Friday, August 29, 2014

Learning to Redirect Your Anger

The following is a guest post by a fellow traveler on the road of couples dealing with illness.  Helena Madsen is a wise woman who is the founder of Chronic Marriage whose mission is to help couples with chronic illness build extraordinary marriages.   Helena is a wife, mother, counselor, and writer who lives with Limb Girdle Muscular Dystrophy.  Get her free resource guide:  For Better or Worse: A Guide to Talking About Illness in Your Marriage.  

In this guest post, Helena offers perspective and advice about managing anger in your relationship.

If there’s one emotion that seems to surface repeatedly in marriages with chronic illness, it’s anger!

You’re angry at your illness and all that you’ve lost – strength, vitality, roles and routines and specific plans for the future. 
You’re angry at your spouse for not always understanding what you need.    
You’re angry that others view you as less dependable or competent because of your limitations. 
Your spouse is angry that his wife is no longer interested in sexual intimacy.
He’s angry that most of the household and parenting duties now fall on his shoulders.
He’s angry that he can’t alleviate your physical pain no matter how hard he tries. 
Both of you have plenty of reasons to be angry.

Anger is not bad.  It’s merely an emotion and a signal that something is uncomfortable, wrong, or undesirable. 

Unfortunately, many people do not process their anger well in the heat of the moment.  When you’re angry at the illness, you often rage at your spouse instead.  Misdirected anger causes you to wound the person you love the most – your mate. Repeatedly lashing out does two things – it weakens your relationship and makes you appear unsafe to your spouse. Both are tragedies. 

Is there a better way to handle anger over your illness?  Yes. 

The most effective way is to distance yourself from the illness.
By that I mean regard your illness as a distinct entity apart from yourself. View it as the third party in your marriage with its own needs and demands.

Marsha and Bob struggled with misdirected anger for years after she was diagnosed with Multiple Sclerosis (MS).  Whenever Bob expressed any frustration with Marsha’s illness, Marsha interpreted it as a direct affront on her character.  The message she received was that she was somehow a failure or disappointment for having MS.  Feeling hurt, Marsha would unleash her anger on Bob who would then strike back. 

Neither Marsha nor Bob knew how to talk about the illness in a healthy way.  Most of the time, they chose not to talk about it until they got to the point where their pain was intense enough that it threatened to swallow them up. 

In counseling, they learned how to take a step back and view the MS as separate from themselves.  Their counselor suggested they view it as an uninvited yet permanent guest in their home.  This idea of a demanding houseguest who refuses to leave was so helpful to Marsha and Bob that they decided to give him a name - George.  Whenever one of them was angry or frustrated with the MS, they gave themselves (and each other) permission to express their true feelings about George.  It allowed them to remain true to themselves and yet not wound each other at the same time.    We may view naming an illness George as silly but for Marsha and Bob, it was effective.  They were at last able to separate their anger towards each other from the anger towards the MS.

What are some other helpful ways to avoid misdirected anger?

- Remember that anger is a secondary emotion

Anger isn’t the first feeling to come, although it’s generally the first one we express outwardly.  Wherever it surfaces, another emotion already existed.  Because emotions like rejection, loneliness and sadness are so strong and painful, we substitute anger because it makes us feel less vulnerable.   
We falsely believe that anger helps us feel in control when we’re feeling out-of-control and powerless.  The first question we need to ask ourselves when we feel ourselves getting angry is “What’s going on inside that’s making me angry?" To resolve your anger, you need to identify the root reason for it.    

Consider using the Anger ABCDs
The Anger ABCDs help you deal with your anger in a basic and easy-to-follow format:
1) Acknowledge that you're angry.  Don't deny it or stuff it; accept and acknowledge it.
2) Backtrack to the primary emotion.  Ask yourself: Why am I angry? What am I really feeling? What is the root reason for my anger?
3) Consider the cause.  Ask yourself: Who or what caused it to occur? Who or what frustrated me? Who hurt or wounded me?  What plans fell through?  What happened?
4) Determine how best to deal with it.  Ask yourself: How should I respond? What should I do? When? How?  

What role does anger play in your relationship and how do you handle it?

Tuesday, August 26, 2014

Sweating the Small Stuff

I had a Hungarian grandmother.  I can still see her strong arms rolling out a sheet of dough and cutting it in strips for her sweet cheese and raisin kugel (casserole).  And if the wind is right, I can just about smell the secret spices in her chicken paprikash as it bubbles on the stove.

