When Social Support is Less Support and More Strain

Social Support is Usually a Good Thing

If you have ever been in a therapy setting, you know that one of the things that we tend to assess is the extent and quality of your social support.  We ask what important relationships you have.  We check on how healthy and caring those important relationships feel to you.  Social support can include partners and children, siblings, friends, co-workers, and more.  It is a truism that strong social support can make a big difference if you are facing a serious illness.

I actually agree with this truism (both because of the research supporting it, and because I have seen the impact of good social support with my clients), most of the time.  However, the issue is not a simple one.  For some of the same reasons I identified in my post on “what makes therapy different,” there are times when a strong support system can feel like an additional burden when serious illness occurs.

What Can Make Social Support Fail

Let’s take a look at the two biggest issues that might cause a person facing serious illness to feel overwhelmed instead of supported by their social network.

  1. Guilt/worry:  This issue comes up when the person who is ill is a parent, caregiver, or other central figure in the lives of others.  Having someone you love diagnosed with a serious illness is nearly as frightening and stressful as being diagnosed yourself.  Those who are concerned about the impact of their diagnosis on their family and friends may choose to keep their fear and stress to themselves.  This is often interpreted as someone choosing to be strong, or private.  However, when you dig deeper, it’s not unusual for the person who is struggling to say things like, “I just don’t want my kids (parents, partner, friend, etc) to worry about me.”  Another one that I frequently hear is, “I don’t want to be a burden.”  If illness has substantially affected ability to work, or contribute around the home, it’s common for people to express feelings of guilt about “not being able to do my share.”   I encourage new clients to begin assessing whether or not guilt and concern for others are diminishing their ability to get their needs met.
  2. Difficult Emotions: Receiving a diagnosis of serious illness, going through an intense medical treatment process, or coping with chronic health issues–all of these experiences create a series of intense, challenging emotional responses.  It is normal to feel shocked, frightened, angry, helpless, confused, frustrated, or many other emotions.  All of these emotions are normal reactions to a difficult event.  But not everyone in your support system will be equally comfortable or competent giving you permission to experience and express your difficult emotions.  In fact, in an attempt to be helpful, there may even be people in your support system whose response to tough emotions makes you feel shut down or dismissed (see my post on “When ‘Helpful’ Isn’t” for more about this).  For example, a loved one may hear you talk about how scared you are, and respond with, “Don’t talk like that!  You need to think positive.  Everything will be fine.”  This response is probably a reflection of their own fear, or their discomfort in facing fear.  Or, if you are having a day when you are angry–angry with the disease, angry with your body, angry with the healthy people who don’t know what you’re going through–people in your support system may struggle with giving you the space you need to be angry, without taking your anger personally.  One of the things that people report appreciating most about therapy is the knowledge that they can bring their difficult emotions, without censorship.

You’re Talking About My Life!  Now What?

If these examples sounded familiar to you, if there have been days when you feel like a huge chunk of your energy is spent protecting your loved ones from your illness instead of truly receiving their support, then it might be time to look at new options.  I’ll explore these more fully in another post, but here’s a short list of possibilities:

  • Have someone close to you draw up a “master list” of helpful things that people who care can do.  This can include meal preparation, going to appointments, doing laundry, coordinating school schedules, going out for coffee–all kinds of tasks, big & small.  This list has all kinds of benefits, including reduced guilt.  When you don’t have to ask for every single thing you need, it’s easier to accept the help.
  • Remember that everyone in your circle is affected, to varying degrees.  It can be helpful to plan for some down-time for partners, kids, parents, etc.  It can also help to develop plans so that anyone having a particularly hard time can use a pre-set “distress signal.”
  • People want to make a difference.  If you’re facing cancer, no one but you and your treatment team can actually “fight the disease.”  So, if asking for help is not your style, think of your request as a way to help someone else feel useful.
  • Get additional support.  Whether you work with a therapist, a pastor, or another outside support system, it is important to have at least one place where you can express all your needs without concern about “burdening” others.  Outside support can also be helpful for caregivers.

What have been your biggest challenges getting support during a time of crisis?  Please feel free to share your most successful strategy for turning strain back into support

2 thoughts on “When Social Support is Less Support and More Strain

  1. As a support person, one thing I try not to do is say “call me if you need something”. If a person is ill or going through some other crisis, the thought of making a number of phone calls is daunting, therefore you don’t make the calls. I try to leave voice mail or use email and try to say “tell me what you need and I will do it”. Sometimes you will be surprised that the answer is “I need to be left alone for awhile” and that’s what you need to do. I have recently had several different friends going through a crisis and it is crazy how many people say “call me”.

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