Having the Hard Conversations by Lucie Kavanagh



Having the hard conversations

by Lucie Kavanagh

“Such she often felt herself—struggling against terrific odds to maintain her courage; to say: “But this is what I see; this is what I see,” and so to clasp some miserable remnant of her vision to her breast, which a thousand forces did their best to pluck from her.” 

― Virginia Woolf, To the Lighthouse 


I had a phone conversation with a mental health nurse recently. Before the call I had in mind a few difficulties that I was experiencing and wanted to try and talk about. I stumbled through them and although courage failed me before mentioning everything I had in mind, I somehow got out the main points of what I wanted to say.   

“So you’re doing really well,” she replied, “that’s great!” 

My confusion at the feeling, not a new one, of having just accidentally spoken in an entirely different language, lead me to agree with her. Maybe she was right, I decided. Maybe what I said was trivial to her.  Maybe she was in a hurry and had other patients to speak to. Maybe I called at a bad time. Maybe I wasn’t clear enough. 

But what I forgot in that moment was…none of those things were anything I needed to take responsibility for.  

I have a few theories about what makes a conversation, especially one about mental health, difficult. They range from preconceived ideas on both sides of the conversation, emotional involvement and anxiety, shame, worry about appearing weak, inability to put words on to very complex feelings to feeling like a burden or a problem. Any one of these things is a powerful silencer so straight away a conversation is never going to be easy, either to initiate or receive.  

In my experience, it was the conversations that I thought would be ok (because they would be with “professionals”) such as with doctors or in my own workplace in a social care setting that turned out to be the very hardest.  It’s so often the case in difficult times, the greatest supports can come from the unexpected sources and vice versa. 

The first ever conversation of this sort I had was with my GP. I think it was particularly complicated because I tried to describe a feeling when in fact what I was experiencing was a lack of feeling. It was like a light had gone out. It was like time had become distorted. The days were suddenly too long because all of my usual favourite routines and pastimes didn’t feel worth doing. More and more there was a darkness – a sense of nothing – no rest, no activity, no peace, and a desperate need to hide it from everyone I knew. But I didn’t have this insight back then and I spoke in terms of the general “I think I’m depressed” and “I don’t feel like myself”. 

My GP looked at me for a moment and then said “well-you’re 34.  You’re single.  Your career hasn’t progressed.” 

I remember mentally doing a slight double take. Of all the responses I anticipated, I had never for a moment expected that a response to my admission of feeling depressed would actually point out why I should be! He was looking at my life from his point of view and his own opinion of where the problems lay, but the fact was that none of those things had ever been a problem for me. I was happy being single and I loved my career as it was. Suddenly these observations felt like an added failure, as if a mirror was being held up to pile more reasons on top of everything bad I already felt about myself. 

For me, the hardest conversations to actually initiate and follow though were and are those with people I love. I can talk to doctors and psychiatrists, write articles like this, tweet, post and debate the topic of mental health without difficulty.  But with people I am close to, there’s still an urge to protect them from it. There’s shame about what they will think. Will I seem weak? Will they think I’m not trying enough? Will they be upset or distressed? All of these fears make those conversations very difficult and a lot of this has been further fuelled by the hardest conversations of all which were those at my workplace and with people who had known me for years. Again, these were conversations I worried about having but had an expectation and hope of being understood. I wanted to be fair to my colleagues and those I supported in case my difficulties began to impact my work. This sadly was my undoing but I still can’t say that I regret the decision to disclose. I just regret not seeking support for myself in the process, not stepping away when it became too much and not ensuring that I knew exactly beforehand what I needed to impart.   

Without doubt, one of the scariest aspects of starting a difficult conversation is the fear of how it will be received. The response is something we have no control over and maybe this is what makes it truly frightening. 

“We’ve googled it [Borderline Personality Disorder] and it’s not pretty.” 

“You drink far too much coffee” 

“Have you tried yoga/mindfulness/CBT/positive thinking?” 

“You take too much medication” 

“You need to take more medication” 

“This medication worked for my friend’s mother’s sister” 

“Therapy will make you worse” 

“Therapy will really help” 

“You need to try harder” 

“You’re making yourself unemployable” 

“Everyone feels like that” 

These are all responses that I’ve had in response to conversations or statements about my mental health and I know that I am not alone in being familiar with all of these. The thing is though, when you are struggling, when it’s hard to think, when you feel desperately ashamed because you think you should be able to get on with things, advice isn’t helpful and quite often just adds to the sense of shame and uselessness. What we need is to be heard and seen, for example: 

“That sounds so tough for you.” 

“What would help right now?” 

“Would you like me to come with you/stay with you/meet with you/ring you?” 

“Would you like to tell me about it?” 

“Would you like company at/after that appointment?” 

As in the example above, how someone else reacts to us is not something we need to take responsibility for (easier said than done). If someone isn’t in a position to hear or respond to us in the way that we need we can’t change this and it’s not our fault. The more we can find words and speak about how we feel, we will find the people who will hear or see us and they might surprise us. But sometimes there’s no fault on either side; emotion or anxiety can get in the way and we need to keep reminding ourselves that we are not wrong to communicate and that we have a right and deserve to be heard and seen. It’s not easy but the “right” response is a very powerful thing and worth striving for. 

I think it’s also important to bear in mind that we can choose to step away from a hard conversation. This is something I often wish I had realised sooner, particularly in those work situations. We can say we need to change the subject for now, that it’s getting a little overwhelming, that we would like to have a think and come back to it later. These are all valid choices. The priority is self-care and not letting the talk have a detrimental effect. Sometimes a little time to regroup and take a breath can work wonders. 

If all else fails, we need to remember too that there are so many ways to communicate without words. If we are finding it hard to speak, our bodies might be doing it for us. Our facial expressions. Our silence. And these can be read and understood and hopefully responded to with compassion and care. We can write paragraphs, poems, paint or draw, use colours…there are so many way to have a conversation and speech is only one of them. Emotions and feelings can be portrayed and emphasised with in so many different ways and just as we sometimes find a piece of art or music that seems to impact on a deeply personal level, it’s all communication. Words quite often are merely a lead in rather than the whole of what needs to be said. 

Above all and however you can, keep saying what you need to. You deserve to. 


“We cannot control the way people interpret our ideas or thoughts, but we can control the words and tones we choose to convey them. Peace is built on understanding, and wars are built on misunderstandings. Never underestimate the power of a single word, and never recklessly throw around words. One wrong word, or misinterpreted word, can change the meaning of an entire sentence and start a war. And one right word, or one kind word, can grant you the heavens and open doors.” 

― Suzy Kassem, Rise Up and Salute the Sun: The Writings of Suzy Kassem 



If you are having a tough time at the moment and need to reach out for support, please contact any of the following

Shine: phil@shine.ie

Samaritans: 116123

Pieta House: 1800 247 247

YourMentalHealth.ie: 1800 742 44

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