The Effects of Chronically Ill Children on Marriage, Part 3
The effects of a chronically ill child on marital satisfaction have been studied by a number of researchers, with some studies indicating overwhelmingly negative reactions. In my previous articles, I have discussed some of the ways in which couples, together with their families, are coping with the stress, role assignments, perception, and depression related to the care of an ill child. Unresolved, untreated, or unrecognized marital problems and/or depression that were present before the care of a chronically ill child was demanded often become intensified. Moreover, more women expressed general dissatisfaction with their marriages than men did before and during their season of care for a chronically ill child. However, most studies on the marital effects did not include input from husbands, who, when they were included, expressed general marital satisfaction and a lack of depression.
In this article, I continue this discussion by looking at the factors that have been found to help married couples who find themselves in the situation of caring for a chronically ill child.
The Role of Therapists
Therapists can help couples in this situation by encouraging them to communicate regarding the negative impact that the chronic illness has on their marriage (Berge et al., 2006). They can help couples to establish caretaking assistance for the primary caregiver (Berge et al., 2006). When therapists point out and normalize the gender differences in responses to a chronically ill child, couples are able to gain understanding and empathy for each other (Berge et al., 2006).
Factors Involved in Maintaining Marital Satisfaction
In research conducted by Cook, Hoffschmidt, Cohler, and Pickett (1992), couples were found to maintain marital satisfaction when they were able to recognize and resolve their feelings of self-blame and inadequacy. In addition, this study found that each partner needed to be able to be vulnerable regarding issues of sex, anger, and their positive feelings for the other, and that they needed to be able to comfort each other. Having economic resources and other healthy children was also found to be a condition for maintaining marital satisfaction.
Coping Strategies for Parents
According to Sallfors and Hallberg (2003), stress is not inherent in any situation. Rather, stress occurs because of the interaction between the person and his or her environment. They concentrated their qualitative study on coping strategies used by the parents of chronically ill children and found that the two most common coping strategies used are, firstly, obtaining information, and, secondly, advocating and receiving support from hospital professionals. Too little information and inadequate support hindered the parents’ efforts to cope with their child’s pain and disability (Sallfors & Hallberg, 2003). One couple waited almost a year for a diagnosis, while another child was diagnosed with a broken leg and kept in a cast only to find out weeks later that they had rheumatoid arthritis. Parents cope better when they experience some sense of control and, as a result, so does the rest of the family (Sallfors & Hallberg, 2003). Family resources and the demands of the illness must be balanced in order for the family to thrive (Sallfors & Hallberg, 2003).
Sallfors and Hallberg (2003) outlined three categories that represent the process of coping. The main category is parental vigilance. This category includes anxiety, protection, and watchfulness that is expressed by the parents. Parents describe having the child and his or her care always in the back of their minds. They constantly watch for signs of physical changes that may need medical attention. A factor in this vigilance is the fact that some parents have experienced shaming by the medical profession for either bringing a child in too soon or too late (Sallfors & Hallberg, 2003).
The second category discussed by Sallfors and Hallberg (2003) is emotional challenges, which include uncertainties in parenting, communication with others, and the unknown. Many parents of chronically ill children experience anxiety, frustration, and powerlessness (Sallfors & Hallberg, 2003). Many mothers, especially, have hope one minute and despair the next. They struggle with how much protection to provide, how much independence to allow, and even how to interact with the child themselves (Sallfors & Hallberg, 2003). Mothers also face challenges in communicating with health care providers, school employees, and others who may not understand or respond to the situation with understanding and/or empathy (Sallfors & Hallberg, 2003). The unknown factors include questions with regard to the effects of puberty on the disabled child, his or her length of life, the progression of the condition or disease, and its future effects on the child, to name just a few (Sallfors & Hallberg, 2003).
The third category outlined by Sallfors and Hallberg (2003) is continual adjustment. Under this heading in their journal article they list “Living in the here and now,” “Looking for information,” and “Striving for relief and strength.” Many parents experienced having to adjust to the changing face of illnesses, which may not affect the child the same way every day. Taking life a day at a time can affect a couple’s ability to follow through on plans, take a vacation, or get away for a weekend together. As a result, some couples may end up feeling isolated from what used to be “normal life” (Sallfors & Hallberg, 2003). When looking for information, the parents were often the ones who solved problems that arose, including dietary needs and the management of side effects to new medications (Sallfors & Hallberg, 2003). In addition, normalizing the chronically ill child’s activities as much as possible creates an environment in which all of life does not revolve around the illness (Sallfors & Hallberg, 2003).
The Importance of Hope
Hope has been cited in numerous studies as the factor that kept parents the most balanced during stressful times of uncertainty, fear, anger, and bewilderment. Couples who had hope often coped the best, irrespective of other factors.
Christian Counseling when Caring for a Chronically Ill Child
As a Christian counselor, I have witnessed the impact that caring for a chronically ill child can have on parents, and the strains that this can have on a marriage. However much you love your child, this is a trying and challenging time and you need to be attentive to your own needs and those of the rest of your family. Christian counseling can provide a safe space in which to process all that is happening to you, and can give you the strength to face your challenges in a healthy way.
“FlattopFamilyTime,” courtesy of Flattop341, Flickr CreativeCommons (CC BY 2.0); “Family,” courtesy of Kat Grigg, Flickr CreativeCommons (CC BY 2.0)