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Excerpt from A Caregiver's Challenge: Living, Loving, Letting Go
by Maryann Schacht, LCSW, BCD

Each of us has our own way of existing in this world. We learn various ways of coping from our families of origin, as well as from the world around us. It is not unusual for patients to accept their diagnosis with more equanimity than their mates. Remember the often-voiced aphorism, "This hurts me more than it does you"?

Bob and I differed in fundamental ways-in personality, in styles of thinking, and in behavior. As we faced stressful circumstances, we responded individually. This time I responded from the sensible adult part of me. My hurt child could just as easily have spoken up and escalated the situation.

Relationships flourish or falter because of our coping mechanisms. When styles vary, patience runs short. That certain something that drew us to our partners in the beginning becomes a trial once we fall out of lust. When the heat of first love cools, what needs to remain is caring and deep friendship.

I had always loved Bob's sense of surety, his directness, his take-charge approach to life. When we were new lovers I cherished our differences-I enjoyed his measured conclusions. He never proposed anything without weighing and measuring all the possibilities. He was the "silent man" to my "talking woman." I put my thoughts out into the universe fully aware that they were not final conclusions. He processed in his head before coming to a conclusion. He took time. I jumped right in. We were matched opposites.

When a "talking woman" slows down long enough to choose a mate, she often picks a paragon of strength and control. Is this a potential mismatch or a vital, creative, difference that stimulates the coupling?

In some cosmic approximation of dark humor, my talking everything out upset him and his thinking everything through set off feelings of being shut out in me. I felt ignored. He felt harassed. Danger signs flashed under stress.

We want our partners to cope in the same way we do, but we also expect them to fill in our spaces. It is easy to see someone else's approach as "bad" and attempt to pressure them into doing it our way. Under stress we want them to solve problems the way that we do-if only to increase our sense of mastery. We assume that our way of coping is "right," which makes their way of coping "wrong." I arranged things neatly and couldn't find what I was looking for. Bob used the floor for a desk and knew exactly which paper was hidden where in all his mess.

In the beginning of our marriage, we looked to each other for completion. With time, we both realized that we were both happier when we recognized our differences. We let go of our expectations. But, in our current trauma, we both forgot. We regressed into old ways of operating. When illness intrudes on a marriage, even the strongest, most supportive environment can erode, tossing us back into the fragile expectations of our early years. In our vulnerability, we regress to recapture the innocence of youth. The patient pins a child's expectations on his or her healthy partner, who is bound to fall short. In the regressive household, the healthy partner assumes the role of the good parent offering a hug, a cookie, and the choice of TV program to the ailing partner. The patient yearns for a caretaker or guru to assume control. The caretaker cast in the role of "Father Knows Best" wants to fulfill the role, but the burden is heavy.

To psychiatrist Carl Jung, the "Human body represents a whole museum of organs, each with a long evolutionary history behind it, and we can presume that the mind is organized in a similar way."1

Some of our images are noble, others jealous or self-serving. Our shadows manifest the person we would be if not bound by society's rules and by conscience. They are not necessarily bad, but they are untamed.

Without shadows, we lack humanity and often energy. When we suppress them we become rigid.

For Jung our uniqueness is derived from the choices we make. We have the ability to choose how we deal with our desires. I believe that our individual temperament directs our actions. Temperaments are varied and unpredictable, developed and plucked from a bucketful of physiological, sociological, and psychological factors.

According to Jung, no one drive is more important than another. We are shadow-motivated, but we have our preferences and act accordingly. No partner can ever know all the things that were "good" in our families of origin. No one can make up for all the old hurts and difficulties once suffered.

One couple is so intent on building a life different from what they experienced in childhood that they "over bond." They allow no space for individual expression. One or the other (and sometimes both) gives up self. They become totally absorbed in each other and lose touch with the world.

They squash every difference of opinion. They sacrifice anything that might disrupt their delightful dyad. They find safety in dependency. Fear of change traps them in the status quo and robs them of spontaneity. Yet what others may see as an ironclad alliance is actually fragile circuitry, ready to shatter. Neither partner is a differentiated self. When illness intrudes, each experiences betrayal and flounders in despair.

Another couple is terrified of dependency. Each may have experienced their original families as intrusive, so they defend themselves by fighting to maintain private space. Some couples lead totally separate lives. They have little glue to bind them and under stress reside in eerie isolation, facing the change of circumstance alone.

Illness changes roles as well as rules. Familiar home life wavers and turns into a hall of mirrors. Instead of comfortable routine, there are odd reflections and strange whispers.

As the physically ill partner declines and becomes more of a burden, his concern for self grows. The healthy partner is often burdened by a frantic sense of inadequacy. Why can't I do more? Is this the right thing? Why am I so impatient? Worse, there is guilt about being healthy. Why him and not me? The nurturing spouse is called to do double duty, bending under an already staggering load. As if hallucinating, one may see the simple act of toasting waffles as alien and oppressive, or confusing and subversive. Where is stability? What is real?

