PITFALLS OF FAMILY LIFE: DISAGREEING ABOUT THE ILLNESS

The second unhealthy relationship pattern that can become exaggerated in reaction to illness is the habit of always disagreeing. Some couples seem locked into this habit. She says it's sunny, he says it's cloudy. She feels hot, he feels cold. He's ready to kiss and make up, she's still angry. This pattern of disagreeing is often based on true differences of perspective, but it is sometimes fueled by failure to resolve underlying relationship issues that have left a sense of distrust and resentment in the relationship. The constant disagreeing becomes a way of expressing underlying negative feelings.
Some couples, like Jim and Peggy, take this habit to the point of disagreeing about the very, existence of illness.
Jim was a very emotional, dramatic individual who perpetually complained that his wife, Peggy, should show him more love and attention. He frequently complained to Peggy, "Just because I'm a man, it doesn't mean I don't feel fear and need reassurance."
Peggy was disgusted and angry with Jim over his "constant whining" and over the many times in their marriage when she had been manipulated by him. She was especially angry about an extramarital affair that Jim had had many years ago with someone from whom he was supposedly getting medical help with one of his many vague health problems.
Jim had a moderately serious heart attack one year before I met him and Peggy. They were referred by Jim's cardiologist, who was concerned about Peggy's refusal to accept the reality of her husband's heart condition. She adamantly refused to participate in any cardiac rehabilitation efforts. The cardiologist was also puzzled by Jim's tendency to exaggerate his physical symptoms. From a medical perspective, he was in reasonably good shape now, but he continued to show up for appointments with a wealth of complaints and lists of vague symptoms.
As I got to know this couple, it became apparent that they were locked in a dance revolving around Jim's health concerns. Their dialogue about Jim's condition was symbolic of their long-term struggles with intimacy and trust. Jim now requested attention and special consideration from Peggy by acting as though he might die any minute. Peggy expressed her distrust and anger toward Jim by openly doubting that he had even had a heart attack.
Whenever Jim complained of having chest pains, Peggy chided him, saying, "You're not going to fool me like you did those doctors; I know you, and they don't. Everybody has chest pains sometimes. That's not the same as having a heart attack. You just need to grow up and stop expecting to always get your way in life."
The more Peggy criticized and withheld affection, the more Jim complained about his health; the more Jim complained about his health, the more Peggy criticized rather than nurtured; and so on. Jim and Peggy were stuck in a relationship cycle that fueled illness behavior. But this dance also allowed them to interact around a topic (Jim's illness) that was in many ways less painful and complicated for them than the underlying marital issue of lost trust and intimacy.
Even couples who are not as seriously troubled as Jim and Peggy are likely to disagree in their reactions to heart illness and cardiac rehabilitation. Unlike many other disabilities, such as having a leg amputated, heart illness has invisible effects. It is therefore easy for a couple to adopt different notions about the seriousness of the illness or the extent to which the patient's activities and roles need to be changed because of the illness.
Furthermore, some couples simply differ in their overall attitude toward life: one feels that we are Born to Choose in reacting to life, and the other feels that we are Born to Lose. In this same vein, the couple may adopt different philosophies in reacting to illness. These philosophies then shape an attitude that affects the different ways each individual reacts to the illness on a day-to-day basis. Illness may be viewed in various ways:

• As a challenge—a life situation that consists of multiple tasks that must be mastered.
• As an enemy, like an invasion of harmful forces that have entered your life and body.
• As a punishment being delivered justly or unjustly for your lack of perfection.
• As a sign of weakness.
• As a relief' from your typical life stresses.
• As a strategy to use in trying to get more nurturing attention from the world.
• As a irreparable loss of valuable aspects of life.
• As an opportunity for growth and development.