She also gifted me with her white glove test.  You know -- running a gloved finger over a counter top to test for spotlessness.  Her standards for cleanliness bordered on psychotic.  Dust and dirt specs did not stand a chance.  They were captured and ejected almost before they hit the floor.  If she had a mop in her hand, you wanted to be sure you were in another part of the house and not vulnerable to her manic, but oh so powerful, swings.

I am not like her.  I swear.  My standards are lower.  I let dust settle for at least a few hours before I banish it.  OK.  I like clean.  To see a string of rooms, all in order, with floors shining and  pillows plumped, gives me ridiculous satisfaction.

Part of this tendency comes from grandma.  But another part of it comes from being sick.  When I get stricken by a pain flare up, I go down.  I tend to spend a lot of time in one place trying to relax the pain away or drug it down.  My world shrinks to the room I am in, and my safety totems become the objects in that room.  Clean space matters.  It gives me hope.

So when Richard, my husband, puts a wet drink glass down on our granite counter top, again,  after I've asked him not to three times in the past ten days, I get upset.  It leaves a circular ring where the base of the glass rests on the granite.  And it takes work to make the mark disappear.  I really do get upset, and I insist on showing him how hard it is to remove the mark.  I ask him repeatedly, "Why do you have to leave a wet glass on the countertop?"  A silly question, I know.  What could the answer possibly be?  "I was attacked by an army of dust mites and had to put the glass down to defend myself!"

It doesn't really matter why.  What matters is that he caused a disturbance in my spacial equilibrium.  If my home is in balance, maybe I can be too.  If everything is in its place, maybe my pain will also be in its place - in a corner of a locked and forgotten trunk in the recesses of a dark basement room.

Sometimes it's OK to sweat the small stuff.  Some small stuff has meaning and is worthy of attention.  And if you allow yourself to be curious about the small stuff, it may just reveal its underlying message to you.  The message that says: "You're OK.  And it's OK to get upset because this means something to you."

Sometimes a glass ring on countertop is more than just a glass ring.

Wednesday, August 13, 2014

How Differences Can Lead to Trouble

The impact of the illness is experienced differently by each partner.  They do not perceive the situation in the same way, and they are not feeling the same things about their situation.  Recognizing these differences in perception and feeling is critical to maintaining connectedness.

The ill person suffers both physical pain and soul pain – both are severe.  Her body has betrayed her and her identity has been hijacked by illness.  The life she had is gone and she doesn’t know what to do or who she can be.  There is a sharp and potentially demoralizing gap between her internalized image of herself (young and healthy) and the present external reality.  And while she is in this state she has to rely on specialists she might not really know.

For the well partner, his world has changed on him.  On top of his confusion and fear, he feels he has to be strong while he helplessly watches his sweetie suffer.   And he may feel resentful - of the illness, of doctors, and even of her -- and guilty for feeling that way. 

Here's a not unusual scenario about how these differences can play out:
The ill partner may need some alone time to adjust to her new state; and the well partner may be driven to find a way to help her.  If they don’t recognize that their needs are different in this moment, he is likely to feel rejected by her need for alone time, and she is likely to feel pressured by his attempts to help her.   

The result: she is likely to hold more tightly to her privacy, which will make him feel more excluded; and he is likely to pressure her more strongly to let him in so he can help.  They grow resentful and distant.   

If they could recognize and make space for their differences – she might be able to say “I need some alone time to think – but I am not retreating from you.”  And he might be able to say –“I want to help you any way I can so I’ll respect your space, but I need to check in with you periodically to see how you are, and hope that’s OK.” 

In this way they are respecting their differences while maintaining their connection.

Friday, July 25, 2014

Interview on Chronic Marriage

Interview with, Barbara Kivowitz, by Helena of Chronic Marriage blog.

From Helena's post:

"What are my personal “nuggets of gold” from reading In Sickness As In Health?  Here are just a few:

1)  Illness can be a gateway and not an epilogue; and that, even in the absence of a cure, healing is possible.
2)  You can end up holding so tightly to the old image that in order to sustain the illusion you reject the reality of the illness and in so doing, reject your partner.
3)  Illness compresses time and summons mortality and can help us filter out the trivial.  We can attend to what is truly important with intention and can live each moment potentially feeling more alive with illness than the deadness of life before illness.
4)  Revealing secret hopes and fears does not make you more vulnerable, but rather builds a strong bridge to your most powerful ally, your partner.  Speaking the unspeakable makes both of you stronger.
5)  Love each other, support each other, and don’t leave each other alone in the dark."

