It’s hard to be present in the face of pain. Sometimes it’s really hard. If we’re already feeling fragile or scared, someone who is hurting can feel like a whirlpool that sucks us down. If someone’s pain is really big and deep and strong, being with them on any level can feel like we’re caught in a storm. The sense of helplessness can be overwhelming. We want so badly to make it better. We want to stop them hurting, to ease and heal that tangle of futile rage and helpless hurt. I’ve been here. I know what it’s like to have no words for someone, to fumble badly and find myself turning to silence or clichés because I don’t know what else to say. I remember the terror I felt the first time I went to visit a friend in hospital after they survived a suicide attempt. Walking in was so damn hard, I was so frightened that I would do or say the wrong thing and make it all worse. I remember sitting with someone I loved who was in emotional agony, night after night, and literally singing to myself in my head to dissociate from their distraught, racked, sobbing because it felt like it was going to kill me. I have spent a lot of my life in pain, and I have spent a lot of my life reaching out to other people in pain. I still get scared, and I still stuff it up.

We are to some extent, wired to ‘catch’ emotions from each other. We’re social, we live and work and play in groups and families. Emotions are powerful ways we connect to each other and communicate with each other. We mirror emotions in each other. This can be a wonderful thing, it can help us to realise something is badly wrong and we need to be scared before someone even opens their mouth. Our ability to treat each other as human is partly founded on our ability to empathise with each other. But it can make it hard when people are hurting, because we feel a little of their pain. And we hurt too because we have to witness it and face our own inability to fix it, and that helplessness is a really hard place to be in. We also hurt and get scared because it’s frightening seeing other people hurt and realising this could be us.

If we are brave and skilled, we can be with people who are in pain. If we lack courage, we’re too vulnerable ourselves, or we don’t have the skills to stay afloat, we are left with really only response – distance. We might simply go silent. We might stop calling or visiting the friend with cancer, we might block the family member who is drowning in depression. We just retreat, make our excuses, and quietly move the threat out of our lives. Another form of distancing is to blame the person who is in pain. If their pain is in some way their fault, it gives us a lot of breathing room. We can disconnect empathically, because the solution is right in front of them and they are foolishly not doing it. We can feel less afraid of going through what they are suffering, because we know better. Some people blame to justify leaving. Others stay connected but use the blame to distance themselves and protect themselves from feeling the hurt too.

Anyone who has suffered has had some experiences with people distancing themselves like this, and it’s extraordinarily painful. Take whatever it is you’re already experiencing, and magnify it significantly for every time someone plays the role of Job’s comforter in your life. It’s a cruel twist that other’s people inability to handle your pain will add to it. People distancing themselves hurts. People telling you that there is something you are doing wrong, or something you are failing to do, that would make everything better is a kind of torture. I’m not talking about people sharing resources – that is a wonderful thing, and many of us spend a lot of time passing along and gratefully receiving suggestions for therapies, physio’s, and good books. This is done in an attitude of shared humility – hey, this thing was helpful for me – it might work for you! It’s timed for when we’re looking for information, and we feel like equals. Blaming you for your problems may be done under the guise of ‘trying to help you’ but it is actually about managing discomfort around pain. It’s done when you are most hurting, without connection but in place of it, and the more distressed you become, the more adamant they are that all this upset is simply needless if you would just see their doctor/meditate more/ask for forgiveness from God/fix your karma/take this supplement. It’s not about your pain, it’s about theirs. For you, being told that you have control over something you simply don’t is an impossibly painful place to be in. The only thing more distressing than being bashed against some terrible obstacle – be it sickness, grief, mental illness – is being told that it’s not actually there in the first place.

