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Communicating With Your Partner
Communicating with your partner about how cancer has affected you can be difficult. Even strong relationships can become strained under the pressure of managing a complex illness. Taking steps to improve your communication skills can help you to feel more supported and understood.
Detailed Information
Suggestions
Additional Resources
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 Email this Topic
Communicating With Your Partner: Detailed Information
This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions and Additional Resources documents for questions to ask and for more resources.
Why is it important for survivors to communicate well with their partners?
A spouse or partner can be a primary source of support to a cancer survivor. However, if communication begins to break down, it can be stressful and result in low levels of support for both. While the cancer journey can be emotionally challenging for survivors, it can also be hard on loved ones. In some cases, a partner may experience more emotional distress than the survivor.
Both survivors and their partners may have strong emotions such as fear, anger and guilt. Stress is also common. A decline in the physical or emotional status of either may create a “cycle of distress” for the couple. If this happens, one person’s distress also affects the other. High levels of emotional distress can strain the relationship. Good communication may be the most effective strategy for breaking this cycle. It may also improve the quality of life for both.
Good communication skills can help survivors and their partners to:
- Receive and offer emotional support
- Get help making decisions
- Share advice and encouragement
- Learn new ways of handling stressful situations
- Clarify misunderstandings
- Learn new coping strategies
- Plan for the future, such as family, employment and financial decisions
Important issues that partners may need to discuss together include:
- Ways to solve problems with changing roles and responsibilities in the relationship
- Instructions and preferences for decisions about health care and financial matters
- Concerns about changes to sexual relations and expressions of intimacy
- Challenges adjusting to the cancer experience
- How to maintain the quality of the relationship
The cancer experience can be a time that enriches and strengthens the relationship. A partner can play a large role in shaping the emotional experience of the survivor to the experiences of cancer and life after treatment. Research shows that survivors who feel they have support from their partners are more likely to focus on the positive aspects of their cancer journey. This can improve their quality of life.
Why is it sometimes difficult for survivors to communicate with their partners?
There may be a number of reasons why it can be difficult for survivors to communicate with their partners including:
- A partner’s negative response to the survivor’s discussions may discourage open communication.
Research shows that a survivor is negatively affected if his or her partner uses criticism, withdrawal or acts uncomfortable when the survivor talks about the cancer experience. This may cause the survivor to use fewer healthy and effective coping strategies. Emotional problems can result and a cycle of distress may occur in the relationship.
Negative responses from partners that may make communication difficult include:
- The cancer journey may require that couples communicate about topics that they normally would not talk about.
Issues, such as the side effects or aftereffects of cancer and treatment, may be difficult to discuss. For example, some survivors experience incontinence, sexual or fertility problems or changes in self-esteem and body image. These may be very hard for some people to talk about.
Long-lasting complications, such as fatigue and chronic pain, may be difficult for partners to understand. This is especially true when the survivor is in remission or looks healthy. The partner may want the survivor to move on and return to life the way it was before cancer.
Sensitive issues that may be difficult to discuss include:
- Living with uncertainty
- Stress
- Feelings of guilt
- Financial difficulties
- Dealing with fear of recurrence
- Changes in outlook on life and death
- Other health and physical problems
- Losses of all kinds including job, friends, abilities
- Changing roles and responsibilities
- New compromises that need to be made
- Feeling overwhelmed
- Anger
Survivors may feel guilty discussing certain topics with their partners.
It can be hard for survivors to ask others for help. This is particularly true if the survivor has always been the one to help others. Some may continue to try to do tasks that have become too emotionally or physically challenging.
Some survivors are worried about stress on their partners. They may feel guilty about asking partners to take on new roles and responsibilities. They may be concerned that a partner is as distressed (or more) than the survivor. A survivor may try to protect his or her partner by not sharing information. Important discussions about certain topics, such as health care directives and financial matters, may be avoided in an effort not to upset the partner.
Survivors and partners may have different priorities.
Cancer survivors and their partners may find that some things that were important to them before treatment are no longer as important. There may be a change in the way they view life. Some decide to change jobs or other relationships in their lives.
Sometimes both partners and survivors can easily understand the change in priorities and be comfortable with them. Other times, one of them might not understand why these changes are happening or may not agree with them. This can feel threatening to a relationship.
How can survivors learn to communicate well with their partners?
Couples sharing the cancer journey can learn new and effective communication strategies. Even though it can be difficult to change old habits, learning skills and developing new communication habits is possible. The key is to practice the new skills regularly. The benefit is that healthy communication can increase satisfaction in a couple’s overall relationship and positively affect the quality of life for both.
Some ways to improve communication skills include:
- Being aware of your own communication patterns and behaviors
- Understanding the communication patterns and behaviors of your partner
- Learning and practicing effective communication skills together
- Taking time to discuss difficult topics with your partner
- Consulting a licensed counselor about your relationship
How can better communication benefit survivors and their partners?
There may be times when survivors and their partners have a hard time talking with one another. During times of stress, effective and healthy communication might be a challenge for couples. This can be especially difficult if there were already problems talking and sharing before the cancer diagnosis.
If communication between you and your partner is not what you would like, you may need to work on building skills. You may be able to do this together or with the help of a licensed counselor. You may want to talk with your health care team about getting a referral to a counselor who is experienced working with cancer survivors.
Signs that it is time to work on better communication with your partner include:
- Frequent misunderstandings
- Withdrawal from one another or avoidance of talking together
- Frequent use of criticism, sarcasm or name-calling
- Not sharing information with your partner
- Frequent disagreements over the same issues
- Concerns about sexual matters
- Lessening of expressions of love and affection such as talking, touching and sharing
- Confiding in others instead of the partner
- Inability to ask the partner for help or support
- Finding the support received from the partner is unhelpful
- Feeling hurt emotionally by the partner
If there is ever physical aggression in the response of you or your partner, seek immediate help. Options for professional assistance include:
- Calling 911 if you are in immediate physical danger
- Talking with crisis intervention specialists such as crisis hotlines and local abuse shelters
- Talking to a mental health professional such as a psychologist, psychiatrist, or marriage and family counselor
- Consulting a legal professional to understand your rights such as an attorney or law enforcement officials
This document was produced in collaboration with:
Cindy L. Carmack Taylor, Ph.D.
Assistant Professor, The University of Texas, M.D. Anderson Cancer Center
Works Cited
Christensen, Andrew, and Neil Jacobson. Reconcilable Differences. New York: The London Press, 2000.
Fincham, Frank D., Leyan O.L. Fernandes, and Keith Humphreys. Communicating in Relationships: A Guide for Couples and Professionals. Champaign: Research Press, 1993.
Manne, Sharon, Stephen J. Pape, Kathryn L. Taylor, and James Dougherty. “Spouse support, coping, and mood among individuals with cancer.” Annals of Behavioral Medicine 21 (2) (1999): 111-121.
[return to top]
Communicating With Your Partner: Suggestions
The suggestions that follow are based on the information presented in the Detailed Information document. They are meant to help you take what you learn and apply the information to your own needs. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Additional Resources document for links to more resources..
Understand communication patterns and behaviors in your relationship.
Before you can work on improving communication with your partner, you need to understand the patterns. Identify areas that need to be changed because of the cancer experience.
Men and women generally communicate very differently. Men may want to try to solve the problems. Women often want to talk about problems and share emotions in an effort to give and receive support.
It can be reassuring to men to know that sometimes simply sharing and discussing problems that cannot be solved is helpful to women. It may be helpful for women to be aware that discussing problems that cannot be solved can be frustrating for men.
Discuss the following questions with your partner:
- What topics do we frequently agree on?
- What topics do we frequently argue about?
- When we disagree, how do we each respond?
- Are we able to be honest with one another?
- Can we calmly discuss issues and try to resolve the disagreement?
- Do we criticize, blame, yell, walk away or give in?
- When have we handled a disagreement well?
- Can we trust one another?
It is important for survivors and partners to be aware of their own communication needs and behaviors. Both need to take responsibility for their own patterns and recognize their own role in communication challenges.
Learn and practice effective communication skills together.
- Schedule time daily to sit and talk with your partner. Make sure it is a time you both agree on and in a place where there will be no interruptions. It will most likely occur if it is a part of your daily schedules.
