Why patients resist asking others for help

by Carolyn Thomas   ❤️   Heart Sisters (on Blue Sky)

Asking for – and accepting – help from other people can be a challenge for those of us who generally see ourselves as the helper, not the helpee.  I come from a long line of Ukrainian women who are born helpers. My late mother’s reflexive response to neighbourhood news of a new baby or a broken leg, for example, was to turn on the oven and start baking for the occasion.   . 

But because “I’m fine!” seems to be my genetic default response to almost any inquiry about my own health, I’ve turned down countless offers of help over the years from others who truly seemed willing to help.

I could be the poster child for feeling fiercely reluctant to ask for that help (notably while recuperating from a widow-maker heart attack in 2008, and more recently after finding a breast lump while showering  – which turned out to be a malignant tumor).  Ironically, I have often been surprised since launching Heart Sisters  in 2009 by how many breast cancer patients follow this site, or buy my book, or leave comments in response to my articles here – even though I rarely if ever write about breast cancer.

What I have written about at length since Day One, however, is the profoundly surreal and predictable experience of becoming a patient – no matter our diagnosis.

Most patients report that they can recall, in exquisite detail, the exact words a doctor used to deliver their diagnosis – even decades later. See also:  The 5 stages of “What the hell just happened to me?”

Stanford University researcher Xuan Zhao studies the known reluctance to ask for help, as she described in a recent interview:

“When people are in need of help, they may not fully recognize the motivations of those around them who are ready to help. This can introduce a persistent difference between how help-seekers and potential helpers consider the same helping event.

“Our research team consistently observed that help-seekers underestimated how willing strangers – and even friends – would be to help them, and how positive the helpers would feel afterward. They also overestimated how inconvenienced helpers would feel.”

Our society, she added, tends to value independence, so asking others to go out of their way to do something for us may seem wrong or selfish – even when it’s a perfectly reasonable request and when helpers are in fact very willing to help.

Last week, for example, I knew I’d need a ride to my first appointment with my cardio-oncologist (that’s an emerging medical specialty, by the way, focused on minimizing both the acute and chronic cardiac side effects of powerful cancer treatments). See also:  When cancer treatments damage your heart

As this appointment loomed closer, I studied my list of people who had told me: “Just let me know if there’s anything I can do to help!”  And exactly as Dr. Xuan Zhao’s research confirmed, I began to second-guess the likely  response of each potential helper (e.g. “Hmmm…can’t ask Jenni – she’s always so busy!”)

But because I really needed that ride, I did ask my friend Jenni (I think my rambling request included lots of explanatory disclaimers like “only if you’re available, of course….”

Her immediate response: “Yes! I can do that for sure! ”

Dr. Xuan Zhao explains a perspective that turns out to be common among our potential helpers:

“The truth is, most of us are deeply pro-social and want to make a positive difference in others’ lives. Empathizing with and helping others in need seems to be an intuitive response, and dozens of studies, including my own, have found that people often feel happier after conducting acts of kindness.

“Earlier Stanford research also suggests that people tend to overestimate how likely their direct request for help would be rejected by others.”

 Remember too that the people closest to you might even feel annoyed if you don’t reach out for help.

Dr. Gregg Levoy tells a compelling story about that reaction in his Psychology Today column. While he was housebound with torn ligaments suffered after a freak accident, a friend of his dropped in unannounced one day – and became upset when  he learned more about that accident. Dr. Levoy explains:

“When I told him what had happened, he was genuinely angry with me, for being too stubborn to call him or anyone for help. I hadn’t told anyone of my accident, hadn’t called anyone to come cook me a meal or do a load of laundry or go food-shopping for me.'”

“What the hell are friends for?’ he scolded as he began picking up pizza boxes and dirty clothes. ‘What were you thinking?’ “

Dr. Levoy suggests that you tell others directly what would help you:  “If you just tell people that you ‘need help’, they’re likely to try to diagnose what sort of help you seem to need.”

I knew I’d need a very specific kind of help when I started chemotherapy on June 2nd and learned that, in our Cancer Agency, patients are prescribed pre-loaded syringes of certain meds to inject ourselves at home for seven evenings in a row following each round of chemotherapy.  Yes, INJECT OURSELVES!  Because I have an enthusiastic vaso-vagal syncope response (I faint at the sight of blood, or even the bony crunch sound of Hilary Swank getting her nose broken in the movie Million Dollar Baby) – seriously! –  I knew I’d need somebody to help me with these self-injections.

And when I say “help with” – I mean “give me the shot!”

Most of my family members had to put their heads between their knees and fan their faces to recuperate from simply being asked to do these injections.

So I took a big deep breath and crossed the street one day to have a chat with my longtime neighbour Sue, whom I’ve known since the 1970s.  And best of all, Sue is a retired nurse.  She said YES right away when I asked if she could do my injections. I could hardly believe she was so casually agreeable about what to me was such a huge favour. When my grown children offered to pay Sue for her time, her answer was a firm “ABSOLUTELY NOT!”  I’m just being neighbourly!”   And when she had previous plans for one of those 7 p.m. injections, it became a team effort when my lovely daughter-in-law Paula (also experienced with sub-cutaneous injections herself) stepped in with a big smile. Seven successful injections – and no fainting.

Sometimes what patients really want or need the most isn’t so much help with practical tasks like meals or laundry or grocery shopping (or seven days of injections) – but help with emotional support.

My longtime reader Deborah shared her own example of needing to ask directly for this kind of support in her response to an article here called “Choose Your Listeners Carefully“:

“When I was diagnosed with my thoracic aortic aneurysm, I had enough time before surgery to consider who, in my family, would be most physically and emotionally supportive during my post-operative recovery.

“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 a sister and sister-in-law to be here for me. They were, and they were wonderful.”

Speaking of asking directly, another neighbour Pam brought over a bowl of her insanely delicious homemade lemon mousse one evening last week. Because everything I eat these days tastes either bland or metallic due to chemotherapy, my poor little taste buds were blown away by every  lemony spoonful. It was quite simply the best food I’d ever eaten.

And later, when I was returning her empty bowl, she said: “Just let me know if there’s anything else I can do.” 

So I pointed to the empty bowl and asked:

“More of this after my next Chemo Week, please!?”

♥

Image:  PositivelyPresent

Q:  Do you tend to resist asking others for help?

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NOTE FROM CAROLYN:  I wrote much more becoming a patient (and about accepting help!) in my book, “A Woman’s Guide to Living with Heart Disease”  (Johns Hopkins University Press). You can ask for it at your local library or bookshop. Please support your favourite independent neighbourhood booksellers, 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).