HEART ILLNESS: PICTURES OF A HEALTHY MARRIAGE
It has been said that the patient may recover from his coronary but that his wife may not. She has often seen her husband when he looked near to death, she may have been warned that he could die. . . . She has the same fears, lack of knowledge, and misconceptions as her husband. . . . Months after the infarct many wives report that they lie awake listening to their husbands' breathing to make sure that he is still alive. . . . She may also collapse under the strain of anxiety, become sick, depressed, develop chest pains. . . . Alternatively, wives may take over decision-making and bread-winning roles and become highly overprotective; this may increase the patient's feelings of helplessness and despondency.
I have never met a heart patient's spouse, male or female, who could not relate to this quotation. The secret that haunts many cardiac marriages is the spouse's unexpressed and unsoothed agony over the current and future struggles that this myocardial invasion has brought into the couple's life.
My interest in working in cardiac rehabilitation has endured primarily because of my experiences with the spouses of the cardiac patients whom I have treated. In fact, as a marriage and family specialist, I have spent almost as much time with cardiac spouses as I have with heart patients themselves. What I have learned and continue to learn from these brave and overstressed men and women has been a fascinating set of lessons on how healthy and unhealthy marriages are created and maintained.
The stress of cardiac rehabilitation seems to bring out the best and the worst in marriages. Almost all partners are able to put aside their differences at least momentarily and rekindle mutual affection or further fuel existing love and commitment to each other during the initial scare when illness changes their lives. However, as the case examples presented here illustrate, the many stresses that accompany cardiac rehabilitation inevitably seem to create problems in sustaining comfortable intimacy. I propose that the question is not whether your marriage will be affected by heart illness and cardiac rehabilitation; the question is, How are you doing in your efforts to overcome the negative impact that this illness had or is having on your marital relationship?
In the pages that follow, I describe how healthy marriages—those that maintain a reasonably high degree of intimacy and passion— develop and grow. Next, I disclose the secrets of establishing and maintaining intimacy in marriage and discuss the very important topic of sexual functioning and heart illness. And I give special consideration to the ways personality factors, especially those that have to do with Type A personalities, affect marital reactions to illness.
In my clinical practice, I usually begin marital therapy by coaching and educating the couple on the concepts described in the upcoming pages. I invite you to pretend that you are now paying me to sit with you in my cozy office to say out loud to you all the words printed on these pages. If you pretend you have paid a small fortune to hear these recommendations for enhancing your marriage, you are much likelier to follow through on the suggestions I make.
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