What You Should Never Say To Someone Who Is Suffering, And What You Should

Artist Emily McDowell has a series of "empathy cards" to send to people who are suffering. McDowell has an unusual talent for saying what a lot of people experiencing pain are thinking. Among her more popular cards are those that announce:

• I wish I could take away your pain. Or at least take away the people who compare it to the time their hamster died.
• If this is God's plan, then God is a terrible planner.
• When life hands you lemons, I won't tell you the story of a friend who died of lemons.
• One more chemotherapy session down! Let's celebrate with whatever doesn't taste disgusting.
• Please let me be the first person to punch the next person who tells you that everything happens for a reason.

Well-worn platitudes recited by sometimes-friends can be at the least annoying but sometimes downright painful. That's because a pollyanna attitude that everything is OK undermines one of the premiere coping skills of people in pain:

• When people who have chronic, serious illness or who have endured painful personal loss manage to be cheerful, it's usually because they focus on the things in their lives they truly value, not because they minimize their negative experiences.

Sometimes a long experience of pain shapes someone into a person of remarkable resilience, courage, and purpose. It's never just "part of God's plan" that someone finds opportunities to grow even during pain.

Depression Causes Pain, But Pain Also Causes Depression

It's not unusual for people who experience chronic pain to be depressed. That's not because they have negative attitudes or they fail to see the silver lining in their cloud. Depression follows chronic pain as dopamine and serotonin become depleted. Pain's effect on the brain are themselves depressing. Pain can also lead to anxiety, as the sufferer worries about its effect on the ability to carry out everyday functions.

If you really want to help someone with their depression, don't give them a little lecture on keeping a positive attitude, help them with some tangible, daily task. Relieve anxiety by running an errand, walking the dog, doing the dishes, or helping out with the laundry. Be present without need to discuss illness. Your friend won't forget he or she is sick if you spend the time you have with them talking about something else, or maybe doing something fun.

READ How to overcome grief & loss of a loved one?

A Positive Attitude Isn't Fatalism

A lot of what people who aren't sick and haven't experienced loss regard as "positive attitude" is really fatalism. Telling someone that their suffering or loss is part of God's plan isn't positive. It's fatalistic. After all, what can you possibly do if it's the will of the Supreme Being that you suffer? Of course, the real advantage of this kind of advice accrues to the person giving it. If you really believe that another person's suffering is fated, then you they can't do anything about it, and you don't have to, too bad, I'm OK, you're suffering, what's mine is mine and what's yours is yours.

What's A Real Positive Attitude?

Positive people, in my view, are like javelinas. For those of you who didn't grow up in parts of the world infested by these infamous, wild hogs, a little description may be helpful. Javelinas are not the cute and cuddly little piglets that show up in movies like Babe. They are tough. They tend to dig in their hoofs and stake out their territory. They fight off challenges, and they are wonderfully gifted at surviving under all kinds of conditions. None of these characteristics make javelinas especially popular. Where I live, there are even bounties for killing them. However, the javelina is anything but an endangered species. The javelina is a survivor.

If you can't get your mind around the idea of a Texas wild hog as a model for positive attitudes, consider the aardvark. Aardvarks, like many cancer patients, are nearly hairless. They have an especially keen sense of smell, which they mainly use to feed on termites, grasshoppers, and ants. When they are threatened, even if they are flat on their backs, they fight back on all-fours, hitting their enemy with all they've got.

In javelinas, aardvarks, and cancer patients, efficacy is what keeps up spirits. Efficacy is knowing that what you do makes a difference. Efficacy isn't all about knowing how to do something. It's also about using that knowledge to achieve desired results so you can look back on your efforts and see how they benefited your life. Fatalism, on the other hand, is a passive approach. Seeking God's plan can take the place of pursuing your own. Taking each day into your own hands can build up your self-esteem and help you deal with loss and disability.

How can kind friends and family members assist the suffering in increasing efficacy?

• Be there. Answer the phone. Respond to the text message. Reply to the email. Visit. Keep your friend or family member in the loop. Friends who are present during good times and bad relieve anxiety and help others find their own paths to success.
• Give and accept sincere compliments. Pointing out what's good about someone despite their situation, and accepting validation as a token of respect, helps both you and the person you are trying to help.
• Be patient with "moods." People who are chronically ill or chronically in pain tend to "fly off the handle" now and then. If your friend or family member expresses anger or irritation, but their anger isn't directed at you, don't make it a major issue if it only occurs occasionally.
• Allow for strength in numbers. Help your friend in need connect with others. It's easier to become distracted from pain or loss the more people one is around. Invite you friend to "normal" gatherings, such as meals, parties, and meetings.
• Allow for relaxation. Someone who is sick may not move as quickly as you do. Don't make them race you to a vehicle, for example, if you are giving them a ride. Allow them to speak at their own pace or eat at their own pace, within reasonable limits.

READ Going Through Grief

It's always possible that you will have to negotiate "boundary issues." The best way to handle this is to go slow. Be supportive, but not obsessive, and be present, but don't "move in." Being a great friend takes practice.