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The question

My friend has terminal cancer. What are the best ways to support her emotionally?

The answer

The most important thing you can do is listen to your friend. This may sound easy but it can be stunningly difficult. Allow your friend to just talk. Give her permission to share the range of thoughts, fears, and anxieties she is having, even if they make you uncomfortable.

The support of friends and family is absolutely essential for someone who is dealing with a terminal illness. Despite the best of intentions, however, loved ones often struggle with knowing how to best provide this support.

When we are faced with difficult situations, a natural human tendency is to want to "fix" the situation for the loved one who is hurting. Be aware of this tendency as it can actually inadvertently feel invalidating or dismissive of the experience the other is having.

Ask your friend what she needs from you, and what you can do that would be helpful. This can involve both emotional support, as well as support with errands, cleaning or other day-to-day tasks she may be struggling with. It's okay to let your friend know that you don't know what to do or say, but that you want to support her.

Avoid the tendency to say things like "it will be okay", or "I know you will make it", as this is inaccurate and may be perceived as trivializing her circumstances.

Be mindful of not inadvertently communicating to your friend that you "know" how she is feeling.

Saying things like "I can't even imagine what this is like for you - please help me understand" can provide her with space and permission to communicate openly with you.

Allow your friend to just be. Simply being present with her can be tremendously helpful. Avoid the tendency to fill every moment of silence with talking. The physical presence of a loved one has an immeasurable impact on alleviating some of the emotional and/or physical pain someone who is dying will be undoubtedly experiencing.

Avoid focusing all discussions on her illness. Individuals that are at the end stages of life often very much appreciate and want to continue to have the types of conversations they normally would have had before their illness – about kids, hobbies, sports, work.

Pay attention to how you are being impacted by your friend's illness. Being aware of the range of emotional reactions this is bringing up for you is important. It is natural for you to be experiencing a range of emotions – sadness, anxiety, anger, perhaps even guilt. Ensure that you have your own outlet for support, as if you are able to deal with your feelings that will put you in a better place to support your friend.

Be genuine and authentic with her. There is no "right" or "perfect" thing to say. You can let her know that you are scared, that you don't know what to say, that this is hard for you as well but that the most important thing for you is to give her the support she needs.

Finally, communicate to her how much she means to you. Tell her you love her and express all the wonderful ways she has positively impacted your life.

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Samra.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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