Chronic Communication Tip #1: Encourage your family members to talk about their feelings.

Dr Gary
By Dr GaryCA Latest Reply 2012-03-03 19:50:10 -0600
Started 2012-02-26 15:10:31 -0600

It seems like I am always reading discussions that are focused on the challenges that families face when one family member has been diagnosed with a chronic condition. And so I want to share some of experiences that I have had with clients and their families, and what they have taught me through the years. The biggest lesson that I have learned, and that I want to start sharing with you, is the importance of communication.

From my perspective in counseling patients and families, when one family member is diagnosed with a chronic condition, all family members are affected. In that way, everybody in the house is diagnosed.

A chronic condition means change for everyone in the family. How daily responsibilities are shared, new responsibilities, treatment regimens that everyone has to adapt to, adjusting to good days and bad days that the individual with the chronic condition may be experiencing, accommodating dietary requirements, financial concerns… and on and on.

Change results in a lot of feelings – anger, frustration, fear, sadness, disappointment. The family member with the diagnosis may be experiencing some or all of these feelings, depending on what’s happening at that moment, and so are family members. But so often, nobody wants to talk about how they feel. They are protecting themselves from acknowledging feelings that may be uncomfortable or “negative” in some way. Or they are protecting the other family members, or so they think.

Family members may fear that they will say the wrong thing, or assume that the family member with the chronic condition doesn’t want to talk. They may all hope, unrealistically, that by ignoring their feelings, they will go away after awhile, or everybody will “just get used to it.” They may think that they need to “stay positive” for each other. Or, they may fear that if they start to talk about how they are feeling, the feelings will come out in such force that they will lose control, “blow up,” and do damage to the relationship. But we’re all human, right?

So what do you do?

You can start by talking about your own feelings, not just physical but emotional. When a family member asks that usual question, “how are you doing?” you might want to start introducing some emotional words. “I am feeling a little sad today.” “I am worried.” “I’m kind of mad.” Let them know what’s going on, how your diagnosis is affecting you emotionally.

Talking about your emotions can accomplish a couple of things. First, it gives you a chance to let out some of your own feelings and be heard. And, it communicates to your loved ones that talking about feelings is okay, that you aren’t holding back, and that you don’t expect them to.

And here’s another way to get the ball rolling:

Ask your family member how they are feeling. “I’m a little bit sad today. How are you feeling?” “I’m frustrated about my new diet. How are you feeling about it?”

Often, because family members are at a loss as to how to get the conversation about feelings started, they need to take their cue – or get permission – from the family member who is facing the diagnosis.

Are you ready to start that conversation?

You may not get much response, at least not at first. Some families are better at the emotional stuff than others, regardless of the situation. But opening up communications is a step-by-step process. You may have to lay a lot of groundwork, starting by dipping your own toes into the emotional waters, and showing your family members that you can talk about your own feelings, even the uncomfortable ones. “Whew, I said it. And the house didn’t come crumbling down.”

You will be helping yourself by not bottling up your own emotions, and you’ll be a role model to your family members by showing them that talking about feelings – the “good” ones and the “uncomfortable” ones – is okay.

Keep the conversation two-way, or multiple-way!

By the way, I am not trying to promise you pie in the sky (my favorite banana cream or any other kind). I know that some families just aren’t hardwired for communication, and that family members can be downright insensitive. Still, I encourage you to give it a try. Sometimes family members can step up to the plate, in their own sweet time, and surprise you.

Now for your kids…

Children may need some additional help in opening up. Children learn to stay positive out of fear that they will cause their parents additional worry. They may also interpret your own insistence in maintaining a positive attitude as a signal that they aren’t supposed to express their own feelings. Start the conversation by simply asking your child is feeling, along with reassurance that you want to hear whatever it is they want to tell you, even the ‘scary stuff.’ Give a few extra hugs and reassuring words.

Ready to tackle the chronic communication in your family? Stay tuned for more.

And please let me know about your experiences.

29 replies

2012-02-29 18:37:54 -0600 Report

I'm trying to. But my family all seems to be such closed lipped and doesn't want to talk about anything.

Dr Gary
Dr GaryCA 2012-03-02 14:06:01 -0600 Report

Hey annalease,

It's nice to hear form you. It's been awhile. Some family members just can't talk about hard stuff, and so they can't be supportive. I hope that you are getting support from friends, and/or finding family members who can be there for you. But I am glad that you are here with us on Diabetic Connect! I hope you will stay in touch!


Just Joyce
Just Joyce 2012-02-28 23:31:54 -0600 Report

Communication is important in all families. Unfortunately adults can create an atmosphere where children learn not to talk about their problems for fear of being ridiculed, ignored, or told one doesn't talk about such things. By the age of 8 I became the invisible child in my family. I stopped living and began surviving and doing what I could to keep my parents and sister alive. By the time I was 12 fear and shyness was my best friend. My fathers best friend decided it was wonderful to sexually abuse me and made it clear that if I said anything he would kill my family. I had several aunts who I knew if I told them would immediately tell my parents. I knew my father would never believe me or them so I said nothing. By the age of 12 he lost interest in me.

