You care. You see them struggling. You hear them crying at night when they think everyone else is sleeping. You see them wince at unexpected triggers as memories resurface. You see them nervously start to fidget when you pass the hospital on the way to church. You see the PTSD. The grief. The broken heart. The lost life.

You love a chronically ill person, but you have no clue how to help them as they wrestle with sadness — with grief — too deep for you to reach.

Today, I want to talk to everyone who knows a chronically ill person. (If you’re a spoonie yourself, you might appreciate this article I wrote on the same topic.) There’s something really important you need to know: every chronically ill person goes through a period of grief. They mourn everything illness has stolen from them. Which is a lot. And I’m not sure when grief ends here on earth, if it even does.

Of course, reading this, you should be aware that I’m no counselor. Not yet, anyway. I’m just sharing the things that would be helpful to my own grieving — the spoonie in your life may appreciate the same things or hate them. Proceed with caution, every person is different.

You also shouldn’t assume that the chronically ill person in your life is grieving. Obviously, they are fighting a huge battle, and the following principles can be beneficial. But for me at least, it took three-plus years to truly begin mourning everything illness stole from me. Sure, it hurt to think of the things I’d lost and the things — like my heart — that got broken. But it wasn’t until my health started to improve that I was able to breathe and think and —- feel the pain.

So. Without further ado, my very tired brain — and heart — shall share four tips for loving a chronically ill person through their grief.

• See and Validate

Yeah, I know this seems obvious. But seriously, truly stop and see them. See the pain in their eyes. See the dropping of the shoulders. See that the anger and fear could really be grief. See the fake smile. See past the mask. We spoonies can try to hide our grief. We tend to not want to burden you further.

But so often, the most powerful thing you can do is see our pain and validate it. At least for me. Acknowledge that it’s there. Help us realize it’s a real emotion worth processing. See the link between the current grief and the chronic illness, even if the illness is far in the past.

1. Give Hugs

In his book, A Teen’s Guide to the 5 Love Languages, Gary Chapman writes, “During times of grief, touch communicates love silently and powerfully. So while Touch isn’t normally your thing, for that intense season of grief, it might mean a lot to you.” Physical affection can be a huge comfort when grieving from a chronic illness.

It helps us know you see our pain even if you don’t know what to say. In fact, be aware of your words. Don’t say stuff just for the sake of saying something. On the other hand, don’t necessarily go totally quiet on the subject, because that makes us feel more lonely. Saying “I wish I knew what to say,” counts as speaking, you know.

However, be aware that sometimes physical affection is the last thing we need, especially from someone who walked through the trial of chronic illness with us. Because if you walked through it with us, chances are you made human mistakes and unintentionally hurt us — and if that’s what we’re grieving about, hugs from a person who hurt us are not ideal.

1. Identify Triggers

I’m not sure how it is with other grieving spoonies, but personally, there are things that trigger waves of grief. I can be fine one moment, and then something will happen and the aching, clenching pain will wash over me.

Sometimes, it will cause instant tears if I’m alone. Sometimes, it will just be visible by a sagging of my shoulders or one squeeze of my hand. Other times, it isn’t noticeable at all, even if you were paying attention.

Triggers can be places, people, smells, phrases, sounds, movies, songs, whatever. For example, I struggle a lot with guilt about the way illness has affected the lives of those around me, so one of my triggers for grief tends to be people accusing me or even just implying something, or me making a mistake and blaming myself for something.

If you can be aware of the triggers for the grieving spoonie you know, it can help you know how to love them. You can work to counterbalance lies they may be believing, or you can give them extra care when you notice something triggered grief. You can be gentle and also try to spare them grief at inopportune times or when they have a lot on their plate.

1. Understand Grief Is A Process

I don’t say avoid grief completely because to heal, us spoonies need to grieve. It’s part of the healing process, and we have to do it at some point or another. Grieving what illness has stolen and broken is a process. In C. S. Lewis’ book,  A Grief Observed, he writes, “I thought I could describe a state; make a map of sorrow. Sorrow, however, turns out to be not a state but a process. . . .Grief is like a winding road where any bend may reveal a totally new landscape.”

It’s horribly hard. Some days, it won’t seem to affect us at all, but other days grief can be more crippling than nausea or dizziness or weakness or physical pain. I’m not exaggerating. It clouds our thoughts, it creeps into our conversations and interactions, it makes us crave distraction, it steals our sleep. It’s unpredictable and changing. As soon as we find our feet, it switches — different triggers, different memories, different emotions.

Grief is a process. And unfortunately, it appears to be a long one. Years of life stolen by chronic illness, years of pain — they aren’t going to magically go away just because you forget it’s there or you think it’s time. The grieving person feels is continually, even if they don’t show it.

So be willing to stick by your chronically ill friend’s side for a long time, even when others forget. Continue to acknowledge their pain, give hugs, and watch for triggers. Yes, they will heal. Our God is in the healing business. It’s kinda His thing. But give them time and continual love. Try not to leave them to fight alone.

There are so many more tips I could give. Like when to push and when to give space. This is not complete, and I will repeat, this is just my experience. The spoonie in your life may need and want totally different things. But if nothing else, seek to be aware. And rely on God for help. He knows exactly what your chronically ill loved one needs and when. He is love, after all. (See 1 John 4:8)

Note: I should have said “person who is chronically ill” not “chronically ill person”. I apologize.