The Most Frightening Three Words

How are you? Those words, usually from a well meaning friend, or a truly concerned loved one, can strike terror in the heart of the suffering. For the tormented who endure chronic pain, or those silent souls who hide their wounds, the question threatens to expose the sufferer to the inspection of their pain.
Those three words enter their isolated world and threaten to undo them.

How can one answer truthfully, honestly, and completely—when the answer would be filled with details, and a depth of agony, that the listener is unable to comprehend? And, as the sufferer is searching for an adequate response, he’s left feeling ashamed for attempting to provide an answer, knowing that the compassionate questioner cannot possibly enter their world to empathize. They cannot answer for fear of being misunderstood, or their sincerity questioned (or perhaps their sanity).

The question itself is a reminder of the sufferer’s isolation.

And so, the easiest route to take, is to mumble a reply that provides a half-hearted sufficiency in an attempt to remove the danger of exposure.

The afflicted typically reply with the ready response: “I’m okay” and that may be all they can muster, or it may be their default answer to protect themselves from bringing something into the light they so desperately want to keep hidden.

We may need to find a more creative path to uncover the needs of the suffering heart other than the invasive “How are you” question.

I’ve watched LeRoy attempt to respond to that question. And it is so hard. I’ve watched as people tell him how well he looks, or how he seems to be improving. And I’ve known that as they are making those comments, a horrific muscle spasm is making its way up his thigh and into his groin—pulling his leg so hard, he feels it might rip from his body—as he attempts to cover the pain, in order to converse with the questioner and not alarm them.

People don’t realize things like: the reason that he wears shorts even in the middle of winter’s frigid temperatures, is because his leg is searing from the burning nerve pain that never ends, and it’s just too hard to place anything at all near it. Or the reason that he pushes himself to be more mobile, isn’t that he’s no longer in pain or that he’s feeling well, or has suddenly improved dramatically—no, he pushes himself to move because he fears if he doesn’t, that he’ll lose his ability to move altogether.

But, I’ve watched as he exerts himself to do far more than he feels he can—only to pay dearly for it through the night with painful episodes that keep him from sleeping. 

For those of us who long to come alongside the sufferer to provide help, it is important to be mindful that they are weary of answering the question of how they are feeling. They need the opportunity to voice their pain—but in voicing that pain, they fear that it may trigger more pain. They fear that in sharing, it will be more than the listener is ready to receive, or more than they have the emotional capacity to share.

I’ve learned that it is best to patiently and gently approach those who are traumatized by their pain and be willing to wait.

Let the sufferer know you are praying for them, ask if there is anything specific you might be able to do for them, but wait for them to voice their pain when they are ready. Always, always, be asking the Holy Spirit to direct your conversation with them that you might bless them and not accidentally add to their suffering.
As a caregiver for one who is fighting a daily battle with pain, it is imperative that I ask God for grace to follow the command of Colossians 3:12:

“Put on then, as God’s chosen ones, holy and beloved, compassionate hearts, kindness, humility, meekness, and patience . . .”

We can only “put on” compassion, kindness, humility, meekness, and patience, through the power of Christ, accessing the grace He provides.

We must patiently set aside the need to know every detail of how our loved one is feeling, or what they are thinking, and simply display the compassion of one who is willing to step into the pain with our loved one. Compassion doesn’t demand answers, but watches for opportunities to serve the hurting.
Kindness steps in to serve, supplying the need that is evident without requiring information from a weary sufferer.  

The sufferer knows that you know they are suffering, but they don’t want that to be the focal point of your relationship. Instead, treat them in a normal way, talk to them about subjects in the same way that you would with any other friend. Ask how their kids are doing, talk about the latest sports event, or tell them about a new hobby you have—just like you would if they weren’t ill.

LeRoy doesn’t want his illness to be the focus or the topic of every conversation, in fact, most who are suffering would like the opportunity to put their mind on something else.

