How to help a friend in need

(Oprah.com) -- "If there's anything I can do, just let me know." Surely you've said that to someone going through a rough time -- we all have. It's the sort of well-worn, well-meaning phrase that we utter reflexively before hanging up the phone, anxious to do our friendship duty.

But here's the thing -- most people in the midst of a crisis can't really get it together to tell you exactly what they need.

How, do you best help a friend who is having serious difficulties? How do you open a conversation in a sensitive manner? And what should you avoid saying at all costs? We asked the experts -- and some women who have been there.

How do you help a friend who's seriously ill?

Psychologist Alice Chang, co-author of A Survivor's Guide to Breast Cancer", says that if a friend is ill but mobile, you should take her out to eat every week or two, because sick people are often isolated.

If she's housebound, drop off some food, and bring videos and books on tape, because certain treatments impair vision. "Don't overstay your visit," she says. "Acknowledge the illness and ask what the progress is, and then talk about activities of daily living." If she's a close friend, volunteer to do laundry or clean her house, chores she may be unable to do herself.

And be sensitive to the pendulum swings of her mood. Chang says, "I tell people, 'I know that the feelings are not always rational, because that's how emotions are. But it's okay.'"

Don't blurt out that she looks awful, but don't tell her she looks great if it's clearly not true. "Hug the person and say, 'Some days are better than others, and I hope you have more better days,'" says Chang. If her appearance has radically changed -- if she's bald from chemo, for instance -- don't pretend you don't notice. "Instead," Chang recommends, "say, 'You have a nicely shaped head' or 'Isn't it a lot cooler?'"

Don't say, "I know how you feel." An epileptic patient once told Chang, "If I've heard it once, I've heard it a thousand times -- 'I had a dog with epilepsy, so I know how you feel.'" The truth is, you don't know how your friend feels, so the best approach is to invite her to tell you.

Want to help a friend who's in an abusive relationship?

Pam Smieja, a public speaker and educator on domestic violence -- and an abuse survivor herself -- says that above all else, it's important to be a stable presence. A friend who is consistent, reliable, and gentle, even down to her tone of voice, is a profound source of comfort for someone dealing with an abuser's volatile moods.

If your friend is open with you about her situation, says Merry Arnold, PsyD, a Boston-area therapist who specializes in trauma including domestic abuse, "you can help her plan an escape by getting spare car keys, duplicate I.D., and a stash of cash that she can keep in her car or at your house -- all things she'll need if he locks her out or she has to leave her house in a hurry."

Call a 24-hour domestic abuse crisis hotline to educate yourself, then give her the number. A hotline can be more helpful than friends or family, says Smieja, because "many volunteers have been abused themselves and understand the fear and pain and chaos." Offer to let her call from your house, where she'll be safer -- and give her privacy while she's on the phone. "She wouldn't want you sitting there listening," Smieja says. "It would be too shameful."

It's better to give your friend the number of a nearby domestic abuse shelter than a spare key to your house, which could jeopardize your own safety. "The address of the safe house is confidential," Smieja says. "A cop once slipped me the name and number of a shelter. I hid that sucker really well, and that's what I used when I left."

If you suspect abuse, don't ask an open-ended question like, "What's going on?" Smieja says. "Because she'll lie. I always lied. Gently touch her arm, look her in the eye, and say, 'If you need me, I'm here for you.' That will open a door. Eye contact is very, very important. If she senses you're uncomfortable, she'll never go to you."

Don't ask why she doesn't just leave. "Living with an abuser is like being in a concentration camp," Smieja says. "There are consequences. My abuser copied my whole address book, waved it in front of me, and said, 'If you leave, somebody will pay.' I knew he was capable of ugly things." Arnold agrees. "The person can leave only when she's ready. Be patient."

If you'd like to help a friend who's in a financial mess, enjoy each other's company on the cheap, says Liz Perle, author of "Money, a Memoir: Women, Emotions, and Cash." "Take a walk. Get your nails done for 10 bucks. And unless it's her birthday, don't treat her -- that will only make her feel less empowered. Money really is power, and you have to be sensitive to that."

"Talking about money is the last taboo," Perle says. "It's like talking to teenagers -- never ask a direct question." Get her to open up by discussing your own financial challenges.

Unless she's a responsible person and faced with an unexpected short-term problem -- say she totaled her car and needs help with the down payment on a new one -- don't loan her money.

"Money problems are often about something else; if you take over, you may be solving the wrong problem," Perle says.

"Offer support emotionally and help her find a financial counselor." Avoid hindsight advice like "You should have bought an apartment," says Shana (not her real name) from Burlington, Vermont, who is coping with financial problems after a job loss. "We all look back and know what we could have done better." E-mail to a friend

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