How to Be There for a Friend When You Don't Understand

TW: Mention of suicide and self-harm

A friend supports you even when they don’t understand you.

— Anonymous

I recall a conversation years ago with a friend. Let’s call her Natasha. Tash. I was telling her how another friend felt no one had ever understood her. The things in her head. What made her tick. What motivated, delighted, and disturbed her. Tash was indignant. She said no one has a right to expect others to understand them. I didn’t get it. But I do now, which is ironic when you think about it. I doubt she’ll read this. We parted ways years ago. But if you chance on these words, Tash, thank you.

Knowledge and Understanding

It’s natural to want to understand how things are for someone who’s poorly, distressed, or struggling in some way. That’s especially so if it’s someone you’re close to and care about. I knew very little about mental illness when Fran and I met fifteen years ago. Nothing about mania or depression or the chronic fatigue and pain she also lives with. I’ve learned a lot by talking with her and other friends, by taking courses, and by reading blog posts and books. We wrote a book to share what I’d learned. Four years ago I wrote a blog post on how to educate yourself about your friend’s mental health condition. The central message still rings true for me.

Whatever your friend’s situation, approach educating yourself about it as a privileged insight into something you may never fully understand.

That may never fully understand is what this blog post is about.

Frames of Reference

There are degrees of not understanding. I’ve known low moods and flatness. Fran’s suggested I’ve been clinically depressed at times, though I’ve never sought professional help or been diagnosed. I have been physically and mentally exhausted. I’ve known moderate to severe pain. I can extrapolate these experiences towards a partial understanding of what she goes through with depression, chronic fatigue syndrome (CFS/ME), and fibromyalgia. That’s not true of everything. Some things are so far beyond anything I’ve experienced that it would be ridiculous of me to say I understand. As Fran put it, I don’t have any frame of reference. I’ll explore four of these in more detail: mania, psychosis, self-harm, and suicidality.

I Don’t Understand Mania

When Fran and I met in May 2011 she was wildly manic. I was captivated by her energy and presence. I’d never met anyone like her before. It took a while for me to recognise how dangerous mania can be. I learned to spot the red flags. The looping hamster wheel thinking. The obsessive note taking. The need to share everything she was thinking with everyone she knew. The grandiose schemes. The changes in her use of language. I became her vigilance partner, confidante, and editor-in-chief. Recognising the signs and helping to ground her through episodes of mania — being the string of her balloon, as Fran once described it to me — was vital to her well-being. More than once she told me she would not be here if not for me. But it isn’t understanding. Fran excels at describing what she’s going through but even the best analogy of mania is no more than an approximation.

I Don’t Understand Psychosis

Fran doesn’t experience psychotic symptoms but I have other friends for whom these are very real. I write “very real” deliberately. Hallucinations don’t just seem real to the person having them. They may be indistinguishable from what we call real experiences. I once read that the brain of someone experiencing a psychotic hallucination — hearing voices, for example — is receiving exactly the same nerve signals as they would if the sound was external. My friend and fellow mental health blogger Aimee Wilson described her auditory hallucinations in a 2013 post titled The One With The Headphones Analogy.

The best way to describe the voices I hear so that you can understand is that they’re like when you wear headphones to listen to music. They go in through your ears but somehow it’s like the music is in your head and no one else can hear it (unless it’s really loud!). That’s how I hear my voices; through my ears.

I have no idea if this is true for everyone or for all aspects of psychosis. It nevertheless gives me a sense of how confusing and scary it must be to hear, see, think, or feel things that other people insist are not real. How would I feel — how would you feel — if everyone you trust told you the things you could see or the voice you could hear or your most concrete beliefs about the world were false? How terrifying would that be? How would you ever trust them again? How would you ever trust your senses and thoughts about anything? How would you know what was safe to believe or act upon?

I Don’t Understand Self-Harm

Self-harm is an umbrella term. It encompasses a wide range of essentially unhealthy behaviours which nonetheless serve some purpose in a person’s life. My knowledge of self-harm is partial and second-hand. A number of years ago I attended a self-harm awareness session at my local Recovery College but most of what I know comes from talking with friends. The reasons or triggers that lead someone to self-harm are complex and may not always be obvious even to the person involved. Logically, I can understand someone self-harming if it alleviates intense emotional or physical pain, moves them though a moment of crisis, or protects them from attempting something more dangerous. It’s harder for me when “weird thoughts” lead someone I care about to act in ways that imperil their health and safety. From the outside I can see that the rational basis for their actions was flawed. I may not be able to understand but I can accept they acted on the basis of things they believed at the time to be valid and necessary and true. I’m grateful to Aimee for allowing me to share the following excerpt from her social media post for this year’s Self-Injury Awareness Day.

