Restoring Balance: Relationships and Illness, Part I

A couple walks along a wooden fence, holding their arms out for balance.Before you got sick, was there a better balance of power in your relationship? Did you feel more like an equal to your partner? Did you have greater confidence?

Before you got sick are the operative words here. Since then, I’m guessing the balance of power has shifted in your relationship. Perhaps you’re no longer able to work full time, or you’ve had to give up your job entirely. Maybe you require a lot of personal caregiving from your partner. Perhaps you value yourself less because you can no longer do certain things for yourself or your family.

Illness creates imbalance in a relationship like few other things can.

We suddenly feel shameful for needing to rely on our partner for physical, emotional, and financial support. Not only are we forced to face the terrifying things happening to our bodies but also cope with our own feelings of loss and fear about the future. Tack on trying to manage a partner’s feelings, and soon we’re under water.

Many of us shut down. We stop talking about how we’re feeling and give up trying to make our partner understand. We somehow think that if we just put on a happy face and stop complaining in spite of the pain, everything will work out fine.

Except, it doesn’t.

Instead, we fight more. We feel less understood than ever. We decide that we’re not compatible anymore. But, we’ve got it all wrong: instead of staying quiet, we need to start talking.

If you’re experiencing conflict in your relationship, it’s usually because you’re not using your voice in some way.

Think about that for a moment.  How many times have you silenced your voice for fear of upsetting your partner? Or not asked a probing question for fear of what the answer may be?

Here’s something very few couples knowsuccessful couples don’t deal with fewer or easier problems, somehow they are able to use the challenges of illness to strengthen the relationship rather than weaken it.

So what’s the best way to strengthen your partnership and bring it back into balance? Start talking! Yes, I know that’s easier said than done. Most people don’t even know where to start and when they do, it usually turns into an ugly argument.

Not to worry, today I bring you the first article, in a series of two, designed to inspire and equip you to communicate your way back into balance.

If you are past the diagnosis/crisis stage and now living with the daily effects of illness, I don’t have to tell you how hard it can be on your marriage. There is the constant push-pull, while you are trying to balance your former roles and sense-of-self, with needing to change things—sometimes rather dramatically—to accommodate the illness.

In many ways, chronic illness mirrors marriage. By definition, chronic means “of long duration” which is similar to the “till death do us part” vow we take at the marriage altar.  With a spouse or a chronic illness, you’re in it for the long haul. In both, there can be seasons of joy and stability as well as seasons of flare-ups and pain. How do you achieve a healthy balance when chronic illness often dashes your hopes for a storybook life together?

You write a new chapter in your relationship story.

You begin this new chapter with what I call Level One: Basic Information. This level is critical because you can’t proceed to the other levels until you’ve got this one nailed down. There’s no use talking about emotions or trying to create a new future together until you both have a very clear understanding of the illness and how it affects you.

The first basic question you and your spouse EACH have to answer is this: What is the expected course and outcome of the illness? It is incredibly common for partners to learn that they have very different ideas about the expected course and outcome of an illness.

We all listen through filters. Two people can hear the exact same information but arrive at two different conclusions, because of the way they filter information.

It reminds me of a couple I once worked with where the wife was diagnosed with Multiple Sclerosis–Relapsing-Remitting (RRMS). Both husband and wife were present when the doctor gave the diagnosis and explained the disease in depth. The husband heard “relapsing-remitting” and believed his wife would be fine as long as she took her immunomodulatory medication. The wife however, couldn’t get past the words “multiple sclerosis” and believed she would become completely disabled within five years. It’s not hard to understand why this couple came close to a marital breakdown. They were each operating from a completely different understanding and expectation of the disease.

Perhaps you’ve been recently diagnosed and the news has left both you and your spouse feeling overwhelmed. You’re too scared, stressed, and exhausted to talk much about the illness, but it’s already apparent that the two of you have very different expectations.

Maybe you were diagnosed 20 years ago with an illness that has steadily gotten worse.  When was the last time you and your partner sat down and did a check-in with each other on current research, promising treatments, or new ways to accommodate the disease’s progression?

Fear, worry, resentment, bad decisions, and wrong thinking can all stem from a lack of accurate information. Once you’ve landed on a similar understanding of the illness, its characteristics, physical symptoms, expected progression, and outcome, you’re ready to go a little deeper.

Take some time to answer the following questions thoughtfully. Set aside a time when you’re both in a good mood and can talk uninterrupted. I highly encourage you to record your answers in a notebook that can serve as your blueprint.

  • How have we had to reorder ourselves around the illness? List all the ways you can think of. Examples include: socializing less, postponing having kids, cutting down to part-time work, quitting a job, hiring a housekeeper. How will we need to do so in the future if the illness progresses?
  • In what ways have our pre-illness roles changed since the diagnosis? Include roles at home, work, with kids if applicable, extended family, and community.
  • Given the demands of the illness, do our current roles seem realistic? Is there overcompensation or under-compensation by either of us? Try not to let emotions, resentment, or defensiveness get in the way. Keep it as factual as possible.
  • How do our current roles and expectations fit with those recommended by our doctor(s)? For example, did the doctor say that you should rest as much as possible, but you insist on doing all the same things you did before your illness?

If you and your partner take the time to answer these questions, I applaud you! Not many couples are willing to be so honest with each other; it takes courage and vulnerability. Perhaps some of your partner’s answers will hurt or make you cringe a bit. Hang in there! Shared power in a relationship comes from seeing the reality of a situation, discussing your options respectfully, and then taking action as a team.

In the next article, we’ll take the answers to some of these questions and go a bit deeper into the realm of emotions. We’ll touch on how to use your voice to express emotions in a healthy way and how to receive your partner’s emotions without judgment.

© Copyright 2010 by Helena Madsen, MA, therapist in Gilberts, Illinois. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • The Hulk

    The Hulk

    December 2nd, 2010 at 2:54 AM

    All this comes down to family dynamics and the depth of relationship the couple shares and not to mention the length of the marriage. I have a friend who was involved in an accident two years ago and is bed-ridden ever since. All the family responsibility then fell on his wife but there was no friction or problem because their son graduated soon after and is contributing well to the family.

    If there is love and understanding then there will never be problems that are too big to handle.

  • Jeannie


    December 2nd, 2010 at 5:41 AM

    the key is that no matter what happens in a marriage there has to remain a balance between the partners in order for there to be a healthy relationship. if one person has the upper hand all of the time or always makes the decisions then that is not equitable and someone is going to end up feeling used and probably very hurt, as well as marginalized and made to feel less than worthy.

  • benson


    December 2nd, 2010 at 11:53 AM

    illness or not,if there is understanding and connection the marriage will go strong and if there is not then it is bound to fall apart.
    an uncle of mine developed an illness years ago and his wife has been the bread-winner ever since.she has never complained and even today if I see them I can see the love they have for each other.

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