There are basically three reasons for talking (and listening) and they are described below. There are also obstacles to this communication.

There are, of course, many different ways of communicating – kissing, touching, laughing, frowning, even just being together and 'not talking'. However, talking is the most efficient and the most specific way that we have of communicating. It is the best way of making any communication clear between people. Other ways of communicating are very important, but for them to be of use we often have to talk first.

There are many things that a conversation can do and there are many reasons for us to talk. There are obvious ones – such as telling the children not to touch the hot oven, telling a joke, asking about the football results and so on. But there are also less obvious reasons for talking, and one of these is the simple human desire to make a connection with other people and to be  listened to.

Often, particularly when things go wrong, people talk in order to get what is bothering them off their chest, and to be heard. This releases a bit of stress, which helps the person to feel better. Talking can be a huge relief. So, you can provide relief for an ill person by listening and by simply allowing them to talk. This means that you can help your friend greatly even if you don't have all the answers.

In fact, 'good listening' is known to be helpful in itself. An interesting research study took place in the United States in which a number of people were taught the simple techniques of good listening. Volunteer patients then came to see them to talk about their problems. The listeners in this study were not allowed to say or do anything at all. They just nodded and said 'I see' or 'Tell me more'. They weren't allowed to ask questions, or say anything at all about the problems that the patients described. At the end of the hour, almost all of the patients thought they had got very good help and support – and some of them rang the 'therapists' to ask if they could see them again, and to thank them for the therapy.

It is always worth remembering that you don't have to have the answers, just listening to the questions will help.

One of the reasons that friends and family put forward to avoid talking to the patient, is that talking about fear or an anxiety might create that anxiety if it didn't exist beforehand. So, a friend might say to herself 'If I ask my friend whether he's worried about radiotherapy and he wasn't worried about it, I might make him worried about it'. However, this does not happen.

Research has been done by psychologists talking to people with illnesses that can’t be cured. The research has shown that conversations between people who were ill and their relatives and friends did not create new fears and anxieties. In fact the opposite is true; not talking about a fear makes it bigger.

People who have nobody to talk to are more likely to be anxious and depressed. Research has also shown that when people are seriously ill one of their biggest problems is that other people won't talk to them, and feeling isolated makes them feel even worse. Often, if a person is very worried about something and has no-one to talk to about it, they find it difficult to talk about anything else at all.

One of the reasons that people find it hard to talk about their feelings is shame. Many people are ashamed of some of their feelings – particularly of their fears and anxieties. They are afraid of something but feel that they aren't 'supposed' to be, and so they become ashamed of having the fear. One of the greatest services you can do for your friend or relative is to listen to their fears and stay close when you've heard them. By not changing the subject or making them feel that they are silly for having the fears, you show that you accept and understand them. This will, in itself, help to reduce the fear and the shame that they feel.

So, you have everything to gain and nothing to lose by trying to talk to, and listen to, someone who has just been told that they have cancer. Starting a conversation in these circumstances often feels very awkward and embarrassing. However, there are ways to overcome these difficulties, and these are looked at next.

There are six major types of obstacles to free communication between you and the person who is ill. They are:

• The person who is ill wants to talk but you don't.
• The person who is ill doesn't want to talk but you do.
• The person who is ill wants to talk, but feels they ought not to.
• You don't know how to encourage the person with cancer to talk.
• The person who is ill appears not to want to talk, but really needs to.
• You do not know what is best and don't want to say anything that may make things worse.

These seem like major barriers. However, there are ways of making yourself available for listening and talking without overwhelming your friend or relative. There are also ways in which you can work out whether they need or want to talk or not. In the next section we'll look at the basic ways of listening that make this possible.