by Roberta Horton, LCSW, ACSW
You could be rejected. When you do ask, the answer could be “no” — and you might not want to put yourself in a position to find that out. There are emotional costs that you would pay, for example, in learning that your partner is not willing to share more in household tasks or that your boss refuses to allow you flex time.
Your cultural values and upbringing stop you. Some cultures emphasize the importance of “picking yourself up by the bootstraps” and going it alone. Other cultures underscore the value of allowing oneself to be dependent on extended family and social networks. What kinds of expectations existed in your family growing up, and how do these expectations frame your current thinking about asking for help? Family members, and your own internalized “family values,” may interpret asking for help as being lazy, emotionally weak, or manipulative.
Gender and age can make a difference. In the United States, men generally have more difficulty asking for help than women do — even for travel directions. Being a man in our culture may make it additionally hard to show dependence on others. Age is another factor. If you are a younger person with arthritis, people may not expect you to ask for help, making it harder to approach them with your needs. The stereotype is that arthritis affects women and older adults. (In fact, we know that arthritis can affect both men and women, young and old.)
You look fine. Your arthritis may not “show.” Although in some ways reassuring, this can also make it especially hard to ask for help when you don’t look as though you need it. Whether you are requesting a special parking permit or are in need of extra rest at home, you may be afraid that others will not believe your need for help is credible. You may have had the experience, for example, of people resenting your taking a seat on public transportation reserved for people with disabilities, when you seem able-bodied.
You don’t know whom to ask. Sometimes you’re not sure who the right person is to ask for help, and this can be a deterrent to asking at all. Sometimes you may feel isolated and sense that you don’t have someone you can really turn to to ask for the help you need. Living with arthritis for some time may have reduced your circle of support.
You’re not sure how to ask. Finding the right words when asking for help can be stressful in and of itself, making you even more reluctant to ask. You want to communicate your request in a way that is likely to be understood and acted on but are just not sure how.
So far, we’ve described some of the kinds of help you may need — help with physical functioning, with work and financial considerations, with education about your arthritis and its treatment, and with emotional support. We’ve also identified and described some of the barriers that can get in the way of asking for help. With this in mind, here are a number of strategies you can use to assess your personal situation and overcome the barriers that keep you from asking for the help you need.
Prioritize, specify, and develop an action plan. Since asking for help doesn’t come easily for many of us, figure out in what area of your life help is most needed. Initially, you may feel “everywhere.” Unless you prioritize, however, asking for help will feel overwhelming, and you may not even attempt it. Instead, consider writing a list describing what you need help with and labeling items as top, second, and third level priorities. (You could use the four areas described earlier as a framework.) This list can serve as a good planning tool. (A tip: You may want to consider first asking for help in an area in which you are most likely to achieve success, as this can help bolster your confidence in moving forward and asking for other kinds of help.)
Next, make the items in your list as specific as possible. For example, you might replace “I need more information from my doctor” with “I need more help understanding treatment options and possible drug side effects so I can make better choices at my next doctor’s visit.” Doing this can help you more easily move from a general concept of needing help to taking the step or steps necessary to actually asking for help. You might end up deciding, for example, that what you need to do is “write down specific questions before my next appointment,” “research medicines on reputable Web sites ahead of time so I’ll be more informed,” or “go to a support group to hear what other people’s experiences have been.” Develop a timeline for your request for help and the activities leading up to it.
Once you make up your mind to ask for help and actually do it, the stress and even dread that you had will likely be replaced by a feeling of relief — relief that you decided to take care of yourself and relief that others actually responded. Of course, there’s no guarantee that all the help you hope for will be forthcoming. What you’re telling yourself (and others), however, is that your needs count.
Last Reviewed on December 14, 2011
Roberta Horton is Director, Social Work Programs and Staff Development, in the Division of Patient Care & Quality Management at the Hospital for Special Surgery in New York City.
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