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Chronic IllnessGeneral WellnessThe Undefeated

Guide to Difficult Conversations

by Ariela Paulsen January 29, 2020May 21, 2020
written by Ariela Paulsen
Guide to Difficult Conversations

Chronic illness often brings up a need for difficult conversations with loved ones.  When needs are raw and what you both want may not be possible, pain can wedge its way into relationships.  I have learned, through the necessity of illness, however, how to handle these conversations. In fact, I truly believe that I am a better communicator, and that my relationships are stronger and more intimate, because of being a spoonie.

If you feel nervous or tense going into these conversations, check out our tips on how to broach challenging topics with love and respect!  We chatted as a team about positive conversations we’ve had, and this is what we came up with:

1. Come prepared to the conversation

One of the things that has really helped me in the past is to know what I want to say going into a conversation. I’ll often write notes that I bring with me that can help to keep me on track and stay true to my intention / goal going into the conversation.  Coming emotionally prepared is also helpful; starting a conversation already feeling triggered or angry will be more likely to run amock. Meditating, doing deep breathing, and reminding myself why I hope the conversation will stay respectful makes it more likely to end up that way.

2. Be aware of the other person’s needs

Nonviolent Communication has really opened my eyes to what it means to be respectful of where other people are in and what they need from an interaction. When both people’s needs are being acknowledged and met, I think it is much easier to speak about challenging topics, or even to confront someone about something that has bothered you. 

3. Acknowledge the underlying emotions

Odds are, if this is someone who cares about you, any resentment or anger is coming from a place of genuine love.  Maybe they feel helpless for not being able to help more. Or perhaps they’re afraid of losing the role you’ve played in their life, or simply sad about the situation.  These emotions — helplessness, fear, sadness — are not easy to feel long-term. Since chronic illness is, by definition, long-term, often we turn these feelings into something else easier to swallow.  It’s easier to feel annoyed at someone for not being able to make themselves better, than to feel like a failure for not being able to fix things yourself. Do your best to express what you’re really feeling (this is where being prepared can be so handy!), and then ask what it is they are feeling.  Usually, if you are honest and vulnerable, they will reciprocate.

I have found this feelings wheel tremendously helpful in pinpointing what’s going on!

4. Lean into the discomfort

When things feel icky, we tend to avoid them.  With difficult conversations, running away simply exacerbates the problem; the issues go unresolved and both people end up feeling irritated that they weren’t heard. Accept that there will be discomfort!  Feel free to say “this feels really difficult to say” if that helps it come out. Accept that you may not be able to “fix” the problem, but acknowledging one anothers’ feelings will help the problem feel less heavy.

5. Practice!  Practice! Practice! 

Conversations take skills that improve just like anything else — by doing it!  Practice preparing for conversations that feel less emotionally stressful so that you’re more at ease for the tough stuff.  Practice listening on a daily basis; ask someone an open ended question and genuinely listen to how they are feeling and communicating, without thinking about what you will say next.  Practice being brave by not shying away from discomfort in low-risk situations. The more you take these risks and practice these skills, the more comfortable you will feel with any conversation.

Do you have a trick you use to prepare for, or engage in, tough conversations?  Or an example of one that went well? Share with us in the Friends in the Fight facebook group!

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Ariela Paulsen

Ari struggled with a wide array of health problems for decades before being diagnosed with EDS/POTS/MCAS/etc at age 25. She began writing as a way to heal while spreading information and helping others through their own journeys. She loves being part of the Mighty Well team, sharing the stories and strengths of spoonies everywhere!

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