The Three Vs of Good Friendship

Supporting Your Friend Through Illness and Loss

• A close friend calls to tell you he has just received the results of the biopsy. He has cancer.

• A neighbor asks to meet you for lunch. Over the meal, she shares that her husband has been diagnosed with ALS, a progressive and fatal disease.

• A co-worker informs you that she is leaving her job in order to care for her terminally ill mother.

As you go through life, you and the people you care about will experience illness and other losses.  Challenges brought on by illness or loss affect not only the person who is experiencing it, but also family members, friends, co-workers and all who are touched by his or her life.

As a friend you too will be affected, because it will change the nature of your relationship. You may feel powerless and helpless, wondering how to respond, how to assist.  These conflicting feelings may lead you to avoid your friend, beginning a terrible cycle of guilt or assumptions. "I haven't called or said anything in so long, she'll be upset with me if I do it now."  Whether a friend is ill or caring for someone who is, they may have to give up treasured activities, things you shared or did together.  They may have less energy, time, or even income.  All of these circumstances may spark many feelings for you such as sadness, anger, guilt or anxiety.

Being a good friend during times of crisis can be a challenge.   Stories and guidelines inside this pamphlet can help.

Nina could tell something was wrong. 

Normally her friend Julia would call and launch into a story before Nina finished saying hello. She'd say,  "Jason said the cutest thing" or "Mary Ann Bowie is pregnant." or "My husband is so insensitive."

That morning, all Jules said was  "Are you busy?"

After a few minutes she told Nina about the lump in her breast, the biopsy, and the initial diagnosis of cancer. She and her husband Mark had just returned from a visit to the third oncologist. His opinion proved to be just as devastating and painful as the first two.

"Mark is beyond distraught," Jules said.  "My mother is hysterical.  My brother says I should ignore my mother and that it will be fine.  I wanted to tell you the first time, but we were so hopeful that he was wrong.

"Oh Jules." Nina said softly.  She didn't know what to say.  "I am so sorry." She added.  "I am so sorry." She said again, afraid to say much more.

Venture

You may often feel inadequate because you do not know what to say or even whether it is appropriate for you to say anything. Sometimes, you may honestly want to know how your friend is doing, but then wonder if you should how or if you should ask.  You may feel like if you say something it will bring up or create sad feelings.

When someone is experiencing illness, loss, or caring for another who is, he or she is always aware of it. So, it is best always to venture - to acknowledge and to offer opportunities for conversation. A simple, "I am sorry or how are you doing?" can convey your empathy, and show your interest and concern. After that initial response, follow the person's lead.  Recognize that sometimes, individuals will need to talk about the experience while other times they may wish to avoid addressing caregiving, loss, or illness issues.   They may prefer, at that moment, your normal conversation.

Cynthia sighed.  Today had been a hard day for her husband Sean who was suffering from ALS.  The nurse had called Cynthia at least ten times, and each time Cynthia felt a searing sense of guilt.  Even though she knew she needed the full time job, it still hurt to be away from him during the day.

A quick knock on the door interrupted her thoughts and she looked at the clock.  It was time for Sadie, her boss' secretary's short visit, and Cynthia smiled. She felt guilty for looking forward to Sadie's hilarious monologues about their boss each day.  But now, it really was her only moment of normal conversation.  She was grateful Sadie could provide that brief but needed reprieve.

"Bill, I'm a little confused.  I thought you were going to handle that Longnecker Account?"  Raul said casually to his business partner before the staff meeting.

 Bill exploded.  "No, I handle most of the accounts so I thought my partner would have the courtesy to take on one. I wish you would learn to handle something, I'm sick and tired of having to carry this entire business all on my own!" he shouted.  He stormed down the hall and slammed his door.

Raul was shocked.  He and Bill were old college friends and had maintained a respectful working partnership for over 15 years.  But now, Bill's 9-year-old daughter had cancer.  So when he started canceling their weekly lunch meetings, and became more sullen and removed, Raul understood.  

Raul looked at his embarrassed employees.  He couldn't believe Bill would chastise him in front of them.   He felt anger start to rise into his chest and took a deep breath.  He knew his friend was depressed.  He thought about his own children and how he would feel if any of them were sick.

He walked down the hall towards the office.  He had a feeling that Bill needed to talk.

Validate

When a friend has an illness, that person will struggle with many feelings. She may feel angry, guilty, sad or lonely. He may experience fears and anxieties. "Will I get through the operation?  How tough will it be? What will I have to struggle with down the line?" He may grieve the losses he has already experienced - losses of dreams, health, perhaps even financial stability.

