Hello Folks: I thought you would appreciate this Guest Blog. It was contributed by Psychologist, Seth Gillihan Ph.D., author of Retrain Your Brain. – Suzanne Phillips

“A Sorrow Shared is Half a Sorrow.”

 When the sorrow goes on and on, however, as it does with chronic pain, both partners in a couple can suffer.

Pain narrows our focus, making it hard to attend to anything else, and for good reason—pain gets our attention to motivate us to protect our bodies. But chronic pain can take center stage in our lives, crowding out experiences and relationships we care about.

A recent article in Cognitive and Behavioral Practice by a team of researchers at Wayne State University described some of the common ways chronic pain affects couples:

Stress: 

Chronic pain may lead to frequent medical appointments. Accompanying a spouse who is in pain can become a logistical burden on the partner. Disability from pain may also lead a person to stop working which can create financial strain for the couple, and may require the spouse to take on additional work.

Distress: 

When one partner experiences disability, marital satisfaction tends to go down. Additionally, both partners may experience increases in depression symptoms from the continued experience of a partner’s chronic pain.

Dissatisfaction with the Relationship:

Couples who deal with chronic pain often get locked into communication patterns and ways of interacting that are unsatisfying for both and deepen dissatisfaction with the relationship.

Kathy had dealt with pain for most of the 37 years of marriage to Nick. She limited enjoyable activities like being with friends and going to concerts with Nick because she feared the activities would worsen her pain. At some point she retired early from her job, in part because of her chronic pain.

As a result, Nick also became less engaged in activities, spending most of his time at home with Kathy. In addition, he took over the work around the house, most of which he did not enjoy.

At some point, Kathy and Nick reported significant depression symptoms, as well as unhappiness in important aspects of  their relationship.

They often avoided difficult conversations, and felt emotionally distant from one another. Not surprisingly their sex life had suffered.

Reaching for Help

Wanting to reconnect and reduce the strain on their relationship, Kathy and Nick sought help at Mindful Living and Relating, a treatment program at Wayne State for couples dealing with chronic pain. A close look at the program offers suggestions that couples might begin to consider to relieve the impact of chronic pain on their relationship:

A Couple Focus

Rather than treating only the person with chronic pain, the treatment program provides help to both partners, with the rationale that both  can benefit. Moreover, a couple’s conflict can get in the way of treatment for chronic pain, leading to greater dropout from treatment. A program that improves the couple’s relationship may lead to better outcomes.

An important goal of the Mindful Living and Relating program is to increase flexibility for individuals (“psychological flexibility”) and help them break out of unhelpful patterns of interacting with their partner (“relational flexibility”).

Two Components of the Program

The two major components of the program that enhance flexibility are Mindfulness and Living Our Intentions.

Mindfulness involves bringing one’s attention to the present and cultivating greater acceptance of what is. Many studies have shown that this approach can help people suffer less and experience life more fully, including individuals with chronic pain.

The program starts with three individual practices. These individual practices provide a foundation in mindful awareness before using joint mindfulness exercises.

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

Joint Mindful Exercise

  • The first couples’ practice is mindful handholding—simply focusing on the sensations of holding the other person’s hand. Through this intimate exercise, spouses practice giving their full attention to the other person.
  • Couples also practice a loving-kindness meditation (an example is here), in which each person silently wishes that they and their partner will experience “kindness, compassion, and freedom from anger and pain.”
  • Mindful listening builds on these exercises. It’s a rare thing to have someone really listen to us, and let us know they hear us. The experience can transform couples’ communication. Spouses take turns talking about an emotional experience they have had—first a positive emotional experience and later a negative one—while the listening partner gives their full attention to the speaker.
  1. This exercise calls on the practice in mindfulness as couples nonjudgmentally bring their attention back to the conversation if they get distracted.
  2. The practice also involves taking a mindful breath before responding, thereby increasing the ability to respond with compassion.

Kathy had often felt like her feelings were being invalidated when Nick would tell her, “Don’t worry.” Through the practice of mindful listening, Nick learned to respond in a more empathic way that made Kathy feel heard and supported.

Kathy and Nick both reported that this exercise was very valuable, since they had gotten into the habit of avoiding conversations that involved negative emotions.

 Living Our Intentions

 Values-based action. 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. We can get sidetracked from our best intentions by the many stresses and strains of life. The problem is that without deliberate nurturing, the important parts of our lives begin to wither.

The Mindful Living and Relating program invited couples to work together on exercises like the following:

Identify their values- In this exercise, partners were asked to imagine what they would like to hear their partner say about them in a speech at their anniversary celebration 10 years in the future. Each spouse completed the exercise individually and then discussed their responses with their partner.

Clarify their values- In this exercise, partners were asked to assess whether they were living in line with them.

  • Were they enacting their desire to be a loving and supportive partner?
  • Were they engaging in activities that brought joy to each other and a sense of meaning?

Couple discussion – Couples then discussed responses with their partner to identify areas with the greatest gap between their expressed values and how much they were embodying those values.

Setting Concrete Specific Goals

The final step in values-based living was setting “concrete, specific goals that would bring them closer to living out their values.”

For example, Kathy committed to doing 15 minutes of gardening when the weather permitted, given the value she found in being an avid gardener and continued to set goals for action throughout the rest of the treatment.

By the end of the program, Kathy was experiencing a little less pain. What had changed more dramatically was her relationship with her pain, which she said had significantly less impact on her well-being and activity level.

The couple also showed decreases in their symptoms of depression and improvements in their relationship satisfaction. They reported feeling more  of the closeness they had shared in years past.

Support for Any Couple

The Mindful Living and Relating program was designed specifically for couples who deal with the difficulties that often accompany chronic pain. However, any major stressor can challenge a couple’s resources for relating to each other. Thus this type of program could be a lifeline for couples dealing with other chronic health conditions, and even other kinds of stressors.

In fact, there doesn’t even have to be a particular “problem” for couples to benefit from these practices. Identifying and living out our values, listening to our partner, enjoying the moment—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 is a powerful pledge to let our partner know we will be with them no matter what the future brings. Having ways to make that happen makes that promise possible.

“A sorrow shared is half a sorrow, a joy shared is twice a joy.”