Background:

Chronic illness, pain, and mental health challenges can have a profound impact on your relationships, including your relationship with yourself, your love partner, your parents, your children, your siblings, your friends, and your coworkers. Even if you had good relationship skills prior to becoming ill, you may have difficulty navigating relationships once you are ill or in pain. For example, you may struggle with communicating, being intimate, taking on certain roles, asking for help, feeling too dependent, feeling misunderstood, and more. This skill helps you identify changes in your relationships due to your illness or pain and clarifies the areas in which you may need help. It is from my book The Psychotherapy Toolbox for Chronic Illness and Chronic Pain.

The Skill in Action:

Sue loved her husband, George, and felt like she had a wonderful marriage. However, when she began to have chronic, unremitting pain, she worried that she was losing her connection with George. She was often irritable and impatient, and she didn’t enjoy sex when her pain was so bad. She was having trouble completing tasks around the house, and her performance at work was slipping because her desk chair was aggravating her pain. With the help of a therapist, Sue learned how to better understand and manage her anger, set realistic expectations for herself, and ask for help. Sue was able to talk to her husband and share her concerns about their relationship.

Together, they worked out new ways to share intimacy, such as finding more comfortable positions for Sue and exploring how they could meet their needs when Sue’s pain was too great for sex. They also developed a code Sue could use to let George know when she was feeling angry or exhausted, and George started to chip in a lot more around the house. Sue explained her pain issue to her boss as well, who got her an ergonomic chair and lowered her work hours by a few hours per week, both of which helped immensely. Finally, Sue talked with her doctor to make sure he knew the level of pain she was dealing with. The doctor seemed to hear her for the first time and explored several new treatment options.

Skill Building: Identify How Chronic Illness, Pain and Mental Health Challenges Impact Your Relationships

Use Client Worksheet below to help you identify how your various relationships have been impacted by your chronic illness, pain or mental health challenges. Use your answers to brainstorm ways in which you can lessen this impact where possible.

For example, if your boss doesn’t understand why you need to cut back to part-time, explore how you might contact someone in your Human Resources department who is familiar with the Americans with Disabilities Act to explain what you need at work to accommodate your illness or pain.

Then use the Worksheet below to specifically examine the ways in which your love relationship has been strained by chronic illness, pain or mental health challenges and brainstorm possible solutions. For example, if your partner is angry because you can’t help out as much as you used to, but you haven’t been honest with your partner about your illness, explore how you can open up communication, represent yourself, explain your illness, discuss what you are capable of, and ask for what you need. As you brainstorm alternatives, make sure you also consider the situation from your partner’s perspective.

Do the same process for all of your relationships.

Consider working with a therapist to help you through this step. Find one here.

Reflection:

How does your chronic illness, pain or mental health challenges strain your existing relationship skills? Do you have trouble with similar issues in more than one relationship? What basic relationship skills can you learn to address these impacts on your relationships? On the flip side, has your chronic illness or pain had any positive impact on your relationships or your ability to represent yourself?

Resources:

For more resources for help with chronic illness, chronic pain or mental health challenges:

• The Psychotherapy Toolbox for Chronic Illness and Chronic Pain
• Radical Self-Care When You Are Ill
• Radical Self-Care When You Are Ill Digital Card Deck
• Articles about Chronic Illness and Chronic Pain
• Articles about Depression, Anxiety

Worksheet: My Relationships

Check off any changes your illness, pain or mental health issues have caused in your relationships.

• Love Partner
  • We experience reduced intimacy, closeness, or sexual desire. We don’t spend as much time together or engage in shared activities. We have difficulties communicating. My partner is my caregiver, which changes my role from equal partner with them to being dependent on them. I feel guilty about not doing my share. My partner worries about me. My partner experiences loss, too, because I can no longer share activities with them or take care of household chores, and they may not share their feelings about this. My partner often feels ignored. I often feel ignored.
  • My partner treats me like a sick child.
• Children
  • I am not able to participate in my children’s activities as often.
  • I have difficulty taking care of my children.
  • My children fear losing me.
  • My children get angry that I cannot do things other parents do.
• Other family members
  • My family members function as caregivers, which changes their role in my life, potentially including a role reversal in that they now care for me when I used to care for them.
  • My family doesn’t understand what I’m dealing with.
  • My family feels helpless and doesn’t know what to do to help.
  • It is hard to stay connected when my illness prevents me from visiting them or otherwise staying in touch.
• Friends
  • We have difficulty getting together socially.
  • We have difficulty staying in touch.
  • My friends have trouble understanding what I’m going through.
  • I have difficulty relating to my friends’ lives from my perspective.
  • My friends get tired of hearing about my illness or pain.
  • I often feel left out.
• Boss and coworkers
  • My boss and coworkers may not understand how my illness impacts my ability to work.
  • My boss worries that I won’t do my share at work.
  • There are concerns that my illness is impacting my work performance or my ability to keep working.
  • I am losing my connections to my coworkers, as I have missed a lot of work due to illness or medical appointments.
  • I am uncertain about my work future because I don’t know if my illness will prevent me from continuing or returning to work.
• Medical providers
  • I find it hard to feel like my providers really know who I am.
  • I don’t get enough time to discuss my issues with them.
  • I often feel discounted.
  • My providers feel impatient with my lack of progress.
  • My providers blame me for my illness or pain.