I lived in books, music and television. I played with friends and went to school every day. My mother was one to believe what a friend said rather than me most of the time so if she asked me what happened in school and one of my friends said that didn't happen. I was accused of not telling the truth. I made friends my parents didn't know which made me a little bit happier. At 17 my aunt let me go out with my cousin, a night that started out as fun ended in tragedy. I was abducted and raped at gun point. When I had to tell my father, he blamed me so I became invisible again. I believed if I could not be seen no one would bother me. I finally entered therapy. It took 10 years to become visible. I think if I had the nerve to be a defiant child, I would have told and with the help of my aunts, my parents would have done something.

I think families have to be able to communicate and this will make children more apt to talk to parents. Any number of tragedies or illnesses can strike at any time. I know that if my parents were alive today, they would be supportive of my being diabetic. The one thing that did occur in my family was supporting each other if we were physically ill. I had eye surgery. The first time I woke up, my dad was there holding my hand. When I awoke again my mom was there. I had hand surgery and my mom, dad and sister were there helping me.

Life is way to short to let things get us down. We all have to communicate. You have to mend fences within families to be stronger and healthy as a unit. Parents may blame themselves for a child's illness regardless of the age of the child yet they may blame an adult child for their illness. You can't take it to heart because they can't accept that someone they love is ill especially if they don't understand the illness. We have to educate out family members and move on from there.

Dr Gary
Dr GaryCA 2012-03-02 14:04:16 -0600 Report

Hi Joyce,

I really appreciate your honesty and that you shared your tragic story with your friends on Diabetic Connect. You have been through so much, and come so far in life after being so let down by your family. You are the expert on family communication.

It has always amazed me that some children somehow learn to be resilient. The immerse themselves in books and TV, they create an alternative world to live in, and through media the also learn that there is another way to live that is different from their daily existence. Maybe this is how they save their own lives. And unfortunately, there are children who somehow get lost in the negativity of their childhood trauma and never quite find their way out. And I know that somewhere in there, getting the right mental health treatment, at the right time, whenever that is, also helps.

It is interesting that you mention that your family found it acceptable for you to be physically ill, and that they were able to show love when you were sick or needed surgery. They want to see themselves as good parents, and they are of course concerned about their children. On the positive side, children have their parents during this time of need. My concern is that this can also reinforce illness, and kids may feel the need to be sick to get the love and attention they need.

And I agree that family members aren't always very supportive of other adult family members who are ill. I think some of this comes from their own denial. "If you can get sick then maybe that could happen to me" gets replayed in their minds. And they may want to avoid the interpersonal connection, and the emotions, that goes along with being supportive of other family members.

The world would certainly be a better place if families learned to communicate better!

Thanks again for sharing with us! It's great to be in touch with you!


Just Joyce
Just Joyce 2012-03-02 14:22:21 -0600 Report

I too many families physical illness is something they can handle to a point. Mental illness isn't something they want to accept or seek help for the person who has psychological problems. Society today still does not fully accept mental illness.

It is unfortunate that families can be your worse enemy instead of your first line of support. Children learn from birth how to communicate. As they grow and are able to verbalize to communicate, those around them can either reinforce it or inhibit the child's ability to communicate. Once they become adults they will either have the ability to communicate or continue to hold everything in which makes it difficult to function in some situations.

Dr Gary
Dr GaryCA 2012-03-03 19:50:10 -0600 Report

Hi Joyce,

Thanks for your note. I agree with you. Families seem to have a much easier time talking about physical illness than they do mental illness. Stigma still exists.

It seems to me that communication styles kind of get passed from one generation to the next. Children observe and learn, and the wiring is in place. But I think that it is possible to recognize what is working and not working in how you communicate, and to change, and to encourage others to change. To learn how to open up and help others in the family to do the same. It doesn't always work. But it's worth a try. Patience is required!


TsalagiLenape 2012-02-27 20:24:44 -0600 Report

For me this is actually a mute point since my family has abandoned me. Yet I will carry on.

Just Joyce
Just Joyce 2012-02-28 23:57:53 -0600 Report

Tsa, families can be your best friend or your worse enemy. In the end they are the ones who will suffer. You have a virtual family right here 24/7. I won't abandon you. (((((((hugs))))

Dr Gary
Dr GaryCA 2012-02-28 17:44:57 -0600 Report

You have a family right here on Diabetic Connect! I hope that you will stick close. I am an email away! Gary

jayabee52 2012-02-28 17:01:57 -0600 Report

I thought you tossed them overboard Temi?

kaiya2465 2012-02-28 17:50:19 -0600 Report

James, don't make me get ya back…lol

kaiya2465 2012-02-28 18:07:27 -0600 Report

Why would you think Temi would toss us overboard? hehe. Yikes hopefully she don't… Hope you are doing good James, just have to pick on ya once in a while.

jayabee52 2012-02-28 19:02:53 -0600 Report

not a problem. I was referring to Temi throwing her family overboard, not us!

