When you get together with your girlfriends, are there any conversation topics that you believe are not open for discussion? Any that are off-limits? Any personal stories that you think are, well, just too personal to talk about to those women closest to you?
No, me neither.
Nowhere is this communication openness more visible than with our health. We generally like to share our medical news, updates on that medical news, and our opinions about each others’ medical news. Health topics appear increasingly popular as we age (and thus have way more medical news to discuss). It’s what my friend Dave likes to call “the organ recital”. But when it comes to serious health conditions, do you ever wonder if all that sharing is necessarily a good thing?
Immediately after I survived what doctors still call the “widowmaker” heart attack in 2008, every detail of my story, every symptom, diagnostic test, cardiac procedure, chart note and “what the cardiologists said” seemed to spread like wildfire among my girlfriends. By the time I was discharged home from the CCU (the hospital’s cardiac intensive care unit), everybody I knew, near and far, already seemed completely up-to-speed on my whole story.
Linguist Dr. Deborah Tannen described this wildfire communication phenomenon beautifully in her must-read book on communication called You Just Don’t Understand. It’s so good, in fact, that you must now stop reading this and go buy this book (preferably at your small family-run local bookshop and not from an online mega-site) – and then come right back here!
For example, Dr. Tannen’s linguistic studies suggest that women tend to communicate in order to connect emotionally, to express feelings, or build rapport with others. (She also found that when men communicate, they generally tend to share facts and figures, as if in a report).
Dr. Tannen cleverly labels these gender-based communication style differences as “rapport-talk” and “report-talk”.
And is there any topic more important to creating that rapport for women than sharing with our friends the dramatic stories of serious medical diagnoses or health crises?
But recently I read a compelling argument for NOT sharing quite so much. It was written by a woman named E. Amato, who describes herself as a “dulcet-toned poet, spoken word artist, activist and filmmaker”.
She tells a story about experiencing three social outings in four days – which sounds like absolutely no big deal if you’re lucky enough to enjoy the luxury of “healthy privilege“.
But for her, living with chronic pain and other debilitating symptoms, this social schedule was more than she’d even attempted in months. A very big deal indeed. Besides just navigating the exhausting travel requirements to and from each outing destination over those four days, she also knew that catching up with three groups of friends she hadn’t seen in a long time meant updating her story for each one again and again with nary the smallest detail left out.
After the end of the third social outing, she collapsed back at home – the beginning of a medical relapse that would last for many weeks, as she describes it:
“My body was done. I was depleted, mentally and physically.”
It struck her after she started to feel better that the culprit seemed to be in that repetition of those medical updates at each of three separate visits. She explains:
“What I thought I was doing was sharing. Our culture encourages sharing. This is why we have friends, and when they get bored of us, talk therapy. This is why we develop support networks.
“The idea that talking about it is the cure seems to be fairly pervasive. We ‘shine a light’ on hidden issues, we ‘air them out,’ we ‘come clean,’ we ‘get things off our chest.’ All of these idioms show the high regard we have for employing narrative as a cure.
“What if it’s not? What if talking about it makes it worse?
“I was aware of the perils of possible over-sharing with strangers, but it should be different when I tell supportive people close to me the events and details of my life.
“It is different. It’s worse.”
She now believes that repeatedly telling her story may actually cause her to relive the original pain. If an emotional trauma is linked to a physical one, she says, or if somehow they have linked themselves together in her body, she may actually be summoning them back into action. When such self-disclosure happens during this kind of conversation, this is how it feels to her:
- she’s putting her systems on high alert
- she’s triggering inflammation
- she’s triggering the fight/flight response
- she’s triggering shutdown mode
In other words:
“Talking about pain and trauma can actually cause pain and trauma. The truth is, sometimes talking about it is self-harm.”
That sentiment is also what Nova Scotia’s Dr. Barbara Keddy believes. She’s the author of Women and Fibromyalgia: Living With An Invisible Dis-ease and has herself lived with fibromyalgia for over four decades. As if that’s not challenging enough, she’s also a heart attack survivor.
She writes, for example, about a support group of Toronto women also living with fibromyalgia who get together regularly – not, as you might expect – to discuss their shared illness, but wellness only. Dr. Keddy explains:
“Reliving past injuries of a physical or emotional nature only reactivates the nervous system.