The stress level created by illness is multifaceted. One partner worries about selfishness. Another worries about being disengaged. Everyone worries about drowning in a choppy sea of new requirements. While the family struggles to absorb confounding and upsetting information about the disease itself, family roles lurch back and forth like cargo in a hold, constantly sliding. The task of the family is to keep the wild pitching under control, while struggling to batten down the baggage. The family must find their balance and learn new coping skills.

Strange moods spring up. New needs make everyone uneasy. Emotions go haywire, resulting in sleeplessness and loss of energy. Worse yet, lay people have to master a new language of medicine, as well as deal with the complexity of today's health care system.

On a spiritual plane, they must come to grips with their own beliefs about life's purpose. There is no way of denying mortality. We are not immortal. The reality of death and pain hits us with a thud.

How to cope? What to do? When is the next difficulty coming?

Where to consult? Why is this happening?

Our patterns harden and set early in life. They are part of who we are. To isolate and study why we are doing what we are doing takes keen awareness and courage!

Stress provides us an opportunity to develop and change, but it takes determination. We must overcome childhood models. For example, if our parents reacted with panic, we may find ourselves overanxious. If the parents believed in putting the child to bed to stoically face the crisis alone, chances are that the grown-up will want solitude. Following the clue to your earliest malady can be fertile soil. Good digging. One therapist I know asks her clients to think back to their first memory of illness. What was it like? How did your parents react? What was the solution? Prayer? Antibiotics? Isolation? Chicken soup?

Nothing brings about dysfunction like impending loss. Sharing our memories with a partner can explain present reactions and help in anticipating current responses.

We all have a continuing evolving life story. Imagine it is like a meandering ride down a jungle river. Sometimes playful monkeys swing high in the trees. Sometimes we encounter crocodiles sliding ominously into the water. A panther screams. We shudder. A bird trills and we are filled with joy. One by one the moments pass-a remarkable journey as long as we realize we are separate from the events.

We have the power to float or paddle. We can drift with the current or try paddling upstream. We can circumnavigate, head for the shore, or cross over. The journey is ours.

Native American wisdom simply says, "What is…is." The river simply is. We often want to convert "what is" into what we wish it would be. In I'm OK-You're OK, author Thomas Harris says that seeing more than one point of view is the response of the mature adult who is at peace with himself or herself and others.2

There is no better place to appreciate "what is" than in a lifetime partnership. Here you will find the crocodiles, panthers, monkeys, and more. Do we struggle to change what we see? Make the apparitions vanish? Or do we simply relax and enjoy?

We marry because of our differences and then try desperately to make our partners over. We want them to be like us, think like us, and fill in the places of our insecurities. It is surely an oxymoron. If they acted and thought as we do, they would no longer complement us. The richness of cross-pollination would cease. If that happened, one of the two would become superfluous!

Through the centuries, thinkers have tried to unravel the mystery of our humanity. Who makes us who we are? Scientists have analyzed muscles and bones and brain matter. Social scientists have explored attraction and repulsion and social imperatives. We are still baffled by one another.

Closeness and distance change in every marriage like the tide, with successful relationships adjusting to the constant ebb and flow. Yet each time established rhythms shift and resettle, it feels terrible. What does my partner want? Why can't he or she just tell me? Even in the best of circumstances, relationships are bewildering. In the hard times, it takes humor to get you through.

Illness means chaos. It affects our friends and neighbors too. Some of these people will retreat, leaving us exposed and abandoned. Others take charge and direct us with lordly advice. All the retreat and/or bluster really mean is that they feel so vulnerable that they try to master an uncontrollable situation. Manager types do not like turmoil.

Carl Simonton, M.D., and Bernie Siegel, M.D., are convinced that positive engagement helps release emotional energy and helps in the healing process. Both cite the spontaneous remissions of "exceptional patients." Biologist Candace Pert, Ph.D., says, "Informational substances which have a powerful effect on mood and emotion provide a molecular way to understand the suspected connection between state of mind and state of health. Neuropeptides and lymphokines influence us on a biochemical level while imagery and emotions influence our reactions on the psychological level." 3

What we do and how we react is directly linked to what we think and feel. The field of psychoneuroiummunology is exploding with empirical evidence. Leading scientists and theorists such as Jeanne Achtenberg, R.N., Lawrence LeShan, Ph.D., Ernest Rossi, Ph.D., Deepak Chopra, M.D., and Larry Dossey, M.D., all point out the mind-gene connection, and the list of believers keeps growing. Meditation reinforces memories of health and well-being. We have the ability to tap into joy and remind ourselves of times when we coped effectively with adversity.

Copyright Maryann Schacht. All Rights Reserved.

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