- Practice active listening when your partner is talking. It can be helpful to restate in your own words what your partner said. This shows that you were listening and allows your partner to correct any misunderstandings.
- It may be helpful to begin practicing your skills by discussing positive or neutral topics at first, such as those topics you frequently agree on.
- Avoid negative communication styles such as name-calling, sarcasm, yelling and criticism.
- Stay positive. Even when you are unhappy with your partner, start by mentioning something positive. Avoid blaming and name-calling.
- Use “I” language when describing your feelings and thoughts. This can prevent judgment or blaming comments that may make your partner respond defensively. Make sure that ‘I’ statements are followed by a word that describes how you are feeling.
- Use statements such as: “I like that you included me in your decision about your new job. I felt confused and disappointed when not included in your decision to travel more frequently for work.”
- Avoid broad statements such as, “You always seem to think only of yourself when it comes to our money.”
Take a break out if a discussion becomes heated or too filled with tension. Agree in advance about how long the break should last. Each partner may need to go to a separate area to calm down. After calming down, you can try again to return to the conversation.
- Focus on the present, and do not bring up old arguments from the past.
- Focus on the topic of discussion, and avoid bringing up other topics of disagreement.
- Recognize that you may not yet know your partner’s feelings or thoughts. Let your partner know what you are feeling. Give your partner a chance to agree or disagree with what you assume is true. Listen with an open mind.
Take time to discuss difficult topics with your partner.
- Challenging topics can be discussed during regularly scheduled times together. Let your partner know ahead of time that you would like to discuss it
- Discuss one difficult topic at a time. Avoid trying to solve everything at one time—especially at first.
- Include your health care team when you discussing medical topics. Your partner may better understand your physical and emotional symptoms when they are explained by a health care provider.
Consider meeting with a licensed counselor about serious challenges in your relationship.
Sometimes communication problems are the result of more complicated problems. In some cases, a couple may require the help of a counselor or therapist.
Ask your doctor for a referral if you:
- Feel depressed, anxious, angry, disappointed, frustrated, lost
- Use physical aggression with the other or use threatening statements towards another
- Have thoughts of hurting yourself or someone else
- Have problems with alcohol or other drugs
- Think you cannot work out a solution without assistance
In many cases, serious relationship problems can be avoided or improved with the assistance of a licensed counselor or therapist.
Understand communication patterns and behaviors in your relationship.
Before you can work on improving communication with your partner, you need to understand the patterns. Identify areas that need to be changed because of the cancer experience.
Men and women generally communicate very differently. Men may want to try to solve the problems. Women often want to talk about problems and share emotions in an effort to give and receive support.
It can be reassuring to men to know that sometimes simply sharing and discussing problems that cannot be solved is helpful to women. It may be helpful for women to be aware that discussing problems that cannot be solved can be frustrating for men.
Discuss the following questions with your partner:
- What topics do we frequently agree on?
- What topics do we frequently argue about?
- When we disagree, how do we each respond?
- Are we able to be honest with one another?
- Can we calmly discuss issues and try to resolve the disagreement?
- Do we criticize, blame, yell, walk away or give in?
- When have we handled a disagreement well?
- Can we trust one another?
It is important for survivors and partners to be aware of their own communication needs and behaviors. Both need to take responsibility for their own patterns and recognize their own role in communication challenges.
Learn and practice effective communication skills together.
- Schedule time daily to sit and talk with your partner. Make sure it is a time you both agree on and in a place where there will be no interruptions. It will most likely occur if it is a part of your daily schedules.
- Practice active listening when your partner is talking. It can be helpful to restate in your own words what your partner said. This shows that you were listening and allows your partner to correct any misunderstandings.
- It may be helpful to begin practicing your skills by discussing positive or neutral topics at first, such as those topics you frequently agree on.
- Avoid negative communication styles such as name-calling, sarcasm, yelling and criticism.
- Stay positive. Even when you are unhappy with your partner, start by mentioning something positive. Avoid blaming and name-calling.
- Use “I” language when describing your feelings and thoughts. This can prevent judgment or blaming comments that may make your partner respond defensively. Make sure that ‘I’ statements are followed by a word that describes how you are feeling.
- Use statements such as: “I like that you included me in your decision about your new job. I felt confused and disappointed when not included in your decision to travel more frequently for work.”
- Avoid broad statements such as, “You always seem to think only of yourself when it comes to our money.”
- Take a break out if a discussion becomes heated or too filled with tension. Agree in advance about how long the break should last. Each partner may need to go to a separate area to calm down. After calming down, you can try again to return to the conversation.
- Focus on the present, and do not bring up old arguments from the past.
- Focus on the topic of discussion, and avoid bringing up other topics of disagreement.
- Recognize that you may not yet know your partner’s feelings or thoughts. Let your partner know what you are feeling. Give your partner a chance to agree or disagree with what you assume is true. Listen with an open mind.
Take time to discuss difficult topics with your partner.
- Challenging topics can be discussed during regularly scheduled times together. Let your partner know ahead of time that you would like to discuss it
- Discuss one difficult topic at a time. Avoid trying to solve everything at one time—especially at first.
- Include your health care team when you discussing medical topics. Your partner may better understand your physical and emotional symptoms when they are explained by a health care provider.
Consider meeting with a licensed counselor about serious challenges in your relationship.
Sometimes communication problems are the result of more complicated problems. In some cases, a couple may require the help of a counselor or therapist.
Ask your doctor for a referral if you:
- Feel depressed, anxious, angry, disappointed, frustrated, lost
- Use physical aggression with the other or use threatening statements towards another
- Have thoughts of hurting yourself or someone else
- Have problems with alcohol or other drugs
- Think you cannot work out a solution without assistance
In many cases, serious relationship problems can be avoided or improved with the assistance of a licensed counselor or therapist.
Communicating With Your Partner: Additional Resources
The resources listed below provide more detailed information and support services to help you communicate with your partner. Please read the Detailed Information and Suggestions document for more information and questions to ask.
LIVESTRONG SurvivorCare Program
www.livestrong.org/survivorcare
| Email: |
Send email through the LIVESTRONG website. |
| Phone: |
1-866-673-7205
1-866-927-7205 |
|
Intake Coordinator is available for calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (Central Time). Voicemail is available after hours. |
LIVESTRONG SurvivorCare offers assistance to anyone affected by cancer, including the person diagnosed, loved ones, caregivers and friends. The program provides information about treatment options and matching to clinical trials or treatments in development. Counseling services and assistance with financial, employment and insurance issues are also available. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations including CancerCare, Patient Advocate Foundation and EmergingMed.
American Association for Marriage and Family Therapy
www.aamft.org
| Email: |
Send email through the website. |
| Phone: |
1-703-838-9808 |
|
Intake Coordinator is available for calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (Central Time). Voicemail is available after hours. |
The American Association for Marriage and Family Therapy provides a searchable database for locating licensed marriage and family therapists. This website also has information about a variety of emotional concerns, including chronic illness, caregiving, bereavement and loss. Descriptions of related books, audio tapes and articles are also available.
American Psychological Association Help Center
www.apahelpcenter.org
The American Psychological Association (APA) has an online help center that offers consumers free information, facts, and tips about mental health issues. The APA Help Center provides a variety of brochures and online information about a wide range of emotional concerns, including chronic illness, stress, mind-body health, resilience, and issues including managed care and health insurance. The site also includes a psychologist locator service and a toll-free number to obtain contact information about psychologists in your area. Some information is available in Spanish.
American Psychosocial Oncology Society (APOS)
www.apos-society.org
| Phone: |
1-866-276-7443 |
|
Voicemail is available after hours. Messages will be returned within 24 to 48 hours. |
APOS works to ensure that all people with cancer have access to psychosocial services as a part of quality cancer care. They provide mental health care referrals to local counseling and support services throughout the United States. If no services are available in your community, a professionally trained Helpline staff member will provide crisis counseling over the phone. To use this service, call the toll-free number.
National Register of Health Service Providers in Psychology
www.findapsychologist.org
The National Register of Health Service Providers in Psychology sponsors this free psychologist referral website to promote consumer access to more than 12,000 professionally screened psychologists in the United States and Canada. This site also contains frequently asked questions about getting help, web links and resources on behavioral health care issues for consumers.
