In Sickness and in Health: Coping with Chronic Illness in Marriage

"...in sickness and in health...until death do us part." Most married couples have pledged these words to each other, but how many really know what it entails? "Sickness" often conjures up visions of the flu, pneumonia, broken bones, cancer or diseases related to old age. But what happens when a spouse becomes chronically ill, or when a chronic illness causes a severe shift in the relationship dynamics?

The best way to cope with chronic illness is to come up with a plan for handling it before an illness occurs. This can be accomplished through discussions about how different aspects of the marriage will be handled. Are both partners open to therapy or third-party intervention? Is third-party intervention approval required by one or both partners? How will financial difficulties be handled? Talking about how chronic illness may affect your relationship before marriage may save the marriage later on down the road, should chronic illness to occur. But, if you are already married or are currently dealing with chronic illness, there are still things that can be done to alleviate the stresses that come with it.

Very few marriages survive the chronic illness of a partner, simply because most people are unprepared for coping with chronic illness. However, there are ways to cope with chronic illness in a marriage, and one of them is to be able to empathize with what the other spouse is going through. Chronic illness affects both partners in many different ways and on many different levels. It can drastically affect a couple's financial life, strain their emotional bond, and alter their intimate relationship.

A chronically ill partner may not reveal their true feelings about their illness, for not wanting to scare the healthy partner. Fears about becoming more sick or disabled are a frequent occurrence. Many chronically ill people suffer from guilt. They may feel guilty for not being able to contribute to the financial, emotional and intimacy needs of their spouse as they once could. A chronically ill person may become depressed if they feel like they have become a burden to their spouse. They may find it extremely difficult to shift from an independent lifestyle to one that is dependent upon others. Chronically ill people can actually begin to blame themselves for becoming sick, thinking that they are getting what they deserve, or they may resent the fact that their spouse is able to carry on with all their normal activities while the ill person cannot. With all these feelings of guilt and shame, the person suffering from chronic illness may begin to emotionally distance themselves from their spouse, friends and family members.

A healthy partner is likely to feel helpless over not being able to heal the person with the chronic illness. Difficulties could arise when shifting perspective away from "fixing" to one of "managing" the illness. The healthy partner oftentimes will feel depressed over the loss of normal life they once enjoyed with their spouse. They might become angry at the situation, and feel like this is not what they signed up for. In addition, the healthy spouse may become overwhelmed by caring for the needs of the chronically ill spouse. The healthy spouse may view themselves as weak for not being able to handle everything on their own. They may also feel abandoned by the sick spouse, or feel that their needs are no longer being met, and this can lead to resentment and more guilt. However, they might never express their negative emotions out of guilt for what they are feeling.

All of these negative feelings are quite normal and natural. Unfortunately, we often treat negative feelings as though they are bad, or somehow wrong. It is quite normal to go through a grieving period when a spouse becomes very ill or hurt. There is the grieving for the relationship, as it will inevitably change. There is the grieving for future plans, as they likely will need to be altered. It is normal and natural to mourn the loss of what once was before a new way of living can be embraced. In addition, both partners may grieve in different ways, and if these differences are not discussed, they could lead to feelings of abandonment, isolation, desperation, anger, guilt and depression.

Along with being empathetic to what each person is going through, it is imperative that a greater level of communication be reached. Simple misunderstandings can quickly escalate into a downward cycle of resentment if feelings are not talked about. For example, a chronically ill spouse may feel abandoned by the healthy spouse if that person spends an evening out with friends. Meanwhile, the healthy spouse may be doing what is necessary to alleviate the stresses he or she is under. This feeling of abandonment could cause the chronically ill spouse to distance themselves from their partner, in turn making their partner feel abandoned or that their efforts are not being appreciated. But, if one or both people talks about their feelings and needs, the example scenario could be avoided completely.

Open dialogue can also help alleviate feelings of guilt and shame that each partner shares. By listening to each other's feelings, they can be acknowledged in a healthy way and then released from thought. However, one must take care that neither spouse takes advantage of this airing of grievances to the point that it allows the person to wallow in self-pity. A professional therapist can supply many tools to help establish boundaries in this area.

Once open dialogue has been established, the couple can begin forming a new plan for their life going forward. To effectively cope with chronic illness, every aspect of the marriage must be discussed openly by both partners: how to handle the illness, how to handle the finances, how to handle the care of children or other family members, how to handle intimacy, how to handle letting go of the past, how to handle new needs created by the chronic illness and how to fulfill old needs. Once both people know where the other one is coming from, they can come together to find a solution. Both people should be actively involved in creating a new plan for the future that both can be excited about.

Coping with chronic illness is difficult and is not something that most people anticipate dealing with until it happens. However, with a lot of empathy and open communication, couples facing life with chronic illness can go on to live happy, fulfilling lives, one where the chronic illness does not define the marriage or person, but just becomes another thing to manage.