicidal thoughts in the past, ask them directly if they are thinking about hurting or killing themselves. You may feel uncomfortable bringing it up, but <a href="https://www.sciencedirect.com/science/article/pii/S0272735818301351">research</a> shows that asking about suicide is unlikely to harm people and may benefit them. It opens opportunities to share mental health resources, like the <a href="https://www.crisistextline.org/">Crisis Text Line</a> or the <a href="https://suicidepreventionlifeline.org/">National Suicide Prevention Lifeline</a>. It's also helpful to talk about a plan for safety, including <a href="https://www.hsph.harvard.edu/means-matter/">reducing access to firearms and other lethal means.</a>
<h3>Reassure them, realistically. </h3>
Statements like "Everything will be fine," "It could be worse," or "You just need to stop thinking that way," often lead people to feel ashamed for expressing pain, and rarely set them on a better path. Instead, try saying things like, "There's help available; we'll find it together," "A lot of people love you. You don't have to get through this alone," or "I've seen you get through extremely challenging times in the past, I believe in you." 
There's no perfect thing to say in the most difficult situations, but we can support each other by opening dialogue, expressing compassion, and listening with the goal of understanding. Though sometimes hard to initiate, these conversations are the ones that strengthen our relationships. They make us feel we have a place to turn the next time the world feels lonely and dark.
Kathryn Gordon, Ph.D., is a licensed clinical psychologist living in North Dakota. She is writing The Suicidal Thoughts Workbook: Cognitive-Behavioral Therapy Skills to Reduce Emotional Pain, Increase Hope, and Prevent Suicide for New Harbinger. You can follow her on . </div>

First-person essays and interviews with unique perspectives on complicated issues. Science supports what we intuitively understand: Strong relationships enhance the quality of our lives. We have all felt our outlook brighten after a meaningful conversation and our mood sour after conflict.

How to help a friend through a tough time, according to a clinical psychologist

Asking about feelings

Willingness to understand

Offering support

Negative thoughts

Reassurance

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