Today’s article and Wednesday’s “How Do You Show Your Love” Contest (enter by 2/19) are in honor of Valentine’s Day.

This is a guest article by Dr. David Kannerstein, who answers a reader’s question about her marriage affected by pain.  Dr. Kannerstein is a psychologist who specializes in helping individuals and their families manage chronic pain.

Debbie writes:
I’ve been suffering from RSD (a painful neurological disorder - HtCwP) since 1999.  I was married to a wonderful man in February, 2003, but lately, my wonderful life has started to crumble.  As a result of my RSD, my husband has said he wants out of the marriage.  He feels like he is losing himself.  Needless to say, I completely lost it.

He still is loving, and kisses me goodbye, when gets home from work, and before going to bed.  He even calls me in the middle of the day to see if everything is alright. Yet at the same time, I feel like I am living with a man who is not there.  Part of me wonders if it’s just that he can’t handle seeing me getting worse, and knowing that he can’t do anything to take it away.

Any suggestions on ways to help him not feel as if he’s losing himself?  To keep my marriage together - that’s all I want.

Dr. Kannerstein responds:

You clearly are suffering not only from RSD, but also from your husband’s apparent withdrawal from the marriage.  Keeping a marriage or relationship together when you’re suffering from RSD, or other chronically painful conditions, can be extremely challenging.

Spouses or other loved ones often feel a mixture of negative emotions related to their loved one’s pain.  Your husband may feel guilty or even depressed because he feels powerless to help.  He may be anxious about what he fears may happen in the future - financial problems, further deterioration in your health, etc.  He may feel angry at you - despite his loving behavior - because of a perceived withdrawal of affection, a lack of sexual contact, or having to take over responsibilities you previously handled.
 
You didn’t say what your husband meant by “losing himself.”  It would be important to clarify this and help him identify what emotions, specifically, he feels and what triggers them.  For example, he may be coping with the pain of seeing you suffering, by shutting down emotionally.  He may also be referring to not having time or energy to do hobbies or recreational activities he loved, because he now has to do chores you previously did (if this is the case).
 
Chronic pain is a condition that affects not only the person suffering from it, but their entire social network - especially their spouse.  As Dr. Paul Brand wrote, “Pain sends a signal not only to the patient, but to the surrounding community as well.”  Unfortunately, most of us don’t know how to respond to this signal in a helpful way - this leads to increasing frustration, anxiety, and depression.  Just as severe pain (and its associated losses and stressors) is traumatic to the individual suffering from it, it’s also traumatic for those who love the individual suffering with pain.  While they may not be in pain, they are surely suffering.
 
Fortunately, there are resources available.  Two excellent books that discuss how pain effects family members are Dr. Julie K. Silver’s Chronic Pain and the Family: A New Guide (2004, Harvard University Press), and the ACPA Family Manual: A Manual for Families of Persons With Pain (by Penny Cowan, 1998, ACPA).  I also recommend looking at the website of Mark Grant, an Australian psychologist, Overcoming Pain.  There’s no substitute, however, for personal contact with a therapist who is knowledgeable about pain.  Both you and your spouse might want to consult one together, as well as individually.
 
I don’t know if things will return to how they were before, since having RSD or any severe chronically painful condition has changed a lot in your lives.  However, much of the suffering endured by those with chronic pain can be addressed through some combination of medications, alternative medical approaches, physical therapy and exercise (tailored to the individual), and psychological treatments which take advantage of the intimate relationship between the mind and the body - hypnosis, meditation, biofeedback, energy psychology, guided imagery, autogenic training, and other approaches.  Successfully coping with pain may actually lead to a quite fulfilling life.

Dr. Kannerstein is a colleague, and a psychologist in private practice with Margolis Berman Byrne Health Psychology in Philadelphia, and SRI Psychological Services in Jenkintown, PA.  He specializes in helping individuals and their families manage chronic pain, and is currently accepting new patients.  He can be contacted at dkanner@comcast.net.  Please note that all responses to readers’ questions are general comments, and not meant as individual guidance.  See this disclaimer for more information.

Other articles you might like to read:

• Surviving a Loved One’s Chronic Pain
• Are You Pain Free?  10 Things People With Pain Would Like You To Know
• “Pain and Your Family” Series
• 3 Great Resources For Families To Learn More About Pain
• Help Your Family And Friends Cope With Your Pain Disorder

If you’d like, you can submit your own question or guest article here.  Your submission for the February Pain-Blog Carnival is due 2/22.

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