There’s whole branches of self-help and spiritual ideas that are specifically about this kind of distancing. Books and gurus that are geared around making us feel better about awful things that happen to people by reassuring ourselves that we can avoid it. It’s a form of victim blaming. The most obvious forms we tend to see in situations of violence – the ‘s/he was asking for it’ line after a sexual assault. Facing that the world is not under our control is a hard thing. There ARE things we control, and they are very important! When we try to control things we can’t – or when we’re expected by people around us to be in control of things we are not – it’s like a moth trying to reach the ligth inside the globe, or a fly to get through a windowpane. It’s a futile nightmare, and it takes energy away from the things we CAN actually do in our difficult situations. When it comes to sickness, grief, and other kinds of suffering, there’s so many ways to make it someone’s fault. In spiritual practices this is as simple as a ruthless assessment that the suffering person in some way deserves their lot. God, the gods, spirits, or karma are doing their thing. It is fair and just and the person should either endure it and be ennobled by the experience, or figure out what they’ve done wrong and make amends. Sometimes it’s conceived of as a ‘test’ of some kind. The single standard feature is the horrible lack of empathy hurting people are treated with. The self help alternative health sector can also be ruthless. Entire disciplines of thought have developed around the idea that people are in control of every aspect of their health and able to control their experiences. Much of this is a warped take on some very real, very important discoveries about how people function. Books such as Louise Hay’s You Can Heal Your Life put forward the idea that all physical illnesses are caused by emotional struggles. This is a gross misunderstanding of the reality that our physical and emotional health are interrelated. Blaming the person is not a new thing, and it especially occurs around conditions and diseases we don’t really understand yet. The victim blaming ‘it’s your personality’ theories that used to be levelled at people with tuberculosis are now dumped on the door step of people with fibromyalgia, for example. These ideas put sick people under impossible strain and tend to polarise the conversation – everything is emotional and under your control – everything is physical and how you feel is irrelevant. This clouds the information we actually need to be able to manage it.

Let’s look at what we do know. Physical illnesses are physical processes. Aids, cancer, strokes, cholera, chromosomal abnormalities, and so on, are not caused by grief, issues with your mother, or a lack of self love. There is a physical mechanism in action. Sometimes there’s things we can do about this – good diet, care about sanitation, keeping an eye on genetic conditions. Sometimes there isn’t, bad luck deals us a crappy hand and we do the best with it we can.

Our emotional life is different from, but connected with, the rest of our health. Sometimes it’s the filter through which we experience things – for example, our perceptions of pain are far more intense when we feel scared. Sometimes the interaction is more direct – how we feel can impact how our immune system functions, and how quickly we heal. Sometimes it’s more subtle but even more powerful – how we feel influences our life choices, how much energy we have to look after ourselves and how much we care for our bodies. Sometimes we can trace the mechanisms by which emotions and health interact, and sometimes we can’t. But there’s no denying that they are, indeed, very important! Dr Dean Ornish has written a beautiful booked Love and Survival, which details the costs of experiencing things like loneliness, and the health benefits of intimacy and love. Research projects of many different kinds with many different conditions demonstrated that feeling loved and supported was a key – something the biggest single factor in recovery or preventing relapse – bigger even than diet or exercise or smoking or other things we know are huge risk factors. Sick people who felt lonely, unloved, or lacked support were twice or three times more likely to die. Emotions do matter, a great deal! But they do not give you control. You cannot stop planes falling from the sky, or cancer, with your feelings. For every story of someone who miraculously survived an illness, apparently due to positive thinking, there are ten amazing people who loved deeply and looked after their bodies, and were very optimistic, and had children to live for who died anyway.