The Wellness Community
www.thewellnesscommunity.org
| Email: |
Send email through the website |
| Phone: |
1-888-793-9355 |
The Wellness Community is an international non-profit organization. It provides free support and education to people with cancer and their loved ones. Professionals lead support groups, educational workshops, nutrition and exercise programs. They help people affected by cancer regain control and reduce isolation regardless of the stage of their survivorship. Wellness Communities and satellite programs are located across the U.S. Online support groups for cancer survivors and caregivers are offered in both English and Spanish on their website.
[return to top]
Communicating With Your Partner
Communicating with your partner about how cancer has affected you can be difficult. Even strong relationships can become strained under the pressure of managing a complex illness. Taking steps to improve your communication skills can help you to feel more supported and understood.
Detailed Information
Suggestions
Additional Resources
Print this Topic
Email this Topic
Communicating With Your Partner: Detailed Information
This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions and Additional Resources documents for questions to ask and for more resources.
Why is it important for survivors to communicate well with their partners?
A spouse or partner can be a primary source of support to a cancer survivor. However, if communication begins to break down, it can be stressful and result in low levels of support for both. While the cancer journey can be emotionally challenging for survivors, it can also be hard on loved ones. In some cases, a partner may experience more emotional distress than the survivor.
Both survivors and their partners may have strong emotions such as fear, anger and guilt. Stress is also common. A decline in the physical or emotional status of either may create a “cycle of distress” for the couple. If this happens, one person’s distress also affects the other. High levels of emotional distress can strain the relationship. Good communication may be the most effective strategy for breaking this cycle. It may also improve the quality of life for both.
Good communication skills can help survivors and their partners to:
- Receive and offer emotional support
- Get help making decisions
- Share advice and encouragement
- Learn new ways of handling stressful situations
- Clarify misunderstandings
- Learn new coping strategies
- Plan for the future, such as family, employment and financial decisions
Important issues that partners may need to discuss together include:
- Ways to solve problems with changing roles and responsibilities in the relationship
- Instructions and preferences for decisions about health care and financial matters
- Concerns about changes to sexual relations and expressions of intimacy
- Challenges adjusting to the cancer experience
- How to maintain the quality of the relationship
The cancer experience can be a time that enriches and strengthens the relationship. A partner can play a large role in shaping the emotional experience of the survivor to the experiences of cancer and life after treatment. Research shows that survivors who feel they have support from their partners are more likely to focus on the positive aspects of their cancer journey. This can improve their quality of life.
Why is it sometimes difficult for survivors to communicate with their partners?
There may be a number of reasons why it can be difficult for survivors to communicate with their partners including:
- A partner’s negative response to the survivor’s discussions may discourage open communication.
Research shows that a survivor is negatively affected if his or her partner uses criticism, withdrawal or acts uncomfortable when the survivor talks about the cancer experience. This may cause the survivor to use fewer healthy and effective coping strategies. Emotional problems can result and a cycle of distress may occur in the relationship.
Negative responses from partners that may make communication difficult include:
- The cancer journey may require that couples communicate about topics that they normally would not talk about.
Issues, such as the side effects or aftereffects of cancer and treatment, may be difficult to discuss. For example, some survivors experience incontinence, sexual or fertility problems or changes in self-esteem and body image. These may be very hard for some people to talk about.
Long-lasting complications, such as fatigue and chronic pain, may be difficult for partners to understand. This is especially true when the survivor is in remission or looks healthy. The partner may want the survivor to move on and return to life the way it was before cancer.
Sensitive issues that may be difficult to discuss include:
- Living with uncertainty
- Stress
- Feelings of guilt
- Financial difficulties
- Dealing with fear of recurrence
- Changes in outlook on life and death
- Other health and physical problems
- Losses of all kinds including job, friends, abilities
- Changing roles and responsibilities
- New compromises that need to be made
- Feeling overwhelmed
- Anger
Survivors may feel guilty discussing certain topics with their partners.
It can be hard for survivors to ask others for help. This is particularly true if the survivor has always been the one to help others. Some may continue to try to do tasks that have become too emotionally or physically challenging.
Some survivors are worried about stress on their partners. They may feel guilty about asking partners to take on new roles and responsibilities. They may be concerned that a partner is as distressed (or more) than the survivor. A survivor may try to protect his or her partner by not sharing information. Important discussions about certain topics, such as health care directives and financial matters, may be avoided in an effort not to upset the partner.
Survivors and partners may have different priorities.
Cancer survivors and their partners may find that some things that were important to them before treatment are no longer as important. There may be a change in the way they view life. Some decide to change jobs or other relationships in their lives.
Sometimes both partners and survivors can easily understand the change in priorities and be comfortable with them. Other times, one of them might not understand why these changes are happening or may not agree with them. This can feel threatening to a relationship.
How can survivors learn to communicate well with their partners?
Couples sharing the cancer journey can learn new and effective communication strategies. Even though it can be difficult to change old habits, learning skills and developing new communication habits is possible. The key is to practice the new skills regularly. The benefit is that healthy communication can increase satisfaction in a couple’s overall relationship and positively affect the quality of life for both.
Some ways to improve communication skills include:
- Being aware of your own communication patterns and behaviors
- Understanding the communication patterns and behaviors of your partner
- Learning and practicing effective communication skills together
- Taking time to discuss difficult topics with your partner
- Consulting a licensed counselor about your relationship
How can better communication benefit survivors and their partners?
There may be times when survivors and their partners have a hard time talking with one another. During times of stress, effective and healthy communication might be a challenge for couples. This can be especially difficult if there were already problems talking and sharing before the cancer diagnosis.
If communication between you and your partner is not what you would like, you may need to work on building skills. You may be able to do this together or with the help of a licensed counselor. You may want to talk with your health care team about getting a referral to a counselor who is experienced working with cancer survivors.
Signs that it is time to work on better communication with your partner include:
- Frequent misunderstandings
- Withdrawal from one another or avoidance of talking together
- Frequent use of criticism, sarcasm or name-calling
- Not sharing information with your partner
- Frequent disagreements over the same issues
- Concerns about sexual matters
- Lessening of expressions of love and affection such as talking, touching and sharing
- Confiding in others instead of the partner
- Inability to ask the partner for help or support
- Finding the support received from the partner is unhelpful
- Feeling hurt emotionally by the partner
If there is ever physical aggression in the response of you or your partner, seek immediate help. Options for professional assistance include:
- Calling 911 if you are in immediate physical danger
- Talking with crisis intervention specialists such as crisis hotlines and local abuse shelters
- Talking to a mental health professional such as a psychologist, psychiatrist, or marriage and family counselor
- Consulting a legal professional to understand your rights such as an attorney or law enforcement officials
This document was produced in collaboration with:
Cindy L. Carmack Taylor, Ph.D.
Assistant Professor, The University of Texas, M.D. Anderson Cancer Center
Works Cited
Christensen, Andrew, and Neil Jacobson. Reconcilable Differences. New York: The London Press, 2000.
Fincham, Frank D., Leyan O.L. Fernandes, and Keith Humphreys. Communicating in Relationships: A Guide for Couples and Professionals. Champaign: Research Press, 1993.
Manne, Sharon, Stephen J. Pape, Kathryn L. Taylor, and James Dougherty. “Spouse support, coping, and mood among individuals with cancer.” Annals of Behavioral Medicine 21 (2) (1999): 111-121.
[return to top]
Communicating With Your Partner: Suggestions
The suggestions that follow are based on the information presented in the Detailed Information document. They are meant to help you take what you learn and apply the information to your own needs. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Additional Resources document for links to more resources..
Understand communication patterns and behaviors in your relationship.
Before you can work on improving communication with your partner, you need to understand the patterns. Identify areas that need to be changed because of the cancer experience.
Men and women generally communicate very differently. Men may want to try to solve the problems. Women often want to talk about problems and share emotions in an effort to give and receive support.
It can be reassuring to men to know that sometimes simply sharing and discussing problems that cannot be solved is helpful to women. It may be helpful for women to be aware that discussing problems that cannot be solved can be frustrating for men.
Discuss the following questions with your partner:
- What topics do we frequently agree on?
- What topics do we frequently argue about?
- When we disagree, how do we each respond?
- Are we able to be honest with one another?
- Can we calmly discuss issues and try to resolve the disagreement?
- Do we criticize, blame, yell, walk away or give in?
