Dear Eric >> I am a middle-aged woman, who, for most of her life was the center of the social scene. I entertained in my home, organized outings and helped my friends out whenever I could. A lot of this was not reciprocated, but I was fine with it, because I enjoyed it, and deep down, I always suspected that if I did not make the fun, the fun would not come to me.

I kept this up long after I felt like doing it, but for the past couple of years, illness has kept me from organizing and participating in activities I used to enjoy. And I was right. No one thinks to include me very often anymore.

I can’t blame them — I’m ashamed to admit that I have dropped friends, too, when they could no longer keep up with me. And I’m mostly OK with not being included, anyway. I’m good at entertaining myself.

Here’s my problem: the people in the group I used to hang out with tend to discuss their plans for fun when I’m right there in the room. I try to leave when I can, but it’s not always possible. It is a sad reminder of how much of myself I’ve lost and how many people I’ve lost to my illness. This is not their fault, but I also think they’re being inconsiderate. I was taught not to discuss any events other people weren’t included in in front of them. Am I just being too thin-skinned? If so, what can I do to toughen myself up? I am already in therapy to deal with my grief over my losses, but it doesn’t help on days I’m feeling especially vulnerable.

— Want to Be Included

Dear Included >> Your skin is just fine. As hard or, perhaps awkward, as it may initially feel to ask for what you need, I’d encourage you to do it.

Sometimes, yes, we can feel hurt in situations where we just need to change our perspective or, as you wrote, toughen up. But at other times, it’s helpful to say to friends, “Hey, my skin is a little thinner here. Handle with care.”

In your case, that might mean having one-on-one conversations with a few friends wherein you acknowledge the ways your capacity has changed and ask them to invite you to things they think you might enjoy. The curse of the social butterfly is that people assume you can always take flight without assistance. And so, they also assume if you’re not joining in an activity, it’s because you’re off doing something else or you don’t want to. This can be painful because it feels like being forgotten. But I’d encourage you to reframe it if you can.

It’s healthy that you’re working on accepting the ways your life has changed, but if your friends are still discussing their plans in front of you, they can be nudged to think more creatively about those plans so that everyone can be involved. Talking one-on-one, as well as using concrete examples, can help get your friends thinking in different ways about how to show up for you.

Send questions to R. Eric Thomas at eric@askingeric.com