Sharing the burden

What happens to relationships when illness strikes? The diagnosis of a chronic disease can isolate you not only from the anonymous masses of "the well," but from the person closest to you --spouse, parent, friend, companion-who is also, very often, the chief caregiver. Finding your way in a couple when one partner is sick is no easy task: shame, anger, fear, disappointment, loneliness-these difficult emotions can undermine the most well-meaning and devoted pair. For every sick person and caregiver the chief source of these dark feelings, and the chief stumbling block to an authentic relationship, is the problem of dependency. Dependency may have its good points-it can be an expression of love for the person who gives the care, and an expression of trust for the one who receives it-but the danger is that it will distort the relationship. Partners may be tempted to fall into stock roles--controlling caregiver and captive invalid, or demanding invalid and enslaved caregiver-that turn the relationship into a covert power struggle rather than a lively interaction between equals. One way to keep the relationship authentic is to maintain a space for normalcy, for give-and-take, for colliding points of view and the occasional refreshing fight. Tiptoeing around the illness can constrict the relationship, draining it of vitality, energy, and pleasure. In After the Diagnosis, we describe a couple, Leslie and Ken Snow, who have figured out a way to emphasize the ordinary. Leslie has a host of medical problems, including an ileostomy (a bowel resection to treat severe colitis) and diabetes, not to mention breast cancer, but she also has an ironic sense of humor and an ability to forget she's sick. Ken goes with her to the hospital when she has blockages and breast biopsies, but aside from that, they don't let illness intrude on daily life. The two take mutual care of each other: Ken makes Leslie soup when she has a cold, she makes him tea when he has one; they split the household tasks and share the rearing of the kids. When she feels like griping she'll complain, oh, my hip hurts, my tooth hurts, my appliance hurts. Her ileostomy appliance is just one more thing on the list. And they don't pull punches when they're mad at each other: they have a good old-fashioned fight, and then the air clears. The lesson? Don't let illness run the show. Continue to be yourselves-to have expectations of each other, to even have friction. Collisions are a source of liveliness, of authenticity, of new learning. Allow your relationship to grow, even "after the diagnosis."