morning for the past two years, my friend and I have taken our dogs to the
neighborhood park. On those mornings, rain or shine, we share the park with a
Vietnamese couple in their sixties. We have come to expect to see one another
every day and have begun our own unspoken ritual of waving and exchanging a
pleasant "good morning.” The couple comes to the park to exercise and over the
years they have captured my heart and attention because of the apparent love
and care that they have for one another. I have had the privilege to witness
how much this couple values mutual health-positive behaviors.
describe some of the sweet moments I have witnessed from this couple. First,
the husband seems to struggle with a health-related challenge and is in a
wheelchair most of the time. He appears to count on his wife for assistance and
care. I have become familiar with their routine, as I’m sure they have become
with ours. They walk from their home which is about a quarter of a mile away.
Sometimes the wife pushes the husbands’ wheelchair, other times she is
stabilizing him on one side as he walks |
for a short time in a slow and
who face chronic
gender roles and
more mutual or
Once they arrive at the park, they approach a cement bench
that they use as a sort of "home base”. The wife begins to work with the
husband as he gets his physical activity going. He spends about 10-15 minutes
on his feet and while holding onto his
wife, he bends, squats, steps and stretches. His exercise comes first. Once he
has finished, he takes a seat on the bench or in his wheel chair, relaxes, and
begins to encourage and observe his wife as she starts her morning workout. She
has a number of workout courses that she has created at the park, keeping
things relatively new and fresh for herself. She may do some push-ups on an
incline, walk up and down a steep hill, or speed-walk up and down the front of
the park. As she works out, her husband is close by, watching, smiling,
enjoying his wife’s exercise process. Imagine also that this is a couple that
is soft and patient with one another. Never upset, always encouraging.
I recall what I observe every morning I find myself smiling at the couples’
love and care towards one another. However, I also know that when one spouse
becomes sick a lot changes in a relationship. Often the person who gives care
can experience lack of personal health as they put the ill spouse first. However,
the couple at the park has shown me that there can be joy and connection
through a shared experience of health, illness and care. This has been
particularly valuable for me as I am working on research related to a
relational orientation towards illness, in other words, shifting from a "my”
illness to an "our” illness orientation.
& Badr, 2005; Burwell, Templeton, Kennedy,
& Zak-Hunter, 2008; Dankoski & Pais, 2007; McDaniel
& Cole-Kelly, 2003) have highlighted that female spouses easily adapt
to a relational orientation of illness.
As a result, this process has the potential to further burden the female
partner when disparities in power between males and females in the relationship
are not attended to. When females, or
the well partner, take on a greater degree of relational responsibility than
their spouse, it is common for relational strain to increase. Therefore, it is important to recognize and
highlight that a process within the relationship must continually occur so that
each spouse takes a role in the mutual processing of ‘our’ illness experiences (Kayser,
Watson, & Andrade, 2007).
who coped with their chronic illness by confronting challenges and expressing
feelings and experiences openly had greater overall marital satisfaction, as
did their husbands (Badr, 2002; Acitelli & Bahr, 2005). This same "active” coping from the wife is
associated with greater marital satisfaction for ill husbands as well. From a gender lens, this suggests that the
couple is not mutually engaged in an "our” orientation towards illness. Instead,
the illness experience is being shaped by gendered power processes that place
the primary relational burden on the female partner.
couples who face chronic illness, traditional gender roles and processes are
challenged and often redefined, sometimes becoming more mutual or egalitarian (Dankoski
& Pais, 2007). Whether
couples progress to more egalitarian styles of coping or revert to more
traditional gendered patterns, flexibility is a key issue. In fact, Cross et al., (2001) found that
inflexible gender roles often lead to difficulty and distress for couples and
families and can potentially lead to separation or even divorce, especially
when the female partner is the one who becomes ill.
I only see the Vietnamese couple for about an hour each day and only observe
their exercise process, I feel as if I get to witness a
care-giving/care-receiving relationship that is oriented around the couples’ experience of health and
illness. I see flexibility in their gender roles, mutual support, and care. I find
that I look forward to seeing my park friends every morning. I am encouraged by
Acitelli, L. A.,
& Badr, H. J. (2005). My illness or our illness? Attending to the
relationship when one partner is ill. In T. A. Revenson, K. Kayser & G.
Bodenmann (Eds.), Couples coping with
stress: Emerging perspectives on dyadic coping. Washington, DC: American
Badr, H., Carmack, C. L., Kashy, D. A., Cristofanilli, M.,
& Revenson, T. A. (2010).
Dyadic coping in
metastatic breast cancer. Health
Psychology, 29(2), 169-180. doi: 10.1037/a0018165
Burwell, S. R.,
Templeton, B., Kennedy, K. S., & Zak-Hunter, L. (2008). Feminist-informed
medical family therapy principles and techniques across biopsychosocial systems
levels for younger women with breast
cancer and their partners. Journal of
Feminist Family Therapy, 20(2), 99-125.
Dankoski, M. E.,
& Pais, S. (2007). What's love got to do with it? Couples, illness, and
MFT. Journal of Couple & Relationship
Therapy, 6(1), 31-43.
Kayser, K., Watson, L. E., & Andrade, J. T. (2007). Cancer as a
"we-disease": Examining the process of coping from a relational
perspective. Families, Systems, &
Health, 25(4), 404-418. doi: 10.1037/1091-7522.214.171.1244
McDaniel, S. H., & Cole-Kelly, K. (2003). Gender, couples, and
illness: A feminist analysis of medical family therapy. In L. B. Silverstein
& T. J. Goodrich (Eds.), Feminist
family therapy: Empowerment in social context (pp. 267-281). Washington,
DC: American Psychological Association.
|Beth Patrick is a third-year PhD MFT
student at Loma Linda University and has worked at the Loma Linda
Transplantation Institute for the past two years. She has also spent a
year working in Primary Care as a part of an
integrated healthcare team. Her professional interests include medical
family therapy, teaching and mentorship, and socially just/contextual