What Happens When Partners Fight Chronic Pain Together?

If you've ever been in pain, you know how it can affect our relationships. Whether it's an infected tooth, a headache, or anything else, we're not our best at relating to the people around us.

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For those dealing with chronic pain, the toll on relationships can be severe. Both partners tend to suffer as the pain takes center stage, crowding out other parts of life.

Based on a recent study, some of the common ways chronic pain affects couples include:

• Stress: Chronic pain often requires frequent medical visits, which can tax a partner who needs to accompany the person to the appointments. Pain-related disability may also force a person to stop working, creating financial strain and requiring a spouse to take on extra work.
• Distress: Marital satisfaction tends to go down when one partner experiences disability; both partners are more likely to experience depression when one partner has chronic pain.
• Rigid communication patterns: Chronic pain may lead couples to interact in ways that leave both partners feeling unsatisfied. For example, a spouse might feel like her partner only talks about his pain, while the person in pain may feel like his partner doesn't validate his emotions. Rigid communication patterns can deepen relationship dissatisfaction.

What's more, a couple's conflict can get in the way of treatment for chronic pain, leading to greater dropout. Thus a program that improves one's relationship may lead to better outcomes.

Since both halves of a couple are affected by chronic pain, it makes sense to include both partners in treatment. A team of researchers at Wayne State University recently did just that, developing a couples-based treatment program called Mindful Living and Relating (MLR).

The program aims to increase psychological flexibility (each person's ability to act with greater flexibility) as well as relational flexibility (breaking unhelpful patterns of interacting with one's partner).

Although the program was tested among a group of couples who deal with chronic pain, the principles of the treatment apply to any couple in which one partner suffers with a chronic condition.

Practicing Presence

If you've ever had someone truly listen to you, you know it can be a powerful experience. More often we listen with one ear while doing or thinking about something else. The first component of MLR provided training in mindfulness to help couples focus their full attention on their partner. (Chronic pain was one of the first conditions for which training in mindfulness was shown to be helpful.)

The program started with three individual mindfulness practices:

• a breathing meditation (here is an example)
• a body scan meditation (attending to sensations in each body part)
• a meditation for allowing thoughts to come and go (the leaves on a stream meditation).

Once the couples had a foundation in mindful awareness through these individual practices, they began joint mindfulness exercises:

1. 

   Source: Public Domain/Pexels

   Mindful handholding: This simple and intimate exercise involved focusing on the sensations of holding the other person's hand; it allowed spouses to practice giving their full attention to the other person.

2. Loving-kindness meditation (an example is here): Each person silently wished that they and their partner would experience "kindness, compassion, and freedom from anger and pain."
3. Mindful listening: Spouses took turns talking about a positive emotional experience they had had; the listening partner gave his or her full attention to the speaker. Later they practiced talking about a negative emotional experience. This exercise built on their practice in mindfulness as they nonjudgmentally brought their attention back to the conversation if they got distracted. It also involved taking a mindful breath before responding, thereby increasing their ability to respond with compassion.

Source: Public Domain/Pexels

These exercises proved to be very effective for couples in which one partner often feels invalidated and the other struggles to provide continual empathy. They also helped couples reverse the habit of avoiding emotionally difficult conversations.

Living With Greater Intention

It's easy for any of us—not just couples with chronic pain—to experience a disconnect between how we want to live and how we're living. The many stresses and strains of life can sidetrack us from our best intentions, allowing the important parts of our lives to wither.

Thus the other half of the treatment focused on "values-based action" to deliberately cultivate a rich and meaning-filled life. The treatment included:

1. Identifying one's values: Each couple wrote down what they would want their partner to say about them at their anniversary celebration 10 years later, and then discussed their responses with their partner.
2. Assessing match between values and actions: Subsequent exercises helped couples further clarify their values and assess whether they were living in line with them. For example, were they engaging in activities that bring them joy and a sense of meaning? Were they embodying their desire to be a loving and supportive partner? Through discussion with one another, couples identified areas with the biggest gap between their values and their behavior.
3. Setting action goals to increase alliance with values: This final step in values-based living invited couples to set "concrete, specific goals that would bring them closer to living out these values." For example, one participant committed to doing 15 minutes of gardening when the weather permitted, given the value she found in being an avid gardener. Couples continued to set action goals throughout the rest of the treatment.

The program tended to produce relatively modest improvements in pain. The more dramatic change came in a person's relationship with her pain, as it had less of an impact on well-being and activity level.

In other words, MLR increased one's ability to live the life one wanted, even while dealing with chronic pain.

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Couples also had decreases in their depression symptoms and improvements in their relationship satisfaction. By living with greater intention in their relationship, they were able to start feeling more of the closeness they had shared in years past.

Good for Any Couple

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Any major stressor can deplete a couple's resources for relating to each other. Thus this type of program can be a lifeline for couples dealing with other chronic health conditions or other kinds of stress.

In fact, there doesn't even have to be a particular "problem" for couples to benefit from these practices. Being a better listener for our partner, enjoying the moment, living out our values—these are healthy practices for any couple.

When two people are joined in marriage they often vow to love and cherish the other person "in sickness and in health." It's a powerful pledge, letting our partner know we'll be with them no matter what the future brings.

Living and relating mindfully can support that promise, helping us be the partner we want to be—even in the hardest times.

• A version of this post first appeared on Healing Together for Couples.
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