In a recent session with a couple I was reminded of the importance of focusing on the CAN DO things in our lives. The couple was attempting to adjust to a medical condition that the husband was facing and all of the resulting individual and relational consequences that sprung up in the marriage. In difficult circumstances like this, whether  unexpected or planned, it can be tempting to pull away from your partner.

If we are experiencing shame or depression due to a decrease in functioning (general energy level, sexual performance, ability to help around the house, etc.) the first reaction is often to isolate. We don’t want others to see us at our weakest moments. This becomes a big problem when the functioning does not improve because we have then established a go-to strategy of hiding our pain and fear from the person who cares most for us.

If you are the partner in the relationship watching your partner go through the difficult physical transition, the problem is as much yours as theirs. When you said your vows you agreed that their pain would be your pain, their joys your joys. Certainly their transitions in life to different phases (new jobs, illnesses, etc.) are shared experiences as well. There are as many possible reactions to changes in our partners as there are people on earth. That said, there are two major general categories of response: moving toward, and moving away. If your strategy is to move away, to get space, to isolate, to dwell in fear and resentment, I can promise you that the long term picture for your relationship is not going to turn out the way you initially hoped.

So what can we do when a partner/spouse/loved one is unable to continue caring for and relating to us in the same ways as before? What can we do when, despite our best efforts, we are simply unable to perform tasks the way we used to when we were at full strength? There are just too many great ways to move forward to be adequately captured here. I hope you’ll consider the following three approaches as a starting point for coping together, rather than trying to “be strong for (insert partner’s name here)” and taking on the majority of the burden alone.

1. Talk about it! One of the biggest difficulties for most couples I see in my practice is communication. Establish good habits around communication as early as possible. This means not just talking about the goings-on from your day, but how you experienced them. Did you have fun? Whom did you get mad at? Did you struggle with anything? These are sometimes difficult habits to establish when we feel too busy to even get through the basics of our day, let alone the associated reactions and feelings. But as difficult as it may seem, this is exactly what you’ll need to do when adversity strikes your marriage. Talk about the struggles. Talk about what you’ve lost. Mourn what used to be, and talk about what might be ahead. Validate each other. Support each other. Fears. Hopes. Sadness. Things you’re grateful for. These should all be part of the discussion. Not just what medications you are taking or what rehab strategies the doctor has recommended. Talk about it.
2. Get support! A recent study¹ found that only about 2% of general medical practitioner communications with patients focused on positive coping and utilization of available resources. This is not enough! On top of that, about half of that discouraging 2% was from only two of the more than 20 doctors in the study. As a group, we professional healers/helpers need to help our patients/clients to focus more on what is positive and possible. Let me encourage you as a patient or partner of a patient to make the most of what is available to you. First of all, lean on each other (see #1 above). Second, make sure to take stock of the other supports around you. There is probably more available to you than you realize. Talk to your pastor/priest/rabbi. Reach out to family and friends. Find an online support group. Better yet, find an in-person support group. Talk to a therapist. (Yes, you can go to a therapist and not be in a relationship that’s on the brink of disaster). Check with your local library or community center. You never know where support may be found.
3. Focus on what you CAN DO! If you are the partner personally experiencing a decline in ability, consider what options are still available to you. What activities are still reasonably within your abilities? Where can you go? How can you get there? What might you do once you arrive? If you love the outdoors and used to hike as a couple, where is there a park with a beautiful walking path you can tread leisurely down together holding hands? If you are the partner helplessly watching your loved one cope with the frustration of losing control of their body, take stock of what is still available. How can you encourage your partner to take advantage of their remaining physical abilities? What activities will you continue to do on your own (or, at minimum, without your spouse)? Will you still golf/hike/bowl/surf? Will you participate less frequently to accommodate your partner’s new set of abilities? What are you willing to give up to spend time with your spouse, and what would you like to continue even if it means doing things separately? The point here is to avoid feeling discouraged as individuals by embracing what is possible both from individual and relational perspectives.

As a final thought, it’s important to realize that where you are now, you may not be in the near future. Things may improve; they may get worse. Whatever the case, remember to come together during the changes. Discuss what’s happening, and focus on the positive CAN DO activities are there for the taking!

 Dr. Robert Pate is a licensed Clinical Psychologist (PSY27089) practicing in Orange County, California. For more information about Dr. Pate’s practice, call 657-200-8080 or visit www.cavfamilytherapy.com.

¹Mjaaland, T., & Finset, A. (2009). Frequency of GP communication addressing the patient’s resources and coping strategies in medical interviews: a video-based observational study.BMC Family Practice, 10(1), 1-9. doi:10.1186/1471-2296-10-49