Finding the Right Words

In part 2 of the Mesothelioma Cancer Alliance's interview with Dr. Richard McQuellon, Dr. McQuellon offers expert advice on how honesty is paramount to an open and loving relationship between a patient and a caregiver. Finding the right words to say to a loved one battling with cancer is already a difficult task, and when compounded with a rare cancer like mesothelioma, honesty is the best policy for open and effective communication to continue during this tough time.

The second requirement of healing conversation is to respond thoughtfully and honestly. Our conversations reveal what we think, feel, believe, desire and question. Healing conversations require that we put into words our response to what we have heard. But there are two obligations; we must call things as we see them while maintaining profound respect for our conversation partner.

Anyone taking relationships seriously feels the tension inherent in honest, loving speech. Something may be true, but that doesn’t mean it will always be well received, no matter how tactfully you put it. For example, it may be true for some patients that “chemotherapy is very hard” or that “a particular type of cancer almost always comes back,” but saying that to a person may likely be misguided honesty, perhaps revealing a caregiver’s discomfort more than delivering necessary information.

Truthful conversation is a process best informed by experience, compassion and wisdom. While the requirements of healing conversation are simple— namely, to listen and respond— the communication process itself is a complex matter of mutual interpretation of facts and feelings. Caregivers may find that accurate interpretation and skillful use of language are acquired over many years and will surely be tested in challenging times.

Honesty, Finding the Right Words

Finding the right words can be difficult. Not knowing what to say is an important concern for caregivers accompanying someone in pain, coping with a cancer diagnosis and being treated for a life-threatening illness. Most people have little practice at this, and even experienced professionals are often at a loss for words. Words can seem hollow. Consequently, we feel inadequate, don’t know what to say, or when to say it, and may avoid the topic of what’s happening to our friend or loved one altogether because we simply can’t find good words. Even if we find the right words, can we then make them words well spoken?

As mentioned before, effective conversation requires responding thoughtfully and truthfully. Many caregivers get stuck on “the right thing to say.” Sometimes there is no need for words – just having an attentive presence and a caring silence is all that is required.

Words can take strange twists during times of illness and pain, and not only for caregivers. Patients often search for the right time and the right words to speak the truth. Often, they are aware their honesty will lead to suffering. When someone trusts you to share his or her emotions, remember the importance of responding thoughtfully.

Not sure what to say? When offered honestly, these phrases or questions may comfort:

  • I am with you in this.
  • You can count on me.
  • Can you tell me how you’re holding up?
  • How can I be useful?

Stated with genuineness and empathy these phrases invite further conversations rather than closing off meaningful dialogue. A person who listens carefully and responds thoughtfully with simple, direct statements like these has the power to help lower the emotional distress.

Whatever the details of a life-threatening illness, and however great the differences in backgrounds, roles and responsibilities of those communicating about it, authentic conversation has the power to enhance how people cope. Talking honestly and listening well can illuminate and enrich the meaning of life for caregivers and people living in the sacred place of coping together.

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Richard McQuellon, PhD, is professor in the Department of Medicine, Section of Hematology and Oncology and Director of the Psychosocial Oncology and Cancer Patient Support Programs at Wake Forest Baptist Medical Center. He received a BS in Psychology from the University of Washington, Ph.D. in Counseling Psychology from Michigan State University and has over 20 years of clinical experience working with cancer patients and their families. His clinical work involves survivorship planning from diagnosis though end of life and the psychosocial care of patients undergoing extreme cancer treatments including stem cell transplantation. He has served on the editorial boards of the Journal of Clinical Oncology and Bone Marrow Transplantation and has published over 125 abstracts, journal articles and textbook chapters. He is currently on the editorial board of the Journal of Hospice and Palliative Medicine.