I’m not saying that we should ignore their suffering, but don’t treat them as though their illness is their identity.

If the sufferer was a social bug before, or enjoyed group activities, offer to include them in any way you can—they have the option to decline, but at least give an opportunity to accept your invitation if they feel they can. The sufferer lives an isolated life, and when you offer to include them in normal activities, it helps them to feel that you view them as more than just a person with a disability, or an illness.

When you treat the sufferer as a valuable person, rather than a victim of suffering, it helps to remove the stigma that they feel characterizes them.

When the setting is right, and seems appropriate, introduce laughter—tell them your latest funny story or most embarrassing moment you had recently. Laughter is so very important, and hard to come by, when you’re living an isolated and pain-filled existence.

And finally, if you tell your friend you’re praying for them, don’t let it be just a “Christian buzz phrase” but actually pray. Don’t think lightly of the ministry of prayer. As you come alongside the sufferer and offer heartfelt intercession for them, in their presence, it can provide them with the reassurance of the Lord’s care for them and is an opportunity for the two of you to join together in that intimate work of the Spirit.

“Therefore, confess your sins to one another and pray for one another, so that you may be healed. The urgent request of a righteous person is very powerful in its effect.” (James 5:16)

For a believer who has a suffering friend or loved one, no matter how difficult it is to attempt to minister to them, we are commanded to “put on compassionate hearts and kindness” (Colossians 3:12) and one way we can do that, is by being sensitive in how we approach them. The next time you see that friend, instead of asking “How are you?” perhaps begin that conversation with: “It is so good to see you, I’ve missed getting together with you . . .” and before you walk away, pray with them.


  • Jane

    Thanks so much for the guidance. I especially appreciated the specific suggestions on alternative conversation starters and also the suggestion to actually pray for the situation, not just say you’ll pray. This had already been suggested to me from a friend whose daughter was struggling with an aggressive cancer, and I recognized the voice of experience in it. I might suggest these thoughts may cover how to greet a recent bereaved friend or acquaintance. I can see them thinking, when I ask “How are you?”, “Well how do you think I feel? My heart just got ripped in half! Father God, be with this couple as they follow the path that is set before them. Strengthen both to step beyond the day and into Your continued service. Lessen the pain of this brother, and enable Kim to continue sharing Your truths with us all. We cannot see the why’s but know there will be a reward for enduring. When time comes to see You face to face, we will forget the why’s, and rejoice in Your presence! Amen

  • kimberlywagner

    Hello Jane ~

    Yes, totally agree that this could cover those type of situations, anytime one is grieving a hard loss or dealing with trauma. Thank you for your kind and encouraging words. Your message was a tangible blessing today! May you be blessed as well ~

  • Rebekah

    Oh those words! I try to stay away from pat answers. Instead I express my sorrow in the situation and try to empathize even if I have not experienced their pain. I also always say God knows and He is with you. My heart hurts even this morning for friends facing horrendous circumstances.

  • Kim Oneal

    Oh my goodness can I relate. Sometimes the pain of going to church and having to try to answer the dreaded “how are you?” “how is your husband?” question makes me want to stay home. There is no answer that can portray the suffering he endures on a daily basis and even if I try often people don’t know what to do with it. So I just mumble “ we are ok” “he’s holding on”…and move the conversation in a different direction.
    And when people tell me how good he looks or how well he is doing, I often find myself wanting them to see what I see and what survival looks like everyday and the losses that are our new normal. There is no easy answer and ultimately I have to fall back and know that only Jesus fully sees and knows. Thank you for sharing Kimberly and continued prayers for you and Leroy. 💕

  • Heidi Herrick

    Kimberly, thank you for articulating so beautifully how I feel. I just wrote a post on this topic but couldn’t quite formulate my emotions as you’ve done in this post. Thank you for expressing this and providing these practical tools.

