“You look well today!” and other well-meaning but unhelpful comments

This blog is for you if you have heard or said phrases such as:

-          “you look well today!”

-          “are you feeling better?”

-          “but you don’t look like you’re ill/in pain”

-          “but I saw you manage that yesterday”

-          “do you really need a stick/wheelchair if you only use it some of the time?”

-          “maybe if you thought a bit more positively it would help”

-          “you should try homeopathy/acupuncture/turmeric/CBD oil etc.”

This blog is separated into two sections for ease of reading – the first section for people who experience chronic pain or illness and the second for people who know someone with chronic pain or illness. Feel free to skip straight to the relevant section or feel free to read both!

Section 1 - For people with chronic pain or illness

How many times have you heard one of the phrases above? And how many times has it made you feel better? I can guess that it resulted in you feeling invalidated, not listened to, frustrated, deflated, hopeless, helpless, or a mixture of all of these feelings and more.

My aim for this blog is to try to give you some tips on how to manage when you hear something like this.

People don’t usually mean it in a hurtful way

First of all, it can be helpful to remember that the majority of the time, people mean these phrases in the nicest possible way. A lot of people struggle to understand chronic pain and illness so say things that they think are helpful – they want to make things better or show you that they acknowledge you have an illness/pain. As human beings we are programmed to problem-solve, to come up with solutions.

So when we are faced with someone with chronic pain/illness, we hate seeing them struggle and want to try and help – “I’ve heard x, y or z is helpful, you should try it!”. But unless that person has a chronic illness themselves, they do not realise quite how difficult and frustrating it can be hearing something like that.

Pick your battles

A little mantra that I like is “pick your battles”. When you have a chronic illness or pain, you don’t have the energy to fight every battle so you have to choose carefully.

For example, imagine you are in a social situation - you hear “you look well today!” or “are you feeling better?” and you know that you do not have the time to talk to this person for long. Maybe you choose at this time not to fight this particular battle. Maybe you just smile and move on or change the subject, reminding yourself that the person does not mean anything hurtful by it. You put your attention instead into trying to enjoy the evening.

But if for example, imagine you have someone who regularly says these phrases to you – it causes you to you feel deflated, not listened to and you do have the time and energy to talk to this person. Maybe this time you choose the battle. In situations like this, it is really important to pick an appropriate moment, stay calm, to try and clearly explain the issue and offer a solution. Although I have used the word ‘battle’, I don’t mean to imply that you should be confrontational to the person. Staying calm can help the other person listen to what you have to say. It can also help you to say what you want to instead of letting frustration take over the conversation.

Communication is key

Let’s take an example of someone saying to you regularly “is your back feeling better?” when you know that your back pain is never going away. You could choose a time and place when it is just the two of you and explain that you have a chronic pain condition that will not improve. You could acknowledge that you know the person means well and thank them for checking in on you. You could then explain that you find it difficult to answer the question and that you would prefer instead the question “how are you feeling today?”. You could also ask the other person if they had any questions for you about your back pain. 

The same structure would go for things such as “I saw you do that yesterday, why can’t you do it today?”, “you don’t look ill/in pain” or “you can’t possibly need a wheelchair because I’ve seen you walk”. You could sit the person down, explain your condition calmly and clearly and tell them that it is hurtful to hear statements like that. You could then offer a solution, saying perhaps you would prefer something like: “are you feeling up to managing this today or shall we try tomorrow?”; or “I’ll book us a table for dinner, do you need access for your wheelchair or will you be using your stick?”.

Positive thinking is not a cure

I sincerely hope that you have never been on the receiving end of “have you tried thinking more positively?”. This is such a hurtful thing to hear.

If you have the energy, you could point out to the person who said this that positive thinking cannot make pain or illness go away. Maybe with a bit of humour you could ask them to try thinking positively themselves when they have a toothache or if they break their leg and see if it helps!

There is no such thing as a magical solution

One of the hardest phrases to hear can be “you should try x, y or, z!” as if it is a magical cure for your incurable illness. It can feel very frustrating as hearing the word “should” can feel as if someone is forcing an idea on to you. It can also result in you feeling that you have not tried hard enough to find a solution to your pain. If you are trying to come to terms with living with a life-long condition, it can impact your progress if you think there is something you have not tried that could help.

Some days you may not have the energy to get into it so you could just try to change the subject and move on. Other days, maybe you have enough energy to sit down with this person and explain what your condition is. It could be helpful to explain that you have seen professionals in their field and you are following their advice. You might also want to explain that your condition is not going to be cured. Therefore, you could politely explain that spending money on something that has no evidence base is not the best use of your money.

If you wanted to offer alternatives, you could ask the person to try not using the word “should” when suggesting things to you. You could also ask them to help you adjust to living with chronic pain by asking how you are feeling instead of offering solutions. You could ask them to focus on activities that you can do together so you can have a fulfilling and enjoyable life rather than trying to chase a ‘cure’.

In conclusion

Pick your battles! Where appropriate, it is perfectly acceptable to shrug off a well-meaning but hurtful comment and move on, reminding yourself that the person probably did not mean it negatively. And where appropriate, it is also perfectly acceptable to sit down and explain to someone how it makes you feel and what you would prefer them to say.

If you are interested in learning more about how to speak to someone assertively, you can find lots of information here.

