The directors of the 85-year long multi-generation Harvard Study of Adult Development have a new book out called The Good Life: Lessons from the World’s Longest Scientific Study of Happiness.* In it, authors conclude that most of us “underestimate the beneficial effects of human connection.”
One of their key findings about fostering these connections seems directly aimed at those with chronic medical diagnoses like heart disease – especially as we get older: .
“Talk about what you’re struggling with, wherever you are in life.”
This study began in 1938 to understand human health by investigating not what made people sick, but what made them thrive, now following three generations of descendants of the original study group.
The Harvard study director and book co-author Dr. Robert Waldinger reports that “it’s important to make space in your relationships to talk about your troubles.” He adds that as our life stages change from from adolescence through to late life, what we need from each other can also change over time:
“We move with our life stage. Our big concerns change. And it’s okay to talk about that, and to be interested in other people’s big concerns.”
Dr. Waldinger explains:
“I used to think, ‘I’m never going to complain about my health the way my parents do!’ But now I find, because I’m getting old, when we’re with friends who are our age, we talk a lot about our health, and I don’t censor that.”
Although I’m impressed by longitudinal research over decades, this statement doesn’t sit well with me. Here’s why:
I grew up in a big family where talking about your various problems – health or otherwise – was barely tolerated, as this house rule suggests (from the U.S. poet Arthur Guiterman in the mid-century years just before I was born):
“Don’t tell your friends about your indigestion. ‘How are you?’ is a greeting – NOT a question!”
My Santa Barbara friend Dave has a name for a long-winded response from those who believe that every “How are you?” demands a long-winded response: he calls it “the organ recital”. I feel a bit like Dr. Waldinger used to feel long ago when he announced he’d never complain about his health like his parents did. And yet one day, Dr. Waldinger turned into his parents. Will this happen to all of us? And should it?
My own hard-working parents rarely if ever complained about medical woes, and paid little attention to the complaints of others – unless those people were very sick or very pregnant – in which case my mother would start making soup and her famous home-baked Chelsea buns for delivery to neighbours or friends in need.
In 2009, the year after I survived a misdiagnosed “widow-maker” heart attack, I learned about Dr. Barbara Keddy, a teacher of nurses, professor emerita at Dalhousie University in Halifax, and author of the book Fibromyalgia: Unravelling the Mysteries of the Dis-ease. Fibromyalgia is a debilitating chronic condition that Dr. Keddy has lived with for over 50 years. And as if that’s not enough, 10 years ago she also survived a heart attack. Meaning: she knows about pain.
I’ve been quoting her wisdom since 2009 because so much of what Dr. Keddy has written rings true for heart patients, too. For example, she wrote about a support group of Toronto women living with fibromyalgia who get together regularly – not, as you might expect, to discuss their shared illness but wellness only. Dr. Keddy explains this unusual group etiquette:
“Reliving recent or 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.”
In other words, sharing our specific health struggles with others as we get older may not make us feel better after all. I learned similar lessons in my Pain Self-Management classes, which encourage us to shift focus away from our chronic pain symptoms toward distractions that can help to calm down a jumpy nervous system.
For years, I’ve been reminding heart patients here on Heart Sisters, and in my book, and in my Heart-Smart Women presentations that it’s not a legal requirement to share every personal health update with every person we meet. See also: “I Don’t Want to Talk About It”
Remember that for the freshly-diagnosed heart patient in very early days, it is completely normal for us to want/need to tell our stories, and for those who care about us to want/need to hear every detail. That’s not the kind of sharing we’re talking about here – but even then, you have the right to talk – or not to talk. If all of this seems too overwhelming, you can always tell family and friends that you suddenly feel really tired and need a nap right now (nobody ever argues with heart patients over that request).