- When have we handled a disagreement well?
- Can we trust one another?
It is important for survivors and partners to be aware of their own communication needs and behaviors. Both need to take responsibility for their own patterns and recognize their own role in communication challenges.
Learn and practice effective communication skills together.
- Schedule time daily to sit and talk with your partner. Make sure it is a time you both agree on and in a place where there will be no interruptions. It will most likely occur if it is a part of your daily schedules.
- Practice active listening when your partner is talking. It can be helpful to restate in your own words what your partner said. This shows that you were listening and allows your partner to correct any misunderstandings.
- It may be helpful to begin practicing your skills by discussing positive or neutral topics at first, such as those topics you frequently agree on.
- Avoid negative communication styles such as name-calling, sarcasm, yelling and criticism.
- Stay positive. Even when you are unhappy with your partner, start by mentioning something positive. Avoid blaming and name-calling.
- Use “I” language when describing your feelings and thoughts. This can prevent judgment or blaming comments that may make your partner respond defensively. Make sure that ‘I’ statements are followed by a word that describes how you are feeling.
- Use statements such as: “I like that you included me in your decision about your new job. I felt confused and disappointed when not included in your decision to travel more frequently for work.”
- Avoid broad statements such as, “You always seem to think only of yourself when it comes to our money.”
Take a break out if a discussion becomes heated or too filled with tension. Agree in advance about how long the break should last. Each partner may need to go to a separate area to calm down. After calming down, you can try again to return to the conversation.
- Focus on the present, and do not bring up old arguments from the past.
- Focus on the topic of discussion, and avoid bringing up other topics of disagreement.
- Recognize that you may not yet know your partner’s feelings or thoughts. Let your partner know what you are feeling. Give your partner a chance to agree or disagree with what you assume is true. Listen with an open mind.
Take time to discuss difficult topics with your partner.
- Challenging topics can be discussed during regularly scheduled times together. Let your partner know ahead of time that you would like to discuss it
- Discuss one difficult topic at a time. Avoid trying to solve everything at one time—especially at first.
- Include your health care team when you discussing medical topics. Your partner may better understand your physical and emotional symptoms when they are explained by a health care provider.
Consider meeting with a licensed counselor about serious challenges in your relationship.
Sometimes communication problems are the result of more complicated problems. In some cases, a couple may require the help of a counselor or therapist.
Ask your doctor for a referral if you:
- Feel depressed, anxious, angry, disappointed, frustrated, lost
- Use physical aggression with the other or use threatening statements towards another
- Have thoughts of hurting yourself or someone else
- Have problems with alcohol or other drugs
- Think you cannot work out a solution without assistance
In many cases, serious relationship problems can be avoided or improved with the assistance of a licensed counselor or therapist.
Understand communication patterns and behaviors in your relationship.
Before you can work on improving communication with your partner, you need to understand the patterns. Identify areas that need to be changed because of the cancer experience.
Men and women generally communicate very differently. Men may want to try to solve the problems. Women often want to talk about problems and share emotions in an effort to give and receive support.
It can be reassuring to men to know that sometimes simply sharing and discussing problems that cannot be solved is helpful to women. It may be helpful for women to be aware that discussing problems that cannot be solved can be frustrating for men.
Discuss the following questions with your partner:
- What topics do we frequently agree on?
- What topics do we frequently argue about?
- When we disagree, how do we each respond?
- Are we able to be honest with one another?
- Can we calmly discuss issues and try to resolve the disagreement?
- Do we criticize, blame, yell, walk away or give in?
- When have we handled a disagreement well?
- Can we trust one another?
It is important for survivors and partners to be aware of their own communication needs and behaviors. Both need to take responsibility for their own patterns and recognize their own role in communication challenges.
Learn and practice effective communication skills together.
- Schedule time daily to sit and talk with your partner. Make sure it is a time you both agree on and in a place where there will be no interruptions. It will most likely occur if it is a part of your daily schedules.
- Practice active listening when your partner is talking. It can be helpful to restate in your own words what your partner said. This shows that you were listening and allows your partner to correct any misunderstandings.
- It may be helpful to begin practicing your skills by discussing positive or neutral topics at first, such as those topics you frequently agree on.
- Avoid negative communication styles such as name-calling, sarcasm, yelling and criticism.
- Stay positive. Even when you are unhappy with your partner, start by mentioning something positive. Avoid blaming and name-calling.
- Use “I” language when describing your feelings and thoughts. This can prevent judgment or blaming comments that may make your partner respond defensively. Make sure that ‘I’ statements are followed by a word that describes how you are feeling.
- Use statements such as: “I like that you included me in your decision about your new job. I felt confused and disappointed when not included in your decision to travel more frequently for work.”
- Avoid broad statements such as, “You always seem to think only of yourself when it comes to our money.”
- Take a break out if a discussion becomes heated or too filled with tension. Agree in advance about how long the break should last. Each partner may need to go to a separate area to calm down. After calming down, you can try again to return to the conversation.
- Focus on the present, and do not bring up old arguments from the past.
- Focus on the topic of discussion, and avoid bringing up other topics of disagreement.
- Recognize that you may not yet know your partner’s feelings or thoughts. Let your partner know what you are feeling. Give your partner a chance to agree or disagree with what you assume is true. Listen with an open mind.
Take time to discuss difficult topics with your partner.
- Challenging topics can be discussed during regularly scheduled times together. Let your partner know ahead of time that you would like to discuss it
- Discuss one difficult topic at a time. Avoid trying to solve everything at one time—especially at first.
- Include your health care team when you discussing medical topics. Your partner may better understand your physical and emotional symptoms when they are explained by a health care provider.
Consider meeting with a licensed counselor about serious challenges in your relationship.
Sometimes communication problems are the result of more complicated problems. In some cases, a couple may require the help of a counselor or therapist.
Ask your doctor for a referral if you:
- Feel depressed, anxious, angry, disappointed, frustrated, lost
- Use physical aggression with the other or use threatening statements towards another
- Have thoughts of hurting yourself or someone else
- Have problems with alcohol or other drugs
- Think you cannot work out a solution without assistance
In many cases, serious relationship problems can be avoided or improved with the assistance of a licensed counselor or therapist.
Communicating With Your Partner: Additional Resources
The resources listed below provide more detailed information and support services to help you communicate with your partner. Please read the Detailed Information and Suggestions document for more information and questions to ask.
LIVESTRONG SurvivorCare Program
www.livestrong.org/survivorcare
| Email: |
Send email through the LIVESTRONG website. |
| Phone: |
1-866-673-7205
1-866-927-7205 |
|
Intake Coordinator is available for calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (Central Time). Voicemail is available after hours. |
LIVESTRONG SurvivorCare offers assistance to anyone affected by cancer, including the person diagnosed, loved ones, caregivers and friends. The program provides information about treatment options and matching to clinical trials or treatments in development. Counseling services and assistance with financial, employment and insurance issues are also available. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations including CancerCare, Patient Advocate Foundation and EmergingMed.
American Association for Marriage and Family Therapy
www.aamft.org
| Email: |
Send email through the website. |
| Phone: |
1-703-838-9808 |
|
Intake Coordinator is available for calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (Central Time). Voicemail is available after hours. |
The American Association for Marriage and Family Therapy provides a searchable database for locating licensed marriage and family therapists. This website also has information about a variety of emotional concerns, including chronic illness, caregiving, bereavement and loss. Descriptions of related books, audio tapes and articles are also available.
American Psychological Association Help Center
www.apahelpcenter.org
The American Psychological Association (APA) has an online help center that offers consumers free information, facts, and tips about mental health issues. The APA Help Center provides a variety of brochures and online information about a wide range of emotional concerns, including chronic illness, stress, mind-body health, resilience, and issues including managed care and health insurance. The site also includes a psychologist locator service and a toll-free number to obtain contact information about psychologists in your area. Some information is available in Spanish.
American Psychosocial Oncology Society (APOS)
www.apos-society.org
| Phone: |
1-866-276-7443 |
|
Voicemail is available after hours. Messages will be returned within 24 to 48 hours. |
APOS works to ensure that all people with cancer have access to psychosocial services as a part of quality cancer care. They provide mental health care referrals to local counseling and support services throughout the United States. If no services are available in your community, a professionally trained Helpline staff member will provide crisis counseling over the phone. To use this service, call the toll-free number.
