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Halfway through my c-section, the anesthesia started to wear off.

I took a deep breath and tried to distract myself. My doctor was working with some nurses behind the surgical curtain, and I forced my brain to focus on their conversation. I was determined not to interrupt. I wanted them to like me, and who likes a needy patient who can’t take a little pain?

This strategy didn’t work for long: I was getting less and less numb. “Tell them this is hurting me,” I whispered to my husband, so the nurse sitting near my head wouldn’t hear. He didn’t hear me either, as he cradled our gorgeous newborn daughter.

Another minute or two passed before I finally couldn’t take it. “Please. I NEED MORE MEDICATION,” I yelped. The anesthesiologist leaped into action. “Of course, of course. Why didn’t you tell me,” he muttered.

Weeks later, when I had time to think about it, I realized something wasn’t right about my attitude in those moments. I was so focused on being a “model patient” who wasn’t a burden to anyone that I failed to ask for help right away when I needed it. I was so embarrassed about my own body’s needs, I’d tried to offload responsibility for getting help to my husband. And it was help I was already paying for, confirmed by the gigantic hospital bill that eventually appeared in my mailbox.

I’m not alone in this. Conventional wisdom holds that women are good at reaching out for assistance. Or at least, we do so more than guys. But that doesn’t mean it’s easy. Personally, I regularly have to give myself a pep talk before doing something as simple as asking my friends for help with childcare. Why is this? I think the biggest obstacle is our culture of shame, which afflicts even our closest relationships with wounds of fear, blame, and perfectionism.

The shame factor

Liz Adams of Cincinnati, Ohio, knows this first hand. She grew up in a tight-knit family, but still struggled to ask for support after she ended her nine-year relationship with her fiancé.

“I didn't even want to tell my parents how bad it was, or let them know how dark of a place I went into,” she says of that painful time in her life. “I think joy is this public feeling you want to share and have it be infectious, whereas asking for help comes with shame which is something that feels very private and isolated.

“I was worried they would worry about me. And that felt very selfish and demeaning in a way. This was a problem that was mine, and not theirs to have to be burdened with.”

Shame is so powerful it can make us feel as though our pain could be contagious. To protect the people we love the most, we hide from them when we need them the most. If I think that asking for help will just spread my agony to other people, why would I do that to someone I care about? For instance, if I had a bathtub full of incredibly deadly spiders, I wouldn’t call my dad to come over and fight them for me, even though he’s probably the only person on the planet who would be willing to do it (and one of the few people I know with access to the required blowtorch). With this view of help-seeking, love is turned inside out; it becomes a force that pushes people who care away from each other instead of pulling them together.

For Liz, the loved ones she hesitated to speak to turned out to be the best source of help. “I think at that point I had already processed through what had happened, and knew I couldn’t fix it all alone,” she said. After she revealed what was going on, “[My parents] were great at picking me up emotionally and encouraging me that I was better than my circumstances.”

It’s lonely in a quarantine, and it’s hard to get help from inside one. But it’s also hard to be embarrassed in isolation: there’s no one to look at you and notice how vulnerable you are. All of us crave “being seen” and understood, especially by our loved ones. But what if they see you in hot mess mode? Having to ask for help strikes at the heart of our culture of perfectionism, in which we are expected to project an image of being self-reliant, independent, competent, and not needy or “dramatic.”

Julia Biars, of Cleveland, Ohio, told me about how that dynamic can turn her willingness to seek help on and off like a light switch. “I’ve often turned around and gone home if I can’t find my way to a place I was trying to get to when I’m by myself, but in undergrad whenever I was on the move with friends I wouldn’t hesitate to ask for help if we got lost,” she says. “All social anxiety disappeared when someone else’s good time was at stake. It wasn’t a safety in numbers thing, either, because my best friend at the time was even more anxious than me and was often so reluctant to ask that she would stay behind in the car while I went inside a place to get help.”

Advocating for others comes naturally for many women, but for ourselves, not so much. “If I’m able to help someone else, I’m contributing. If I need help, I’m a drain,” Julia explains.

The difference between giving and getting care

What about when you need help from people who don’t love you like family? In a way, it’s not a surprise that my urge to conceal my “neediness” reared its ugly head when I was in the middle of major surgery. Study after study shows that women often struggle to get help when they turn to the health care professions—their pain and symptoms are often dismissed, downplayed, or disregarded. It’s no wonder that many of us have taken that treatment on board and worry about looking “hysterical” in front of doctors, to the point that we, too, downplay our needs and fear asking for help.

