While clinical psychologist Susan Silk was recuperating from surgery, she decided that she wasn’t feeling up to having any visitors. But when one of her work colleagues who really, really wanted to visit was asked to respect Susan’s request for privacy, her astonishing response to Susan was:
“This isn’t just about you!”
Well, actually, it was all about Susan, and only about Susan. Yet sometimes, our friends, family and other visitors seem to forget what to say – and what never to say – to people suffering a trauma, as Susan described in a Los Angeles Times article co-written with Barry Goldman last year.
In fact, her own experience as a patient prompted Susan to come up with a deceptively simple technique to help others avoid doing or saying the wrong thing. She claims that this technique works for all kinds of crises: medical, legal, financial, romantic, even existential. Susan calls it the Ring Theory:
“Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma. (If it’s a medical trauma, that’s the patient’s name.) Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma (like the patient’s spouse, children or parents).
“Repeat the process as many times as you need to. In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones.
“When you are done, you have a Kvetching Order. Tape it to your refrigerator.
“Here are the rules. The person in the center ring can say anything she wants to anyone, anywhere.
“She can kvetch and complain and whine and moan and curse the heavens and say: ‘Life is unfair!’ or ‘Why me?’ That’s the one payoff for being in the center ring.
“Everyone else can say those things too, but only to people in larger rings.
“When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. Listening is often more helpful than talking. But if you’re going to open your mouth, ask yourself if what you are about to say is likely to provide comfort and support. If it isn’t, don’t say it.
“Don’t give advice. People who are suffering from trauma don’t need advice. They need comfort and support. So say, ‘I’m sorry!’ or ‘This must really be hard for you!’ or ‘Can I bring you a pot roast?’ Don’t say: ‘You should hear what happened to me! or ‘Here’s what I would do if I were you.’
“And never say: ‘This is really bringing me down.’
“Complaining to someone in a smaller ring than yours doesn’t do either of you any good. On the other hand, being supportive to her principal caregiver may be the best thing you can do for the patient.
“If you want to scream or cry or complain, if you want to tell someone how shocked you are or how icky you feel, or whine about how it reminds you of all the terrible things that have happened to you lately, that’s fine. It’s a perfectly normal response.
“Just do it to someone in a bigger ring.”
Susan sums up this technique by reminding us that the goal of the Ring Theory is “Comfort IN, dump OUT.” You can say whatever you want if you just wait until you’re talking to someone in a larger ring than yours.
I’d love to add one additional reminder to Susan’s Ring Theory: when you’re talking to the person in the centre of a crisis (the patient, for example) do not under any circumstances start talking about your own or your Aunt Stella’s far more interesting crises. Those coping with a crisis simply cannot begin to focus on you or your fascinating stories. Remember Susan’s advice:
“Ask yourself if what you are about to say is likely to provide comfort and support. If it isn’t, don’t say it.”
And don’t worry, warn Susan and Barry. You’ll get your turn in the center ring. You can count on that.
Watch this simple video (2:36) created by critical care nurse Heather MacNamara. Thanks for sending this to me, Heather!
Susan Silk is a clinical psychologist. Barry Goldman is an arbitrator and mediator and the author of “The Science of Settlement: Ideas for Negotiators.”
- Empathy 101: how to sound like you give a damn
- “You look great!” – and other things you should never say to heart patients
- “I care about you” and other things to say to sick friends
- ‘Healthy Privilege’ – when you just can’t imagine being sick
- Ten helpful things to say to a sick friend
Q: How did Susan’s Ring Theory advice ring true for you?