Q. How long after a tragedy is it even feasible to approach this question?A. It depends so much on the particular individual and what the tragedy means to them. The example that comes to mind is someone I worked with whose oldest friend was suddenly killed in a freak accident. Within a month or two of the accident, he realized he wasn’t doing well, that his whole world had fallen apart. He started therapy within a month or two of the accident because he felt the need to process it right away. We didn’t work together for all that long, and then he was ready to go on. He still felt terrible pain because of his loss, but he didn’t feel he was falling apart any more. On the other hand, I also have had people come in several years after a tragedy—a death, an illness, a painful divorce-- because it feels like there is something unfinished. People do this on their own timetable.Q. Is coping a conscious decision? Are we able to direct ourselves to cope?A. People often worry that somehow they should be able to cope right away. We have this idea in our society that people who experience terrible things should just be able to get over it. Sometimes they think therapy will help them get over it quickly. I tell them, “You have to take the pressure off yourself. The idea that you can get on top of it and deal with it isn’t helpful. It can take a long time.” In the case of major tragedies, we never get over them completely.Q. Is it possible to go back to normal?A. You can’t go back after a major trauma. If we’ve have lost someone close to us or suffered a major illness, our lives are never going to feel the same, much as we would like them to. I’ve worked with many people who have had life-threatening illnesses, and even though they’ve survived and, in many cases, thrived, every time they have to go in for a screening, their old fears and anxieties are revived. Going through treatment was so difficult that the thought of having to go through it again is overwhelming. My job is to try to strike the delicate balance between acknowledging the reality of their fears and never losing hope.Q. Can friends be helpful?A. Not everyone who suffers a tragedy needs to get professional help. Friends can be very helpful, especially if they can really listen and not try to tell the person who is suffering how to feel. Sometimes people feel that it’s their job to get their friend to open up and talk about their pain. That’s not always what a suffering person wants. Similarly, not everyone wants to be reassured that everything will be okay. If we can be attuned to what the person finds most helpful and refrain from imposing our own agenda, our friendship can mean a great deal. People sometimes seek therapy because they feel they don’t want to burden their friends with their deepest worries and fears. They want a place where they can talk about things that can be hard for their friends to hear.Q. Change is inevitable. How do you help clients see that it can be a positive thing?A. I’ve never heard anyone say that having a life-threatening illness or losing a spouse or going through a painful divorce was a positive experience. But I do think that, over time, people are often able to find redeeming qualities in their worst experiences. I’ve certainly heard people say that they found reserves of strength they didn’t know they had or realized that their friends really cared about them or recognized that the relationship that fell apart really wasn’t good for them in many ways. When people can find meaning in terrible things that happens to them, it can make a huge difference.Click to learn more about finding your life path with Jane Rubin, Ph.D.