It happens to all of us. As you go through life, your friends may struggle with serious illness or the loss or potential loss of a family member. You want to be a good friend, but what do you say? What do you do? This can be a confusing time because while you want to be helpful, you are also cautious to avoid making things worse or uncomfortable in some way. The Center to Advance Palliative Care reports that 70 percent of people will care for a seriously sick friend or relative at some point in their lives.
What all of these situations have in common is facing loss. It may be a loss associated with a death that has occurred or the threat of death from a serious illness. Even having a non-terminal illness that is in some way incapacitating is a form of loss whether temporary or longterm. With serious illness, life changes and a friend’s ability to function is somewhat limited. This, too, is a form of loss. All loss results in some change from the way things used to be.
Losses require some form of grieving, which is the process of confronting the change and accepting it. The changes that come from loss in death or from loss during an illness that is longterm, incapacitating, or life threatening result in losing some ability to do things you once were able to do. Grieving helps to integrate the loss (the change) into your mental framework for living. It helps to change routines and to make adjustments. Grieving helps you find new ways to live.
While you want to help, knowing how is not always easy. Likely, you have seen or experienced people who say or do things that are not helpful in these situations. At the other extreme is the tendency to be too quiet or absent in fear of saying or doing the wrong thing. Fortunately, research into grief and loss has provided some guidelines of how to support your friends when they are grieving.
You can best help a friend if you first understand the grief process yourself. Consider reading and research to better understand what they are experiencing. Some aspects of grieving include the following:
There are no right or wrong ways to grieve. While there are “typical stages” of grief, everyone’s experience with grief is different. For example, in a long-lasting terminal illness, the person has likely already been undergoing some aspects of grieving before the death. In sudden loss, there is more shock associated with the loss, which often disconnects a grieving person from reality for days.
Grief is not linear; it comes in waves. A grieving person experiences intense emotions and then seems to feel some relief. Hours, days, and even weeks later something might trigger another round of intense emotions, remembering, sadness, and pain.
Grief takes a long time. For non-traumatic losses, grief can linger for two years or more. For traumatic losses, the time frame might be closer to five years. While the intensity of the grief emotions fade over time, the triggers that serve as reminders of the loss are everywhere. The person must adjust to living life without their loved one.
Grief can involve intense emotions and behaviors. These emotions include sadness, anger, fear, guilt, worry, and loneliness. If the person grieving is not a danger to themselves or to others, they should be allowed to express their grief emotions however they need. The most intense emotions and behaviors occur early in the process of grief and tend to subside in the following weeks and months.
Grief is necessary. Grief is the process of detaching from what you have lost in order to attach to other things in life that give meaning and purpose. Detaching from what was lost does not mean forgetting about it. Rather, detaching is being able to remember and to invest life in other people or activities. Getting to the place of living life fully again after loss actually honors what was lost.
What not to say
It is normal and a sign of caring to want to say something to a grieving person, but pause and think carefully before speaking. If a person is dealing with an illness or health crisis, do not to ask a lot of questions about it. Here are a few examples of what not to say:
Pull yourself together. You must be strong now or be strong for the children. Urging someone to be strong when grieving will likely push those grief emotions down under the surface. The person will think they have to take care of those around them and neglect their own grief process. Often, the pain re-emerges when alone, after the support is gone, when accessing help is more difficult.
Your loved one lived a good life. While that might seem comforting and affirming, the person grieving is most focused on the loss. What they want most is more time with the one lost. They miss the person who is gone and need to have that affirmed. There will be time later to celebrate the life the person lived.
Everything happens for a reason. Avoid this cliche. It is an attempt to relieve suffering or to make it better; however, the grieving person does not need for you to relieve his or her suffering. Instead, just be present in it. While statements like this may fit either the grieving person’s or your own belief system, they tend to distract from the emotional processing that is necessary and undermine the person’s pain.
I know exactly how you feel. No two losses are the same. While similarities may exist, you do not know how the other feels. Only they know how they feel. It is okay to tell someone you have been through a similar loss and are willing to talk. Those words will build connection. Ask the other person to tell you how they feel and focus more on hearing their story than sharing yours.