“Instead, it is more important to recognize our reactions rather than the specific events related to the trauma.”
The question for many of us, however, is how to NOT share important updates about one’s health with those who care about us.
Can we join our friends for lunch at the pub on Saturday and suddenly refuse to answer their questions?
Should we announce that from now one, no further medical updates will be forthcoming?
Should we default to the standard “Fine, thank you!“ smiley-face conversation stopper instead?
As I wrote about in How Our Girlfriends Help Us Get Through the Toughest Times, social scientists tell us why so many women instinctively talk about what’s going on for us so freely compared to the men in our lives.
In 2009, a landmark UCLA study found that women respond to severe stress (such as going through a serious health crisis like a cardiac diagnosis, for example), with a cascade of brain chemicals that cause us to seek and maintain friendships with other women.(1)
Researchers used to believe that when we experience severe stress, both men and women trigger a hormonal cascade that revs the body to either stand and fight, or flee as fast as possible, explains Dr. Laura Cousin Klein, one of the study’s authors. This is the ancient fight-or-flight survival mechanism left over from the time we were chased across the planet by all those sabre-toothed tigers.
At least, that’s what happened to men.
But Dr. Klein and her team found that the credit for women’s unique stress reactions may belong to the hormone oxytocin (also known as the “love hormone”). It’s the body’s own wonder drug – released when we nurse our babies, for example, as well as during a woman’s stress response. It’s instinctual, it buffers the fight-or-flight response and it encourages us to tend children and gather with other women instead – what’s called our tend-and-befriend response to stress. This calming response does not occur in men, says Dr. Klein, because testosterone – which men produce in high levels when they’re under stress – seems to reduce the effects of oxytocin. Estrogen seems to enhance it.
Lisa Genova, author of two of my favourite novels (Still Alice and Inside the O’Briens – the latter I’ve been both laughing and weeping through all weekend) recently wrote of confiding in a person she hardly knew. The woman happened to ask her during a kids’ birthday party a simple question: “How are you?” But instead of replying “Good!”, Lisa surprised herself by confiding in this stranger some painful details about the divorce she and her husband were going through. The woman shared her own remarkably similar divorce story, and the two eventually became close friends. Lisa explains:
“I realize we can’t open ourselves to every person we sit next to on a bench, or stand behind in line at Starbucks. Sometimes a smile and a ‘Good!’ are the best we can offer and all there is time for.
“But sometimes, ‘How are you?’ can be an opportunity to reveal some of what is genuine inside our carefully dressed and armored exteriors and to be seen, down to our complicated truths. It invites the possibility of a connection with another human being.”
So rather than toss those natural tend-and-befriend instincts, let’s consider how we can modify our medical updates if we, like Amato, suspect that such updates may be leaving us drained and exhausted.
- pick and choose carefully who to say what to (you don’t need to repeat every detail of every doctor’s visit to every casual acquaintances)
- as Rev. Debra Jarvis advises: “Claim your experience. Don’t let it claim you. It’s never too late to become someone besides simply a survivor.”
- try not to interrupt someone in the middle of sharing their serious medical news update to tell them your own far more fascinating story (that’s just plain rude)
- even with close friends or family, decide which bits to talk about and which to keep to yourself
- you’re allowed to have private and personal thoughts
- you’re also allowed to share these – but again, choose your target audience wisely
- practice not going into any detail about your latest medical update just because people ask about it – just to see how that feels for you
- if something is overwhelming for you, consider making an appointment to talk to a therapist, pastor or professional counsellor (talk therapy can often be very helpful, particularly in the early days post-diagnosis to gain perspective on what’s just happened)
1) Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Taylor, Shelley E.; Klein, Laura Cousino; Lewis, Brian P.; Gruenewald, Tara L.; Gurung, Regan A. R.; Updegraff, John A. Psychological Review, Vol 107(3), Jul 2000, 411-429.
NOTE FROM CAROLYN: I wrote more about sharing – and not sharing – details of a serious health crisis in my book A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017).
Q: Which feels better for you: sharing your medical news with friends and family, or choosing not to?
- Good news: your story is not yet locked in
- How our girlfriends can help us get through the toughest times
- Little social support: a big gap for younger heart patients
- Get over yourself: how to stop boring others with your heart attack story
- The loss of ‘self’ in chronic illness is what really hurts