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 serious illness.

"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 challenge.

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 you.

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 stronger relationships.