The Problem with Well-Intentioned, but Hurtful Comments
People who live with chronic illnesses—conditions that last a year or more and require ongoing medical attention or limit daily activities—face unique challenges. While friends and family often mean well, certain phrases can come across as dismissive, judgmental, or uninformed. The common desire to offer a solution or silver lining can end up invalidating a person's lived experience of pain and struggle, especially with invisible illnesses where symptoms are not always obvious. The key to being supportive is to focus on listening and empathy, rather than fixing or comparing.
Dismissive Phrases and Their Harmful Impact
When someone is struggling, the last thing they need is for their pain to be dismissed. These phrases can make someone feel like their illness is not real or important.
- “But you don’t look sick.” This is one of the most common and frustrating things a person with a chronic illness hears. It implies that their illness is not real simply because it isn't visible, suggesting they are faking it. Many chronic conditions, such as multiple sclerosis, fibromyalgia, and autoimmune disorders, have invisible symptoms like severe fatigue and pain.
- “It could be worse.” This toxic positivity minimizes their current suffering by comparing it to others' pain. While it's true that someone else may have it worse, that doesn't lessen the reality of their own difficulties. This phrase invalidates their feelings and can lead to shame or guilt.
- “Everyone gets tired.” Chronic illness fatigue is not the same as regular tiredness after a long day. It is an overwhelming, debilitating exhaustion that sleep doesn't fix and can severely impact all aspects of life. Comparing it to everyday fatigue shows a deep lack of understanding.
Unsolicited Advice and 'Miracle Cures'
Unless specifically asked, offering advice can feel like an accusation that the person hasn't tried hard enough to get better. This can feel particularly insulting when they have spent years consulting with specialists and managing complex medical protocols.
- “Have you tried yoga / essential oils / a new diet?” While these things can be helpful for some, they are not universal cures, and suggesting them implies that the person simply hasn't found the right, easy solution. It trivializes the complexity of chronic disease.
- “You just need to think more positively.” This places the burden of recovery on the patient's attitude, suggesting their negative feelings are preventing them from healing. It is an unhelpful and scientifically baseless idea that dismisses the physical reality of their condition.
- “You'll be fine.” This statement is often used to soothe one's own discomfort with another's suffering but can give a false sense of hope or feel condescending. For many with chronic illness, there is no “fine” to return to, only a new baseline to manage.
Blame-Oriented and Insensitive Comments
Some comments, even if not meant maliciously, place the blame for the illness on the person, or are simply insensitive to their situation.
- “You're probably just stressed.” Stress can exacerbate symptoms, but it is rarely the root cause of a chronic illness. Suggesting this implies the illness is psychosomatic and that the person brought it on themselves by not managing their stress properly. It is a deeply invalidating and frustrating comment to hear.
- “I knew someone who was cured by doing X.” Sharing anecdotal stories of someone's recovery is often more for the speaker than the listener. It creates an unfair comparison and pressure for the chronically ill person to achieve the same result, ignoring the unique nature of each individual's health journey. It also suggests that a cure is always possible, which isn't true for many conditions.
- “Is that really what you should be eating?” Questioning a person's diet shows a lack of trust in their self-management of their condition and can feel intrusive and judgmental. Trust that they know what is best for their own body.
What to Say Instead: Shifting to Supportive Communication
Instead of focusing on what not to say, the goal is to reframe communication to be genuinely supportive and validating. Start by acknowledging their feelings without minimizing or offering solutions.
- Start with empathy: "That sounds really difficult." or "I'm sorry you're going through this." This validates their struggle and shows you are listening.
- Offer specific help: "I'm going to the store, can I pick anything up for you?" or "I'm free on Tuesday if you need a hand with anything." Vague offers like "let me know if you need anything" put the burden on the ill person to ask for help, which can be hard for them to do.
- Engage with them as a person, not an illness: Ask about their life beyond their health. "How was your weekend?" or "Have you seen that new show on Netflix?" A person's identity is more than their diagnosis.
Comparison of Harmful vs. Helpful Responses
| Harmful Phrase | Effect | Helpful Alternative | Rationale |
|---|---|---|---|
| "You look great!" | Implies they must act sick to be believed, invalidating their invisible symptoms. | "It's good to see you. How are you feeling today?" | Focuses on their well-being, not their appearance, and gives them space to be honest. |
| "Just push through it." | Demeans their pain and fatigue, suggesting they lack willpower. | "It must be so frustrating when you want to do things and your body won't cooperate." | Validates their frustration and acknowledges their effort without minimizing their pain. |
| "At least it's not cancer." | Creates a hierarchy of suffering, making them feel guilty for their own struggles. | "That sounds incredibly tough. I can't imagine how that must feel." | Recognizes their pain without comparison and affirms their feelings are valid. |
| "Everything happens for a reason." | Can feel like a spiritual platitude that denies their suffering and grief. | "I'm here for you, no matter what." | Provides unconditional support and companionship without forcing a positive spin. |
Conclusion
Navigating conversations with chronically ill individuals requires a shift from a "fix-it" mentality to one of empathy and genuine support. By being mindful of the impact of our words and focusing on validating their experience, we can create a space where they feel seen, heard, and respected. The intention behind our words is important, but the impact is what truly matters. Learning what not to say to chronically ill people is the first step toward becoming a better, more compassionate ally. By offering a listening ear and specific, thoughtful support, we can make a real difference in their lives, helping to alleviate some of the loneliness and frustration that can accompany chronic illness.
For more insight on empathetic communication, visit the Cleveland Clinic website to see further advice from medical experts on communication strategies.
