Episode 14: Chronic Illness, Emotional Labor, and the Friend No One Checks On

In this episode of Both Sides of the Couch, Kari reflects on a small, ordinary moment that sparked a much bigger realization about imbalance in relationships. Through the lens of a therapist, a chronically ill person, and a friend who often gives more than she receives, she explores what it feels like to be emotionally capable yet quietly unsupported.

Kari unpacks how emotional competence is frequently mistaken for self-sufficiency, how chronic illness causes support to fade over time, and how helpers often become invisible in their own relationships. Drawing from personal experiences with grief, friendship, and long-term illness, she names a pattern many people feel but struggle to articulate: being strong doesn’t mean not needing care.

This episode is for chronically ill listeners who feel forgotten, therapists and helpers who are quietly overgiving, and well-intentioned friends who care deeply but aren’t sure how to show up. With compassion rather than blame, Kari offers validation, insight, and gentle reframes for building more attuned, sustainable relationships.

Transcript

0:01

Welcome to both sides of the couch. I'm Carrie, a therapist who also happens to be a human navigating chronic illness, which means I see life from both sides. This is where I share honest stories, lessons, and little reminders that you don't have to have it all figured out to keep showing up. Let's get into today's episode. Today we're on episode 14, chronic illness, emotional labor, and the Friend, no one Checks on. So today I am gonna talk about a personal experience that happened that triggered some reflection on these three roles I kind of play in my life. And the concept of. Equality and relationships. So this was a very small, ordinary moment. I really wanna emphasize this wasn't a conflict, this wasn't something I was deeply upset about. Just a thought that kind of lingered. This has been more reflective for me. I don't want anyone to take this as reactive to the example I'm gonna share, and I'm gonna make it really vague. Because I don't want the person that this is about to know it's about them, and then feel like it was more than it was. I was having dinner with a friend and there was like a casual mention of an event that already happened, and there was just like a, oh, in the moment, a definite like, huh. I don't even know if I would say it truly brought up hurt. Maybe just like surprise. I wanted to show up for this person and celebrate with them by inclusion. It was not there and it was shocking to me. But for many reasons I didn't want to bring this up because I didn't wanna make it about me.'Cause it wasn't about me. And there are just some other circumstances where I felt like it would've been really distasteful for this person's situation to make. This event about my feelings, but I had been reflecting on it'cause it was just kind of like, I don't know, lingering, the thought was lingering in my mind. So I kind of zoomed out as I was processing it and realized this is about what I experience as a pattern in my relationship, not an isolated event. That's why this feeling felt kind of familiar and it was lingering there for me. So there was like my therapist lens, which I feel like ties in with my emotional capabilities as a human and a friend. So I guess for me to sum it up, this is an episode about an imbalance in relationships. So I feel like I give much more in my relationships, maybe sometimes in like a physical capacity. But mostly in an emotional capacity. So I feel like I am there for my friends more when I know they may be struggling and I don't feel that's reciprocated. I. Make sure to like celebrate with my friends more when they have like an accomplishment or you know, something celebratory happens. I make sure to say something about it. Obviously, like read other people's emotions really well, so I pick up on little things and kind of check in more. And also like working as a therapist, I learn for so many people how important it is to just feel supported. So I'm always trying to find a way to show that support. Another example that kind of came up for me when I was piecing this together was grief. The way we show up for the people that we care about when they're grieving I have a few examples of this, but most recently, this past year, I lost a family member and had to put my dog down within 48 hours of each other. It was a really rough month for me because of these two reasons, and I told people about it. I'm more reserved, I don't just Overshare or, you know, I'm not dropping all of this personal information about myself to most of my friends and people in my life, but you know, the ones that knew me and my dog and my relationship with this family member. I let them know as a therapist, I'm really attuned to loss and how that could potentially affect people, and also the complications around expressing condolences and support and care that it's really tricky. Not an easy thing to do. And when your friend is hurting about something so big that there's nothing you can really do to make them feel better, a lot of people just tend to avoid it. Why? I don't wanna make them feel bad. I don't know what to do, so I'm just not gonna talk to them about it. So I