Through this mutually protective collusion, the pair accentuated the positive so avidly that their rapport became superficial and stilted. Like so many caregivers and care recipients, the couple subscribed to "the power of positive thinking." What they missed out on was the healing power of sadness.
And that's understandable: The best way to sustain each other's morale through this medical crisis, they believed, was to cheer each other on. To accomplish that, the man and woman gave voice to almost exclusively upbeat thoughts and feelings. Venting negative emotions, in their view, could only harm their health, their psyches and possibly their relationship. But that needn't be the only way, and it's very likely not the best way.
Sharing what you've lost in the wake of a chronic illness or medical event, sometimes disparaged as "stinking thinking," can actually bring couples and families closer together.
Like others struggling to cope with adversity, the couple profiled above is engaging in what psychologists call a conspiracy of silence. Perfectly normal fears and other emotions churned up by a life-changing condition — the wife's fear of a second heart attack, the husband's frustration at his wife's slow recovery — are pooh-poohed or squelched.
Optimism counts; its effects are far more salutary than wallowing in misery. But when well-meaning family members start censoring what they say to one another, they stop sharing the full range of life's joys and sorrows. The result: unintended distancing and isolation.
To make that point, I frequently ask couples, "Did you argue, or complain to one another, before this medical event occurred?"
"Of course," comes the response.
I then ask, "Has this crisis made you less open with one another? Do you confide in each other less now than you did before?"
The reply to that is usually just an uncomfortable shrug.
A better way to bolster family cohesion and resilience in situations like these is to balance — or try to balance — the positive and the negative: Keep hope and good humor alive, yes, but at the same time feel free to voice your doubts, disappointments and anxieties.
How can caregiving families put the (seemingly) negative to positive use? Here are three ways:
1. Put worries into words
Throughout the caregiving years, all family members worry to some degree or another. It's a natural response to uncertainty; it's also a proven means of preparing for the challenges ahead. When family members hesitate to speak up, however, they often start to internalize their angst. If only they would voice their concerns! Doing so enables relatives to gauge (and possibly correct) each other's unrealistic anxieties, thereby gaining reassurance. In short, sharing worries can activate a family's comfort and support systems.
2. Announce annoyances
The irks and quirks of everyday living — finding dirty dishes in the sink, for example, or missing another's cue that he or she needs attention — don't come to a halt with the onset of an illness. Instead, they multiply. Caregivers don't want to compound the suffering of the afflicted, obviously, so they often keep their grievances to themselves. Yet this robs family interactions of mutuality — the notion that loved ones have expectations of (and are committed to caring for) each other. Caregivers who refuse to say what's bothering them may eventually brim over with resentment — a sure sign of impending burnout.
The healthier alternative? Caregivers should calmly and constructively express their annoyance to care recipients; just because someone is sick doesn't mean they stop being a fully fledged member of the family. This is a better way to air and settle gripes, because it largely restores the give-and-take of family life before the illness. Caregivers who vent don't resent.
3. Don't suppress sadness
If there's one negative emotion that family caregivers and care recipients seem to avoid the most, it's sadness. Some people fret it's the first step on the path to depression. Others tamp it down because they're afraid it will be seen as a sign of defeat or resignation.
But as anyone who has ever attended a moving funeral service knows, expressing sadness can bring family members closer. Discussing their losses — both actual and anticipated — can bond caregivers and care recipients, giving each a sense that they will face whatever comes together. What's left said, not unsaid, is the real silver lining of this dark cloud.
Barry J. Jacobs is a clinical psychologist and family therapist who writes regularly about caregiving issues for AARP.
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