Thank you Helena.  I look forward to reading all your insightful posts.

Wednesday, July 16, 2014

When Illness Warps Your Relationship

Sadly, it's not uncommon for the illness to wrap the couple relationship around its nasty finger.  Illness, especially if pain and exhaustion are present, can consume way too much of your life force.

The ill partner can become focused on the illness, at the expense of relationships with partner, children, and friends.  The well partner can become more and more remote as s/he tries to hold onto normalcy.  And both partners can wind up blaming each other - for everything.

Underneath these scenarios run such deep fear and anger that often the couple avoids these feelings,  and in doing so, the partners grow more distant from each other's emotional centers.  It is natural to want to suppress such hurtful emotions - but they do tend to seep out, and often in subversive ways.  How many of us have screamed at a jar lid that won't come off, or at a medication with side effects, or at a partner for not making it all better (even though both of you are trying as hard as you can)?

What can you do?  No easy answers here - because our situations are just not easy.  Use your best judgment about trying any of the suggestions below:

  • You can try directing your anger and fear at the illness, instead of at each other.  Talk to the illness, privately or in each other's presence.  Tell it how much you hate it or fear it.  The illness is the true target.
  • Sit silently, side-by-side, and summon your compassion for each other and your appreciation of the qualities you each possess.  Give yourselves a 5 minute quiet break from the noise of illness, doctors, worries.  In that quiet, remember what brought you together in the first place.
  • You can try individual or couples therapy.

I'd like to ask you to try one thing.  That is -- be as compassionate and gentle as you can with yourself.  You are doing the best you can, every day.  If the illness has overtaken most of the kindness around you - it may sound cliche, but do try to be understanding and validating of yourself.  That too can become subversive and spread.

Let me know how illness has seeped into your relationship, and what you've tried to maintain your balance, as individuals and as a couple.

Monday, July 14, 2014

The Turmoil of the Caregiver

From an excellent article in the Washington Post, written by a woman who is the primary caregiver for her husband who has multiple chronic conditions.  The article, written in the first person, captures the physical and emotional turmoil many caregivers know too well.

Living with a husband's chronic illness has a bad effect on his wife's health
by Katherine McQuay Lewis

"My husband, Dave, may officially be the sick one in our marriage, but his steadily declining health is also doing a real number on my mental and physical well-being. Emotionally, I’m the little silver ball in the pinball machine. I’m alternately angry, resentful and critical; then I’m overwhelmingly guilty, so I careen into being loving, kind and almost a little clingy.
To borrow from the caregiver vernacular, I am the “well spouse.” But “well” is becoming an increasingly relative term..."

Monday, July 7, 2014

Arguing and the Immune System

excerpts from an article on Medical Press about the effect of arguments between partners (and other stressors) on the immune system:

"Rebecca Reed, a doctoral candidate in family studies and human development in the University of Arizona College of Agriculture and Life Sciences, is studying how a couple's recovery from an argument affects their immune systems and overall health....

Though we hopefully know the difference, our bodies' immune responses don't differentiate between a peeved lover and a predatory lion. When confronted with a psychological stressor, such as a tense discussion or giving a public speech, our immune systems respond the same as they would for an impending physical attack....

Essentially, too much psychological stress literally can make you sick, while the ability to recover from stressful situations may decrease risk of chronic illness and improve overall health and quality of life......."

She believes that one way to turn off the immune response may be for couples to foster effective interpersonal communication with attention to each other's emotional states. This could help them not only emotionally recover from stressors, but also immunologically recover, she said."


When Richard and I have a doozy of a disagreement both of us feel tender, even broken, for a while afterwards.  I go into my cave and hibernate until I feel reconstituted.  Richard immerses himself in his computer. After a bit of time passes, we reach out to each other again.

I really like the idea of each wounded partner helping the other to recover from the effects of arguing.  It's a hard task for someone who is angry or defended to also be empathic.  But the empathy is there, just retreated.  If you can make space for empathy in the rush of anger, the disagreement is likely to be more tolerable, with a quicker, more balanced resolution.

How do you and your partner do arguments and disagreements?  Do you feel the stress of arguing in your body?  How do you recover?