What I wish I knew back then: “New heart patients must choose their listeners carefully.”

 by Carolyn Thomas   ♥  @HeartSisters

I once heard the late author Dr. Leo Buscaglia tell a conference audience a touching story about how he grew up equating caregiving with love. When he was a little boy, for example, his own mother was 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 each painful twinge, listen carefully to his every wimper, and become the kind of loving mother he rarely knew when he was healthy.   

But 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, his bride seemed to have zero tolerance for his sickly ways and even seemed annoyed while listening to his  complaints  – until he was up and around again, when she would resume being her usual loving self.

Trouble is, as Dr. B. learned, most of us seem to have specific if unspoken expectations of how our friends and family *should* rally around us during a health crisis.     See also: What’s Your ‘Being Sick’ Style?

This post is Part 8 of a 10-part summer series called “What I Wish I Knew Back Then”  – which revisits some of the most common questions asked by freshly-diagnosed heart patients. For example, many of us were as surprised by who DID step up to offer support during those early days as much as we felt disappointed by who DIDN’T.

My readers often express this disappointment like this:

” I was 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 comfort others if the tables were turned.

This is why I now offer both the women in my “Heart-Smart Women” presentation audiences, or here on this blog, or reading my book an important bit of advice:

“Choose your listeners carefully!”

Spouses, siblings, grown children and longtime friends, 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 an accurate assumption at all.

Surprisingly, in fact, those closest to us might be the least appropriate listeners once the acute illness/crisis stage has passed.

Consider that in the early days following any freshly-delivered diagnosis, we’ll often tell and re-tell our story to almost anybody.  It’s how many of us  process and debrief what’s just happened.

That was certainly my experience at first. But if I hadn’t become better at assessing who to lean on, especially around family and close friends, I could have slipped unwittingly into ruminating  (generally defined as repetitive fretting about negative past events).  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) 

She explained that ruminating can often have a chilling effect on the willingness of even our family or closest friends 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 help. Instead, some ruminators report that others tell them to buck up and get on with their lives. After a while, people may become frustrated and start pulling away, which gives ruminators even more to ruminate about: (‘Why are they abandoning me?’)”

One reason others might pull away is that we aren’t selective about choosing who to tell our stories to. Instead, we automatically turn to those who may actually be the least appropriate listeners: our family and closest friends.

This may seem like crazy talk at first, but what so many of those people actually want – and need – is for us to be better again. They want and need to know that our frightening health crisis is being managed.  They want and need to be able to STOP WORRYING about us.

In cardiac psychologist Dr. Wayne Sotile’s excellent book Heart Illness and Intimacy,  he explains this common reality for 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 the heart patient and doctors, and the patient’s conscience about new health care habits, all at the same time. “

He adds communication advice for heart patients, 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 each need.”

It can be helpful to debrief a traumatic medical event and talk about how it has affected us and what it all means. Sometimes, however, no matter how much we try to process it, we won’t figure it out – and yet we can continue to ruminate.  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.”

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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:

1. Is this person a good listener?
2. Is this person supportive?
3. Can this person offer empathy and emotional validation?
4. Is this person likely to shift the talk to be all about them?
5. Is this person loyal? 

So, for example, do not expect that the person who always highjacks any conversation into a long story about themselves will suddenly turn into an empathetic listener just because you’ve had a serious health crisis that you need to talk about.

To even expect that unlikely 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”

When Deborah, one of my longtime readers, learned that she’d need surgery for a thoracic aortic aneurysm, she knew that she had enough time before her hospital admission date to consider who in her family would be most physically and emotionally supportive for her during post-operative recovery. As she explained to me:

“I’d already done lots of ruminating and, while I didn’t like this fact, I knew my husband would likely need to pull back his emotional support at some point, and I didn’t want that when I needed it most. (He did withdraw at one point, but he was back in supportive mode after about a 24-hour ‘rest’).  So to be on the safe side, I asked my sister Catherine and sister-in-law Jan to be here for me. They were – and they were wonderful!”

But what can you do if you don’t happen to have appropriate listeners like Deborah had?

Please do not despair, and try NOT to blame family or friends 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 feeling  depressed;  this can be with a professional therapist, a peer counselor, a pastor, or a trained community help-line volunteer.  Start a daily journal to write about all your feelings – the good, the bad and the ugly. Sign up for a cardiac rehabilitation program if you’re newly diagnosed and haven’t yet registered. (If your cardiologist has still not referred you to rehab, call and request that referral!)  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 every possible form of heart disease. It’s free to join, open 24/7, and you can participate in discussion topics or ask specific questions about what you’re worried about.

As Toni Bernhard, author of the useful book about chronic illness called How to Be Sick, once wrote:

“Remember that people’s abilities to help (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.  But 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.”

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1. Nolen-Hoeksema, Susan. Journal of Personality and Social Psychology, JPSP 2005 (Vol. 77, No. 4, pp 801-814).

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    Q : Who have you decided are the most appropriate people in your life to confide in about a medical crisis, and why?

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NOTE FROM CAROLYN:   I wrote much more about both receiving 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).

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See also:

The new country called Heart Disease

The bumpy road between diagnosis and getting better

Why hearing the diagnosis hurts worse than the heart attack 

How we adapt after a heart attack may depend on what we believe this diagnosis means

Which one’s right? Eight ways that patients and families can view heart disease

Surviving the crisis: the first stage of heart attack recovery

Image: Mohamed Hassan, Pixabay