At least he didn’t suffer (or some similar statement). This is another statement that attempts to ease the pain or soften the blow by getting the person to see that it could have been worse. This will not be a comfort to the person grieving. Loss is not eased by the realization that more tragic losses exist than the one experienced.
Let me know if you need anything or would like to talk. A person who is grieving is often consumed by the pain and is likely not aware of their needs. Additionally, often those grieving want to be strong and may be ashamed to seem needy or inconvenience anyone. This is one of those times when it is helpful to anticipate a need and ask how it can be met or offer a way to meet it.
How are you? Whether the person is dealing with a death or an illness, if you bump into them unexpectedly, asking how they are doing can feel like an empty question to which they feel they need to give some form of the accepted “fine” answer when the truth may be a painful contrast.
What to do or say
You care about your friend and want to show it, but knowing what to do can be difficult. People experiencing loss need others to show up and be present. They need others to listen. They need others to give them practical help. Remember that the person grieving is overwhelmed, confused, consumed, and distracted. Here are some ways to serve:
Show up. Be present, listen, and help. The early days of the loss will require more assistance to get through the initial crisis.
Stay for the longterm. Whether the loss is death or longterm illness, people need contact and help from caring friends for an extended period of time. It will look different in each situation, but staying connected is important. It may take the form of regular phone contact for many months. It might include helping or taking on a practical task. The biggest mistake that “helpers” make is disengaging after the funeral. Afterward may be the time when help is imperative.
Be willing to listen. A grieving person works through the loss by talking about it. They need to tell stories and to express feelings of sadness, anger, fear, guilt, and gratitude. Those grieving want to remember and want others to remember. You may hear the same point multiple times, but know that listening is important. Friends often feel uncomfortable bringing up the loved one, but usually people want to hear fun stories and share memories of them.
Acknowledge what happened. Be willing to use accurate and realistic terms for the loss, talk about specifics, and address awkward and difficult topics.
Ask to help with specific tasks. “Can I pick up your kids from school? Can I bring you some meals? Can I mow your yard?” These are examples of specific tasks with which the person may need help. Remember that merely asking if you can help may not be enough because the grieving person is not really thinking about all that needs to be done. Let the person know what is easy for you and fits in your schedule so that they feel they can accept, such as saying, “I am going to the grocery store this afternoon; what do you need? I am running errands tomorrow afternoon downtown; do you have any I can take care of?”
Pay attention to warning signs. While the grief process can look like an episode of depression, pay attention to certain signs, especially if they linger past a few weeks. These include:
Extended sleeplessness or loss of appetite.
Verbalizing thoughts of suicide.
Isolation and an inability to begin taking on more of life’s tasks.
Neglecting personal hygiene.
Excessive drug or alcohol usage.
Excessive bitterness, anger, guilt, or hopelessness.
One of the most difficult aspects of helping a grieving friend is the personal cost to you, the helper. It is probably the most common reason that some people do not show up to help. Several personal costs can occur when helping a grieving friend:
Time. To walk through grieving a loss with a friend will require a time commitment. Talking with regularity and being willing to listen take time. Helping with practical tasks also requires a time commitment.
Emotional pain. When truly present with a grieving friend, you will connect and feel some of their pain through a process called empathy, which is to feel and understand the other’s thoughts and feelings from their perspective. At the same time, connecting with their pain is comforting and healing. It is truly a gift you can give to those you care about.
Your sense of safety and a predictable world. When your friends encounter tragedies and losses, you are reminded that you, too, are vulnerable. People like to live in a world in which they feel secure. Walking through grief with a friend reminds you that bad things can happen and can cause you to struggle with fear and worry.
Having close friends with whom you walk through life is one of the aspects that makes life worth living. Being there in dark times of loss and grieving deepens those relationships. With just a little forethought, you can truly be a comfort to those about whom you care.
Dr. Thomas Barbian is the executive director for the Christian Counseling Center of First Presbyterian Church in Columbia. He received his doctorate in clinical psychology from the Cambridge Graduate School of Psychology and Counseling in Los Angeles. He also holds a master’s degree in marriage, family and child counseling and a bachelor’s degree in Biblical studies.