Thursday, January 7, 2010

A Guide on how to Support someone with Cancer

Sort of repeatedly over the past few weeks the topic has come up time and again about how my friends and family support me. Its never been straight out asked, but usually plays in to whatever I'm writing about, and its caused me to take a serious look at how I interact with my friends and family on the cancer issue, and even more revealing, how I handle when friends or family tells me they have cancer. I've also been trying very hard to start seeing things from other people's perspectives, like my mom, who tends to see all the people in her life getting sick as being something that is done to her.

I've always been very careful about how I tell my friends about what's going on. Its awkward. "Hey, so it looks like I have cancer."... "Uh, so it looks like the cancer is back"... "Another round of surgery and radiation, wooo!"... "So yeah, by the way, remember that cancer thing... turns out I"m probably gonna have it for the rest of my life." or god forbid I try to talk about how I'm feeling... "So, I sort of hate my life right now."... Cancer rather sucks"... "I feel like total shit"... I mean how do you react to that? ... "Uh, I'm sorry, don't worry, I'm sure it will be ok and work itself out in the end."

Whallah, there, you've been a caring and supportive friend; there in someone's time of need.... yeah right. Congratulations, you just deferred to the most classic packaged responses known to man. I don't care how genuine you are when you say it, the fact is you are probably talking to someone who has heard it 50 million times, rather than purely upset, they are probably angry, tried, frustrated, and want to yell at the world. Those words, actually make me feel worse. As far as I'm concerned they indicate just how absolutely alone in this I am. You clearly don't get what I'm going through, and there's no indication there you want to learn about it. You're probably even thinking in the back of your mind about how melodramatic I am making huge deals out of nothing... whether that's true or not... I don't know... but its what I think.

And whats worse is that you've made yourself feel better. The fact is friends and family being sick sort of reminds us of just how mortal we are, and how unpredictable life can be. A little self reassurance that everything will be ok seems like its more of our own defense mechanism to keep out the "what if" thoughts. And its what you think the other person wants to hear.

I am guilty of all of these things. Even as a cancer patient myself, I find over and again falling into the same pattern of support. But not so much recently. I've started not giving reassurance as much as seeing where I can help, offering up websites, and an ear if someone needs it.

So after some thought, here it is... my guide and suggestions to supporting someone w/ cancer:

1a. LISTEN!!
This is easily the number one thing people don't do. But if you know your friend well, sometimes just listening to not just what they are saying, but how they are saying it can tell you what your supportive response should be. Am I telling you bad news because I need to let everyone know, or are you one of the first few people I'm turning to because I need you to know now? Am I venting, or am I genuinely trying to figure out how to fix my life. Am I upset, but could be cheered up, or am I really depressed?

If you have any developed social skills, reading through those you can probably see the differences in the emotion behind them. And at the same time you can probably see how many people would just shovel out the generic "It'll be ok" for every single time.

1b. Acknowledge to yourself that you have no idea what they are going through
Like I said, you basically get discredited when you say " It will all be alright" as someone who clearly doesn't have a clue about whats going on.

2. "Man, that sucks"
As weird as it sounds... this is a fantastic initial response. Its acknowledgment of what someone is going through. It's not "OMG I'm so sorry!" which leads to ...

3. Don't tell me your sorry
I don't want pity. That's actually one of my biggest issues. I don't want my friend feeling sorry for me. Unless of course you caused my cancer... then be damn sure I want you to be sorry. And if your aren't, be damn sure you will be once I'm done with you.

4a. Don't give me unsolicited advice
This is uber tied in with listening to what I'm telling you. No seriously, it is. Sometimes I'm asking you what to do. I'm not always asking you what to do. Sometimes I just need to vent. Before you go on to tell me what you would do, what you think I should do, what your Uncle Patty did, etc, try asking me what I plan to do, or what I'm doing. If I'm not directly asking you for your opinion, but you have some insight, say something like, "My Uncle Patty had x cancer, so I can recommend some things he did." or "when I had x cancer, this is what I did." I'm more receptive to advice when it comes in the form of your experience. It gains a little bit more credibility, and feels a lot less like you are telling me what to do. You have to remember that I'm being told by doctor every day what to do. I've done hours of research into my disease, read countless blogs on how to live my life outside of cancer.

