How to Be Heard When It Feels Like No One Wants to Hear About Your Pain


Living with chronic pain and illness can be traumatic. There is a tremendous sense of loss that compounds with each new experience: loss of resources from time, money, energy, loss of freedom and mobility, to loss of dreams and identity.

When your body is ravaged by pain, illness, or disease, you don’t have the luxury of dreaming and planning for the future, as sometimes it takes all you have just to get from one moment to the next.

What underlies trauma is being forced to perpetually exist in one of two states: survival mode or recovery mode. For the one who suffers, there’s nothing more longed for than a helping hand and yet, at times, no phrase more feared than, “How are you?”

The iconic image in which only the tip of the iceberg is visible is a gentle reminder of how much might be going on below any surface.

When asked, “How are you?” most people just say, “Fine, thanks. How are you?”

Chronic pain and illness is so multilayered, and yet largely invisible, that one can never share the full extent of their experience at any given time. However, patients of chronic pain so desperately need to share, to be heard, to know that they are not alone in a dismal abyss with no hope of escaping. Someone who lives with chronic pain is rarely fine, and yet “fine” is all they likely ever feel safe to express.

How do you give a simple answer to a complex question?

Bessel Van Der Kolkata, M.D. makes a powerful point in his book, “The Body Keeps Score,” when he writes, “Talking about painful events doesn’t necessarily establish community — often quite the contrary. Families and organizations may reject members who air the dirty laundry; friends and family can lose patience with people who get stuck in their grief or hurt. This is one reason why trauma victims often withdraw and why their stories become rote narratives, edited into a form least likely to provoke rejection. It’s an enormous challenge to find safe places to express the pain of trauma.”

Compassion fatigue is very real in our society, especially with the heightened drama of the fast-paced news cycle. Everyone is seems is overwhelmed and stressed out. As Paul Fussell wrote, “No one is very interested in the bad news they have to report.”

Adding to this is the cultural and medical stigma that if you talk too much about your pain, you must be doing so just to get attention, or that you are neurotic or that your illness is your only identity and therefore all you can talk about. But as Karen Duffy, author of the books “Model Patient and Living with Chronic Pain Without Turning into One” so eloquently coined, “Concealing an illness is like keeping a beach ball under water.”

We cannot hide our pain, nor should we feel we must. Nor however, can we indulge in it. Asking a person who lives with chronic pain, “How are you?” is like asking a person who is dehydrated if they would like a glass of water. It’s hard to take just a sip when you know you could drink the entire pitcher. We have to find a way to balance the telling of our story so that we feel we are being honest and heard without overwhelming ourselves or others with the totality of it all. We do that by having a secure support system in place that allows us to stay hydrated so that we aren’t in a perpetual state of thirst when tempted to drink from the well of expression. Enter, the Listening Partner.

Listening Partner (LP). I first heard about listening partnerships through Hand in Hand Parenting created by Patty Wipfler. My understanding is that it is a system set up for mothers to have a safe place to vent about the challenges of parenting. It’s a brilliant concept that can used for just about anyone, including patients who need to be able to discuss their chronic pain.

The guidelines are simple. Find a listening partner you feel safe with*. You can take turns with this person or hire a therapist and ask them to take on this role. Agree on a set amount of time. Example: 10 minutes daily or a set weekly appointment of one hour.

Guidelines for the listener:

1. Set a timer for the agreed amount of time and listen with empathy. You are not listening to respond; you are just listening to hear. The role of the listener is not to fix or solve the problem but just to listen. There can be tremendous healing in simply having a witness to our pain. It can help exponentially in feeling less alone.

2. Do not give any advice or share your own experiences on the subject matter. Believe in the inner wisdom of the person sharing with you. Trust that in allowing them a space to be heard, they will process their pain and come to solutions on their own. The help you are giving them is simply giving them your time and a place to be heard.

3. Restrain all judgment. It’s not your job, nor will it serve to judge who they are, what they are telling you, or what they are going through. Allow them to be who they are and to feel safe sharing that with you.

4. Keep whatever is shared confidential. Do not bring up anything shared with your listening partner to anyone else and do not bring it up with your listening partner outside of the listening time.

5. When the timer goes off, take a deep breath. In my opinion, it’s best if the listener just says something simple like, “Thank you for sharing with me.” If the listener says something encouraging to help one feel better like, “You are doing great,” it can sometimes open up the need to share again. It’s better to have a closing statement when the times goes off and just move on. Some people end by asking a non-sequitur question as a way of cleansing the emotional pallet or shifting gears.

Without a listening partner, when someone with chronic pain answers the question truthfully, “How are you?” and opens the floodgates, a tsunami of emotion threatens to push away the person who asked, even when a caring friend or family member says, “Don’t worry, I can handle it. I’m here for you. I want to support you.” The truth is that the desire may be genuine, but their ability may not be. Even superheroes can’t prevent a tsunami from flooding the town it surrounds. It’s hard to hear about the pain and struggle of any human being, but especially someone we love and care for. Hearing about hardship over and over again can leave the listener feeling hopeless.

A vicious cycle ensues: The person who is suffering shares openly about their struggles. Those who listen become overwhelmed by what they are hearing. They feel helpless and as a result often try to make the situation better by offering what they feel is helpful advice (“Have you tried this? You just need to do that,” etc.). Nothing dramatically changes in the patient’s suffering. To the listener, it doesn’t appear that the advice was taken (in reality the patient has probably taken that advice before). The listener starts to feel drained by the situation and annoyed by the patient when they feel powerless to end the suffering. The patient feels judged and rejected by the listener. Resentment builds between patient and listener. The patient retreats and isolates. The listener may push or pressure a bit more but eventually may avoid and discard the patient as a whole.

The patient comes to believe that if they answer honestly, they face rejection; and if they answer falsely, they continue to suffer in silence.

When a person with chronic pain has a listening partner, they have a safe place to offload how they really are, or how they mostly are, so that when asked by others how they are, they can focus on how they are in an area of life that might be more fulfilling to discuss.

If a patient felt heard when discussing their pain, it might provide more space for them to explore discussing that which brings them joy. When patients have the time and space to process the pain below the surface, they can feel safe in rising to the surface where “fine” actually lives.

“Fine” only means excellence when used as an adjective. As an adverb, the definition of “fine” is actually just “satisfactory.” When a patient’s feelings about their chronic pain and illness are heard and witnessed and responded to with empathy on a regular basis, the patient can effectively manage their vulnerabilities, and can in fact, embrace being fine.

When no one wants to hear about your pain, find one safe person who can and will listen regularly. For when that which we most have a need to express is finally heard, we are given the freedom to talk about literally anything else and to give and receive a gift from the confines of chronic pain.

* When seeking a qualified listening partner, make sure that their self-worth is not tied too heavily in being the rescuer, the peace maker, or the problem solver as this can add insult to injury. Some people from dysfunctional homes or who suffer themselves, may be the first to line up to endure your suffering because they have empathy and resonate with your pain. Unfortunately, there are people who use the pain of others as a way to self-soothe their own discomforts or fuel their self-worth tanks. This kind of availability to be present to the pain of others can seem saintly but lead to codependent enablers and enmeshed relationships. It’s best to find an LP with strong boundaries or to begin with a therapist in the role of an LP.

Getty photo by MangoStar_Studio


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