Q:

I know how I’m about to sound, but I don’t know what to do. My bff–from high school, and we’re in our late 20s now–moved across the country. He has a few chronic illnesses that cause him a lot of pain every day. I want to be there for him, which usually takes the form of phone calls, but more and more when we talk on the phone we inevitably wind up spending a lot of time–sometimes more than an hour–rehashing his symptoms and his anxiety about it. I just don’t know what to say sometimes–I know solutions aren’t really helpful, and it’s not like I have any medical advice to give anyway, so I am just left repeating, “damn, that sucks.” I want to be a good friend and try and keep our friendship strong after he moved away, but the phone calls feel like they’re not fun for either of us and leave me feeling resentful. Is it ever appropriate to try and bring this up with someone who is actively sick? Do I just suck it up and find something to do with my hands while he vents? I feel like such a jerk.

A:

This is a tough situation to find yourself in. Often, when it comes to relationship issues — whether with romantic partners, family members, or friends — the common (and well-intentioned) advice is to just communicate on the issue. Usually this is good advice, but we sometimes find ourselves in situations where communicating our frustration or resentment to someone hurts them deeply and damages the relationship. Some things can’t be unsaid, and it’s important to keep actively trying to have empathy for people who are struggling with intense and ongoing challenges like depression, abuse, or chronic illness. Your friend isn’t in control of his illnesses and shouldn’t have to hold back his anxieties to make other people feel better. That being said, you’re not a jerk for feeling helpless and resentful.

Caregiver burnout and compassion fatigue

It’s very likely that you’re experiencing a kind of caregiver burnout or compassion fatigue. These are characterised by being in a caregiving situation and feeling exhausted (mentally, emotionally, or physically). The difference between the two is that caregiver burnout is the result of caregiving stress (think a licensed carer, health advocate, etc), while compassion fatigue is usually in response to another person’s traumatic stress. You might also be feeling a kind of compassion fatigue from constant exposure to your friend’s chronic illnesses. What’s interesting about compassion fatigue is that it also results in a diminished capacity for empathy. In that state of mind, empathizing becomes tiring and frustrating. You’re not a bad person for feeling this way. It’s actually a warning sign for your well-being.

Your letter sounds like you’re under pressure to help your friend. You want to offer good advice and solutions but (as you pointed out) there’s really not much you can do from where you are. I think it’s important to ask yourself where this pressure is coming from. Does your friend expect consistent support from you for his illnesses? Is the expectation internal to you because you have a strong desire to be a good friend? Solutions-oriented people like me suffer when someone in our orbit needs help and we can’t ‘fix’ it for them. Could this be your feeling? If the pressure is coming from your friend, then yeah, you may need to (kindly and empathetically) communicate boundaries about what you can and can’t do to help. If the pressure is internal, you’ll have to recalibrate your expectations.

Without getting into the woods of long-term caregiver fatigue, I’ve got some starting points:

Your feelings are valid

Whatever your feelings are, it’s better to acknowledge them and pick through the ensuing responses to learn more about yourself. Fatigue, resentment, and frustration aren’t signs you’re a ‘bad’ person. In this situation, they’re a bodily signal telling you to make a change before things get out of hand. It’s okay to experience those feelings fully.

Know your reach

Everyone has limitations and restrictions. There’s little you can do to directly address your friend’s chronic illnesses. If you’ve reached the point of frustration and resentment, you’ve probably doing everything within your power already. Knowing that we have limits isn’t an admission of weakness — it’s a protective factor that stops us from overcommitting to the impossible.

Turn the lens inward

After seeing your feelings as valid and finding your limits, you’ll have the resources needed to practice self-care. Self-care isn’t always relaxation for its own sake. It goes much further if you have an idea of why you’re doing it and where it’s aimed.

More ideas from the peanut gallery

With the why of your situation covered, let’s look at more practical solutions. Based on your query, I’m guessing that he’s had chronic illnesses for a long time and your difficulties started after he moved cross-country. In that case, the issue isn’t the illnesses alone but that there’s suddenly more distance between you. This understandably makes it harder to maintain the friendship, especially if your expectations were set by a time when you could meet face-to-face. On top of that, phone calls place sole focus on conversation and the expectation to update each other. For your friend, the developments of his illnesses and anxieties fall under that umbrella. They take up a lot of his mental space, so it’s natural that he wants to talk about it.

With all that in mind, is it possible to digitally recreate how you used to spend time together? Shaping your catch-ups with a shared activity or interest takes the focus away from life updates. It might just give you breathing room when the conversation is naturally broken by an activity. Something to take the edge off between heavy topics? For example, I’m a gamer. I can stay in touch while playing games with friends (not even the same game) and chat via Discord. If not gaming, do you have other shared interests that can be linked? Art sessions, taking a walk, cooking together, or watching a show?

You can even parallel play or body-double for each other. That’s when you do separate things (playing for parallel play, work/chores for body doubling) in a shared space. It can be done digitally. You could hang out on a call while washing dishes or making dinner. Or while one of you builds tiny model ships inside glass bottles or something. Body-doubling can even make chores more bearable by adding a friendly social dimension. You may have to find common ground, but a good starting point is to tell him that you want to recreate how you used to hang out. Or do something new and hang out together, rather than take another call.

Maintaining close friendships is hard. The difficulty is doubled when someone’s going through a difficult time or there’s distance. You’ve got both on your plate. Whatever happens, try to stay emotionally open to your friend’s struggles while also letting go of the need to aid them. Remember: You’re only human. You’re not a jerk. Friendship isn’t just about providing lending aid or staying up-to-date on each other’s lives. Friendship is about having fun and spending quality time together. You both deserve that.

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