National Register of Health Service Providers in Psychology
www.findapsychologist.org
The National Register of Health Service Providers in Psychology sponsors this free psychologist referral website to promote consumer access to more than 12,000 professionally screened psychologists in the United States and Canada. This site also contains frequently asked questions about getting help, web links and resources on behavioral health care issues for consumers.
The Wellness Community
www.thewellnesscommunity.org
| Email: |
Send email through the website |
| Phone: |
1-888-793-9355 |
The Wellness Community is an international non-profit organization. It provides free support and education to people with cancer and their loved ones. Professionals lead support groups, educational workshops, nutrition and exercise programs. They help people affected by cancer regain control and reduce isolation regardless of the stage of their survivorship. Wellness Communities and satellite programs are located across the U.S. Online support groups for cancer survivors and caregivers are offered in both English and Spanish on their website.
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Communicating With Your Partner
Communicating with your partner about how cancer has affected you can be difficult. Even strong relationships can become strained under the pressure of managing a complex illness. Taking steps to improve your communication skills can help you to feel more supported and understood.
Detailed Information
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Communicating With Your Partner: Detailed Information
This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions and Additional Resources documents for questions to ask and for more resources.
Why is it important for survivors to communicate well with their partners?
A spouse or partner can be a primary source of support to a cancer survivor. However, if communication begins to break down, it can be stressful and result in low levels of support for both. While the cancer journey can be emotionally challenging for survivors, it can also be hard on loved ones. In some cases, a partner may experience more emotional distress than the survivor.
Both survivors and their partners may have strong emotions such as fear, anger and guilt. Stress is also common. A decline in the physical or emotional status of either may create a “cycle of distress” for the couple. If this happens, one person’s distress also affects the other. High levels of emotional distress can strain the relationship. Good communication may be the most effective strategy for breaking this cycle. It may also improve the quality of life for both.
Good communication skills can help survivors and their partners to:
- Receive and offer emotional support
- Get help making decisions
- Share advice and encouragement
- Learn new ways of handling stressful situations
- Clarify misunderstandings
- Learn new coping strategies
- Plan for the future, such as family, employment and financial decisions
Important issues that partners may need to discuss together include:
- Ways to solve problems with changing roles and responsibilities in the relationship
- Instructions and preferences for decisions about health care and financial matters
- Concerns about changes to sexual relations and expressions of intimacy
- Challenges adjusting to the cancer experience
- How to maintain the quality of the relationship
The cancer experience can be a time that enriches and strengthens the relationship. A partner can play a large role in shaping the emotional experience of the survivor to the experiences of cancer and life after treatment. Research shows that survivors who feel they have support from their partners are more likely to focus on the positive aspects of their cancer journey. This can improve their quality of life.
Why is it sometimes difficult for survivors to communicate with their partners?
There may be a number of reasons why it can be difficult for survivors to communicate with their partners including:
- A partner’s negative response to the survivor’s discussions may discourage open communication.
Research shows that a survivor is negatively affected if his or her partner uses criticism, withdrawal or acts uncomfortable when the survivor talks about the cancer experience. This may cause the survivor to use fewer healthy and effective coping strategies. Emotional problems can result and a cycle of distress may occur in the relationship.
Negative responses from partners that may make communication difficult include:
- The cancer journey may require that couples communicate about topics that they normally would not talk about.
Issues, such as the side effects or aftereffects of cancer and treatment, may be difficult to discuss. For example, some survivors experience incontinence, sexual or fertility problems or changes in self-esteem and body image. These may be very hard for some people to talk about.
Long-lasting complications, such as fatigue and chronic pain, may be difficult for partners to understand. This is especially true when the survivor is in remission or looks healthy. The partner may want the survivor to move on and return to life the way it was before cancer.
Sensitive issues that may be difficult to discuss include:
- Living with uncertainty
- Stress
- Feelings of guilt
- Financial difficulties
- Dealing with fear of recurrence
- Changes in outlook on life and death
- Other health and physical problems
- Losses of all kinds including job, friends, abilities
- Changing roles and responsibilities
- New compromises that need to be made
- Feeling overwhelmed
- Anger
Survivors may feel guilty discussing certain topics with their partners.
It can be hard for survivors to ask others for help. This is particularly true if the survivor has always been the one to help others. Some may continue to try to do tasks that have become too emotionally or physically challenging.
Some survivors are worried about stress on their partners. They may feel guilty about asking partners to take on new roles and responsibilities. They may be concerned that a partner is as distressed (or more) than the survivor. A survivor may try to protect his or her partner by not sharing information. Important discussions about certain topics, such as health care directives and financial matters, may be avoided in an effort not to upset the partner.
Survivors and partners may have different priorities.
Cancer survivors and their partners may find that some things that were important to them before treatment are no longer as important. There may be a change in the way they view life. Some decide to change jobs or other relationships in their lives.
Sometimes both partners and survivors can easily understand the change in priorities and be comfortable with them. Other times, one of them might not understand why these changes are happening or may not agree with them. This can feel threatening to a relationship.
How can survivors learn to communicate well with their partners?
Couples sharing the cancer journey can learn new and effective communication strategies. Even though it can be difficult to change old habits, learning skills and developing new communication habits is possible. The key is to practice the new skills regularly. The benefit is that healthy communication can increase satisfaction in a couple’s overall relationship and positively affect the quality of life for both.
Some ways to improve communication skills include:
- Being aware of your own communication patterns and behaviors
- Understanding the communication patterns and behaviors of your partner
- Learning and practicing effective communication skills together
- Taking time to discuss difficult topics with your partner
- Consulting a licensed counselor about your relationship
How can better communication benefit survivors and their partners?
There may be times when survivors and their partners have a hard time talking with one another. During times of stress, effective and healthy communication might be a challenge for couples. This can be especially difficult if there were already problems talking and sharing before the cancer diagnosis.
If communication between you and your partner is not what you would like, you may need to work on building skills. You may be able to do this together or with the help of a licensed counselor. You may want to talk with your health care team about getting a referral to a counselor who is experienced working with cancer survivors.
Signs that it is time to work on better communication with your partner include:
- Frequent misunderstandings
- Withdrawal from one another or avoidance of talking together
- Frequent use of criticism, sarcasm or name-calling
- Not sharing information with your partner
- Frequent disagreements over the same issues
- Concerns about sexual matters
- Lessening of expressions of love and affection such as talking, touching and sharing
- Confiding in others instead of the partner
- Inability to ask the partner for help or support
- Finding the support received from the partner is unhelpful
- Feeling hurt emotionally by the partner
If there is ever physical aggression in the response of you or your partner, seek immediate help. Options for professional assistance include:
- Calling 911 if you are in immediate physical danger
- Talking with crisis intervention specialists such as crisis hotlines and local abuse shelters
- Talking to a mental health professional such as a psychologist, psychiatrist, or marriage and family counselor
- Consulting a legal professional to understand your rights such as an attorney or law enforcement officials
This document was produced in collaboration with:
Cindy L. Carmack Taylor, Ph.D.
Assistant Professor, The University of Texas, M.D. Anderson Cancer Center
Works Cited
Christensen, Andrew, and Neil Jacobson. Reconcilable Differences. New York: The London Press, 2000.
Fincham, Frank D., Leyan O.L. Fernandes, and Keith Humphreys. Communicating in Relationships: A Guide for Couples and Professionals. Champaign: Research Press, 1993.
Manne, Sharon, Stephen J. Pape, Kathryn L. Taylor, and James Dougherty. “Spouse support, coping, and mood among individuals with cancer.” Annals of Behavioral Medicine 21 (2) (1999): 111-121.
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Communicating With Your Partner: Suggestions
The suggestions that follow are based on the information presented in the Detailed Information document. They are meant to help you take what you learn and apply the information to your own needs. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Additional Resources document for links to more resources..
Understand communication patterns and behaviors in your relationship.
Before you can work on improving communication with your partner, you need to understand the patterns. Identify areas that need to be changed because of the cancer experience.
Men and women generally communicate very differently. Men may want to try to solve the problems. Women often want to talk about problems and share emotions in an effort to give and receive support.
It can be reassuring to men to know that sometimes simply sharing and discussing problems that cannot be solved is helpful to women. It may be helpful for women to be aware that discussing problems that cannot be solved can be frustrating for men.
