10 Things Not to Say to People With Chronic Pain or Illness

Chronic pain and illness is an isolating, disheartening experience that often stumps mental health professionals and leaves their clients confronting the complexity of their grief alone. Clients with these conditions face distressing comments from various sources, intensifying their struggles. As a therapist living with chronic pain and illness, I've experienced the difficulty of seeking help and dealing with dismissive remarks firsthand.

We all reach for connection, hoping to be seen, heard, and felt. Sometimes, meeting one another’s needs is all in a shift in language and the ability to open ourselves to understanding what is underneath the surface of experience. Often, a supportive presence outweighs words.

Consider how you might exercise presence with the person you are supporting as you read this list of common upsetting statements that people with chronic pain and illness often hear, and alternatives that foster a greater sense of connection.

1. “Have you tried…”

This one is famously feared. This statement puts into question the real pain being experienced and leaves the person feeling invalidated and disempowered.

Unless you are that person's medical provider, it is not your place to question, suggest, or give unsolicited advice to the person experiencing pain. Just because something worked for you does not mean it will be helpful for someone else, and making a suggestion at all can deprive the interaction of the empathy needed for connection.

Alternatives:

• “I am curious about what you have tried already that feels helpful or unhelpful to you.”
• “Is there anything you would like to do that would feel supportive for you at this time?”
• “I feel unsure what to say. Can I just be here with you?”

2. “The same thing happens (or happened) to me.”

When a person with chronic pain and illness is injured, experiencing fatigue, or is in pain, it is not the same as a person without chronic conditions experiencing it. From its etiology to its impact, it is different. The best thing you can do is de-center your own experience and listen to the experience of the person suffering.

Alternatives:

• “Can you tell me more about your pain so I can try to understand it as much as possible?”
• “While I have experienced pain of my own, I know your experience is so different. I want to connect with you about this in any way I can, even though it's hard.”

3. “I have a friend who this happened to…”

Much of the time, this “friend” has had a very different history from the person experiencing chronic pain and illness. For those of us who have been living with conditions from a young age, the dimension of our condition(s) is much more complex. Keep the attention on the person needing support.

Alternatives:

• “I have heard about how hard it is when people go through this. I am here to listen.”
• “I know a few people who have been through similar experiences. I know it might be different from yours. Would you be open to hearing about them?"

4. “Is it really that bad?”

Saying this is dismissive and is more about the comfort of the person asking than the comfort of the person needing support.

Alternatives:

• “It is so hard to know that you are in this much pain.”
• “I believe you. It is just difficult to imagine the pain.”

5. “But you looked fine the last time I saw you!”

For those living with chronic conditions, our lives do not stop. We find ourselves trying to muster the energy to go out to that dinner, see friends and family, work, and more. Even when a person is feeling happy and seems to “function” in the ways society demands, it does not mean the pain is not happening. I guarantee you, it very often is.

Alternatives:

• “I must really not understand how much pain you are in all the time."
• “I love when you are able to spend time with us, even when you are in pain. Is there something I can do to help support you next time?”

6. “You are so resilient.”

Resilience is one of those words that has two sides to it. On one hand, it speaks to an individual’s strength. On the other hand, a person usually only has to be resilient because of oppressive external factors. Rather than attempt to challenge greater systemic discourses that contribute to the pain experienced, this statement puts the onus on the person who has to endure it.

Alternatives:

• “You have been through so much”
• “It must be so difficult to endure all that you have”
• “it makes sense that you feel (x, y, z), I am here”

7. “I understand.”

If you don't have the experience of chronic pain and illness (and even if you do), it is more than likely that you don’t understand. Saying you do may cause the person to feel misunderstood, isolated, and anxious.

Alternatives:

• “I hear how sad and angry you are. It makes sense that you feel this way."
• “I hear you. I would love to share a time when I felt sad and angry. Would that be OK? It may not be the same situation, but I can connect with your feelings right now.”

8. “We all have something.”

Despite being an attempt at empathy, this is more of a sympathetic response that misses the opportunity for connection, dismissing the person needing support.

Alternatives:

• “I know so many people feel pain, and I hear that yours is unique to your experience.”
• “There is so much pain in the world. I wish you did not have to go through this, and I know you have no choice.”
• “My pain is different, but I would like to share it with you if you have the capacity. Maybe we will be able to connect about it.”

9. “You’re too young to be experiencing that.”

If only this were true!

Alternatives:

• “It is so difficult to know you are experiencing this now.”
• “I am so sorry to hear this is what you are going through.”

10. “I know you can do this!” or “You got this!”

This statement often leaves the person in pain feeling isolated and alone, with their needs unmet—a need that often comes from a great desire to connect and feel felt by those around them.

Alternatives:

• “This is so difficult. I cannot imagine your pain, but I am with you.”
• “I would love to support you and am not sure how or what to say. What would be helpful for you in this moment?”
• “It's OK not to know how you would like to be supported right now. I am here for you, either way."

When in Doubt, Ask Questions and Listen

I hope this has felt validating for those experiencing chronic pain and illness, and clarifying for those of you wanting to support. Whether you are the one experiencing it or the one supporting, know you are not alone.

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