A diagnosis of rheumatoid arthritis can be devastating not only for the patient, but for loved ones as well. There is a saying that when one person lives with RA, the family lives with RA. Disease is not a considerate member of the family and will often interfere, and seems to do its best to inflict harm on any relationship if given the chance. Here are eight ways that you and your partner can maintain a healthy relationship despite chronic illness.
Create a safe environment
Create a safe environment for your partner and be willing to ask that your partner create a safe environment for you when you need it. Each member of the relationship needs to know that their partner is committed to a future together. A sense of emotional safety comes from the ability to express your thoughts and feelings openly and to accept each other’s differences. As physical needs change, make alterations at home to assist the person with physical limitations to stay as independent as possible. Working with a financial planner who has expertise in handling chronic medical conditions may help to improve financial security individually and collectively.
It is also very important that each partner knows that he/she is free from the threat of physical harm. If either member feels that he/she is the victim of any form of abuse - physical, sexual, emotional, economic, medical, or psychological - he/she should reach out for help and may contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233).
Create a culture of positivity
Protect your relationship from difficult times by creating positive connections. In the book "7 Principles for Making Marriage Work," Dr. Gottman and Nan Silver list 62 activities that foster positive sentiment in a relationship. The list includes things such as eating together (without distraction), reuniting at the end of the day and talk about how things went, and calling (text/email or send positive thoughts to) each other during the day.
Research indicates that successful relationships have five times more positive interactions than negative ones during arguments, and up to 20 times more positive than negative exchanges in regular interactions. Words of appreciation are important in any relationship but perhaps more so once chronic illness has entered the relationship. Speak of hope and a future, even when you have to talk about grief and loss. Focus on us and we, rather than I and you. Remember, you are in this together
Make your relationship a priority
Accept responsibility for making your relationship a success, and keep couple time sacred. Healthy couples manage their relationship rather than just allowing things to happen. Plan to meet regularly as a couple to discuss any issues that have occurred but have not been addressed to prevent neglected issues from growing out of hand.
Date nights are an excellent way to connect with your partner. They need not be elaborate nor expensive, as the purpose is to spend time together doing something you enjoy, such as watching a movie, going out to dinner, playing board games, or sitting on the porch together talking without discussion of problems, in-laws, or other stressors.
Focus on developing effective problem-solving skills and approach challenges as a team. Don’t assume that things need to be accomplished in a certain way all the time. Maintain flexibility. Also take a few moments each day to think of ways to connect with your partner. It’s the small positive things, done often, that can make a real difference.
Communicate clearly, effectively, and compassionately with one another
Let your partner know that nothing is more important than understanding what she or he is saying. Be willing to express your needs and desires. Practice active listening and empathetic responding with your partner. The goal of active listening is for each person to feel understood, not to reach an agreement or to solve the problem (yet). Take turns speaking and listening; allow the other person to paraphrase what you’ve just said so that you have an opportunity to clarify if need be. Continue the back-and-forth until both people feel truly understood before beginning to tackle the problem.
Empathy should not be confused with sympathy. It does not involve identifying with the speaker, but instead conveys an understanding of the emotions behind what the speaker is saying. The main difference between an empathetic response and a paraphrase is that empathy serves primarily as a reflection of the other person’s feelings rather than focusing on the content of the communication. Examples of empathic responses might begin with: “You must feel uncomfortable with”" or “You seem to love”" In a recent study, it was only when spousal empathic responding was low that patient or spouse depression significantly predicted poorer marital quality for RA patients [Arthritis Care Res (Hoboken). 2014 Apr; 66(4):532-41. doi: 10.1002/acr.22161].
Using effective communication skills can improve the dynamics of your relationships, both at home and otherwise. My therapist recommends that couples practice "compassionate consultation." While this will not change the fact that you and your partner are living with a chronic illness, it may help you better manage the challenges of daily life.
Show appreciation for each other
Praise each other regularly. Find ways to express admiration and appreciation to your partner every day. People like to know when they have done something that makes someone they love happy. When people know what they did that was pleasing, it often increases the chances that they will do it again. Smile and laugh often; both can be highly contagious.
Strengthen social connections
Chronic illness can be isolating; so can caregiving. Having strong friendships and a social network can buffer against depression for both partners. Balancing the desire to connect with others with the spontaneity and flexibility often required when living with an unpredictable disease can be a challenge at times. Avoid feeling guilty for needing to change plans at the last minute. It is better to make plans and have the option of socializing (or canceling) than to never connect with others at all. If you’re the caregiver, you should also feel free to socialize alone without feeling guilty about it. Keeping your own identity and interests are important to a healthy relationship. Also, for times that friends or relatives ask what they can do to help, be prepared with a list of things that need to be done.
Take care of yourself
This goes for both partners. Relaxation techniques, regular exercise, staying active, adequate sleep, and eating healthy foods all help to reduce stress and promote wellness. Stay socially active and spend time with people who make you feel better. Get help if you begin to feel overwhelmed, stressed, depressed, or anxious. And, seek appropriate medical treatment and aggressively treat disease to protect your health.
Focus on intimacy rather than sex
There is much more to an intimate relationship than sexual intercourse. Connecting with your partner on an emotional level is vital to any healthy relationship. It is often the journey that is satisfying, rather than achieving a specific goal, such as orgasm. Sexual behaviors often labeled as foreplay, such as erotic conversations, touching, kissing, and genital stimulation, can be physically and emotionally satisfying sexual activities in their own right. Have fun and enjoy your time with the one you love.
Imagination, creativity, sense of humor, and playfulness are vital to maintaining a healthy sex life. If chronic illness has interfered with your personal relationship and things are falling apart, please consider counseling. Talking with a counselor can help you and your partner work through emotional challenges such as resentment, guilt, or other negative feelings related to your physical relationship.
Here are several helpful articles which offer advice on passion, sex, and relationships:
Emrich, Lisa. How Can I Improve My Sex Life with RA? HealthCentral.com, May 6, 2014. Accessed August 24, 2014.
Andersen, Lene. How to Have Satisfying Sex Despite Chronic Pain. HealthCentral.com, March 7, 2014. Accessed August 24, 2014.
Bailey, Eileen. 8 Tips for Keeping Passion Alive in Your Relationship. HealthCentral.com, February 27, 2012. Accessed August 24, 2014.
Andersen, Lene. Relationship Advice for Your Partner After an RA Diagnosis. HealthCentral.com, October 29, 2010. Accessed August 24, 2014.
Lisa Emrich is a patient advocate, accomplished speaker, author of the award-winning blog Brass and Ivory: Life with MS and RA, and founder of the Carnival of MS Bloggers. Lisa uses her experience to educate patients, raise disease awareness, encourage self-advocacy, and support patient-centered research. Lisa frequently works with non-profit organizations and has brought the patient voice to health care conferences and meetings worldwide. Follow Lisa on Facebook, Twitter, and Pinterest.