So, where does this leave us? How do we untangle this information? What do we do with it? Well, let’s look at the context. Emotions don’t happen in isolation. The primary arena for this – whether it’s healing or harming us – is our relationships. That means those of us who are unfortunate enough to be lonely and isolated, or abused and put down, are a lot more vulnerable than those of us who feel loved, connected, supported, and nurtured. When something bad happens and we’re in a lot of pain, we’re often very scared of being rejected. We know that people may feel overwhelmed and distance themselves, and we try to manage this in different ways. When we’re also under pressure to be positive and make ourselves magically well, we often try to shut down our emotions. Some of us are very good at this and will wear a cheerful face through the most harrowing of circumstances. Some of us are terrible at it and anguish leaks through all our attempts at suppression. Either way, we often start this process of trying to distance people from our pain. This disconnection can leave us very lonely in a crowd, without anyone we can be real about our feelings with. When some of our people also struggle and distance – for some unlucky people everyone in their networks will distance – we find ourselves in exactly that vulnerable place of isolation that makes our situation so much harder.

The research out there about how emotions impact health suggest that, rather than blaming and distancing, entirely the opposite response is needed – empathy, connection, shared experiences. The distance/blame response actually sets up exactly the most vulnerable emotional circumstances for hurting sick people. So the guys doing the loudest, most unbalanced shouting about how important your emotions are to your health are setting the stage for causing harm to people already sick and in pain. Most of the times this is not at all the intention! But to claim it’s all altruistic is also a bit disingenuous. Even if you think you have the cure for a dying person who, through stubbornness, won’t take it, you approach them with love. And with a little integrity you quickly find that for every miracle, there are so many of us who don’t get them. We’re not bad people, or unloving, or denying the possibility of hope, or out of touch with spirituality – or at least, not more than all you healthy people out there. If you can’t see that you’re not much of a friend.

If you are struggling with people stuffing it up when you’re hurting – welcome to the club. And sadly, experiences of pain don’t really equip us with the skills to be automatically awesome when other people are hurting too. I wish it did! But it can motivate us. We don’t have to get it right all the time. Muddling through is good enough. The quote I’ve used to guide me – both to forgive well meaning friends and to comfort myself, is ‘the friend who comes, and holds your hand, and says the wrong thing, is dearer than the one who stays away’. Try to find some grace in your heart for those who love but stuff it up. When you are less overwhelmed, maybe you can share what you do need or need to hear and what isn’t helpful. Or maybe you can lose it and be honest about your feelings and then make up. For those who stay close but don’t listen, don’t empathise, don’t connect, and keep distancing – be careful. This can be abusive and destructive. They may totally disagree with your ideas and approach, but a basis of a relationship has to be that respect for you and some sensitivity to the distress their approach is causing. Some people get off on causing other people pain, and some people work through their own issues around suffering, vulnerability, and mortality on handy nearby hurting people. Don’t let anyone drip feed you poison. Losing ‘friends’ like this might be painful and lonely and bad for your health, but my experience has been that networks full of people like this do far more harm than loneliness does. 

In an odd sense, I feel I was lucky. When I was a kid, as the eldest girl and the one with a knack for first aid, I was taught how to comfort a distressed child when my parents were stretched. I recall hours sitting by the side of a sibling who was suffering from migraines. My mother taught me how a regular gentle stroking action on the skin can help distract from pain, how to match breathing with someone who is panting in distress and gently slow my own down so they calm with me and slip into sleep. I learned how to box up my own feelings during first aid crises such as dislocations, car accidents, or bad lacerations so that I could be present and useful and then feel all my shock and distress later on. I learned how to talk myself through scary things, to remind myself of my values, to accept that some things are very hard to do, to reward myself afterwards with time to wind down. They get easier. They are absolutely easier to do than to lose someone and have to live with the knowledge that you bailed. We distance to try to protect ourselves, but unless we do a massive amount of running away and lying to ourselves, we hurt anyway. It hurts to be near someone in pain, and it hurts to let them down, and it hurts to lose them. If taking on a bit of pain and figuring out how to live with the knowledge that bad things happen to people who don’t deserve it helps to reduce their pain a little, how can you not? One day it will be you, realising the limits of your own power and control, and desperately needing other people to understand that your problems are not your fault. Or one day it will be someone you care about enough to want to stay with them, and it will sure help to have learned a few skills before then.