Communication Skills

Ah, communication. What a tricky thing you are.


When you’re a person living with Chronic Pain (PwCP), you get asked the same question quite frequently.

How are you?

And my standard response has always been, “I’m fine”. But what a lie that is, when clearly, I’m not fine, or I’d be living a different life. If I was fine, I wouldn’t be on disability, using a cane or a walker everywhere I go. If I was fine, I wouldn’t be in constant pain from my Fibromaygia, or my D.I.S.H. or my osteoarthritis in every joint, or experiencing the issues that go along with my Bipolar Disorder or my Diabetes Type 2 or my Trigeminal Neuralgia.

If I was fine, I wouldn’t have insomnia, and be up 22 out of every 24 hours, even after taking valium to help me relax and sleep. If I was fine…I wouldn’t be blogging about being fine.

So why do I respond that way?

People Don’t Want To Hear The Truth

People don’t want to hear the truth. It makes them uncomfortable to know that someone is hurting when there is nothing they can do about it. It makes them feel weird, to hear about someone else’s pain. They get antsy, thinking they’re in for a long diatribe about medical procedures and doctor visits as if they’re at risk for catching something themselves. They get nervous thinking they’ll hear about your emotional state. And to be honest, a lot of the time, people don’t really care how your feeling. They ask you how you because they’re polite. It’s the right thing to do.

So, I’ve decided to stop telling people that I’m fine. I’ve decided to come up with a new response, and that new response is:

“Part of me is great, and part of me is not so great.”

I’ve decided this gives people an out. If they don’t want to know more, they can simply reply “well, I’m glad part of you is great” and carry on with their own lives. If they genuinely want to know more, they can ask about the parts that aren’t doing well. That way, I know that they’re sincere about how I truly am instead of just making polite conversation.

I hope this doesn’t sound like I’m being sarcastic, because I’m not. I’m genuinely trying to help people be more comfortable around People with Chronic Pain and to find a way to make it easier to ask and answer that question of “how are you”. It’s a tough one because there is no one good answer. The PwCP doesn’t know if you’re sincere and we don’t know how much information you truly want. The last thing we want to do is bore you with the latest in our medical news, and trust me…it’s truly devasting for us when we think you’re interested and then we find out you’re not.

Showing Real Interest

I doubt seriously there’s any malicious intent in your question either, but again, it comes down to being polite and being interested. I would rather give you a polite answer and have you ask for more information if you really want it, but that comes with its own complexities as well. Suppose I say “I’m fine” and you hear “oh, she’s fine, I guess everything must be okay” when what I really mean is “I’m fine, but not really and I wish you would ask me more about my day and how I’m feeling”.  It’s a communication breakdown because I don’t feel I can ask for what I want in case you’re not really interested, and you don’t feel like there’s necessarily anything else worth asking about.

If you ask me if I’m fine though and I tell you “actually, I’m not doing so great”, how would you respond? If you’re simply being polite, now you’re stuck. You either have to listen to what’s wrong or say something trite like “oh, I’m so sorry to hear that” and change the subject. Neither of us leaves the conversation satisfied, so my response, even if it’s the truth, isn’t the best one either.


Two small words with so much meaning behind them.  That’s why you’ll be hearing a different response from me going forward. I’m going to try my best to stay away from those two words to make it easier on all of us and start answering with my new response:

“I’m doing as well as expected given the number of health issues I’m living with.” That leaves it open to the person to expand on the subject if they wish or to simply say “oh, that’s good” and move on.

I appreciate your thoughts and comments about this subject. And for those of you without chronic pain, I hope you’re doing fine – really!

There is always hope.

7 thoughts on “Communication Skills

  1. Hi Pamela, first of all I want to say that I am sorry that you are in so much pain. I get depressed when I get sick, so I can’t even imagine keeping your good attitude among what seems like many health issues. I agree that some people so ‘I am fine’ as a knee jerk reaction, and we all should elaborate more about how we are really feeling, but I think it depends on who you are talking to. If it is a good friend, then yes elaborate, if it is a coworker or someone you are passing by then maybe not? I will admit that I am not good with sickness in myself and others, and so I avoid talking about my own sickness (if I am sick), and so I think that sometimes people with health issues want to be seen as just a person sometimes, and not just seen for their health issues, so sometimes I don’t ask, thinking that maybe they are tired of talking about that and want to talk about their emotions, dreams, wishes, goals. Anyway, it is tough, and I really don’t know the answer, but these are my thoughts on it. Take care of yourself, Peta

  2. Hi Pamela:
    I hear what you’re saying. When I ask someone how they’re doing, it’s because I truly care and would listen; however, everyone isn’t wired that way. I have friends in similar situations as you, wheelchair bound, and I have changed my question to what you suggest. How is your day today? It’s a hard one. I appreciate your post, perspective and I’m so sorry to read all the challenges you go through. Xxoo Melanie

  3. Thank you for commenting Melanie. Most people aren’t like you, in that they ask “how are you” out of politeness but don’t really care to hear the answer. I find that hard to deal with. That’s why I developed an answer to let them off the hook. I’m glad you’re one of the caring types!!! Thanks again for writing.

  4. I can relate to this post because while you say you’re fine on the inside sometimes you’re wishing people knew what you were going through or that they cared enough to dig a little deeper. I like that you’ve come up with an alternative response!

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