You’ve been in a nasty flare for a week now. Your joints and muscles are so painfully sore that turning over in bed is a major and dreaded task. You’ve had two migraines so far, and the fatigue is so overwhelming that it feels as if your body has been infused with tranquilizers. You’re a single parent with a sick toddler; or you live alone and are almost out of food; or you’re married to a wonderfully supportive spouse who’s out-of-town (and you’re still almost out of food). You need help.
Research indicates that fibromyalgia often strikes a particular personality type ironically, individuals who were exceptionally high functioning and competent, pre-illness. So, while asking for help is often difficult for the population at large, for these individuals, needing to depend upon others can be daunting. They don’t want to be a "burden," they’re worried others will see them as "weak," or, worse yet, may tire of them altogether. Many of these individuals believe that the above outcomes and responses from others are not only appropriate, but inevitable and impossible to deal with.
Thus, they add to their own predicament by getting caught in a "Catch 22" situation, where they are in desperate need of assistance, yet struggling desperately not to ask for it. Often, they have never questioned the thoughts and feelings that may underlie their belief systems around the issue of dependency, and what they may be contributing to the "Catch 22." They’ve simply assumed that needing others equals being needy. It’s no wonder they find it difficult to reach out.
Without question, Western society as a whole does place a high premium on independence and self-sufficiency, thus helping to create and reinforce negative belief systems regarding dependency in general. And certainly, there are those people who will respond to requests for help in a demeaning or burdensome manner (implied or otherwise), no matter how they are approached. What’s essential to understand is that if or when this does occur, it in no way validates a "truth" that needing others implies emotional weakness or lack of competency. Rather, it is about that person’s belief system about themselves. And while it is also true that some individuals will flee from those who need them, this is a lesson to be learned about that particular person not a global lesson about the nature of dependency. The reality is that you can only experience deep and painful rejection if you align yourself with another’s belief system.
There are some basic "tools" one can use when asking for help. Among these are identifying and utilizing appropriate support persons, using communication skills, and remembering the importance of the two tenets of timing and tone of voice. However, many people are still extremely reluctant to reach out, even when they have the skills and the support system. This is because asking for help is not just about "how to." It’s also, and perhaps primarily, about "why we don’t." So, it makes sense that the first step in figuring this out is to address one’s own resistance to doing so.
As noted, while society plays a large part in forming the various beliefs and values of its members, it is invariably the individual family systems that have the last word. This is especially true regarding the issue of dependency vs. non-dependency, which is a key component in the developmental process of children. How one’s parents responded to their needs as children, both physically and emotionally, is a huge factor in the adult child’s comfort and ability to depend upon others later in life in a healthy, reasonable manner.
One example of a dysfunctional family in which the child’s dependency needs are thwarted is that of the family who prizes external accomplishments and self-reliance in their children, to the extent that they block a critical aspect of emotional development. These parents laud the child who "takes care of herself" -- the eight year old who picks herself up after a painful fall and keeps on going, the teenager who deals with extreme peer pressure by himself, right on up to the university student who struggles frantically to excel in order to meet her parents’ unquestioned expectations. In other words, the "easy" child that excels in self-sufficiency and external accomplishments, and who rarely turns to his parents for support, guidance, or comfort.
Another illustration is that of a family where the parents are absent much of the time. Here, it’s not so much that the child is fearful about turning to her parents for help, it’s that the parents simply aren’t around. Perhaps there’s alcoholism or mental illness or poverty, which has resulted in serious neglect and/or chaos. In this situation, the child has no choice but to become their own parent. He learns there is no one else to depend upon. Thus, the need to become self-reliant is, quite literally, a matter of survival.
There are various permutations of dysfunctional family systems that can result in difficulty with reliance upon others. The common denominator is that the healthy dependency needs of the child either do not get met or are demeaned and criticized. Thus, the child grows up with a deep emotional imprint that asking for help is both impossible and shameful. The superwoman/superman mentality is often a manifestation of this, where individuals will wear themselves down to the bone rather than ask someone to give them a hand. These individuals have been unconsciously linking irrational, faulty messages and survival mechanisms from their pasts to the present. The reality is that seeking assistance in an appropriate and reasonable manner is one of the hallmarks of mental health and emotional maturity. While we have no control over the beliefs and mindsets of others, we do have the ability to shape our own. And that can make all the difference.
Once these (usually unconscious) beliefs and feelings are understood and examined, the ability to use the aforementioned tools is generally much easier. So, what are they? A quick primer:
- Identify and utilize appropriate support systems -- make a list of those people that have both the genuine concern and the time to help. Try to tailor your requests to the other person’s time limitations. If you don’t know, ask. Have more than one person on the list. This is where joining a support group becomes essential. If you don’t belong to one, then place this at the top of your list of priorities. No one understands your dilemma better than those who are likewise struggling. Often, support groups work together to help each other out during flare-ups.
- Reasonable expectations -- Just as we want others to try to understand our limitations, it is important that we attempt to understand theirs, be they emotional or pragmatic. It is extremely difficult for those without fibromyalgia to really "get" the debilitating nature of the disorder, especially since one’s physical appearance often "masks" the degree to which one is disabled. And of course, everyone has time constraints. Sometimes, others may need to say "no" because they truly don’t have the resources to be of assistance at the moment.
- Communication skills -- "I statements" and "active listening" are two fundamental tools of effective communication. "I" messages are sender oriented and lessen the potential for hurt and defensiveness on the part of the receiver. Thus, the potential for being heard is greatly increased. An example of an "I statement" is: "I’m really frustrated, because you said you’d pay the bills last week, and you didn’t." An example of an ineffective "you statement" is: "You’re always flaking on your promises to help me."
"I statements" are best used in combination with "active listening." Active listening requires that the receiver "suspend" (not necessarily give up!) her own thoughts and feelings in order to attend exclusively to the sender’s message. It forces accurate receiving in that the receiver must put herself in the other’s frame of reference. Sometimes this process is a bit frightening because it forces the receiver to really understand what the sender is conveying. Then, because of the exposure to ideas that are different, this opens the possibility of needing to reexamine opinions.
- The "two tenets" -- While the importance of timing and tone of voice are self-explanatory, it’s easy to forget these basic tenets when in the midst of pain and distress. However, the fact remains that people will respond more positively when attempts to muster the greatest degree of courtesy and consideration are made.
If it seems that the above suggestions and steps are too difficult to figure out alone, then don’t. There’s always the option of…seeking help. Regarding the examination and resolution of individual beliefs and fears about asking for help, you may want to consider utilizing the services of a local, well-referred psychotherapist. Given the potential complexity and unconscious nature of this material, professional guidance can be enormously facilitative. As for learning more about the communication skills that have been very briefly addressed here, there are countless self-help books available. An especially useful and easily accessible one is Listening with the Heart by Sara Bhakti, Ph.D. It is currently out of print, but can still be obtained at www.amazon.com.
So while this process may not be easy (at least for most people), most would probably agree that life isn’t easy, and that life with fibromyalgia really isn’t easy! But this doesn’t mean life can’t and shouldn’t be rewarding and meaningful. And the achievement of personal growth in this area can bring significant gains, in the quality of one’s lifestyle, relationships, and self-esteem. Learning to reach out to others when in need is not only a major step towards fibromyalgia self-management, it is often a profound life lesson.