I once heard the late author Dr. Leo Buscaglia tell a conference audience his story about how he grew up equating caregiving with love. When he was a little boy, for example, his own mother seemed cold and distant – except when he was sick. During those times, she would sit at his bedside, stroke his fevered brow, spoon-feed him homemade soup, fuss over every painful twinge, listen carefully to his every word, and become the kind of loving mother he rarely knew when he was healthy. .
Those were the only times Dr. Buscaglia remembered feeling truly cared for. So when he grew up and married, he was shocked by his new wife’s behaviour toward him whenever he got sick!
Instead of brow-stroking and soup-spooning as she was supposed to do, she seemed to have zero tolerance for his sickly ways. She didn’t hover over his sickbed, didn’t offer to bring him special things, and seemed annoyed by his weakness – until he felt well enough to be up and around again, at which time she resumed being her usual loving self. (And coincidentally, whenever she got sick, she wanted only to be left alone). See also: What’s Your ‘Being Sick’ Style?
Trouble is, as Dr. B. learned, not everybody receives or offers the same support and consideration that WE would prefer during an illness.
Yet, as I know from both my “Heart-Smart Women“ presentation audiences and responses to my Heart Sisters blog posts, most of us seem to have specific if unspoken expectations of how our friends and family should rally around us during a health crisis.
Many times, we are pleasantly surprised by who does step up to help as often as we feel disappointed by who doesn’t.
An unmet expectation is often expressed like this:
“I felt so disappointed that my ______ (insert one: friend, sister, daughter, spouse, mother) was not there for me!”
This seems especially common in women who see themselves as the kind of friend/sister/daughter/spouse/mother who would readily drop everything to help others if the tables were turned. They sometimes mention specifically that they are the helpers who can be unfailingly counted on to offer an empathetic shoulder to endlessly cry on.
So when it feels like these helpers receive less understanding in return, it can really hurt. “But I would do this for YOU. . .” becomes their silent inner protest.
This is why I now advise women in my audiences and on this blog to choose carefully the people you decide to confide in.
Spouses, siblings or grown children, for example, may appear at first blush to be the most logical people to count on when we need to express all of our fears, worries, symptoms or needs after a serious diagnosis like heart disease.
For some families, this works out just fine.
But in other families, this is not always an accurate assumption.
Surprisingly, in fact, those closest to us might actually be the least appropriate listeners once the acute illness crisis stage has passed.
In the early days following any freshly-delivered diagnosis, we’ll tell and re-tell our story to anybody and everybody. Each visitor/caller asks the same worried questions, and gets the same story. It’s often how we process and debrief what’s just happened.
In fact, many heart patients have told me that they initially felt so overwhelmed that they would tell their story to just about any warm body who asked, “How are you doing today?” After my own heart attack, nobody was safe from me and my dramatic story of misdiagnosis and survival.
If this goes on and on, however, and especially with a chronic illness, it’s called ruminating. In my book A Woman’s Guide to Living with Heart Disease, I cited the research of the late Yale University professor Dr. Susan Nolen-Hoeksema, who warned about the inherent problems with longterm ruminating.(1)
As she explained, ruminating can have a chilling effect on the willingness of others to keep listening:
“Friends and family might respond compassionately at first, but this compassion can wear thin over time. Ruminators report reaching out to others for help more than non-ruminators do, but ironically can end up receiving less of it. Instead, some ruminators report that others tell them to buck up and get on with their lives. After a while, other people may become frustrated and start pulling away, which gives ruminators more to ruminate about: ‘Why are they abandoning me?’“
I suspect, however, that there’s another possible reason others pull away, and that’s simply because we tend to turn immediately to those who may actually be least able to hear: our family and closest friends.
But what so many of these people actually want – and need – is for us to be better.
They want and need to know that our frightening health crisis is over now.
They want and need to be able to stop suffering with worry.
In cardiac psychologist Dr. Wayne Sotile’s excellent book Heart Illness and Intimacy, he offers sound advice to the spouses of heart patients:
“Spouses may feel overburdened with responsibilities to be all things to all people, often drifting into exhaustion from trying to be the family’s emotional cheerleader, the family dietitian, the medical liaison between patient and doctors, and the patient’s conscience about new health care habits, all at the same time.
“A useful guideline for families: do for the sick family member only what that person cannot do for him/herself, and no more.”
He adds communication advice for the heart patient, too:
“You should not feel alone in dealing with the fears of this journey, but neither should you demand excessive ‘rescuing’ from your mate. Be honest with yourself and with each other about what you need from each other. “
It’s not that we have to keep everything to ourselves.
It can be very helpful to debrief a traumatic medical event and talk about how it’s affected us and what it all means. Sometimes, however, no matter how much we try to process it, we won’t figure it out. See also: Looking for Meaning in a Meaningless Diagnosis
And as psychologist Dr. Guy Winch, author of the book Emotional First Aid, once cautioned:
“Venting doesn’t always bring you relief. The listener makes a big difference.”
He offers five important questions to ask yourself about any potential listener – close to you or not – before you decide if that person is the right one to share what you’re going through:
- Is this person a good listener?
- Is this person supportive?
- Can this person offer empathy and emotional validation?
- Is this person likely to shift the talk to be all about them?
- Is this person loyal?
So, for example, do not expect that the person you know will highjack any conversation into a long story about themselves will suddenly turn into an empathetic listener just because you’ve had a serious health crisis you want to talk about.
To even expect that sudden transformation is to invite disappointment.
Instead, it’s far smarter to make an informed choice about who you’re going to trust with such sensitive personal suffering. It’s okay to choose NOT to confide at length in certain people. It’s okay to just say “Doing better, thanks!” when asked how you’re feeling. See also: “I Don’t Want to Talk About It”
What can you do if you don’t have a good listener who fits the bill?
Please do not despair, and try not to blame family and friends around you for letting you down. That’s like blaming a brown-eyed person for having blue eyes.
Consider instead seeking talk therapy (something that absolutely saved my own sanity) especially if you are depressed; this can also be with a peer counsellor, a pastor, or a trained community help-line volunteer. Start a daily journal to write out your thoughts and struggles. Sign up for a cardiac rehabilitation program if you’re newly diagnosed. Join a patient support group for others diagnosed with a similar condition (either an in-person or online group – like Inspire’s WomenHeart Connect, a support community with over 40,000 other women worldwide living with heart disease. It’s free to join, open 24/7, and you can participate in discussion topics or ask questions as much or as little as you like.
“Remember that people’s abilities or lack thereof are not about you; they reflect their own life history and perhaps their own fears about illness. I used to get upset when people didn’t behave the way I thought they should. Then I realized that getting upset about it only made me feel worse.
“I feel better emotionally when I graciously accept whatever support is offered and let the rest go, including my views about how people should act.”
1. Nolen-Hoeksema, Susan. Journal of Personality and Social Psychology, JPSP 2005 (Vol. 77, No. 4, pp 801-814).
Q: Who have you decided are the most appropriate people in your life to confide in, and why?
NOTE FROM CAROLYN: I wrote much more about both getting and offering support in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 20% off the list price).