My grown kids tease me that my stock answer to every “How are you, Mum?” question has always been “Just peachy!” The only exception might be if I’m in bed at death’s door and need groceries (as I did for four awful weeks last fall when I had influenza. NOTE FROM CAROLYN: please get your flu shot!) I’m not talking about pasting on a fake smile here – just a neutral resting face will do – and you don’t have to face the burden of fake smiling, or what psychologists call emotional labour – which can in fact worsen our outcomes.
Many sick people are shocked to learn the hard way that close family members might not be their best support people. For example, as I wrote in Choose Your Listeners Carefully:
“Spouses, siblings or grown children may appear at first blush to be the most logical people to count on when we need to express our fears, worries, symptoms or needs after a serious diagnosis.”
“But in fact, those closest to us might actually be the least appropriate listeners once the acute crisis stage has passed. Families want and need us to be ‘better’ in order to lower their own anxiety so they can stop worrying about us. But the freshly-diagnosed may be understandably disappointed by a lack of suitable response from those they turn to. I regularly hear from readers who feel hurt after their close family members ‘were not there for me’. ”
It’s not that I don’t care about what others are going through. When those closest to me are the ones going through it, I do care intensely. When I need to know more, I ask them: “How are you, REALLY?”
Self-focused ruminating about health issues can exhaust even the most empathetic listener. As the late psychologist Dr. Susan Nolen-Hoeksema once warned:
“When patients ruminate for an extended time, their family members and friends become frustrated – and may even pull away their support.”
That pulling away can be tragically ironic, because the attention the patient is seeking is the very thing that may end up being withdrawn because of that rumination.
Each day, I experience episodes of distressing chest pain and other ongoing symptoms of coronary microvascular disease, yet I rarely mention my symptoms to others. One day, for example, while out walking with my daughter Larissa, my chest pain became severe enough that I told her I’d need to sit on a nearby bench and take my nitro spray (which I carry with me at all times). She was very frightened. It was the first time she’d witnessed her mother doing what I do almost every day when she’s not around. She wanted to call 911. (Believe me, if I called 911 for every episode of refractory angina, I’d be camping out in Emergency every day).
So I had to reassure Larissa that this episode was actually quite “normal” for me, and that I’d probably be okay in a few minutes. But that event is an example of why I rarely mention my pain. I need to focus all of my energy on getting through that pain, instead of trying to comfort worried family or friends. Yet this is what Dr. Waldinger tells us will make us all happier – to talk about what we’re struggling with.
Honestly, I just don’t feel the need to report my own health updates, setbacks or medical appointment results – even to my own family.
So what happens if we do feel a need to talk about these things – but now hesitate to share because we’re scared about reactivating our nervous system or worrying our family members?
Consider instead seeking talk therapy (something that absolutely saved my own sanity in the early months post-heart attack) especially if you are depressed. This can be found with a professional therapist, a peer counselor, a pastor, or a trained community help-line volunteer. Start a daily journal to write down your private thoughts and struggles. (You don’t have to ever show this to anybody else if you choose not to). And every newly-diagnosed heart patient should sign up for cardiac rehabilitation. If your cardiologist has not specifically referred you, ask for a referral.
But wait (she asked, furrowing brow): What if Dr. Waldinger and his Harvard colleagues are absolutely correct about the need to “talk about our health struggles” – and what if I’m absolutely wrong?
I can’t even imagine sitting around a big table at the Seniors Centre some day with a group of other seniors, all of us talking at the same time about our latest medical news. I’ve watched these seniors. Most are not even listening to other people’s stories. Each update they hear simply serves to remind them of their own far more interesting struggle – which now must be shared.
Yet according to Dr. Waldinger, after they’ve finished their coffee and enough stories have been told around the table, they will go home feeling more connected to other humans, which will help them feel happier in their old age.
Sometimes I wonder why “Fine, thanks!” isn’t considered a good-enough response any more.
Q: Am I missing out on future happiness if I don’t share my health struggles?
NOTE FROM CAROLYN: I wrote 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 30% off the list price).
Image of sparrows: Susanne Jutzele, Pixabay