understand it, but I can really only remember two people checking in on me outside of me telling them. That my family member and my dog had passed away, and one is my bestie. Shout out to her. You're the exclusion. When I talk about how people aren't showing up for me I do feel super grateful to have her as my best friend. I think us both being therapist. S plays a role in how good of a friendship that we have, and I think we're also super empathetic towards each other because we both have chronic illnesses as well. So I, I'm really lucky that we found each other. We actually met in grad school and we talk every single day, but yeah, so she did check in on me and actually one of my clients checked in on me. I had let my client know that I had to miss a session because I needed to put my dog down and would not be able to have any sessions that day. But reflecting back on it now, I'm like, yeah, no one else. Reached out to me or checked in with me, whereas I would have checked in the first few days, how are you doing? Is there anything you need? I would've followed up after that, even months later. You know, I'm aware this and Syl be lingering. How's that going? Is there anything you wanna talk about? Or even just saying something like, Hey, I'm thinking of you. I feel like that's one thing as a friend like I do really well is grief. When you lose somebody, I feel comfortable in knowing what I can and should be doing as a friend to show up. So anyways, there's just a lot of little moments like that where I'm like, huh, I'm doing this for everybody and they're not doing it for me. And I think a lot of therapists will relate to that, right? Like people just kind of. Mistake, this emotional competence that we have for us being self-sufficient. They don't need to be checked on. They know how to handle this, they'll be fine. They see that maybe we're more regulated than other people in times of crisis or, rough times. And assume that means that we don't need to be checked on. Insight can often be mistaken for independence. Just because people are insightful doesn't mean that they don't need support in the way that people who struggle with insight need, and I think helpers by default just become containers. When you're good at holding space for others, I think people just tend to forget that you need it too. So then there's the chronic illness piece that came in for me as I was thinking about this. I think anyone who's chronically ill will relate to, the fact that people don't check in on you. And show up for you the way that you do when someone has a situational illness. Like if you're getting a surgery, people probably send you flowers. They might visit you at the hospital, they reach out to you, they cook you dinners, right? There's all this stuff that they can do. It's clear cut and it's a one time thing. So it's easier to be there for somebody when it's clear and situational. Yeah, but since people with chronic illness feel bad to some degree every single day, they don't get the help and check-ins like that unless there's a big event like a surgery or a hospitalization. Oh, and something that's still to this day is like very hard for me to hear is when I tell somebody that I've been having a bad flare or I'm not feeling well, and they go. You haven't been feeling well for years. I think it's meant to be empathetic, like oh yeah, I'm aware that you struggle, but there's also a message of I can't tell a difference.'cause you always don't feel well. So I don't get the validation or support when my baseline is lower than it normally is. Like my baseline's already lower than everyone else's, but when I'm in a flare, it's a dip down. That is a struggle for me. And I think a lot of chronic illnesses are invisible and people don't see that. So they don't know that you're not feeling well or when you become used to chronic pain, something that would put everyone else on the floor screaming. You can work and function normally with that level of pain because you don't have a choice. People just don't really check in. After a while because nothing's new. Being someone who struggles with not feeling well pretty much all the time and not getting support and care from loved ones and the way that I give to them when they have situational illnesses or periods of not feeling well. When all that comes together, I kind of feel invisible and. I think I appear like someone who doesn't look like they're in need, and I get erased from people's radar and I notice that I'm, very aware of patterns in relationships, being a couple's therapist. So this episode's for all the chronically ill listeners who feel forgotten. All the therapists and helpers who. Are quietly overgiving and not receiving, and the friends and partners who care, but feel unsure of how to show up for these people. And again, I wanna reassure this episode isn't about blame. It's not recorded out of anger. It's just about awareness patterns and gentler ways of relating. First part for my chronically ill listeners, if this is you, I want to validate for you. You're not imagining it. People do appear to care about us less than we care about them. I think the experience of being checked on less over time is more structural than it is personal. I don't think the people in our lives are looking at us. On a