Discuss the following questions with your partner:
- What topics do we frequently agree on?
- What topics do we frequently argue about?
- When we disagree, how do we each respond?
- Are we able to be honest with one another?
- Can we calmly discuss issues and try to resolve the disagreement?
- Do we criticize, blame, yell, walk away or give in?
- When have we handled a disagreement well?
- Can we trust one another?
It is important for survivors and partners to be aware of their own communication needs and behaviors. Both need to take responsibility for their own patterns and recognize their own role in communication challenges.
Learn and practice effective communication skills together.
- Schedule time daily to sit and talk with your partner. Make sure it is a time you both agree on and in a place where there will be no interruptions. It will most likely occur if it is a part of your daily schedules.
- Practice active listening when your partner is talking. It can be helpful to restate in your own words what your partner said. This shows that you were listening and allows your partner to correct any misunderstandings.
- It may be helpful to begin practicing your skills by discussing positive or neutral topics at first, such as those topics you frequently agree on.
- Avoid negative communication styles such as name-calling, sarcasm, yelling and criticism.
- Stay positive. Even when you are unhappy with your partner, start by mentioning something positive. Avoid blaming and name-calling.
- Use “I” language when describing your feelings and thoughts. This can prevent judgment or blaming comments that may make your partner respond defensively. Make sure that ‘I’ statements are followed by a word that describes how you are feeling.
- Use statements such as: “I like that you included me in your decision about your new job. I felt confused and disappointed when not included in your decision to travel more frequently for work.”
- Avoid broad statements such as, “You always seem to think only of yourself when it comes to our money.”
Take a break out if a discussion becomes heated or too filled with tension. Agree in advance about how long the break should last. Each partner may need to go to a separate area to calm down. After calming down, you can try again to return to the conversation.
- Focus on the present, and do not bring up old arguments from the past.
- Focus on the topic of discussion, and avoid bringing up other topics of disagreement.
- Recognize that you may not yet know your partner’s feelings or thoughts. Let your partner know what you are feeling. Give your partner a chance to agree or disagree with what you assume is true. Listen with an open mind.
Take time to discuss difficult topics with your partner.
- Challenging topics can be discussed during regularly scheduled times together. Let your partner know ahead of time that you would like to discuss it
- Discuss one difficult topic at a time. Avoid trying to solve everything at one time—especially at first.
- Include your health care team when you discussing medical topics. Your partner may better understand your physical and emotional symptoms when they are explained by a health care provider.
Consider meeting with a licensed counselor about serious challenges in your relationship.
Sometimes communication problems are the result of more complicated problems. In some cases, a couple may require the help of a counselor or therapist.
Ask your doctor for a referral if you:
- Feel depressed, anxious, angry, disappointed, frustrated, lost
- Use physical aggression with the other or use threatening statements towards another
- Have thoughts of hurting yourself or someone else
- Have problems with alcohol or other drugs
- Think you cannot work out a solution without assistance
In many cases, serious relationship problems can be avoided or improved with the assistance of a licensed counselor or therapist.
Understand communication patterns and behaviors in your relationship.
Before you can work on improving communication with your partner, you need to understand the patterns. Identify areas that need to be changed because of the cancer experience.
Men and women generally communicate very differently. Men may want to try to solve the problems. Women often want to talk about problems and share emotions in an effort to give and receive support.
It can be reassuring to men to know that sometimes simply sharing and discussing problems that cannot be solved is helpful to women. It may be helpful for women to be aware that discussing problems that cannot be solved can be frustrating for men.
Discuss the following questions with your partner:
- What topics do we frequently agree on?
- What topics do we frequently argue about?
- When we disagree, how do we each respond?
- Are we able to be honest with one another?
- Can we calmly discuss issues and try to resolve the disagreement?
- Do we criticize, blame, yell, walk away or give in?
- When have we handled a disagreement well?
- Can we trust one another?
It is important for survivors and partners to be aware of their own communication needs and behaviors. Both need to take responsibility for their own patterns and recognize their own role in communication challenges.
Learn and practice effective communication skills together.
- Schedule time daily to sit and talk with your partner. Make sure it is a time you both agree on and in a place where there will be no interruptions. It will most likely occur if it is a part of your daily schedules.
- Practice active listening when your partner is talking. It can be helpful to restate in your own words what your partner said. This shows that you were listening and allows your partner to correct any misunderstandings.
- It may be helpful to begin practicing your skills by discussing positive or neutral topics at first, such as those topics you frequently agree on.
- Avoid negative communication styles such as name-calling, sarcasm, yelling and criticism.
- Stay positive. Even when you are unhappy with your partner, start by mentioning something positive. Avoid blaming and name-calling.
- Use “I” language when describing your feelings and thoughts. This can prevent judgment or blaming comments that may make your partner respond defensively. Make sure that ‘I’ statements are followed by a word that describes how you are feeling.
- Use statements such as: “I like that you included me in your decision about your new job. I felt confused and disappointed when not included in your decision to travel more frequently for work.”
- Avoid broad statements such as, “You always seem to think only of yourself when it comes to our money.”
- Take a break out if a discussion becomes heated or too filled with tension. Agree in advance about how long the break should last. Each partner may need to go to a separate area to calm down. After calming down, you can try again to return to the conversation.
- Focus on the present, and do not bring up old arguments from the past.
- Focus on the topic of discussion, and avoid bringing up other topics of disagreement.
- Recognize that you may not yet know your partner’s feelings or thoughts. Let your partner know what you are feeling. Give your partner a chance to agree or disagree with what you assume is true. Listen with an open mind.
Take time to discuss difficult topics with your partner.
- Challenging topics can be discussed during regularly scheduled times together. Let your partner know ahead of time that you would like to discuss it
- Discuss one difficult topic at a time. Avoid trying to solve everything at one time—especially at first.
- Include your health care team when you discussing medical topics. Your partner may better understand your physical and emotional symptoms when they are explained by a health care provider.
Consider meeting with a licensed counselor about serious challenges in your relationship.
Sometimes communication problems are the result of more complicated problems. In some cases, a couple may require the help of a counselor or therapist.
Ask your doctor for a referral if you:
- Feel depressed, anxious, angry, disappointed, frustrated, lost
- Use physical aggression with the other or use threatening statements towards another
- Have thoughts of hurting yourself or someone else
- Have problems with alcohol or other drugs
- Think you cannot work out a solution without assistance
In many cases, serious relationship problems can be avoided or improved with the assistance of a licensed counselor or therapist.
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Communicating With Your Partner: Additional Resources
The resources listed below provide more detailed information and support services to help you communicate with your partner. Please read the Detailed Information and Suggestions document for more information and questions to ask.
LIVESTRONG SurvivorCare Program
www.livestrong.org/survivorcare
| Email: |
Send email through the LIVESTRONG website. |
| Phone: |
1-866-673-7205
1-866-927-7205 |
|
Intake Coordinator is available for calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (Central Time). Voicemail is available after hours. |
LIVESTRONG SurvivorCare offers assistance to anyone affected by cancer, including the person diagnosed, loved ones, caregivers and friends. The program provides information about treatment options and matching to clinical trials or treatments in development. Counseling services and assistance with financial, employment and insurance issues are also available. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations including CancerCare, Patient Advocate Foundation and EmergingMed.
American Association for Marriage and Family Therapy
www.aamft.org
| Email: |
Send email through the website. |
| Phone: |
1-703-838-9808 |
|
Intake Coordinator is available for calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (Central Time). Voicemail is available after hours. |
The American Association for Marriage and Family Therapy provides a searchable database for locating licensed marriage and family therapists. This website also has information about a variety of emotional concerns, including chronic illness, caregiving, bereavement and loss. Descriptions of related books, audio tapes and articles are also available.
American Psychological Association Help Center
www.apahelpcenter.org
The American Psychological Association (APA) has an online help center that offers consumers free information, facts, and tips about mental health issues. The APA Help Center provides a variety of brochures and online information about a wide range of emotional concerns, including chronic illness, stress, mind-body health, resilience, and issues including managed care and health insurance. The site also includes a psychologist locator service and a toll-free number to obtain contact information about psychologists in your area. Some information is available in Spanish.