Yes I am doing well now that I got the news yesterday that I won't have to go back on hemodialysis treatments in the next 2 months (Yippee!) I got some thick skin, and no problem with ya picking on me! None whatsoever!

kaiya2465 2012-02-27 20:45:55 -0600 Report

Your not alone in your boat, I'm aboard. Mine did that to me also. If you don't want me there…push me overboard (lol). Hugs to you girl, hope your evening is good.

Dr Gary
Dr GaryCA 2012-02-28 17:45:38 -0600 Report

I'm right there with you. But hang onto me, I don't like water!

kaiya2465 2012-02-28 19:14:53 -0600 Report

I worked construction & we were re-doing a road, well the two people that were suppose to unload the rebar let it go the wrong way & every bit of it rolled off the truck. It scrunched three of us, I was hurt the least because I seen it coming & told the rest to run. They didn't listen they turned & looked.

Graylin Bee
Graylin Bee 2012-02-27 13:29:00 -0600 Report

My husband and I have managed to keep open and honest communication during the life altering years we have been experiencing recently. A few emotionally charged rants have flown back and forth, as well as calmer discussions. Sometimes only one of us is speaking while the other one listens to the fears. We have been each other's life line.
My Mother and Sisters and I have gotten to know each other even better during this time. It has deepened our relationships. We have talked about some of the scarey stuff in our lifes.It has even extended to more openess with my nieces and nephews. I have kept them informed about the genetic role that may have played a part. Also answered any questions they felt like asking about other things.We have even spoken with my Dad's niece and nephews to warn them of the possibility of a genetic medical condition to be looking out for. They had not seen what the bad leg veins did to my Dad or me. My Mom and sisters really explained how awful it was.But our cousins do not seem to understand how serious it can be. At least we tried and the lines of communication are still open with them. My husband and I have no children.
Unfortunately his family is not very communicative. He visited one of his 6 siblings during the time I was seriously ill and he didn't know if I would survive. They talked, there was an email asking when I was scheduled for surgeries, and a promise to come visit with no follow through. Now this brother is fighting an uncurable brain cancer that came on within just a few months. We have not been able to afford to travel to visit him. Our phone calls have not been answered or returned. After the first two phone calls from his wife we have been out of the loop. When one of his granddaughter's was fighting cancer we heard about it through a friend of my Mom's rather than them.

Dr Gary
Dr GaryCA 2012-02-27 19:06:24 -0600 Report

Hi Graylin Bee!

Nice to run into you here!

This is quite an experience that you describe. It sounds like you and your husband, as well as mother and sisters, have worked hard to establish open communication. I suspect that hasn't been easy. It takes concerted effort and some emotional risks to talk about the hard and scary stuff around illness.

As you said so well, issues like heredity can get in the way of the discussion, when blood relatives want to know but also don't want to know. This is where real information helps to kind of grease the skids. When you're operating on facts, and not fearful imaginings, then you can have a conversation that is not all about avoidance.

I am sure that you have personally done a lot of work to encourage this communication, by encouraging the people around you to talk, by being open about your own feelings, and by being accepting of theirs. I suspect that you were the door opener.

We can't always win. Relatives who can't or won't try to communicate, who want to hold things in or hold grudges, may be motivated by fear, or looking for a target for the anger they feel in their own lives. It's a shame.

Thanks a lot for responding with our wisdom and experience.

Take care,


jayabee52 2012-02-26 15:39:31 -0600 Report

In my family of origin (a family having its roots in the stoic germanic heritage) we didn't talk about feelings at all. And children were supposed to be seen and not heard.

I didn't like that, so my wife (at the time), the mother of my sons (who also came from a germanic background family of origin) and I encouraged our sons to talk and to express their feelings. We heard some pretty hard feelings to hear sometimes, but they were allowed to say their piece without reprisals.

Sometimes it changed our decision about what was to be done, most times it didn't, but our sons felt like they were at least heard.

My middle boy, a couple of years after his mother and I divorced, took me out to breakfast one day and told me about what he felt about his growing up years, and he felt really good about the job I did raising them. At that point I was feeling pretty low about the state of affairs in my life, and it did my heart a world of good to hear that from him.

I never end a telephone conversation with one of my sons without telling them: "I love you" and "I'm proud of you", because I do and I am. They're not some out of control monsters that I see some other peoples' sons turning out to be. I am quite proud of my young men, even with my youngest with whom I am estranged (but we are getting closer together now since his older brothers have gotten married). I think they ALL have turned out quite well.

Dr Gary
Dr GaryCA 2012-02-27 08:11:37 -0600 Report

Hi James!

Always a pleasure to run into you!

Thanks a lot for replying to my discussion, your reply was honest and so well written, as always. This is a great example of how parents can take the lead in encouraging their kids to express what's on their minds. This teaches children that they it's okay to express their feelings, and their opinions. This increases self-confidence, and helps to prepare them for adulthood. You sons are fortunate to have you as a father, and it's clear that they understand that. I have a feeling that your youngest son also recognizes the gifts that you gave him.

I hope you have a great day!


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