4.b Don't talk to me about God
*a slight caveat here, if your cancer friend is religious, then this isn't a bad idea.
But if they aren't, or they don't talk about faith first, you probably want to steer clear. Look at the end of number 3. Its human nature for us to blame things when life isn't going so hot. These things include God. If you ask me, like my dentist did, how being sick has affected my relationship with God, don't be surprised when I give you a blunt answer. Talking to me about God's plan, or maybe how I should find faith to help me through isn't the best advice. Faith is harder when you've been told the "C" word... instead try:

5. Talk to me about what practical things can be done
Ask me about the science. This goes after the listening stage. Telling me everything will be ok bad, but sitting me down and making me figure out what can be done can be good. Make me look at the science, let me tell you the plan of action. And if I dont' have one, work it out with me... unless I'm in "nothing's going to work, everything is bull shit," mode... then I probably just need to sit and yell for a bit.

6. I need to talk to someone who is not my best friend
This doesn't always make sense to people. Honestly, it doesn't always make sense to me. But it goes with not wanting to make someone close to you hurt or worry about you because you are so close... I think. But sometimes I just need to talk to someone that is a little more detached. Maybe someone who I was close with then fell out of touch with pre-cancer. Someone who can talk to me about something else, and remember who i was before. Who hasn't sat and watched me change. Who won't be emotional if I need to lay bad news down.

7. Don't be surprised or hurt if I push you away
This is sort of a foil to number 6. If your in my closest group when I get sick, you just have to bare with me. We have expectations of our supporters... they are rarely met, hence this set of guidelines. We don't want you to feel hurt. We also change. Sometimes having our friends that remind us of who we were just before getting sick is a little harder to deal with.

8. Be careful how you offer help
This is probably the second most important thing on here. No matter what you should offer help. I'm always surprised by how many of my friends don't do this. Which then just tends to build up the concept that me being sick is an inconvenience to them and their lives, resulting in me feeling alone and sort of shutting people out. Less close friends are fine just saying, "Let me know if you need anything." But again, this is a really just generic phrase. You're saying it because you should, not because you really want to help.

Take a more active approach. "What needs to be done?" or "What can I do to help?" If you just leave it up to me to contact you... that isn't really helping, and chances are I will feel far more like a burden. Planned, strategic help. That's what we as cancer patients need. Or just tell me what you are going to do. "Do you need someone to go with you to the doctor?" "Well, no... I mean, it would be nice, but you don't have to if your busy." Vs. "Ok when's your next doctor's appointment, I'll go with you." Do you see the difference?

9. We don't like to ask for help
Its a humbling experience when we ask for help. Its the sign that we have reached our limitations. We don't want to inconvenience you. You should recognize that. If I've actually asked you for help, its because I genuinely need you. Nothing is worse then asking for help, and the person at the other end not realizing its important that they be there. And if you genuinely can't you phone tree, and you find someone who can.

10. Random acts of Friendship
We don't want your advice or your pity. We don't want to solicit you for your help or friendship. We are tired, and sometimes things like interpersonal relationships are what suffer. We need you to pick up some of the slack. Don't always wait for an update, pick-up a phone and call me. Send me a card to know you're thinking of me. Just do something nice for me. Always remember that the hardest impact of cancer isn't the disease or threat of death, its the emotional impact. We feel alone. I feel alone. Whether it is rational or not, I need you to show me that I'm not entirely alone.

And that's about the general gist of what you should and shouldn't be doing with someone who has cancer, and what you should expect. As a final note, remember that we cancer patients tend to be very emotional, whether we show it or not. And I can't emphasize enough how much we feel like we're alone in how we feel and what we are going through. Even with other cancer fighters, each battle is different, each battle is personalized; no one actually has the same experience. But we all need the love and support from our friends and family.


Joanna Isbill said...

Love the post! I was actually working on a similar post a few days ago! Question about 4b: how do you feel when someone sincerely tells you they are praying for you?

robs said...

Hey Joanna...
That's usually one of the times I just say thank you. At the same time I do feel a bit guilty about it. My one grandma always sends me prayer cards, and has had me added to prayer lists at a number of different churches. It's not her pushing faith on me nor does she try to talk to me about my relationship with God, she just does what she can, and she's old and sick herself, so I'm always touched. But at the same time I always question if it wasted on me. If there's someone out there that needs the prayers more who has better faith, or if there were someone else more deserving of that kind of help. I think I've mentioned before that I have a weird relationship w/ religion.