Susan Silk, a clinical psychologist, recently wrote an interesting piece for the Los Angeles Times, explaining how not to say the wrong thing when interacting with those who are suffering from terminal illnesses or who have just lost a loved one. Recovering from breast cancer surgery, Dr. Silk told those concerned about her that she wasn’t up to receiving visitors.
Imagine her shock and hurt when a colleague said to her, “This isn’t just about you.”
“It’s not?” Dr. Silk wondered. “My breast cancer is not about me, it’s about you?”
Dr. Silk described another incident when a friend named Katie had a brain aneurysm. Katie was in intensive care for a long time, finally being transferred to a step-down unit. No longer covered with tubes and lines and monitors, Katie remained in rough shape. That’s when one of Katie’s friends visited but then stepped into the hall with Katie’s husband, Pat. “I wasn’t prepared for this,” the visitor told Katie’s husband. “I don’t know if I can handle it.”
While the visitor clearly was moved by Katie’s condition, what she said wasn’t appropriate. And it was wrong in the same way Dr. Silk’s colleague’s remark was wrong about her cancer being “not only about you.”
Dr. Silk has since developed a simple technique to help people avoid this mistake. It works for all kinds of crises: medical, legal, financial, romantic, even existential. She calls it the Ring Theory.
Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma. For Katie’s aneurysm, that’s Katie. Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma. In the case of Katie’s aneurysm, that was Katie’s husband, Pat. Repeat the process as many times as you need to. In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones. When you are done you have a “Kvetching Order”.
Here are the rules. The person in the center ring can say anything she wants to anyone, anywhere. She can kvetch and complain and whine and moan and curse the heavens and say, “Life is unfair” and “Why me?” That’s the one payoff for being in the center ring.
Everyone else can say those things too, but only to people in larger rings.
When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. Listening is often more helpful than talking. But if you’re going to open your mouth, ask yourself if what you are about to say is likely to provide comfort and support. If it isn’t, don’t say it. Don’t, for example, give advice. People who are suffering from trauma don’t need advice. They need comfort and support. So say, “I’m sorry” or “This must really be hard for you” or “Can I bring you a pot roast?” Don’t say, “You should hear what happened to me” or “Here’s what I would do if I were you.” And don’t say, “This is really bringing me down.”
If you want to scream or cry or complain, if you want to tell someone how shocked you are or how icky you feel, or whine about how it reminds you of all the terrible things that have happened to you lately, that’s fine. It’s a perfectly normal response. Just do it to someone in a bigger ring.
Comfort IN, dump OUT.
There was nothing wrong with Katie’s friend saying she was not prepared for how horrible Katie looked, or even that she didn’t think she could handle it. The mistake was that she said those things to Pat. She dumped IN.
Complaining to someone in a smaller ring than yours doesn’t do either of you any good. On the other hand, being supportive to her principal caregiver may be the best thing you can do for the patient.
Most of us know this. Almost nobody would complain to the patient about how rotten she looks. Almost no one would say that looking at her makes them think of the fragility of life and their own closeness to death. In other words, we know enough not to dump into the center ring. Ring Theory merely expands that intuition and makes it more concrete: Don’t just avoid dumping into the center ring, avoid dumping into any ring smaller than your own.
Remember, you can say whatever you want if you just wait until you’re talking to someone in a larger ring than yours. Unfortunately, we all get our turn in the center of the ring. Until that happens, this Kvetching Order may be a useful guide when comforting those closer than you are to the ones who are in the center of the ring.