Marriage Plans & Pain

Most newlyweds enter marriage with certain expectations. We anticipate defined roles.

This doesn’t mean that one person always does the cooking or that only one person is gainfully employed; it just means that there’s typically agreement about how the daily responsibilities of married life will be handled.

Although these roles may change over time, in marriages in which illness is not a factor, the roles change because the couple agrees to restructure the marital and family tasks.

When one person becomes ill, however, the roles may change suddenly or gradually change over time without the consent or sometimes even the recognition of either partner. This can be devastating for both the well spouse and the person in pain.

In general, the more disabled one partner becomes, the greater the impact on the family and in particular the spousal relationship. This is why treatment for chronic pain is so function-oriented (during my medical training, the physiatrists who taught the residents would routinely remind us to “focus on function”). The reasoning behind such an approach is that if someone continues to function well, despite having pain, his or her life will be much more fulfilling.

Chronic pain affects the spousal or other committed long-term relationship perhaps more than any other. Spouses often spend more time with each other than with anyone else, and the profound feelings they have for each other contribute to the significant effect that illness has on their marriage.

As with all relationships, chronic pain impacts a marriage in many ways. Although every relationship is different, there are some important factors that all partners should consider when their significant other suffers from chronic pain.

First, the effect on the relationship is usually directly proportional to the frequency and intensity of the pain as well as the degree of disability. Someone with occasional severe migraine headaches may function normally most of the time, and so the impact on the spousal relationship will probably be minimal. By contrast, for someone who suddenly sustains a severe back injury, say, and is thereafter in chronic pain and unable to work, the effect on the couple may be very significant.

Second, no two couples will handle the situation in the same way; some will adjust well despite a severe and debilitating injury, whereas others will find it difficult to cope after a lesser injury.

Research has shown that patterns of behavior for both the spouse and the person in pain may positively or negatively impact the marriage and the family dynamics. Couples facing chronic pain must consider what expectations each spouse has for the relationship. They would also do well to tap into any previous experience they have had in dealing with chronic illness.

All of these things will likely influence how couples respond to living with chronic pain as a component of their relationship.

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About the Author:

This article is excerpted from “Chronic Pain & the Family” by Julie K. Silver, M.D.