personal level and deciding not to check in with us, I think there's confusion with our consistency as, oh, we're good cop. And when you're always sick, others don't track the changes the way that you do. They don't notice the little valleys on that normally low baseline. And when pain or discomfort is part of our baseline, we don't really show it. Yeah. The same way that someone who only experiences it occasionally happens. I think, I think what I'm trying to say is it's not that people don't care, it's that long term suffering doesn't fit into how most people understand how to give support. This isn't like a norm that we're taught, so not an excuse, but I understand where people come from, so. It makes sense if you're feeling lonely. It makes sense if life feels unfair and it's not wrong of you to wish that other people would check on you more and show support. For my therapists and emotionally skilled helpers, it's really difficult to be the most emotionally capable person in the room if you are always the regulated one. This might staying, but that core message that we receive is emotional capacity often gets. Misread as emotional independence. So being someone who has high emotional intelligence and does well at processing their emotions independently, often get overlooked as people that need emotional support. I think also, you just feel super isolated. If you happen to be surrounded by a lot of people who don't feel comfortable talking about their emotions don't know how to name their emotions and lack the emotional insight that you're able to find so easily, I think a lot of therapists relate to the fact that it's hard. To make friends as a therapist. I mean, there's the upfront assumptions people make about being a therapist. I often feel like conversations with new people get shut down when they ask what I do for work and I answer they will physically turn away from me after they hear the answer. I don't know if it's the discomfort in realizing that maybe I could notice things about them. That they don't notice themselves or that other people don't notice, or it's that they think we want to be a therapist 24 7 and we're gonna involuntarily provide them therapy, which none of us wanna do. I don't think there are many of us doing that for funsies. If people are, there's red flags being waved. Ferociously in your face. I personally only have a high motivation to work when I'm being paid or compensated in some way. I don't want to work for free for friends and family just because I'm more. Emotionally aware and am better at certain relational aspects doesn't mean that I'm choosing to be a therapist in my personal life. Those are just skills I'm naturally good at at this point. So I think often if you have friends that are not therapists and you go through something difficult or. Somebody has kind of wronged you in some way by leaving you out of something along those lines. People tend to think it's not a big deal for you. Oh, well they're a therapist. They should be able to understand they should be able to handle this on their own, or they don't need someone like me checking in on them. But that's really not true. We want space to be held for us too. And sure, I'd love it to be, uh, the quality of space that I'm holding for you, but I'm aware that I can't expect that from people who are not therapists. And that's okay. We have our therapist friends where relationships tend to feel a little more equal. But. I think it's also hard to be a therapist and be friends with another therapist. There's so much awareness in those relationships sometimes that it's easier to turn it off For me, I know specifically as a therapist, I onal relationships are triggering because it makes me feel used. I don't feel used with my clients because we have a clear defined. Boundary in our relationship on being compensated for fulfilling this role for you. Like it's upfront on the table that it's not gonna be reciprocated, but with my friends, that's not the case. I feel like we each should be equally contributing to the relationship and when I feel like people don't or can't do that for me it's definitely a trigger. I'm not getting paid from this. Why do you get to have all the benefits from the relationship? And I don't. And I just have to accept that most of my relationships are gonna be like this. I've tried communicating with friends about, Hey, this feels unequal, or It's not fair that you're not showing up for me the way I show up for you. And. That really doesn't change the relationships, typically. That's a friendship ender in my experience. It makes people feel too uncomfy. They don't want to be called out like that in a friendship. I do have friends where I'm able to say, Hey. This didn't feel right to me and here's why. And we repair and move on. But a lot of people, I find that I'm the only one that has to initiate repair or, accept the situation is unchanging. But anyways, I think my point was that it makes me feel used. Yeah. Why do I have to. Fulfill this role when it's only one sided. And I know I don't have to, to a certain degree, nobody's saying, you must support me. You must check in on me. You must show up for me. But to me it's the bare minimum and I'm doing it and the fact that you don't want to try to reciprocate that at your own level. But