Social Interaction after Burn Injury

Some burn injury survivors have changes in their appearance. They may worry about how people will react to them when they leave the hospital and go out in public.

Understanding challenges with social interactions

Some of the social challenges that burn survivors face after they leave the safe zone of the hospital and return to their communities include:

• Stares, startled glances, or double-takes;
• Nosy questions or comments about their injury; and
• Bullying and teasing.

If your burns show, everyday activities like going shopping or taking a bus or the subway may involve being stared at and having to deal with people’s curiosity. If your burns are hidden, you may worry about how people will react when they are exposed, such as when you take off your shirt at the beach.

The way people react can make it hard to feel confident during social interactions. People may react verbally, with words. People may also react nonverbally, through body language or gestures. Some burn survivors aren’t bothered by the reactions of others. But you may find it helpful to learn skills to face these challenges.

Do you sometimes feel uncomfortable in social situations?

Some burn survivors may avoid social situations because they think that people may react to their appearance. Other burn survivors may:

• Feel nervous or on edge when they meet new people or when they’re with strangers;
• Feel isolated and alone; or
• Feel emotional distress, including depression.

Finding help to improve social interactions

If you feel nervous or on edge in social situations, you can learn skills to help you gain control, comfort, and confidence. Some resources that may help include:

• Members of your burn team can talk with you and provide resources to help you.
• The Phoenix Society for Burn Survivors has a peer support program called Survivors Offering Assistance in Recovery (SOAR) for burn survivors and their loved ones. This one-on-one program connects people with new burn injuries to other survivors and family members who can share their experiences and offer support.
• The Phoenix Society also offers an online learning program called Beyond Surviving: Tools for Thriving After Burn Injury. This program teaches strategies to help you gain control, act and feel comfortable, and confident.
• The Phoenix Society also offers a weekly peer support chat. This live chat is held on Wednesday nights from 9:00 p.m. to 10:30 p.m. (EST). It covers common concerns and questions facing burn survivors and their loved ones. See https://www.phoenix-society.org/our-programs/phoenix-community for more information.

It’s okay to feel nervous when interacting with people after a burn injury. Here are some strategies you can use when meeting new people or going into new social, work, school, or public situations. In all social interactions, it’s helpful to act positive and use confident body language.

The “STEPS” strategy may help you feel more confident when facing old or new social, work, and school situations. It was developed by Barbara Kammerer Quayle, a burn survivor.

• Self-talk—This is what you say to yourself and believe. Examples include “I love and accept myself the way I am and the way I am not,” “I meet people easily and feel comfortable with them,” and “I can do it!”
• Tone of voice—Use a friendly, warm, and enthusiastic tone of voice.
• Eye contact—Look people in the eye, even if just for a few seconds.
• Posture—Have a confident posture. Keep your head up, your rib cage lifted, and your shoulders back.
• Smile—A smile makes you look confident and approachable.

Ways you can respond when others react to you

If someone stares at you:

People who stare are often just curious because they haven’t seen someone with a burn injury. They usually don’t mean to be rude. If you look back and smile and say, “Hi” or “Hi, how are you doing?” the staring usually stops. Always use your STEPS to look confident and comfortable.

If someone asks what happened to your burn injury:

When strangers ask about your burn injury, remember that you are in control . You can offer as much or as little information as you want. You don’t owe strangers the whole story of your burn injury experience. Rehearse your responses. This requires writing and then saying three short sentences about your injury, smiling at the person asking, and walking on. For example:

• I was burned in a house fire.
• I am doing better now, or I am still recovering.
• Thanks for your concern, or thanks for asking.

Write and rehearse three sentences that feel just right for you and use this tool when people ask questions.

Respond in a positive way.

Change the subject if you don’t want to continue to talk about your burn.

Use humor when appropriate to lighten the moment.

You can find more information about the Rehearse Your Responses strategy at www.phoenix-society.org. Look for: Find Resources/Beyond Surviving Tools for Thriving.

If someone teases you:

• Stand up straight and hold your head high.
• Count to 10 slowly and stay calm.
• Shrug your shoulders, act bored, smile, and walk away.
• Say to the teaser, “I’m wondering why you would say something like that?” or “you must be pretty insecure to pick on other people.” Shrug your shoulders and walk away.

Social Skills Training

Social interaction skills training programs may also help you:

• Get ready for social situations after you leave the hospital
• Understand what goes on in social interactions
• Practice effective ways to manage social interactions

Two well-known social interaction skills training programs are described below.

• Beyond Surviving: Tools for Thriving After a Burn Injury,” (www.phoenix-society.org) which is available through the Phoenix Society and described in this factsheet
• The 3-2-1-GO! strategy—This program was developed by James Partridge (www.changingfaces.org.uk). It includes:
  • Three things to do if someone stares at you
  • Two things to say if someone asks what happened
  • One thing to think if someone turns away

Resources

The Phoenix Society, Inc.
525 Ottawa Ave NW, Front
Grand Rapids, MI 49503

(800) 888-2876 or (616) 458-2773
info@phoenix-society.org
Changing Faces The Squire Centre
33-37 University Street London, WC1E 6JN www.changingfaces.org.uk

References

Blakeney, P., Partridge, J., & Rumsey, N. (2007). Community integration. Journal of Burn Care and Research, 28(4), 598–601.

Blakeney, P., Thomas, C.,Holzer, C., 3rd,et al.(2005). Efficacy of a short-term, intensive social skills training program for burned adolescents. Journal of Burn Care & Rehabilitation, 26(6), 546–555.

Kammerer Quayle,B.(2006).Behavioral skills and image enhancement training for burn survivors: Essential interventions for improving quality of life and community integration. In R. Snood & B. Achauer, (Eds.), Achauer and Sood’s burn surgery: Reconstruction and rehabilitation. Elsevier, Inc.

Kammerer Quayle, B. (2015). Program that has helped thousands began with one survivor’s need to get back to living. Burn Support Magazine, 2.

Authorship

Social Interaction after Burn Injury was developed by Radha Holavanahalli, Ph.D. and Barbara Kammerer Quayle, MS, in collaboration with Model Systems Knowledge Translation Center.

Source: Our health information content is based on research evidence and/or professional consensus and has been reviewed and approved by an editorial team of experts from the Burn Model Systems.

Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. This publication was produced by the Burn Model Systems in collaboration with the University of Washington Model Systems Knowledge Translation Center with funding from the National Institute on Disability and Rehabilitation Research in the U.S. Department of Education, grant no. H133A060070. It was updated under the American Institutes for Research Model Systems Knowledge Translation Center, with funding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DP0082). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this fact sheet do not necessarily represent the policy of the U.S. Department of Education or the U.S. Department of Health and Human Services, and you should not assume endorsement by the federal government.

Copyright © 2019 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.