Emily Palamara, a blogger and Instagrammer from Greenville, South Carolina, experienced this shortly after returning from a trip to Portugal last November. She got sick and went to the doctor complaining of chest pain. “They just told me to go home, rest, [get lots of] fluids, it was probably a flu,” she says. She didn’t get better. “I was so nervous about going back into the doctor and them telling me that I was being a hypochondriac or that I just needed more rest, and I’d waste yet another $25 copay.”

Still, she made another appointment, this time with her regular doctor. She was immediately transported to the ER and put on life support. “Waking up six days later—unable to speak because of the ventilator, walk because of that many days of paralysis, or even think straight because of all the meds—I quickly learned I had to rely on people,” she told me. Doctors later determined that she’d initially contracted a flu-like virus, which turned into pneumonia and acute respiratory distress syndrome, or ARDS. The fast-moving disease can make breathing impossible and kills 30 to 50 percent of people diagnosed with it. “Thank God for the ICU nurses, who seemed to make it their mission to make me feel comfortable [asking] for help with even the most basic of tasks. I cried for days thinking about all the people who helped and still have to get over that ‘indebted’ feeling occasionally.”

There’s a difference between gratitude and that sensation that you “owe.” In our culture, getting help can feel so much like a transaction, and assistance can seem like a high interest loan. Part of this probably results from so much care-giving in our lives being done for a fee. Distancing ourselves from our helpers with money means we don’t have to worry about whether we burdened them. “In reality, we could all benefit from more of a village mentality of taking care of each other,” Emily told me. Of course, even straightforwardly hiring help doesn’t always prevent a shame spiral: Witness the mortification so many busy women feel if they have no choice but to reveal they have hired a house cleaner. Do any men feel embarrassed to admit they don’t have time to do housework, and receive help from a cleaning service? Somehow, I don’t think it’s many.

The blame factor

The other side of “I’m so ashamed” is “it’s my fault.” In her book, I Thought It Was Just Me (But It Isn’t): Making the Journey from “What Will People Think” to “I Am Enough,” Brené Brown writes about how our culture of blame keeps us disconnected. You only have to read comments on social media to see it in action. A feel-good article about a woman getting help after leaving prison elicits responses like “Nice to know crime does pay,” or “She could afford to take care of herself if she didn’t spend her money on those tattoos.” Every summer there are news reports offering ways for parents to avoid accidentally leaving their children in hot cars. Inevitably, commenters pounce on these stories as if they were offering tips on how to stop stealing teddy bears from a cancer hospital. “I will never understand how someone could forget their child in the back,” or “I bet these moms never leave their phone in the car,” they post.

Why does this happen? Brown explains, “There are people like us, and then there are ‘those other people.’ And, we normally work very hard to insulate ourselves from ‘those people.’” The painful experiences of strangers and even friends and family are deeply uncomfortable to hear about and honestly, frightening. Putting space between us and them by identifying them as “those people” is reassuring: we’re not like them, so we’ll never be faced with suffering like theirs. What’s the easiest way to create that distance? Shame and blame.

Brown shares a devastating story from her first pregnancy, when her husband, Steve, was working in a neonatal intensive care unit as part of his medical training. She began asking him questions about the families whose babies didn’t make it. Gingerly, and then more bluntly, she found herself digging for details about whether the parents were drug users, if they were poor, if they’d skipped prenatal care. Steve’s quiet response: “No, Brené, they look just like us. This happens to all types of people, even people just like us.” She burst into tears.

We use shame and blame because deep down we want to believe that bad things happen to bad people. And when bad things happen to us—the decent people! The safe people!—that internalized attitude can make asking for help so hard.

This occurs, for example, when you’ve always felt a twinge of pity for your art-major friend who had to move back in with her mom and dad after college, only to land back at your own parents’ place after a job loss. Or the slight sense of superiority you had over the family in your nice neighborhood who suffered an overdose—until one of your siblings gets arrested for drug possession or DUI.

I have to confess that long ago, when I heard about couples struggling with infertility, I tried to comfort myself by reasoning that they’d married late in life, the husband smoked, or the wife was underweight. Later when I found myself unable to conceive, that shame rebounded on me and made it hard to even admit to others what was going on, let alone ask for help. We have to stop blaming each other, and ourselves, for the things that go wrong in our lives. Self-compassion, according to Brown, is a skill we all have to learn.

Mel Elizondo Landers, of Pittsburgh, Pennsylvania, experienced a similar pattern of blame when she revealed to a family member that she was having suicidal thoughts. “I was in high school. And I’d been struggling with that stuff since grade school, but it got to the point that I wanted to do something about it,” she said. “At the time, a friend of the family’s son had just died. . . . He was really young, too. So [my relative] told me that I was being selfish for wanting to end my life. And basically that I was being ungrateful. And I should think about that person that didn’t have that choice.”

