Woman standing on a ledge
Photo: Hugh Kretchmer
My friend Wes has a brilliant mind, a wicked sense of humor, and a fairly involved case of cerebral palsy. When he and his wife, Sue, bought their first house, Wes insisted it be as thoroughly modified for special needs as was his bachelor apartment. Sue argued that she could always do things for Wes that he couldn't do for himself. "No," he told her firmly. "One day we're going to have an argument, and on that day, I'll get hungry. I need to be able to make dinner for myself without asking you for help."

Wes's physical constraints have made him highly sensitive to the way helping and being helped shapes relationships. Like him, most of us resist asking for something even when we need it. We have our pride. When a tired driver causes an accident or a lonely teen becomes homicidal or a depressed mom neglects her children, their failing to reach for aid isn't noble; it's criminally stupid. So how do we walk the tightrope between self-sufficiency and need? When and how should we ask for help? I'd argue that the solution is to follow Wes's example and answer such questions before the need arises.

Asking for help is psychologically risky because it triggers a mechanism in the human psyche called the norm of reciprocity. If you give me something—money, advice, time—I must give something to you that we tacitly agree is of roughly equal value. Otherwise we won't sustain an amicable bond for long. Only the churlish keep score overtly, of course, but even generous people get uneasy when one party in a relationship takes and takes and takes without giving anything in return. Sociologist Alvin Gouldner called the norm of reciprocity a "plastic filler, capable of being poured into the shifting crevices of social structures, and serving as a kind of all-purpose moral cement."

This means that the more I ask of you, the more everyone will expect me to repay you—and what I can't repay in goods and services, I'll typically surrender in power and control. Children need constant attention and support from their parents, so society gives parents near-total control over them. The same used to be true for wives and husbands, slaves and masters, serfs and lords. Powerful people often infantilized, repressed, and deliberately enfeebled those they were "helping" in order to maintain dominance. For their part, the powerless struggled like hell not to ask for anything, since this drove them deeper into the position of weakness (hence Wes's remodeling project).

There's one type of situation where the norm of reciprocity breaks down, where some even deeper instinct kicks in. Call it empathy, codependency, or grace: When humans see true need, we frequently offer help without expectation of repayment. For example, last week I stopped on a busy freeway to catch a very scared Boston terrier, call the number on its ID tag, and return it to its owner. I think I got more unalloyed pleasure from this simple event than from my own wedding. It felt fabulous to do a favor when it was really needed, no strings attached.

The problem with the purely helpful side of human nature is that people, unlike dogs, take advantage of it. I once met an aspiring writer—a doll-faced woman I'll call Gloria—who had lost whole chapters of her half-finished novel because she didn't know how to back up her computer files. Thinking this was a lost-puppy situation, I hired a babysitter, went to Gloria's house, showed her how to save a file (point this, click that), and sat beside her while she repeated the procedure for each of 20 chapters. Early the next morning, my phone rang. "I wrote a new chapter!" Gloria chirruped. "Come over and show me how to back up the file!" I'm not sure what became of Gloria; I sort of lost touch with her after that.

I mean seconds after.

Now, I don't think Gloria was an evil manipulator. I think she felt genuinely incapable of saving the file—but my gut told me it was learned helplessness, not real need, and the norm of reciprocity inspired me to drop that potential friendship like a bad habit.

My point: We should ask for help guilelessly, confident in human graciousness—but only if it's absolutely necessary. If we abuse the privilege, we risk becoming pariahs. So how do I make this crucial judgment under pressure? How do I know if I am about to get smushed on the freeway of life because I failed to seek aid, or become ditched by people who are sick of my manipulative begging? For answers, I turned to someone whose job it is to stay in the sweet spot of need.

It's hard to imagine a more vulnerable population than the residents of the Neonatal Intensive Care Unit at Cedars-Sinai Medical Center. I'm visiting the NICU with parent liaison Dorothy Williams, who introduces me to the patients, most of whom weigh less than my mocha Frappuccino. No chubby cherubs here: These babies combine the heartbreaking scrawniness of the extremely old with the total inexperience of the extremely young. I'm moved to tears, partly by their fragility and partly by the complicated machines and devoted professionals around each tiny person, attesting to human determination to help the truly helpless.

"It's the parents I focus on," says Dorothy. "They're exhausted, they're in shock, they have to take care of other kids and jobs and mortgages."

I ask her if most parents tell her when they need help.

"Oh," Dorothy says, "they always tell you—even when they won't tell you." I tell her that I'm not quite following.

At this point, one of her coworkers says, "Well, I know it's time to help when they start asking how. 'How do I comfort my newborn?' 'How do I talk to my relatives?' 'How will we pay for this?' The more they ask how, the more they need help, and the more able they are to receive it." Dorothy nods.

Next: How to get the help you need