Marriage after Cancer: Teachable Moment or Missed Opportunity?Sharon Manne, Ph.D.
Fox Chase Cancer Center
- Many cancer patients report their spouse to be their most important helper and confidant. Cancer places unique challenges on a marriage in the form of altered roles, new stressors, a new recognition of mortality, and changes in life priorities. Cancer may provide a "teachable moment" for many marriages; relationship support processes and marital interaction patterns that contribute to couples' psychological adaptation should be identified, and interventions should be developed to help couples reduce distress.
- Observations of interactions between couples in which one member had cancer found that the way a partner responded to the patient's disclosures of his/her feelings or fears mattered to the patient. Female patients felt close to their partners when they perceived the partners' responses as caring. Male spouses felt close when both partners disclosed their feelings and their partner responded in a caring and understanding fashion. Feeling connected or close was found to be related to feeling understood and cared for during interchanges for both patients and partners.
- Vulnerable couples are those with unsupportive partners who may respond to their partners' disclosure of feelings with criticism or changing the topic, or who attempt to protect or avoid emotional engagement. Interventions could be developed to improve these couples' interactions. In one case, a couples' group intervention resulted in reductions in depressive symptoms and an increase in positive well-being among patients who had perceived their spouses as unsupportive before intervention. Couples who dropped out of the intervention did worse in these respects.
- Intimacy and Support Enhancing Therapy was developed to improve couples' ability to comfortably share their concerns regarding cancer with one another; improve responsiveness to the concerns; increase conveyed understanding, empathy, and support regarding the cancer experience; and increase mutual understanding of one another's cancer experience. Preliminary results from couples participating in this therapy show declines in distress and perceived unsupportive behavior and increases in patient-perceived closeness.
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