  • Aaron Fleming

    I just read this article for the first time on encouraging those who suffer. I suffer from extreme neuropathy and it’s very rare that I get a moment where I’m not screaming with pain in my feet. However as a pastor the comments you made were very very helpful. Sometimes the best thing I can do when I am really hurting in my feet is to find someone else that I can encourage who may be suffering worse than I am. Thank u for all ur help here. Blessings. Pastor Aaron Fleming

  • Donna Doverspike

    Kim and Leroy,

    I just wanted to say I am praying for you both and that I pray for answers to your situation soon be revealed.

    Blessings to you

  • Susan Ray

    Thank you so much for writing this. As my mother slowly died by Lewy Body Dementia, the three most frightening words for me were, “How’s you mom?” I pray that the Lord in his mercy for people who are suffering will cause this to be read by many.

  • Gail

    Dear ones,
    I have to say Thank you so much for this honest truth. So many times we care deeply yet have no words that seem right, so it’s easier to not write or say anything. I so appreciate all that’s been said! So for now just know our stumbling words are covering hurting hearts for you. Wanting to help yet we have nothing to give.
    So thankful for prayer, For Jesus , and for heaven to come!

    May God give you His strength to live for Him, which you are 🙏✝️💞

  • Barbara Harper

    When we brought my mother-in-law home from the nursing home, she was down to 90 lbs. and incoherent. We thought we were bringing her home to die. Instead, with one-on-one care and taking her off a narcotic painkiller that we hadn’t even known she was on, she gained weight and became clearer. She was 85, though, so the inevitable decline continued until she passed away last year at age 90. She was bedridden, and the last two years, she slept 20-22 hours a day and didn’t speak.

    It was hard to know how to answer when anyone asked how she was doing. Once when we said she was declining, a man said, “Well, we’re all declining.” If we indicated she was having any trouble at all–not eating well, needing oxygen–the inquirer seemed upset. But this is what it means to care for someone who is dying–things are going to get worse, not better. Most of the time, there was nothing going on good or bad, but when we repeatedly answered, “She’s about the same,” some thought we weren’t being open.

    The ones we felt we could be most open with were those who were taking care of parents or had in the past. They “got it.” When they asked how she was doing, we knew they really wanted to know and they understood.

    Much of what you shared here is good for people in this kind of situation as well. Thank you.

  • kimberlywagner

    Pastor Fleming, I’m so very sorry for your pain. Have you ever read any of Dave Furman’s books on suffering? He is also a pastor who deals with debilitating pain daily. You might find his writings helpful. Thank you for your kind words. Pausing to pray for you now, may God meet you in the pain and provide tangible help in your time of distress!

  • kimberlywagner

    Thank you for sharing some of your story, Barbara. Such a long, hard road to walk . . . and as you said, I think those who “get it” are only ones who have been in a similar place of care-giving. The story of caring for your mother-in-law is a sweet testimony of God’s grace in the midst of sorrow and loss, and I’m grateful you spread that grace here.

  • Anna Elzinga

    Thanks you for those wise words. I find it hard to know how to respond to the “how are you’s” when indeed your fibromyalgia pain is flaring yet on the outside you seem find and may have even dressed up for church. I give people grace knowing they mean well, but am always not sure just how much to say about how I feel. My heart goes out to those with have these more “invisible illnesses”, and struggle daily with pain. Lord may we in the church be sensitive to those suffering in silence and maybe instead of asking how they’re doing just assume its hard for them and offer a hug and prayer.
    Kimberly, your words have such wisdom and God is using you as a care giver to Leroy to help many of us in communication with those in chronic pain. Thank you!

  • kimberlywagner

    Dear Anna ~

    I’m so very sorry for the chronic pain that you experience, and I understand how hard it is to find a response to those who ask. May the Lord provide you with healing and relief, and if He does not, He will provide you with the grace to continue glorifying Him in your pain.

    Thank you for your kind words, your comment blessed me.