Firstly, coping in this way has never felt like a “choice” for me — I’ve always believed that if I had felt there were other effective coping skills, I’d 100% have chosen those!

I’m an atheist so John Bradford’s assertion “There, but for the grace of God, go I” holds no meaning for me. But in my friend’s place I don’t know that I would act differently. That doesn’t make their actions any less serious but it holds open the door to empathy and compassion.

I Don’t Understand Suicide

The distinction between self-harm and suicidality isn’t always obvious or clearly demarcated. The person’s intention and the degree to which they’re responsible for their actions are important factors. I remember a friend insisting that what to me had been an clear and obvious instance of self-harm wasn’t that at all because they hadn’t acted with that in mind. A potentially fatal action such as an overdose might be a deliberate attempt to end a life. But it might be better understood as an instance of self-harm or a desperate attempt to escape extreme physical, emotional, or psychological distress. Fran and I describe several types of suicidal ideation in our book. These include relentless thinking, situational or stress-induced thinking, hopelessness and despair, and suicide by proxy. Some are more comprehensible to me than others. All are valid to the person experiencing them. All are to be taken seriously.

It Doesn’t Have to Make Sense

There are other things I don’t understand. Dissociation. Obsessive compulsive disorder. Addiction. Eating disorders. The aftermath of rape and abuse. It’s not merely that I’ve not experienced these things. I cannot imagine what it must be like. But I don’t need to. What my friend is going through doesn’t have to make sense for me to hear them. Believe them. Accept their reality. I expressed this the best way I know how in I Believe You. It wasn’t Your Fault. You Are not Alone. Being There for a Friend Who’s Survived Rape or Sexual Abuse. That’s not to say it’s always easy for me. We are pattern seeking creatures. We yearn for explanations. Uncertainty is unnerving. Unsatisfying. My inability to understand why my friend thinks or behaves as they do can lead me to frustration or concern. Worry even, despite the don’t worry about me care about me mantra I learned from Fran in our earliest days as friends. Unhealthy and unhelpful as they are, however, my frustrations, concerns, and worries have a right to be here. I don’t always have to make sense to me either.

Accept But Don’t Enable

Accepting things we don’t understand isn’t the same as condoning or enabling unhealthy behaviour. The difference is expressed well in an anonymous quotation I came across when researching this piece.

Support your friend, even when you don’t support their situation.

I haven’t always followed this injunction. When we met, Fran’s mania expressed itself in a compulsive desire to establish a non-profit called Wild Hair. The following is taken from our book.

The idea was noble, to found a charitable organisation offering support to the ill and disenfranchised. Such was Fran’s conviction and energy that several months passed before I realised there was little substance to her scheme. Throughout that time, I supported her efforts. I established a website for Wild Hair, and helped draft and edit e-mails to people and organisations Fran wanted to approach. One friend recognised the dangers more clearly than I did.

Fortunately, we were able to extricate Fran from the scheme before she committed too much of her money and resources. This doesn’t only apply to mania, however. It’s just as important to support someone living with psychosis, self-harm, or suicidal ideation without encouraging their unhealthy beliefs and behaviours.

Support With Dignity

Being a supportive friend means doing what you can whilst recognising that you cannot be and do everything. Your inability to understand doesn’t mean you can’t be there for them, but it may mean they need additional support from people who do. This might include professionals such as doctors, psychiatrists, therapists, or counsellors. It might also include peer groups or individuals whose lived experience more closely matches theirs. SMART Recovery is a peer-led organisation for people recovering from or affected by addictive behaviours. Fran finds their online groups helpful in navigating her relationship with food and supporting her elderly parents. She shared a quotation by American author and podcast host Mel Robbins that she heard in one of the SMART Recovery sessions.

Let them have the dignity of their own experience.

Your friend’s experience is no less valid just because you’re unable to understand it. Understanding that is foundational. I’ll close with an excerpt from I Wish Our Friendship Could Keep You Safe But I Know it Can’t And That’s Okay.

Finally and above all, trust that you and your friend are doing your very best to keep them, you, and your connection strong, safe, and healthy. I’m conformed by the fact that friends and loved ones trust me with their dark and difficult times, as well as their good times. They’re here for me as truly as I am here for them. There may be no guarantees, but we’re committed to remaining present in each other’s lives. And maybe that, ultimately, is what safety is all about.

 

Photo by Lava Lavanda at Unsplash.