Chronic, debilitating conditions and terminal illnesses affect both the patient and the caregiving wife. Too often, important things are left unsaid, making life miserable for the caregiver and challenging for the marriage. As I mention in my book, “The Caregiving Wife’s Handbook,” wives avoid discussing difficult issues with their husbands because they feel guilty, or they're afraid it will upset him, they think it won't make any difference anyway, or because they simply don't know how to do it! You might be surprised how much your mood, your relationship, and the lives of both partners improve once you take some conscious and thoughtful steps toward healthy, open, honest communication. Here is a six-step process that really does work
Step 1. Bring It All Out Into The Open—With Yourself.
For your eyes only, write down everything you've been wanting to ask him or say to him. Don't censor yourself. Your statements will range from pet peeves (Your ostomy bag smells bad. I can't take your complaining), to fears (How will I pay the bills after you're gone? You'll fall down if you don't use the walker), and everything in between (I'm sad we can't make love anymore. I wish I could get a break. I'm mad that you're still sneaking cigarettes. Your family takes me for granted).
Step 2. Choose Your Discussion Topics. File The Rest.
Now, sort all of your questions and comments into four categories: A--things I want to say but don't expect a response to; B--things I want to say but won't, because it won't make a difference; C--things I want to say but should only share with a friend; D--things I really need to talk about, know about, have resolved, or make a decision about. Category D will be the topics you will discuss with your husband. Figure out a way to turn each D statement into a conversation starter, using the tools in step 3.
Step 3. Familiarize Yourself With Basic Communication Skills.
Here are some of the tools you'll need to use: not asking "why" questions; agreeing to disagree; letting him keep his opinion, while working on changing his behavior; reflective listening, where you repeat back to him what he just said, instead of interpreting; using "I" statements, which help you avoid blaming or criticizing; and speaking "his" language, which means structuring your statements in the way he will most easily understand them (If he's very reason- and logic-oriented, for example, you might ask him what he "thinks" about something, rather than how he feels).
Step 4. Make A “Talking Date” With Your Husband.
This is actually one of the trickiest steps, because if you say, "We need to talk," it puts him on the defensive. Plus, he may want to talk on the spot. Here's what to do instead. Start with a statement such as, "Honey, I need to talk about some things with you concerning your health and your care. I'd like you to help me pick a time that would work for both of us." Suggest to him that doing it later gives you both time to think about things you'd like to discuss. Depending on his condition, choose a time and place that's pleasant and comfortable, such as your living room or the hospital chapel or solarium.
Step 5. Prepare For The “Big Talk.”
Before you have your discussion, you need to complete one more step. Take some time for yourself, look at your topic list, and briefly run the discussion through your mind, thinking about ways to encourage mutual respect. Then put away your list and notes. Get yourself as calm as possible. Pray, meditate, or just sit quietly. Avoid caffeine, cigarettes, and sugar, which can make you hyper, and alcohol or drugs, which can cloud your thinking. Remember to breathe. Here's a quote from an Indian saint, Shirdi Sai Baba, that can help: "Before you speak, ask yourself, is it kind, is it necessary, is it true, does it improve the silence?"
Step 6. Have Your Talk—And Create “Understandings.”
Understandings are devices that make life easier and make it work. Understandings create a framework for your agreements, making them easier to remember and evaluate. For example, "For the next month I will try to eat more of what the nutritionist recommends," or "I will talk to the Medicare people this week," or "From now on, my family will visit only on Sundays." Occasionally, partners may have to create an "Agree to Disagree" Understanding regarding a topic that, in order to establish peace in the relationship, you both decide you won't discuss again.
Diana B. Denholm, PhD, LMHC, has been a board-certified psychotherapist for more than 30 years. For 11 years, she was the primary caregiver to her husband during a series of grave illnesses. More detailed guidance, support, and resources are in her new book, The Caregiving Wife's Handbook: Compassionate Strategies, Stories of Success, available at www.caregivingwife.com.http://www.caregivingwife.com
