(This blog was originally posted on Friday, February 20, 2015 on the WebMD website)
Along with the worries, sadness and frustrations of dealing with cancer, many patients experience the heartbreak of their loved one failing to support them. How could a life partner or spouse fail you during cancer? There are many ways, some more obvious than others.
Jan’s husband never came to any appointments, ever. He never learned about her diagnosis, her treatment plan, the side effects of the medicines or the recommendations for how she might improve her energy and strength. He blamed the lymphedema in her arm after her surgery on her “lazy lifestyle.” He told her that support groups were for “wimps” and even took some of her pain medicine for himself.
Sally’s partner came to every appointment – he would never let anyone else bring her. He kept a medical notebook with her test results and argued with every doctor about each treatment plan. He would not let her eat any ice cream or cookies because he thought the sugar would make her tumor grow, even though Sally was at a very healthy weight and ate a very balanced diet.
Gary’s girlfriend would never stop talking about herself. At appointments with the oncologist she would ask questions about breast cancer even though Gary had lymphoma. She repeatedly complained about Gary being at home instead of work, “having him around the house all day is making me crazy, I need my space!” She had no understanding of cancer fatigue: “he looks fine, no vomiting or fever – he should be able to do more!” In the past Gary had been able to participate in his girlfriend’s extremely busy social schedule, but after lymphoma, he asked his girlfriend about limiting their social time to just close friends. His girlfriend insisted on accepting every invitation, and started leaving Gary at home, alone.
Some spouses and partners don’t get it, but they want to, which is huge. If a loved one wants to do better, there is hope for the relationship. If you’re the partner — not the patient — in this scenario, and you’re wondering how to recover from your initial missteps, here’s what I would suggest: Start by setting aside time when there are not any children yelling or bills to be paid or dishes to be done. Begin with a question, “so how are things going for you?“ Wait for an answer. Listen. Then ask “Anything I can do to help?” Breathe, pause, listen. Maybe put your hand on your partner’s shoulder, gently, in order to emphasize you are listening. If you start getting yelled at for being late once 6 months ago, breathe deeply, and respond simply, “I am sorry I was late, but now I really want to help, and do better. Let’s keep talking, but no yelling please.” Make eye contact and smile.
Sally’s partner took the advice above, he set aside the time, took several deep breaths, and listened. He listened closely because he really did love her, and wanted to know how she was doing. He admitted that he had hoped to stop the cancer by controlling everything about her medical care and diet. Sally was able to explain she did appreciate the help with scheduling and tracking her medicines, but she did not want to be treated as an invalid or a small child. Sally’s partner was eventually able to become the partner she needed – a partner interested in caring for her but also respectful of her autonomy.
Gary spent a lot of time after cancer treatment thinking about what kind of life partner he wanted. Reflecting back over the years, he was able to see that his girlfriend had always been self-absorbed. Friday nights, she chose the restaurant; Sunday morning she picked the breakfast; and during the week she rarely asked how Gary was doing at work. Gary realized that he would rather be alone than in a relationship with someone who only cared about herself. “After everything I have been through, I deserve real love.”
Jan always knew that her husband drank too much, but she had hoped he would stop on his own. Through her cancer treatment Jan was terribly embarrassed that her husband was not at appointments. On the day Jan came home to tell her husband that the oncologist told her she was cancer free, he was passed out on the couch. Not being able to share the journey, or the joy in the recovery, pushed Jan to tell her husband that she wanted a divorce. When he realized Jan was actually planning to leave him, he knew he had to get sober. The addiction to alcohol had robbed Jan’s husband of the chance to be a support when his wife really needed him. The only hope for the marriage was for him to get completely sober, and with medical care, Jan’s husband finally stopped drinking. Once sober, he returned to being the kind of husband Jan remembered from when they were first married. He cooked pasta dinners, rubbed her feet in the evening, and actively listened when she talked about her health concerns and hope for the future.
We all hope that our partner will step up and be there for us if we need them, but sometimes they don’t support us as we’d hoped. There are a variety of reasons why a loved one may fail during cancer treatment, and the psychological work is to realize the failure is about their issues, not about you or your self worth. If there is genuine caring, and a real desire for a loving relationship, a couple may get through the challenge of cancer. And if not, there may be grieving process if the relationship fails, but there is great beauty in a cancer survivor taking steps to be in the healthiest, most loving relationship possible. After cancer, you deserve it.
About Dr. Baer
Wendy Baer, MD, is medical director of psychiatric oncology at the Winship Cancer Institute of Emory University, with appointments in the Department of Psychiatry & Behavioral Sciences in the Emory School of Medicine, and the Department of Hematology and Medical Oncology at Winship.
In her work at the Winship Cancer Institute, Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and subsequent treatment. As a psychiatrist, she has expertise in treating clinical depression and anxiety both with medications and with psychotherapy to help people manage emotions, behaviors, and relationships. The fundamental goal of Dr. Baer’s practice is to promote wellness and maximize patients’ quality of life as much as possible. She believes strongly in the team approach to patient care and collaborates regularly with the doctors, nurses, and social workers that make up a patient’s care team.
Dr. Baer attended medical school at the University of North Carolina at Chapel Hill, where she graduated with honors. From UNC she went to the University of Pennsylvania, where she completed her residency in psychiatry and served as the chief resident in her senior year. Prior to moving to Atlanta, Dr. Baer worked with patients dealing with cancer at the Swedish Cancer Institute in Seattle, WA.