How to cope with the burden of disease on relationships

Published: April 07, 2020
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As a faculty member in Auburn’s Marriage and Family Therapy program, part of Josh Novak’s research investigates relationship dynamics during acute sickness such as cold and flu. He applies what he’s learned about disease to COVID-19, how it may affect relationships and offers helpful resources that couples can take advantage of during this time.

How does sickness/disease affect relationship dynamics? In general, do men and women react or respond differently when faced with a chronic disease?

A paper that was published earlier this year focused on men’s perceptions of how they and their female partners experienced the cold/flu. This study specifically found that—at least in heterosexual and traditional relationship types—that men and women experience and express symptoms differently. The men had a harder time recognizing and being in touch with their own physical symptoms and bodily sensations, whereas their female partners could describe a range of symptoms and what they felt in more vivid detail.

Additionally, the men in this study were more likely to minimize or downplay their symptoms, and this seemed to be related to masculine gender norms of not showing weakness. Interestingly, however, some wives also minimized their male partner’s symptoms and said that they were “being a baby” or that it was “not that bad.” There is this phenomenon going around nowadays, called the “man flu,” where men might exaggerate their symptoms, or at least complain about them more loudly, and their partners spoke to how much they have experienced these but still function at work and home. The results from my study suggest that when men do this, it is not only the most socially acceptable time for men to express weakness, but also a time to seek empathy, compassion or support, rather than just outright asking for it. Probably not the best strategy, but again there are some pretty strong sociocultural influences at work for men and the experience/expression of illness.

Another interesting finding was that men were more likely to let the sickness run its course or try to force it out, rather than their partners who were more apt to use medications/remedies or seek health care. Most notably, men reported that their wives did not have the luxury of taking care of themselves or taking it easy—they had to manage household responsibilities, chores and childrearing. In contrast, men felt they could rest and take a break from their work duties. These findings support previous research on illness and division of labor—women resume household duties quicker because their partners are not helping or picking up the slack.

Finally, the couples who had better outcomes and felt closer reported that they saw sickness as a time to bond and unite them as a couple, whereas when men brushed off or rejected care from their wives, it tended to pull the couple apart and lead to resentment and relationship conflict.

How would COVID-19 compare to more common sickness in the context of relationship dynamics?

The current pandemic is shifting things on its head entirely. The general cold and flu might shift household and relationship dynamics for 7-10 days (and maybe only 3-4 days of the worst symptoms), and for the most part, can be managed because it comes around every year for a limited time, but COVID-19 is extending the changes for much longer. In couples where one or both partners test positive, couples are having to figure out how to manage symptoms and balance household and work, for up to three weeks or more, not to mention the extended quarantine and stay-at-home orders. In contrast to the above study, a man might not be minimizing their own symptoms or his partner might be maximizing his symptoms in contrast to a general cold or flu. If anything, we might be seeing some hypervigilance and overfocus on symptoms, and for good reason—it’s a deadly virus that has a higher mortality rate for men specifically.

For those at home without symptoms and having to balance work (or lack of) and family in a totally different way, there is even more communication needed regarding scheduling and structure, not to mention the financial and economic strain to figure out. For couples who are working from home, gone is the typical 9 to 5-workday and work has to be broken up throughout the day. Expectations about work productivity have to be readjusted and partners now have to juggle more family time amidst work. Child rearing might now be more balanced between partners (willingly or begrudgingly) than ever before, so it will be interesting to see how this affects work and family dynamics long-term. For those out of work, it is putting even more strain and perhaps testing their relationship and their ability to communicate and problem solve effectively. Couples in any situation have to figure out spending more time together, which could be good or bad, depending on how their relationship was before. Couples who may have faced some relational difficulties before the pandemic might be facing more turbulence now, although I am seeing some softening amongst couples where they now are focusing more on their relationship.

What advice do you have for couples as they work through the personal challenges associated with the pandemic?

Perhaps more importantly, couples are having to figure out basic needs first, and it makes sense that it is the priority. However, couples should balance “task talk” with “relational talk.” In addition to discussing how to balance the checkbook and the protocol for getting groceries and essentials, couples should still find time to have some quality “we” time—beyond quality family time. This can be difficult without child care and added burdens, but it is crucial to successfully navigate the COVID-19 pandemic. There are inevitable disagreements and mini-fights that will come up while problem solving and budgeting resources, and taking time to not only repair them, but focus on having quality time together will help couples fare better. If some past or larger things in the relationship are unresolved, reaching out and seeking professional help (via teletherapy, of course) can free up some brain space and mental energy to help navigate all the added pressures. Of course, though, some couples might put those larger issues on hold until after the pandemic resolves and life gets back to normal. Those in this situation should still try to make smaller efforts to repair and improve their relationship. Little things can go a long way, such as making attempts to do nice things for their partner, listening to how they are adjusting and experiencing the new changes and making small gestures to show that they love and care for them. Finally, a healthy “we” starts with a healthy “me,” so couples may have to help each other schedule some alone or recharge time to practice self-care.

Are there any online resources you would recommend that couples could benefit from during this time?

The Auburn University Marriage and Family Therapy Center offers teletherapy (online via Zoom) appointments for individuals, couples and families on a sliding scale fee ($10-$50). Call 334-844-4478 or find us here. The Alabama Healthy Marriage and Relationship Education Initiative also provides a lot of great resources and tips for couples as well as families. Finally, there are a lot of great blogs out there such as the Gottman Institute or the Doherty Relationship Institute.

About Josh Novak

Josh Novak is an assistant professor in the Marriage and Family Therapy program in the College of Human Sciences’ Department of Human Development and Family Studies at Auburn. His research focuses on the association between couple relationships and health, specifically in chronic illness management. His work investigates how couple dynamics, such as communication, support and conflict, influence health and wellness and vice versa. Novak earned a master’s in marriage and family therapy from Texas Tech University and a doctorate in marriage and family therapy from Brigham Young University. He joined the Auburn Human Sciences faculty in 2019 after serving at Utah State University.

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