THE PERSONALITY DRIVERS AND HEART ILLNESS: BEING STRONG PERSONALITY
Any personality is capable of making unhealthy choices in reacting to the stress of illness. By understanding these potential problems in dealing with the stress of illness, you can avoid or correct much marital turmoil.
Again, I recommend that the two of you read this table and the following explanations together. Identify your own and each other's coping patterns in reacting to illness. Use this information to help each other begin more open and flexible ways of dealing with the impact that this illness has had on your marriage.
Being Strong in hopes of eventually being nurtured requires that you remain numb to your own feelings. Irritability, anger, and an overall feeling of being alone in one's struggle are the inevitable results of this mode of coping with illness. For some, depression follows. Because the Being Strong personality does not directly ask for support, other family members may eventually stop offering support; no matter how concerned they are. Family tensions then mount as the Being Strong individual begins to feel unnurtured, particularly by the spouse.
Such people lose sight of the fact that they are not letting their needs be known; they think anyone who loves them ought to know that they feel vulnerable beneath the outer layers of coping strength.
If the heart patient follows a Being Strong coping pattern, seeming or actual denial of the medical realities of his or her condition often occurs. Some of these folks simply block out awareness of physical symptoms such as chest pain or shortness of breath and thereby fail to make needed adjustments in their activity levels. Others deny the very existence of heart disease, something that is relatively easy to do given its invisibility.
I periodically see Being Strong patients who are denying their illness with such statements as, "My doctors and my spouse claim I had a heart attack, but I believe all I had was a bad case of indigestion." Of course, such denial is quite frightening to concerned family members. Fear that an ill spouse is not taking heart disease seriously often leads families to develop stress-generating patterns of monitoring the patient's behavior. Having one's behavior monitored is quite uncomfortable for a person who is accustomed to Being Strong and independent, and a spiraling of relationship tensions often results.
Although Being Strong typically involves not directly asking for attention, help, or nurturing from others—certainly a lonely way to live—I have noticed that some Being Strong people develop a different and somewhat surprising coping pattern that contrasts with the denial shown by many Being Strong heart patients: they become excessively focused on physical symptoms. They overattend to physical ailments, suggesting that they derive some form of emotional gain from remaining in a sick role. I am convinced that some Being Strong personalities do indeed become uniquely soothed and nurtured in reaction to illness behavior. Such people are certainly not faking it. The increased love and attention that often come from others when one is sick can lead to such relief from loneliness that the sick behavior becomes unconsciously exaggerated. In this way, the Being Strong heart patient avoids returning to living in emotional isolation.
Of course, these Being Strong patterns do not apply only to heart patients. A spouse, too, can get stuck in Being Strong in trying to be a source of stability for a sick mate. The potential costs of this pattern are similar for spouses and patients: feelings of aloneness and depression, physical symptoms that become aggravated by the stress of the caretaker role, quiet resentments toward the sick partner, and general exhaustion from caretaker burnout.
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