Section 2 - For relatives/partners/friends/colleagues of someone with chronic pain or illness

Have you read the phrases at the beginning of this blog and been able to identify any that you have said to someone with chronic pain/illness before? Are you reading this wondering why it is an issue?

My aim for this blog is to help you to understand why this may be unhelpful, even when you mean well and to provide you with some alternatives you can use. This could result in an improvement to your relationship with this person in your life as they will feel listened to.

If you do read this and realise you have said some of these things, my aim is not to make you feel guilty about it! It happens a lot and this is why I chose to write this blog, to be a source of help and support, not blame.

“But I meant it in a nice way”

First, I will address the seemingly harmless “you look well today”. I know this comes from a good place, from wanting to say something positive. And it might be true that the person looks well! But for that person, they have usually had to take a lot of time and energy to look ‘well’ and usually they will be feeling awful. It can be very invalidating to hear how well you look when you feel dreadful.

For example - if I go out socially, I will spend time doing my hair and makeup ‘just right’. I will plaster a big smile on my face and try to hide how unwell I feel. This is despite being in a lot of pain and feeling exhausted to my bones by the time I get there. Don’t get me wrong, I don’t want to hear “you look awful!”, but a much better response would be “how are you feeling today?”. Telling someone with a chronic illness/pain that they look well could be fine, but equally, it could make them feel that they have to continue to put on a mask to hide how they feel.

This also goes for “are you feeling better?”. People with a chronic illness/pain usually don’t get ‘better’ and even if they feel better for a while, they may have flare ups. It can make the person feel that they are not being listened to, that they are not understood and it can be dismissive. A much better question as above is “how are you feeling today?”.

Fluctuating conditions

Imagine an example where you know someone with a chronic illness/pain and one day you see them manage the flight of stairs to the office, but the next day they have to use the lift. Or maybe you see them arrive in a wheelchair, even though they didn’t the day before. Please do not be tempted to say something along the lines of “you managed to walk/use the stairs yesterday” or even jokes such as “you lazy thing” (unless you know the person very well and know they are ok with it!).

If you do not understand their condition and do not understand why it changes each day, don’t be afraid to ask the person about it in a respectful and genuinely curious way. If you don’t feel comfortable asking them about their condition, you could always just ask the person if they are ok or maybe get the lift with them and make everyday conversation.

“The power of positive thinking”

Please do not ever say to someone “maybe if you tried thinking positively it could help”. Imagine now that you have an awful toothache - you can’t eat, the pain is into your jaw and you’re struggling to speak. You just want to curl up into a ball and be left alone to nurse your pain. Then someone comes up to you and says “I know you are in pain but until you see the dentist, there is nothing you can do about it. If you think positively that things will get better, it will help”. What would you want to say to them in response?! Remember pain does not magically disappear just because you thought positively about it.

If you suspect that the person you are speaking to could be depressed or low in mood, you can always try gently approaching this with them. You could suggest they speak to their GP or access psychological support for it. People with chronic pain or illness are more likely to experience depression and anxiety than those without, which is understandable given how tough it can be. Please keep in mind though that someone might just be having a bad pain day or a flare up. During this time, they need support, not advice.

“But it will help”

The last comment I want to address is “you should try x, y or z” and variations of this such as “one of my friends has an Uncle with your condition and they were telling me they took this herb they found in the mountains on holiday and it cured them, you should try it”.

I know that you are only trying to help. I know that when you see someone you care about in pain, you just want them to feel better. But please remember, it is highly likely that this person has researched their condition thoroughly and tried many different things to try to get some relief. They will have spoken to professionals and possibly experts in their field about it. They may also be in support groups with people who understand their condition. There will be nothing they haven’t already heard! And I can guarantee they know more about their condition than you do. Please don’t force your ‘solution’ onto them.

There is nothing wrong with trying to help, but changing your wording can make the world of difference to the person you are speaking to. It can help them feel validated, listened to and cared for. It could help improve your relationship with them too. A good rule of thumb is do not use the word “should”. Why should someone try your idea? They could or might like to or might already have tried it. Try to be mindful about how you word things.

What to say instead

If someone is in an acute flare up, some examples you could ask instead – “is there anything that you have been told or read about that could help?”, “what has helped in the past?”, “is there anything I can do or get you that might help?”, “what do you need right now?”.

If someone is not in a flare up and is just telling you about their condition, the best thing to do is just listen and empathise. Truly try to understand how difficult it must be to live with pain all the time, knowing that there is nothing that will take it away. If you feel you have to help (which you don’t!), you could ask questions such as “have you heard about x? What do you think?” or “what are your opinions on z?”. But be aware of how the person is reacting to these questions. If the person is trying to shut down the conversation or looks uncomfortable, move on and don’t bring it up again. If the person seems genuinely interested in what you are asking about, then you can have a useful discussion without trying to push your views onto them. Just because it worked for you or someone you know, doesn’t mean it will work for everyone.

It is also worth remembering that sometimes people are told by their health care professionals that their condition will not improve. By suggesting things that could help take away their pain/illness, you may be preventing the person from being able to move on and try to learn how to live their life with this condition.

In conclusion

-          Think before you speak!

-          Be genuinely curious about how the other person is feeling and about their condition.

-          Do not make assumptions or try to force your opinion/solution onto them.

-          Changing how you communicate could make a big difference to someone.

-          Listening to what they have to say and responding appropriately could improve your relationship with them by showing how much you care.