American Psychosocial Oncology Society (APOS)
www.apos-society.org
| Phone: |
1-866-276-7443 |
|
Voicemail is available after hours. Messages will be returned within 24 to 48 hours. |
APOS works to ensure that all people with cancer have access to psychosocial services as a part of quality cancer care. They provide mental health care referrals to local counseling and support services throughout the United States. If no services are available in your community, a professionally trained Helpline staff member will provide crisis counseling over the phone. To use this service, call the toll-free number.
National Register of Health Service Providers in Psychology
www.findapsychologist.org
The National Register of Health Service Providers in Psychology sponsors this free psychologist referral website to promote consumer access to more than 12,000 professionally screened psychologists in the United States and Canada. This site also contains frequently asked questions about getting help, web links and resources on behavioral health care issues for consumers.
The Wellness Community
www.thewellnesscommunity.org
| Email: |
Send email through the website |
| Phone: |
1-888-793-9355 |
The Wellness Community is an international non-profit organization. It provides free support and education to people with cancer and their loved ones. Professionals lead support groups, educational workshops, nutrition and exercise programs. They help people affected by cancer regain control and reduce isolation regardless of the stage of their survivorship. Wellness Communities and satellite programs are located across the U.S. Online support groups for cancer survivors and caregivers are offered in both English and Spanish on their website.
[return to top]
Communicating With Your Partner: Detailed Information
This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions and Additional Resources documents for questions to ask and for more resources.
Partners are usually the primary source of support for individuals facing cancer. Relationships having poor communication may mean low levels of support for both the survivor and the partner.
While cancer can negatively affect the emotional well-being of survivors, it also can negatively affect partners. Some partners actually experience more emotional distress than survivors. Just as survivors can experience emotions such as fear, anger and guilt, their partners can experience them too. Stress is also common for both survivors and their partners.
A decline in the survivor’s physical or emotional status may create a “cycle of distress” for the couple in which one person’s distress makes the other’s distress worse. High levels of emotional distress are likely to strain the couple’s relationship. Good communication may be the most effective strategy for breaking this cycle and may improve both members’ quality of life.
Some ways survivors and partners can both benefit from good communication include:
- Receive emotional support
- Offer emotional support
- Receive help with decision-making
- Receive advice and encouragement
- Learn alternative ways of viewing stressful or difficult situations
- Clarify misunderstandings
- Receive help communicating with the health care team and following their recommendations
- Learn new coping strategies
- Receive support for healthy behaviors (eating properly, smoking cessation, physical activity)
- Plan for the future (includes caring for children, having children after cancer, financial considerations)
- Discuss ways to solve problems with changing roles and responsibilities in the relationship
- Inform partner of survivor’s wishes in case the survivor is unable to communicate these wishes in the future
- Resolve problems regarding changes to sexual relations and expressions of intimacy
- Assist with adjusting to the cancer experience, which will promote emotional well-being
- Maintain the quality of the relationship
- Use the cancer experience to enrich and strengthen the relationship
Overall, partners can play a large role in survivors’ emotional response to the disease and life after treatment. Research shows that survivors who feel they have more support from their partners are more likely to focus on positive aspects of their cancer experience, which may improve their quality of life.
Why is it sometimes difficult for survivors to communicate with their partners?
There are several reasons why it can be difficult for survivors to communicate with their partners.
The partner’s response to the survivor’s discussions may discourage open communication.
Research shows that when a partner uses criticism, withdraws or acts uncomfortable when the survivor tries to share, the survivor may cope using unhealthy and ineffective strategies. Poor coping can cause emotional problems and potentially restart the “cycle of distress” in the relationship.
Other reactions from partners that make communication after treatment difficult include:
- The partner doesn’t want to talk about what the survivor is experiencing because it is too upsetting.
- The partner feels over-protective and won’t let the survivor do anything.
- The partner wants the survivor to “get back to normal” and forget that the cancer crisis ever happened.
Survivorship often requires couples to communicate about topics that they don’t normally talk about.
This is particularly true for side effects of cancer and its treatment. Issues such as incontinence, sexual changes or problems, and body image may be embarrassing to discuss. Further, lasting complications such as fatigue and chronic pain may be especially difficult for partners to understand, particularly when the survivor is in remission and/or looks well. The partner may say that because the survivor does not “look sick,” the survivor should be able to live the way s/he did before cancer.
Examples of other sensitive issues that may be difficult to discuss:
- Living with uncertainty
- Stress
- Feelings of guilt
- Financial difficulties
- Dealing with fear of recurrence
- Changes in outlook on life and death
- Recognizing symptoms of recurrence or other physical problems
- Losses of all kinds: job, friends, abilities
- Changing roles and responsibilities
- New compromises that need to be made
- Feeling overwhelmed
- Anger
Survivors may also feel guilty discussing certain topics with their partners.
Survivors may find it difficult to ask for help, particularly if they are used to being the ones who provide help to others. Survivors may continue doing tasks that are emotionally or physically challenging. They may do this because they feel guilty asking partners to take on new roles and responsibilities, or they don’t think their partners can handle it. Additionally, there are times when partners are as distressed as or more distressed than survivors. Survivors may attempt to “protect” their partners by not sharing information or how they are feeling. Survivors may avoid discussing topics including their own suffering or planning for the future (e.g., a living will) because they do not want to upset their partners.
Survivors and partners may have different priorities.
After treatment, survivors may find that some things that were important to them before treatment are no longer as important. They may be changing the way they view life or want to change certain areas of their lives. Sometimes their partners easily understand the change in priorities and are comfortable with them. Sometimes their partners may not understand why these changes are happening or may not agree with them. Partners also may have changes in priorities after cancer that survivors may or may not understand.
When would survivors and their partners benefit from better communication?
Survivors may encounter situations in which it is difficult to communicate with their partners. During times of stress, effective and healthy communication is often a challenge for couples. This can be especially difficult if there were problems with communication before the cancer diagnosis.
If communication between you and your partner is not what you would like, you may need to work actively on communicating better with your partner, either together or with the help of a counselor. Signs that it is time to work on better communication include:
- You and your partner have frequent misunderstandings.
- You or your partner frequently withdraw or avoid talking.
- You or your partner frequently use criticism, sarcasm or name-calling.
- You find yourself frequently not sharing information with your partner.
- You and your partner frequently disagree over the same issues.
- You or your partner has sexual problems, and other expressions of love and affection (talking, touching and sharing) happen less often.
- You find yourself frequently confiding in others instead of your partner.
- You feel unable to ask your partner for help or support.
- You find that the support you receive from your partner is unhelpful.
- You feel hurt emotionally by your partner.
If ever you or your partner responds with physical aggression, seek immediate professional assistance.
Options for professional assistance:
- If you are in immediate physical danger, call 911.
- Talk with crisis intervention specialists (crisis hotlines, local abuse shelters).
- Talk to a mental health professional (psychologists, psychiatrists, marriage and family counselors).
- Talk with legal professionals to understand your rights (attorneys, law enforcement officials).
How can survivors learn to communicate well with their partners?
Couples facing cancer can learn effective communication strategies. Even though it is difficult to break old habits, learning new skills and developing new communication habits is possible. The key is to practice the new skills regularly. The benefit is that healthy communication can increase the couple’s overall relationship satisfaction and positively affect each member’s quality of life.
Below is a brief list of things to consider. For more detail, see Suggestions.
- Be aware of your and your partner’s communication patterns and behaviors.
- Learn and practice effective communication skills together.
- Take time to discuss difficult topics with your partner.
- Consult a mental health professional about your relationship (psychologist, psychiatrist, marriage and family counselor).
Remember, even with the best intentions, partners can provide the wrong kind of support to survivors and survivors can provide the wrong kind of support to partners. Being able to communicate is important for both of you.
This document was produced in collaboration with:
Cindy L. Carmack Taylor, Ph.D.
Assistant Professor, The University of Texas M.D. Anderson Cancer Center
Works Cited
Christensen, Andrew, and Neil Jacobson. Reconcilable Differences. New York: The London Press, 2000.
Fincham, Frank D., Leyan O.L. Fernandes, and Keith Humphreys. Communicating in Relationships: A Guide for Couples and Professionals. Champaign: Research Press, 1993.
