People ask me for advice about difficult conversations. I guess because I'm a nurse, although nurses certainly do not always do this well. I mean the kind of conversation you dread when someone's been hurt by cancer/mental illness/crime/disaster/loss; the kind where you want to show you care, but you are afraid of making them cry, and you don't know if they want to talk about it or not, and you think you might break down yourself and that would make them sadder, and if you say the wrong thing they will think you don't care, and you'll look stupid saying nothing, and all you can think of is how inadequate you are to have this conversation no matter how much you want to. You know that conversation.

Talking about awful events, you might think, is fraught with potential for error, and if you say the wrong thing, you will make it worse. "But then again," you think, "maybe saying nothing will make it worse. So what do I say?!" Anxiety about what might happen if you start down that road without knowing where it's going is common. The good news is that the fear is usually driven by concern, at least in my experience.

This is a short primer on some ways to think about that dreaded difficult conversation. Why to do it. Ways to start and end it. What to do in the middle when the conversation lags.  I hope it will be useful. These suggestions are in no particular order.

First, know this: nothing you say will do harm if your heart intends to comfort.  Don't you discern another's intentions pretty accurately most of the time? So does the person in pain. They will know that you mean well. They will not be vetting every single word's perfection. They will be listening with a grateful friend's or loved one's ears. 

Second, people who are suffering really need you. This holds whether you are a friend, family member, concerned acquaintance, or spouse. When someone is in pain, your mere presence (or even a telephone call or email) is enough. The right words will come (you have likely already thought of them) but even silence (especially silence?) is enough.  Do not feel compelled to entertain or keep the dialogue running smoothly.  Pain is awkward, and you will not change that.

Speaking of silence, do so.  Just sit. Just be near. It's not at all what we are accustomed to, in our usual chattering existence, but in times of crisis and sorrow, silence can be very comforting. It means you are willing to simply give of your time and yourself, with no agenda or goal. A lovely gift, no?

I said you have probably already composed the right words in your head. They might sound like this: "I don't know Jim very well, but I heard his sister died, and I wanted to tell him that I'm sorry."  An admirable start. Now rearrange a bit and you have "Jim, I heard your sister died and I wanted to tell you I'm sorry." Jim will thank you, and then you will say "Take care," or "You're welcome." And you will have done a good thing.

You could cry, yes.  Doing so would reveal your feelings about the pain endured by your friend/loved one. It would convey something words cannot. And that would be fine.

Do things. Don't ask , "Can I do anything for you?" Instead, say "I'm going grocery shopping and here's the list. Anything else you want?" Or pick up the kids at school, cook, vacuum the house or mow the yard and so on. 

You may think there are others better equipped to take the lead; a closer friend, a professional who understands better than you. Not true. If you care, you are qualified. People with cancer have told me that what they crave most is normalcy.  They want you to tell them a joke, talk about work, complain about politics  --  whatever you'd normally do. And you are absolutely the best-qualified at being you. 

If you do talk about the illness/pain/tragedy, let the friend or loved one  lead the way. No need to probe. They will share what they want, and no more, and that is exactly what they need to do.

People who are suffering don't always want to talk about their disease/loss. "How will I know?",  you will ask. You will know when you say something like "Would you rather not talk about it now?" Then follow your friend/loved one's lead.

If there is one rule for what to say, it may be this: the best thing to say is what you mean, not what a Hallmark card would say. Poetry is unnecessary; psychotherapy is unwarranted; sincerity is all that is required.

You can do this.