Dr. Val Farmer
Rural Mental Health & Family Relationships

Communications Help Couples Cope With Serious Illness

March 9, 1998

"Life is what happens to you when you are making other plans."

Many couples face devastating news when doctors have diagnosed a partner with a serious illness or disease that has life-threatening consequences. Part of successful coping is to go through it together.

Why is it so important for an ill person to talk about their emotions? Talking is a form of coping. Deep communication is a buffer to stress. By talking to your spouse, you try to make sense of what is happening. You try to deal with all the changes an illness brings. You need a sounding board in these circumstances. As you talk, you formulate your own plans for coping with the situation.

By being willing to talk, you invite others to share their love and concern with you. Being soothed, comforted and cared for in a time of crisis softens the impact of the trauma.

What are some of the life changes couples need to work through? There is certainly plenty to talk about. For instance, here are some issues that come to mind:

- Restrictions on outside activities, recreation,

- Changes in gender role responsibilities,

- Financial pressure,

- Compliance with rehabilitation or medications,

- Adjustments in sexual interest and performance,

- Increased social isolation,

- Adjustments to plans, goals and dreams,

- Compensation for the peculiar limitations of disease,

- Acceptance of loss.

Is there a medical reason for talking through your problems? Negative emotions such as sadness, anger, fear, anxiety and frustration need to be expressed. Researchers have found that failure to talk stifles emotions and creates even more worries, intrusive thoughts and unexpressed anger. With time, the inner emotional turmoil undermines the immune system. With heart patients, people who clam up have twice the coronary reactivity.

Autonomic activity improves when emotions are expressed. This is true when thoughts and emotions are written out as well. Besides being a tool in solving important problems, personal expression of emotion by itself reduces stress.

What if one partner wants to talk and the other doesn't? It is easy to forget in these circumstances that the patient’s spouse is also hurting and dealing with emotional pain. By clamming up, the patient is denying an opportunity for their spouse to talk through their feelings and make sense of their lives.

The spouse of an ill person is going through change and crisis in his or her own life as well. By not dealing with the illness, one partner effectively shuts down and shuts out the other. When a spouse is reluctant be open about a health crisis, the patient is faced with sacrificing their own morale in order not to place an excessive burden on their partner.

Either way, going through a crisis alone creates loneliness and isolation.

What happens if you weren't getting along before this happened? Hostility in a relationship adds to health risks. Hostile criticism predicts a relapse of heart problems, higher blood pressure and elevated heart rates. The way a couple handles conflict and the amount of negative interactions in their relationship contributes to poorer health.

What are negative interactions? By hostile or negative interactions, I mean criticism, sharp disagreements, denial of responsibility, interruptions, negative mind-reading, put downs, sarcasm, disapproval, blaming and anger. The marriage is also affected by not tracking what is being said, withdrawal, getting off topic and emotional disengagement.

A health crisis highlights preexisting weaknesses and problems in the marriage. It is the quality of the marriage that determines how supportive the couple will be for each other when a major crisis hits.

Suppose your affected partner doesn't keep on their diet, exercise, or medications and is continuing some risky behavior? Following medical instructions is the smart thing to do and it benefits the marriage as well. By not being compliant, worry, strain and anger is added to the relationship. One spouse becomes overanxious and insistent while the other fights to retain their autonomy.

Can any good that come from a serious health problem? This can be one of the best times in your life together. You share at the most intimate of levels. In meeting the challenge of adversity, you are forced into open and heartfelt communication.

As a couple, you support each other. You draw closer together. Your love and appreciation for one another deepens. You grow closer together. No matter what happens with the illness, you will remember how special you were with each other.