Manne, Sharon, Stephen J. Pape, Kathryn L. Taylor, and James Dougherty. “Spouse support, coping, and mood among individuals with cancer.” Annals of Behavioral Medicine 21 (2) (1999): 111-121.
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Communicating With Your Partner: Suggestions
Understand your and your partner’s communication patterns and behaviors.
Before you can work on improving your communication with your partner, you need to identify areas that need to be changed because of the cancer experience. It may be helpful to ask yourself the following questions:
- What topics do we frequently agree on?
- What topics do we frequently argue about?
- When we disagree, how do I respond? Do I talk calmly about the issue and try to resolve the disagreement? Or, do I criticize, blame, yell, walk away or give in?
- When we disagree, how does my partner respond? Does my partner talk calmly about the issue and try to resolve the disagreement? Or, does my partner criticize, blame, yell, walk away or give in?
- When have I handled a disagreement with my partner well?
- When has my partner handled a disagreement with me well?
Men and women often communicate differently. While men like to try to solve problems when they are discussed, women sometimes like to talk about problems in an effort to share and receive support. Men need to be aware that sometimes discussing problems that cannot be solved is helpful to women. Women need to be aware that discussing problems that cannot be solved can be frustrating for men.
It is important for survivors and partners to be aware of their own communication needs, patterns and behaviors. Both people will need to take responsibility for their own behavior and acknowledge their role in communication difficulties when they come up.
Learn and practice effective communication skills together.
- Schedule time daily to sit and talk with your partner. It will most likely occur if it is a part of both your and your partner’s daily schedules. Make sure it is a time you both agree on and in a place where there will be no interruptions.
- Practice active listening when your partner is talking. Restate in your own words what your partner said. This shows your partner that you were listening and allows your partner to correct a misunderstanding.
- If you and your partner have problems communicating for the first several meetings, discuss positive or neutral topics (such as those topics you frequently agree on).
- Avoid negative communication styles such as name-calling, sarcasm, yelling and criticism.
- Stay positive. Even when you are unhappy with your partner, first say what you like about your partner and then what you disagree or are unhappy with. Otherwise, what you are trying to say can get lost in a stream of negative messages. For example, “I like that you included me in your decision about your new job. I am disappointed that you did not include me in your decision to retire.”
- If the discussion becomes heated, take a time out. Agree in advance about where and for how long time-outs should occur. Each partner should go to a separate room and calm down. After calming down, return to the conversation and continue the discussion for the rest of the scheduled time.
- Use “I” language when describing your feelings and thoughts. Beginning statements with “I” can prevent judgment or blaming comments, which will keep your partner from responding defensively. Make sure “I” statements are followed by an emotion word (describing how you are feeling) and include reference to your partner’s specific behavior (rather than a global personality trait). For example, it would be better to say to your partner, “I feel angry that you did not talk to me before loaning money to your brother” instead of, “You seem to think only of yourself when it comes to our money.”
- Focus on the present. Do not bring up old arguments from the past.
- Focus on the topic of discussion. Avoid bringing up other topics of disagreement if the main focus of the discussion is not resolved.
- Do not assume you know about your partner’s feelings or thoughts. Instead of assuming you know what your partner is feeling or thinking, let your partner know how things seem and give your partner a chance to agree or disagree with what you assume.
- Don’t try to solve everything at one time.
Take time to discuss difficult topics with your partner.
- Difficult topics can be discussed during your regularly scheduled times together. Let your partner know ahead of time that you would like to discuss it.
- Discuss one difficult topic at a time.
- Use time-outs when discussions become heated.
- Include your health care team in discussing medically-related topics. Your partner may better understand your physical and emotional symptoms when they are explained by a professional.
Consult a mental health professional about your relationship.
Sometimes communication problems are the result of more complicated problems that require the help of a counselor or therapist. You should consult a counselor or a therapist about your relationship if one or both of you:
- Feel depressed, anxious, angry, disappointed, frustrated, lost
- Use physical aggression with the other or use threatening statements towards the other
- Have thoughts of hurting yourself or someone else
- Have problems with alcohol or other drugs
- Think you cannot work out a solution together
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Communicating With Your Partner: Additional Resources
The resources listed below provide more detailed information and support services to help you communicate with your partner. Please read the Detailed Information and Suggestions document for more information and questions to ask.
Click a resource for more information:
National Register of Health Service Providers in Psychology
www.findapsychologist.org
The National Register of Health Service Providers in Psychology sponsors this free psychologist referral Web site to promote consumer access to more than 12,000 professionally screened psychologists in the United States and Canada. This site also contains frequently asked questions about getting help, web links and resources on behavioral healthcare issues for consumers.
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American Psychosocial Oncology Society (APOS)
www.apos-society.org
| Phone: |
1-866-APOS-4-HELP (1-866-276-7443) |
| |
Calls are answered Monday through Friday from 9:00 a.m. to 5:00 p.m. (EST). Voicemail is available after hours. Voicemail messages will be returned within 24 to 48 hours. |
The American Psychosocial Oncology Society is dedicated to advancing the science and practice of psychosocial care for people with cancer while striving to ensure that all people with cancer have access to psychosocial services as a part of quality cancer care. APOS provides mental health care referrals to survivors, caregivers and advocates. You can obtain referrals for local counseling and support services throughout the United States. If no services are available in your community, a professionally trained Helpline staff member will provide crisis counseling over the phone. To access this service, call the toll-free number. If you leave a message after hours, include your name, phone number, survivor's cancer diagnosis and survivor's city and state of residence. You should receive a call from an APOS member within two business days. The site also has links to other organizations and a list of suggested books.
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American Association for Marriage and Family Therapy
www.aamft.org
| Email: |
Send email through the Web site. |
| Phone: |
(703) 838-9808 |
The American Association for Marriage and Family Therapy provides a searchable database for locating licensed marriage and family therapists. This Web site also has information about a variety of emotional concerns, including chronic illness, caregiving, bereavement and loss, and more. Descriptions of related books, audio tapes and articles are also available.
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American Psychological Association Help Center
www.apahelpcenter.org
The American Psychological Association (APA) has an online help center that offers consumers free information, facts, and tips about mental health issues. The APA Help Center provides a variety of brochures and online information about a wide range of emotional concerns, including chronic illness, stress, mind-body health, resilience, and issues including managed care and health insurance. The site also includes a psychologist locator service and a toll-free number to obtain contact information about psychologists in your area. Some information is available in Spanish.
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AMC Cancer Information and Counseling Line
www.uccc.info
| Phone: |
1-800-525-3777 |
| |
Counselors take calls Monday-Friday, 8:30 a.m. to 5:00 p.m. (MST). |
This counseling line is staffed by trained professional counselors who can talk to you about your concerns. In addition, they provide medical information, resource referrals and emotional support through short-term counseling at no charge. Services are available to survivors, caregivers, family members, or anyone with questions about cancer. This service is operated by the AMC Cancer Research Center, affiliated with the University of Colorado Cancer Center. The Web site has additional information about a variety of cancer topics, as well as links to other cancer sites.
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LIVESTRONG SurvivorCare Program
www.livestrong.org/survivorcare
| Email: |
Send email through the Web site. |
| Phone: |
1-866-235-7205 |
| |
Case managers take calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (EST). Voicemail is available after hours. |
LIVESTRONG SurvivorCare offers assistance to all cancer survivors, including the person diagnosed, caregivers, family and friends. The program provides education, information about treatment options and new treatments in development, counseling services and assistance with financial, employment or insurance issues. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations, including CancerCare, Patient Advocate Foundation and EmergingMed.
The LIVESTRONG Survivorship Notebook is a tool that can help you organize and guide your cancer experience. The portable, three-ring binder contains a variety of information covering a full range of physical, emotional and practical survivorship topics. You may order a free LIVESTRONG Survivorship Notebook at www.livestrong.org/notebook. Shipping and handling charges will apply.
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The Wellness Community
www.thewellnesscommunity.org
The Wellness Community is an international non-profit organization that provides free support and education to people with cancer and their loved ones. Professionally-led support groups, educational workshops, nutrition and exercise programs, and mind/body classes, help people affected by cancer learn vital skills that enable them to regain control and reduce isolation regardless of the stage of their survivorship. Wellness Communities and satellite programs are located across the U.S. Online support groups for cancer survivors and caregivers are offered in both English and Spanish on their Web site.
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