Unfortunately, more than a few of us will have to face the "sickness" part of those iconic words, "in sickness and in health". This confrontation with reality can take place in a moment of self-reflection, or it can occur when we must change the soiled diapers of a spouse.
Are we all prepared to face chronic pain in a marriage? Are we all able to tolerate the chronic pain a partner suffers? Chronic pain is a stressor which can potentially have the greatest chronic impact on a relationship, notwithstanding the heretofore major "major stressors" as listed in the famous Holmes-Rahe Social Readjustment scale from 1960. This is not surprising, considering the amount of time and the emotional investment partners contribute to a relationship. And one must not ignore the loss of the economic contribution which might result when a spouse's chronic pain impacts employment.
Relationships can deteriorate rapidly when illness strikes, as roles accepted and expected at the beginning of marriage may be forced to change. This is a prime example of the importance of the approach of maintaining functionality in the face of pain; despite pain, hopefully roles and duties will not be radically changed, and thus lessen the burdens on a relationship.
Returning to the Holmes-Rahe scale, one can extrapolate that many of the stressors listed therein can result from chronic pain: Chronic pain can result in frustrations or pharmacologic addictions, which in turn can result in domestic violence, or traffic violations, or worse; these consequences can lead to more stress in the relationship, not to mention life.
The effect of chronic pain on sexual intimacy is perhaps the most devastating to a relationship. Some published data has shown that up to 75 percent of couples living with chronic pain have little or no sexual contact. The partner suffering pain may fear more pain, or the "well" partner may avoid intimacy because of the fear of causing pain. And the well partner, who might already be burdened with more duties because a partner is impacted by chronic pain, could grow to look upon sex as another chore he or she is asked to perform. Of course, the baggage (depression, anger, anxiety, guilt, to name a few) which often accompanies the sufferer of chronic pain in a relationship is capable of damaging a relationship in a variety of ways.
Perhaps the wedding chapels in Vegas should add another line to the vows which echo ad infinitum between the canyons of neon: "Being able-bodied is a temporary condition".