Caregivers too, will struggle with difficult feelings. They may be anxious or fearful. They may feel burdened and resentful. They may feel guilty.  They, too, may experience that sense of loss of hopes, independence and security. They may face painful decisions about how to best care for the person or when they will cease curative treatment.

One of the greatest gifts that you can offer is a safe place for that person to express and discuss fearful feelings. It is not enough just to listen, you need to respect and validate the feelings, fears, and sad thoughts.

Often, it seems easier to try and "fix" these feelings.  Saying things like "You need not be scared," "You shouldn't feel guilty," "Think of the good times." Can be well meaning.  However, these types of statements may only serve to discount the real feelings that your friend has, often isolating that person further.

It is important to respect those fears, to understand that they are real and cannot simply be dismissed.  Rather than saying "You should not feel guilty, angry or afraid," let the person express those fears and feelings. "What makes you frightened" or "I understand you're angry," allows individuals an opportunity to further explore their feelings.  It also provides them with space to decide what they need to do to best handle their reactions.

Give them that space to explore their thoughts and process the decisions they must make. Avoid being judgmental or sharing what you would do, or what you experienced. Share advice when asked, but mostly listen.

            The minister sat down.  Helping members of his congregation cope with tragedy was always extremely difficult.  The Carson's 16-year-old son had been disabled in a car crash last night.

            "I don't care what you say," Mrs. Carson said before he even spoke.  "Don't talk to me about God, I'm really angry at Him right now!"

            The minister sighed.  He only had one answer and he took a deep breath.  "I am very angry with Him too," he said quietly.

Volunteer

One of the most important things that you can do for a friend who is coping with illness or loss is to help in tangible ways. It is not enough to simply say, "Is there anything I can do?" A person living with illness, or caring for someone who is  may be too stressed to consider how you might help or may believe your question to be a caring polite comment rather than a real request.

It is most helpful to volunteer to do specific things. " Can I watch the kids while you go to chemotherapy?"  or  "Why don't I come over and sit with your mother for the night, so you and John can go to a dinner or a movie?"  Tangible acts such as cooking food, helping with chores, assisting in caregiving, can mean so much to friends in crisis.

"My sister was like a small godsend," Lori told her cancer survivor group.  "She arranged for neighbors to do small things like mow the lawn or drop off dinner.  That helped ease our isolation.  But on chemotherapy nights, she'd come over and make a grand Italian dinner for the kids.  She called  it "Auntie Night" and  ended it with a pillow fight  and a story in their room before bedtime.  Now it's a memorable tradition for her and my kids." 

You may find that when you are able to venture, validate and volunteer for a friend in need, you will come to the fourth v - which is value.  By being a friend to someone coping with illness, whether their own or a loved one, you can demonstrate the value of your friendship through your compassion and concerns.

 Nina tossed the rest of her mail on the table and opened the small envelope.  It was a short note from Julia.

"Dear Nina, I just wanted to send you a short note to thank you for your support.  I've learned so much about friendship, and I feel that our relationship is stronger.  I know it's been hard to know what to say or what to do.  But, your presence and kindness is exactly what we need.  I wanted you to know that it's given our family some value to what has been a very difficult time."

Here are some suggestions that may help, taken from the experiences of hospice patients:

BE HONEST WITH ME. I can tell when your feelings or actions are insincere.

LAUGH WITH ME, CRY WITH ME. Allow me to express intense emotions.

DON'T FEEL SORRY FOR ME. Your understanding helps preserve my dignity and pride.

TOUCH ME. I want to be accepted despite the way I may look. Inside, I'm still the same person you always knew.

LET ME TALK ABOUT MY ILLNESS IF I WANT TO. Talking helps me work through my feelings.

LET ME BE SILENT IF I WANT TO. Sometimes I don't have much energy and I just may want your silent companionship. Your presence alone can be comforting.

SPACE YOUR VISITS AND CALLS. Consistent support is very helpful.

OFFER TO BABYSIT The children need a break from my illness, and private times with my spouse are treasured.

SUPPORT MY FAMILY. I may be very sick, but they too are suffering. Let them express their grief.

OFFER TO HELP ME WITH THE SIMPLE CHORES.

  Routine jobs are often difficult to accomplish. 

CONTINUE TO BE MY FRIEND. Don't let my illness overshadow all the good times we've shared together I know this is hard for you too.