She made it to one counseling session, but couldn’t escape feeling ashamed.

“I remember thinking it was selfish to seek help. I should be happy. I had all the usual things I was told would make me happy. But chemically, I wasn’t happy,” Mel told me. She double majored in college and got married, but her illness continued. She wound up spending two weeks in a psychiatric hospital after a psychotic break. “It was probably one of the scariest [times] in my life. You have to ask for help with every little thing, but the workers are so overworked with everyone else that they just can’t help you with everything. I remember feeling so ashamed with asking for something as simple as opening a door.”

Her hospital stay opened up the floodgates of help. Talk therapy helped her deal with issues from her childhood and get to know herself. Medication helped stabilize her initially after she was given a mood disorder diagnosis. Hospital staff helped cope with health insurance.

After recovering enough to get pregnant, Mel found helpful supporters through newfound faith and parenting groups. To this day, she wrestles with staying healthy, but the help is there. “I think shame is the big reason a lot of people don’t get help,” Mel says. “I have to hold to the realization that I just can’t do everything. I’m only human. . . . It’s also one of the biggest lessons I gained from my faith. I need rest. I need community. I need boundaries.”

How to make asking easier

Nora Bouchard (formerly Nora Klaver) is a certified executive coach and leadership development expert. She’s also the author of Mayday! Asking for Help in Times of Need, which is an essential manual for anyone who needs to practice breaking through the shame barrier to get help.

Bouchard writes that one of the hardest steps can be identifying that you’re in need. It can be especially tough because when a person needs help, it’s often at an upsetting time. Her brain is moving so fast, frantically trying to find a solution, that she may not notice her personal “distress signals.” Losing sleep, becoming more impatient, diet changes or a sudden onset of headaches can all be signs it’s time to get help. Bouchard says, “The body doesn’t lie. We might be able to convince our minds and those around us that we’ll be alright, but the body knows better. It’s not going to let you get away with the overwork, the overstress, the doing it alone.”

We also have to give ourselves a break. Bouchard, like Brené Brown, says that self-compassion is absolutely necessary to break through our blame-and-shame culture. Most of us are accustomed to thinking in terms of the “deserving” and the “undeserving” needy, the people who are worthy, versus those whose problems aren’t big enough to justify our aid. Sometimes we don’t even notice we’re doing it.

The truth is, there are only two questions to ask to determine if you qualify for assistance. Are you a human being? And do you have a problem you can’t solve on your own? Congratulations: you are worthy. You deserve help.

Getting help also requires taking a leap of faith. This may take courage you didn’t know you had. Seeking help at work, for example, can be particularly scary because your future and your dreams, not to mention your current paycheck, can all be affected. But if asking for help has a negative effect on your job, do you even want to be in that role anyway? Who wants to spend 40 hours a week (or any time at all) somewhere psychologically unsafe? Life is short, and work-life is shorter. If your colleagues aren’t willing to help you solve your problem, they aren’t likely to help you take your career to the next level, either.

Perhaps most counter-intuitively, Bouchard writes that gratitude should actually come before getting your answer. For someone like me who fears rejection, putting gratitude first can puncture the balloon of anxiety that floats up when I get vulnerable in front of someone else. Gratitude makes us look at life from a position of abundance and strength. It means hearing “no” does not have to be devastating, because I’m aware there are plenty of other times I have heard “yes.”

A thought experiment

Imagine this: you’re on a cruise in the Caribbean, you lucky lady! Alas, while out for a stroll, you lose your balance and fall overboard. Some people standing on the deck see you go into the water; soon you’re fighting to stay afloat in the choppy waves.

What if your fellow passengers watched you struggle and told each other, “It’s her fault she’s drowning. If she tried harder she could swim. She should have been more prepared. Personally, I was on the swim team in high school.”

What if you thought, “It’s my fault I’m drowning. I’m so clumsy, and I’m a terrible swimmer. I need to figure this out by myself, or just die, but whatever I do, I need to do it quietly so I don’t bother those other people. They’re too busy to help, and I don’t deserve it anyway.”

This scenario (one hopes) would never happen. Good Samaritans would jump in after you or throw down a life preserver or hurry to alert the captain to stop the ship. You would not waste any energy feeling too embarrassed to call for help. Of course, you and your helpmates would reach out to each other without letting shame and blame get in the way, because it’s an emergency!

Here’s the thing: even in situations that are not life or death, we all still have needs that must be met. We all need more than secure access to oxygen to get through life. We need each other. The only shame is when we stand in each other’s way.

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