By: Richard Nicastro, Ph.D.
It's natural to enter a
long-term relationship with expectations. And one expectation most
of us have is that our spouse or partner will remain relatively
healthy. Although wedding vows ask us to consider the possibility of
sickness, we don't automatically assume our loved ones will suffer a
"I felt blindsided by the diagnosis. So much of our relationship
changed from that point on. There's no way to prepare for it because
you never think it's going to happen to you. It felt like it came
out of nowhere." ~Jennifer, whose husband Dan was diagnosed with
leukemia at age 37
When Illness Hits Home
The reality is that many couples must learn to cope and adjust to a
life-altering illness. Understanding the impact this can have on
your relationship can help you adjust and adapt to such an enormous
Let's look at some of the ways in which a serious illness can impact
you and your marriage/relationship:
1. Coping with a Sense of Loss
Depending on the nature of the illness, the sick partner may change
in subtle and, sometimes, profound ways. The relationship that you
once relied upon may no longer feel accessible to you.
Adjusting to such a major change can take time, and you may find
yourself struggling with feelings of anger, despair and depression.
It's common to feel anger toward the person who has the illness
(which then may cause you to feel guilty). This is all part of
grieving the loss of what once was the foundation of your
relationship and life.
2. The Impact of Shifting Roles
We all play different roles in our relationships. And very often we
end up with someone whose preferred role complements our own. For
instance, someone who is timid and insecure may find him/herself
with a partner who exudes confidence; someone who is highly
emotional and spontaneous might be drawn to a more rational-minded
planner; the natural caregiver may feel most at home with a partner
who longs for this type of attention; and so on.
An illness can abruptly alter these roles and tip the balance that
once grounded your relationship. The confident, take-charge person
may now find him/herself in an overly dependent position; the
rational-minded planner may have to relinquish control; and the
caregiver may now need to be cared for. Such changes can rock the
foundation of your union by forcing you to assume roles that are
alien to what you've known most of your life.
3. Coping with Uncertainty
We all like to believe we're in control of our lives. When faced
with a significant illness, however, the idea of absolute control is
revealed as an illusion. Questions you never before considered now
become routine: Is s/he going to be OK? What's going to happen to
us? What should I do?
And when an illness interferes with one's ability to work, financial
uncertainty can now take center stage—fear and anxiety are common as
the once secure areas of your life give way to uncertainty.
4. Letting Go of Guilt
Sam began feeling guilty when he finally started spending time with
friends and found himself enjoying time away from his wife more than
a year and a half after she became ill. During his wife's
rehabilitation, Sam rarely did anything for himself. As he
described, "I had to come to grips with the fact that she's sick and
I'm healthy. This wasn't easy. She's slowed down considerably and I
felt bad because I've always been so full of life."
Sam continues to care for his wife when needed, but he has also
begun taking care of himself. For a period of time, guilt-inducing
thoughts flooded his mind ("How dare you have fun while your wife's
sick?"; "You should be home with her"), but Sam was slowly able to
realize that his guilt served no useful purpose. With the support of
his minister, Sam was able to let go of his guilt as he began
embracing life again.
5. Understanding the sick partner's emotional reactions
The person struggling with a serious illness is on an emotional
rollercoaster. In one moment s/he may be grateful for your help and
a moment later s/he may seem to act irrationally, no longer able to
keep the fear, anger and despair in check. At times you may end up
feeling berated, blamed, pushed away, and marginalized—despite your
best efforts to comfort your partner. It's difficult not to take
this personally. For your own sanity, it will be important to
remember that you are not responsible for your partner's reactions
and you will need to repeatedly remind yourself of this truth.
Remember that the partner struggling with the illness is adjusting
to this traumatic life change and is trying to cope with fear and
uncertainty. S/he may not even realize the impact his/her behavior
is having on others, including his/her healthy partner. It's
important for you to seek ways to understand your partner's
unpredictable, tumultuous reactions; and it is just as important
that you protect yourself from any emotional onslaughts directed at
The impact of a significant illness can have a dramatic and
unexpected impact on your marriage or relationship. Some couples
report that their relationship has become stronger because of an
illness, whereas others continue to stumble under considerable
stress. Having an understanding of the different ways in which an
illness can impact you, your partner and your relationship is an
important step in adapting to these painful events.
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Richard Nicastro, Ph.D. is a psychologist and relationship coach
with fifteen years experience helping individuals and couples build