When someone we love is suffering

The problem with loving someone—there are many but let’s start with this one—is that sometimes the person you love will suffer. They will have pain or disease or grief or distress and you will not be able to magically take it away from them. Watching someone you love suffer, physically or emotionally, is awful. And yet, it’s part of the whole deal.

Once, after my mom died, I told a colleague, “I just don’t want my brother and my dad to be sad.” I ended up laughing instead of crying because of the way my sweet colleague stared at me and said, “Elizabeth.” It was, in fact, a bonkers thing to say. It was also true. My own grief was hard enough to bear; I couldn’t stand that the people I love were also suffering.

This is a common theme for my clients, whether they are caretakers or bereaved. Their own grief is awful, all-consuming, exhausting; and yet, they cannot bear to think that other people in their life are also having a hard time. Ignoring the grief and pain of others is doable but doesn’t feel great and also can be hurtful to said loved ones. On the other hand, taking on the pain of others also feels awful and doesn’t take anyone’s pain away. So what to do?

The answer, of course, depends: on what kind of day you’re having; on how the relationship usually functions; and on the cues you’re getting from the other person or people. But in general, as I’ve written ad nauseum, our grief is much easier to bear if it’s shared. You are not protecting your loved ones if you deny your grief or theirs. On the contrary, talking about it opens the door gives them permission to grieve with you instead of protecting you.

We don’t want the people we love to suffer but they will; that’s a part of life. And if that’s true, we may as well suffer together.

Meeting Resistance

I met with a lot of resistance when I worked in hospice. I had plenty of patients who didn’t want to sign a Do Not Resuscitate form, for instance, or who didn’t want to take the medication that would keep them comfortable. Sometimes it was frustrating but for the most part, I accepted that resistance as part of the job. After all, people were literally dying. Who was I to tell them how to live out the rest of their lives? I remember once, at a consent signing, the son of a patient told me that his father “wasn’t handling his death well” and I thought… Well, he doesn’t need to; it’s HIS death. I wasn’t particularly troubled by those moments in that job because the big picture was so very big. Death has a way of throwing things into a very clear perspective.

But now I’m not a hospice social worker anymore. Now my job (a lot of the time) is to help people make changes to their behavior so that they have less stress, less depression, less anxiety, and better health. I feel pressure from the doctor who makes the referral and pressure from the patient who says, this is bad, fix it. And in these sessions, when I meet resistance, I struggle.

I’ve been trying to use motivational interviewing because a lot of what I’m meant to do is help people focus on behavior change. When using motivational interviewing with a patient, the clinician is supposed to keep in mind the stages of change. The first stage is pre-contemplation. Basically, these patients aren’t ready to make any changes. Even if they know they should quit smoking/lose weight/take their medication/you name it: they aren’t there. Sometimes the goal with these patients is just to help them identify what the consequences will be if they don’t take any action. Sometimes they don’t come back. It’s one of the basics of social work, right? MEET THE CLIENT WHERE THEY ARE.

But sometimes I really resist that!

This has been bugging me because I recently met with a patient who shot down everything I said. Every. Single. Thing.  I tried to join him with empathy. I reflected back to him what he was saying to me: job too stressful, health too difficult to manage, lack of social support. I tried to listen for change talk; when he said that he knew he couldn’t continue the way he was going, I seized on that like a drowning man grabs a life preserver. But he wasn’t having it. The session can be boiled down to me saying, “So what about…” and him saying, “nope, won’t work.”

In the end, we were both frustrated. He had started the session telling me that he didn’t think I could help him and honestly, my delicate ego had been marching around my mind the entire time, telling me I COULD help him and I WOULD! But at the end of it, we hadn’t moved much. He was resistant to me and I was resistant to him and we were both stuck.

This is one of those things that keeps coming up for me, however many years into my social work career: dealing with the impulse that screams PLEASE LET ME HELP YOU. It’s disappointing to me when the patient doesn’t want to do anything to change their circumstances. But why is that? Why do I want it more than the patient? Why do I measure my competence as a clinician through how a patient responds in one half hour session? If I’m being generous to myself, I can say it’s because I became a social worker to help people; I want people to leave the session with a plan to feel better. Less generously (but no less true), I let my delicate ego make me think I can save everyone, even people who didn’t ask for it. I’m resistant to their resistance and that’s just not going to work.

So I’m taking a deep breath and stepping back for a second. Pre-contemplation just is; same with resistance. I don’t have to move anyone forward. I don’t have to have any goal except for the goal the patient has given me. I can let my expectations go and get back to hearing what the patient in front of me is saying. And sometimes it may be, “I’m not ready.” And my response has to be, Ok. Tell me more about that.