Will talking about it make it worse? Facilitating family conversations in the context of chronic and life-shortening illness.

This article explores secrecy and openness in the context of chronic and life-shortening illness. Illustrated by clinical work with families at the Center for Families and Health at the Ackerman Institute for the Family, I examine the impact of secrecy on family relationships, including the serious relational price of silence, the danger to physical and emotional well-being, and the formation of triangles. Through the stories of four families, I demonstrate ways to facilitate greater openness when illness pertains. The benefits to families of being able to speak with candor and authenticity are shown. The article concludes with a range of questions to guide the clinician.