by Dr. Katherine Puckett - @DrKPuckett @CancerCenter
February 14, 2017
When it comes to a cancer diagnosis, or any life-altering illness, relationships are affected. In some cases, this type of crisis may bring a couple closer together, while in others, it may put distance between them. Which path a relationship takes depends on the couple, their history, how they communicate and their willingness to courageously talk about the hard topics together.
As a mind-body therapist with many years of experience in social work, I have noticed that caregivers and patients commonly respond to a cancer diagnosis in the following ways:
Patients often do not feel comfortable sharing their emotions with their loved ones because they want to be viewed as strong, have been told that they have to stay positive in order to heal, or do not want to be seen as a burden. They may feel guilty for adding more responsibilities on their partner’s shoulders. They may feel distant because physical and emotional changes caused by the cancer or treatment make them feel undesirable. And – given that serious illnesses such as cancer often force us to look at our own mortality — they may be concerned about what will happen to their significant other if they were to pass.
Caregivers often struggle with seeing their loved one in pain and feel helpless about how to respond. They usually have intense emotions themselves, but may feel that they need to protect their loved one by not expressing their feelings. Additionally, they often take on extra responsibilities, and while they want to be helpful, they may not know how to handle the extra load.
While our response is often to close off from one another and retreat during hard times, communication is key. Sometimes, a couple is unable to bridge communication alone and a licensed therapist is needed. That is where I come into play.
My role as a therapist is to be a neutral party, available to help couples express their emotions with one another, confirm that the feelings they are experiencing are normal, and offer strategies to help them cope and strengthen their relationship. Most couples do not realize it, but they may already have tools available to them from other crises. Remembering how they handled those previous situations may help them tailor their tools for the newer challenge confronting them. Some advice I offer to patients and their loved ones includes:
In any relationship, people unintentionally hurt each other. It’s not realistic to expect this will never happen, but what is really helpful is to develop a process to deal with these disruptions when they happen.
Not everyone is ready to talk. Listen and be available when the time is right, but don’t push one another to share their feelings.
Each person has a different way of communicating. When a couple doesn’t communicate the same way, this can cause a strain on the relationship. That’s why it is important to learn the other person’s communication style and to be patient.
Discussing the hard topics can often bring a couple closer together, even though it may not feel like it at first. Some of the topics may be scary, for example intimacy during cancer treatment. Some patients lose their sexual drive during cancer due to treatment, overwhelming emotions or the cancer itself. But talking through this and finding other ways to be intimate, such as going on dates, holding hands, etc., may help a couple remain close.
Laughing together can be healing. Laughter is a great stress buster and may be a welcome distraction from what is hard in life – at least for a brief moment. It can help the unbearable become bearable.
Talking with other couples in a similar situation may be helpful. Going to support groups and talking with people who understand what you are going through can be reassuring. Additionally, these same people may be able to offer a different perspective and some new ideas. Just know that every couple’s experience is different, and not all advice is right for you and your relationship.
Know there will be easier days and harder days. Cherish the positive memories and don’t dwell on the negative.
Finally, remember that vulnerability is actually a strength and has been shown through research to bring couples closer together.
Keep in mind that there is no one-size-fits-all formula to making a relationship work during cancer. I have seen couples make the decision to divorce or part ways. For these couples, this may have been the best decision. In order for a relationship to remain strong, there has to be a desire from both individuals to work on the relationship. One couple in particular comes to mind regarding this: “Beverly” and “Tom” (names have been changed to protect patient privacy).
I supported Beverly and Tom over a period of years. Beverly was diagnosed with cancer as a young, single adult. Following her treatment, she went into remission and resumed her normal life. After dating for a period, she and Tom were married. The cancer didn’t seem to be a factor in their relationship, and they made plans to start a family. Unfortunately, Beverly’s cancer returned a few years into their marriage. The next few years were an emotional roller coaster for this couple as they dealt with more treatment, uncertainty about their future together and the loss of being unable to have children. I learned that each of them had fears but felt protective of the other and thus reluctant to share their fears. This process of trying to protect each other actually created more distance between them, and they found themselves arguing and disagreeing more often despite their love for each other. As I spent time with the couple through counseling, they began to more readily tell each other what was on their minds and to address really hard things they hadn’t been talking about at home. The couple grew closer again through this process, and found they were able to face and talk about losses or challenges as they came up.
The best piece of advice that I can provide any couple going through a life-altering illness is find a way to communicate effectively with one another. Be open to being vulnerable and talking about the “scary” topics such as body image, intimacy or the uncertainty of the future. Some patients have told me that cancer has even changed their perspective of what a good relationship is – it allowed them to examine their connection with their partner, learn what is most important to them and build an even stronger relationship.
Katherine Puckett, PhD, MS, MSW, LCSW is a licensed clinical social worker. She earned a PhD from the University of Chicago and a master’s degree in social work from Loyola University. Puckett has more than three decades of experience in human services, addressing the needs of vulnerable populations who have sustained major losses. Her broad-based professional background includes leadership positions in social services and health care, with additional experience as a clinician and researcher. Dr. Puckett currently serves as the Chief of the Division of Mind-Body Medicine at Cancer Treatment Centers of America® (CTCA) and Director at the CTCA® location in suburban Chicago. Follow her on Twitter at @DrKPuckett and @CancerCenter