you continue to take the benefits of me doing it for you that's being used. So for the friends, the partners, and these well-intentioned people, I think you care deeply, but you may still be missing it. I see that often in my work as a therapist with couples and with other therapists, right? It's not necessarily that the people in their lives don't care about them, although that may be the message we receive sometimes. But maybe the avoidance comes from helplessness, not indifference. So people don't know what to do. When they can't fix something, like I said earlier, oh, you have this chronic illness that never goes away and I can't help you. Or you're grieving and I can't take that pain away from you. It's a lot harder for people to show up in those situations. Those clear cut like. Oh, you are having surgery. I'll send you flowers and cook you a meal. You can pop in your freezer. It's, those things feel so much easier to do because we know what the expectations are. I think a lot of people worry about saying the wrong thing too. I know I say the wrong thing sometimes, even at work as a therapist I like the part about being human where you can take responsibility and start over. Our words are not never changeable. You can always say, oops, that didn't come out the way I wanted it to land. Let me try again. But I think for a lot of people, silence feels safer than imperfection. And as a therapist, we focus so much on growth. Like any oh moment is an opportunity for growth that I think most therapists find really exciting, especially when it happens in the therapeutic relationship because it is such a safe relationship to process that. But okay, for you guys, I do have a loving challenge. I want you to know that when you're not checking in with someone that still is communicating something. Even when you don't mean it to. So avoidance and not saying anything can actually send the opposite message that your intention is. So if your intention is, I don't want to make you feel bad about something, you're already feeling bad about you, not saying anything doesn't take that away, but you saying something might potentially make it better. Even just knowing someone. Recognized how you felt or cares to check in can mean tremendous things for somebody struggling with chronic illness or the person that never gets checked on. So there are ways that you can express this without asking questions or saying something that could potentially land wrong. We don't need solutions from you, and you don't really need a reason. Oh, I heard you're not feeling well. I'm checking in on you. You really can just say something simple like, I'm thinking of you today. That kind of leaves the door open for the other person to respond to that if they want to or just know. That you're there and maybe they'll respond and say thank you, or maybe they won't respond at all. Or maybe they'll respond and say, Hey, actually I'm having a hard day. And open up to you a little bit. I think the both sides of the couch for me. Is two conflicting sources, right? I have a chronic illness that makes me need support, but as a therapist, I also have the emotional competence that makes me look like I don't need support. So I think those things, when they mix together, I just disappear a lot of times for people. Yeah, and I talked about a lot how it shows up in friendships and it does show up a lot in family systems. Trust me. It is not fun to be a therapist in any family, even if there are other therapists in your family. It's also hard and professional roles. You know, if it's just work relationships where there isn't really a friendship outside that still plays a role. Like when your friend calls outta work'cause they have the flu, you'll check in on them or do something nice. But when you're struggling with your chronic illness, nobody sees that. And I think especially for women, there's another dynamic in here too, as being a woman We are supposed to be the carers and the supporters, and that role often is not left to men. And so being a woman that's also a therapist and has a chronic illness and gives a lot to their relationships, it just feels sometimes a recipe for. Disappointment and loneliness. I don't know. I'm sick. I'm capable, and I'm still expected to carry the room sometimes. So for my chronically ill folks, I just wanna leave you with some thought. It's okay to let relationships be partial. It's okay to stop explaining your pain and it's okay to want more from your relationships and accept limits from your relationships. For my therapists and helpers, you don't owe everyone access to your inner life being strong. It doesn't require being silent and care doesn't have to be reciprocal to be meaningful, but it shouldn't be one way. And then for those friends and support people out there checking in isn't intrusive. You don't need a milestone, and presence matters way more than perfection. Being emotionally capable doesn't mean being emotionally self-sustaining. Thanks for listening. Thanks for joining me on both sides of the couch. If something you heard today resonated, share this episode with someone who might need it. And if you'd like to support the show or find more of my work, check the links in the show notes. Until next time, take care of yourself on both sides of the couch.