The Unspoken Contract That Needs To Be Spoken: Decades ago my husband told me a funny anecdote about one of his aunts. She was a mother of four and her husband passed out in front of her. Not that funny? But what he quoted that she said both jolted me and made me laugh, as he survived for many decades more: “Don’t you die on me, you expletive!” Hardly the statement I expected from the lips of a loving wife. But dead on, pun or not.
I have often referred back to that anecdote over the years as it began to make more and more sense to me. Once the threads of individual lives are sown together, with shared responsibilities and deepening mutual significance, nothing happens to one that doesn’t impact the other, especially related to health.
Difference Even Here: Let me expand a bit on what I mean. Under average circumstances, couples meet while still in good health due to relative youth, though it is not unusual for someone already to be managing a chronic condition, maybe Lupus or Crohn’s Disease, or any number of autoimmune diseases. But generally speaking there is the absence of medical threat in the early stages of forming the shared life and the family that often accompanies it. By the time couples dip into their forties, stuff begins to happen; menopause; high blood pressure; breast and other cancers, heart disease. And the peer group begins to witness friends who tragically succumb to some of these diseases while still in the throes of raising their children. A new and unwelcomed sense of vulnerability ensues and couples look at each other with different eyes: this could happen to you, to me, to us. Perhaps it is a family of origin’s genetic profile that pulls us out of the sand, ostrich-like, when a parent dies, or a sibling, or a cousin. But not everyone behaves the same way following these frightening wake up calls. There is often a very striking and often problematic difference in how each member of The Coupledom responds to that call.
Defenses Again? Yes, how we handle threats of any kind, psychological, physical, social, you name it, depends on our psyche’s typical response to uncertainty, to the sense of vulnerability that new information, unanticipated situations and unpredictable challenges convey. And this difference in our defenses for a couple can make for serious and protracted negative interactions for the usual reasons: we expect the other to think as we do and take action as we would. But they don’t. And that makes us feel powerless, angry and frightened. After all, we are entwined, our fates are interdependent: “Don’t you die on me…!” is not just anecdotal. It speaks to the essence of the joined life: I am vulnerable to you, whether I like it or not. That’s the contract. Now what do we do?
Choices: A man has a chronic condition, he is on medication for it and needs blood levels checked every few weeks. He doesn’t adhere to that protocol and ends up in a life threatening condition. A woman believes that breast-feeding her child for two or more years takes precedence over getting a mammogram, though breast cancer killed her sister. The man is lucky to survive. The woman dies before her youngest child has completed elementary school. Both families are affected: one with permanent damage to one of its members that impacts the family; the other by death, a mother lost to her children and her spouse, forever.
What Happens to You Happens to Me: Smoking, obesity, excessive drinking, driving without a seat belt are just some of the common threats that couples impose on their relationship. Avoidance of check ups or follow-ups is another typical pattern. Even more stunning is how often partners neglect to share the information from those doctor meetings with their partner. Selective hearing is a powerful though unconscious tool in the service of avoidance and denial; unless both partners attend the check-up or the follow-up visit, the spouse may not even know they are in effect “lying” when they relate to their mate what they were told about their health or their test results.
Adolescent Rebellion at Age Forty Doesn’t Help Either: One spouse asking the other to get a check-up or lose weight or stop smoking not only triggers defenses such as avoidance and denial because it taps fears and the individual’s psyche responds to threats in a characteristic style, but also those same requests can trigger some developmental arrest responses/regressions. In other words, though your partner is your peer, the voice may evoke the image of the nagging parent and the response follows in kind. “Stop bugging me, I’ll do it on my own schedule.” Or, “What I choose to do with my body is my own business. What’s it to you? I don’t tell you what to do with your body!”
It is the unusual spouse who outs their long hidden phobias or fears of doctors and willingly traces their roots. Nope, hide that vulnerability, look tough and just say, “I’m fine.” Women or men who have an idealized image of the sacrificing or tough as leather gender paradigm do not realize how endangering their belief system is to those whom they presume to love and protect.
A Mutual Pledge: When two people commit to sharing a life together, something important needs to be added to the spoken contract, even written down and mutually pledged:
The decisions that each of us makes regarding our individual health will be transparent to the other with the understanding that how we take care of ourselves impacts the other. For that reason, each of us vows to be respectful of, and influenced by, the other’s opinion, and provide all data, symptom descriptions and test results to them. That we will aim to share our fears and seek support from the other to face health challenges with mutual respect and the awareness that what happens to each happens to both.
Our Fates Our Entwined, Now Take Care of Yourself: Couples fight about this health stuff, insult each other, avoid each other and lie to each other. Often the spouse who picks up the pieces of the other’s avoidance, neglect or abuse becomes bitter and loses interest eventually in caring for their mate. That is a defense, a reactive defense, to lessen feeling vulnerable, scared, powerless, disrespected, all or any of the above. And often these behaviors are characteristic of other transactions in the relationship. Outing this problem can also help in outing other transactional problems. Take a moment and share this post. And good health to all.
©Jill Edelman, M.S.W., L.C.S.W. 2013