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Well Being

Psychologist's 'Ring Theory' can help you not say the wrong thing to people in grief

Psychologist's 'Ring Theory' can help you not say the wrong thing to people in grief
Concept by Susan Silk, Graphic by Annie Reneau

It's hard to know what to say when someone you know is going through a crisis. Whether a person has lost a loved one, received a dire medical diagnosis, or is experiencing some other kind of grief, we're often at a loss for words for how to comfort them.

It gets even trickier when we share in some measure of the person's grief. When your friend finds out they have a terminal illness, that's painful for your friend and their family, but also for you. While it's important to honor that, it's also important to recognize that your grief isn't the same as the person afflicted, nor is it the same as their spouse's or children's or parents' grief. It's totally fine to feel the weight of your own sadness and loss, but there are appropriate and inappropriate places to put that weight. For example, saying to a mutual friend, "I can't handle this, it's too devastating" is very different than saying the same thing directly to your friend who just found out they are dying.

Psychologist Susan Silk has created a helpful concept that makes figuring out what to say and what not to say a bit easier. She refers to it as the Ring Theory, and she and author Barry Goldman described it in an op-ed in The Los Angeles Times.

Here's how it works:


First, draw a circle and put the name of the person in crisis in the middle of it. Then draw a ring around that and label it with the people closest to them—spouse, parents, children, etc. Then draw another ring for their intimate friends or other family members they are close to. Next, make a ring for their close co-workers, not-quite-as-close friends, distant relatives, etc., followed by a ring for other people who know them—acquaintances, community members, and such.

These concentric rings represent which direction our words of comfort and empathy should go, and which direction the venting or dumping of our own feelings of grief should go.

The person in the center can say anything they want to anyone, of course. The crisis is theirs and they get all the leeway and grace in how they express their feelings. People in the rings around them can vent their feelings toward people in the larger rings, but not the smaller ones. If we're talking to someone in a smaller ring than we are in, our words should only be comforting and empathetic, such as "I'm so sorry you're going through this," or "What a terrible tragedy, let me bring you a meal to make this time a little easier for you."

Silk explains that when we are talking to a person in a smaller circle from us—someone who is closer to the crisis—the goal is to help. It's appropriate not to offer advice, no matter how helpful we think we're being. It's not an appropriate direction for our personal storytelling or expressions of despair, however sincere. If we feel an impulse to do those things, we should point it outward, toward the people farther from the crisis.

We should never put people in smaller circles in a position of feeling like they need to comfort us. Comfort should move inward through the rings, not outward.

Let's imagine my friend Lee just lost her mother to cancer. I lost my much-loved mother-in-law to pancreatic cancer just six weeks after her diagnosis, but this is Lee's crisis, not mine. As a friend, I'm not going to tell her how much I miss my mother-in-law, describe in detail how hard it was to go through losing her, or go on and on about the meaning of life and death. I'm not going to say those things to her spouse, either. I might say, "I'm so sorry. Cancer really sucks, and this is such a hard thing to go through" and then offer to help watch the kids or bring over a casserole.

Concept by Susan Silk, Graphic by Annie Reneau

If I'm talking to a mutual friend or someone Lee knows peripherally, that's when I might share my own story or how Lee's mom's death is bringing up my own feelings of grief. The key is to make sure I'm pointing that emotional venting of my own toward someone in a larger circle, not a smaller one.

As Silk and Goldman explained, it's not so much what you say as whom you say it to.

"If you want to scream or cry or complain, if you want to tell someone how shocked you are or how icky you feel, or whine about how it reminds you of all the terrible things that have happened to you lately, that's fine," they wrote. "It's a perfectly normal response. Just do it to someone in a bigger ring."

"Comfort IN, dump OUT," they added.

Silk and Goldman point out that most of us intuitively know not to dump our feelings on the person in the center of the circle, but we may not be conscientious enough about how we talk to those who are close to the crisis as well. The Ring Theory visual can help us see where it's appropriate to vent and where it's not, and how best to help both those who are grieving and who are in the grieving person's orbit.

It can even help us recognize what we need most when we find ourselves at the center of the circle. All of us will be there at one time or another, and knowing where we are in the rings can help us know how to comfort one another through our grieving processes.

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Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

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It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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