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We’re Better Together: Shared Experience of Health, Illness and Care

Posted By Elizabeth Patrick, Tuesday, April 16, 2013

Each 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.

Let me 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 concerted manner.

For some couples
who face chronic
illness, traditional
gender roles and
processes are
challenged and
often redefined,
sometimes becoming
more mutual or
egalitarian
.

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.

Even as 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.

Researchers (Acitelli & 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).

Wives 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.

For some 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.

Although 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 them.

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 Psychological Association.

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: 10.1037/1091-7527.25.4.404

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.

 

Elizabeth Patrick
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 practices.

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