Q: My partner's become withdrawn since being diagnosed with a serious illness. What should I do?

A: Despite all the advancements in medicine, most of us are still terrified to hear words such as cancer, tumor, incurable, inoperable, experimental, drug resistant, radiation, and chemotherapy.  After the initial shock of a diagnosis sets in, we then have to cope with the physical, financial, and emotional factors about illness, disability, and death.  As one of my clients said, "The finances are the finances-by hook or by crook you work it out-but dealing with my spouse's dealings with illness weighed on me the most."

There are numerous books about coping with illness and death. For example, most recently, The Last Lecture, by Carnegie-Mellon University's Computer Science Professor Randy Pausch, is an inspirational book about his coping with deadly pancreatic cancer. I strongly recommend reading any inspirational book that helps you and your family face illness. 

But, often, after reading these kinds of books, it is difficult to apply your enlightenment to your daily life. I am no stranger to the existential, psychological, and family affects of terminal illness-my mother died when she was young. But I am not here to write about that. Lately, however, I've been counseling couples whose biggest struggles are just like the ones in the question: How do I deal with my partner's reactions to illness?" 

After your partner receives the diagnosis and research treatment options, your job as the partner is just beginning.  You not only have to grapple with finances and insurance companies, you must also face how and what you will tell the family-and how you will deal with your partner's reactions.  Here is a brief guide to coping with illness in your intimate partner.

1. Stay present emotionally. Often, the ill person shuts down emotionally. "Going inward" is a common and usually very valuable state of mind. Problems arise, however, when the person withdraws so much that you don't know how to respond. One solution is NOT to let your partner's withdrawal make you retreat, too.  You may not be the one who is ill, but you are a vital team player in the experience. Tell your partner what's on your mind and say that it's okay if he or she "just listens." Don't tiptoe around the issue.

2. Decide together who should know.  I am not in favor of family secrets.  Yet, I have counseled families who have chosen, for example, not to tell ailing Grandpa.  I urge you to get grief and family counseling to discuss the advisability of not informing family members.  Death and illness are family affairs.  Ill people are entitled to manage their own death, but it is wise to let the person know that other family members might want to say good bye and resolve nagging issues.  Paradoxically, illness can be an opportunity for family closeness.

3. Plan your family announcements and include clarity and assurance. If children-of any age-are part of your family, explain the financial changes such as selling the house or needint to get college loans, for example. Discuss the course of the illness and the treatment side effects. Family members want to know what to expect-and that there is someone in charge.

4. Create an open and brave emotional environment. We all must face illness and death, and everyone handles it differently. One of the most challenging aspects is creating an environment where everyone can talk about the illness, too.  Solutions that have worked well for my clients include keeping diaries and reading from them to the ill family member, videotaping everyone's comments, attending support groups together, and participating as a family in the charitable event associated with the illness. 

Some of the families I've counseled became very creative-and healthily stubborn-by setting up a Family Message Board in the kitchen where they left notes to each other and to the ill family member.  Messages ranged from "I love you, Dad," to "Let's watch a family movie together tonight about loss."

5. Call the bad behavior and encourage the ill person to communicate-in some way. Most spouses and partners say that one of the most trying challenges is how to balance "normal" life with "ill life."   One of my clients said, "I'm burned out just as much from the illness as I am from suffering my husband's bad temper."  The tendency is to excuse too much temper outbursts and abusive behavior.  It's easy to get "ground down" by silence and irritability to the point that you explode, too. 

But ignoring or over-accommodating your partner's reaction is not helpful to anyone in the family.  Usually, these outbursts signal that the ill person is struggling with his or her reaction to the disease.  Tips that have worked with other families include calling the bad behavior on the spot and then sitting down with the partner and ask him or her to say what's bothering them. 

If you get grunts and other avoidant behavior, some families have held up flash cards with words and phrases such as "I'm afraid," "I hate being a burden," or "I am worried about Junior." Other suggestions are to encourage the person to keep a diary or to write letters to family members.

Finally, aim to avoid too much regret BEFORE the family member dies or becomes too incapacitated.  You don't want to burden yourself or your family with too many "If only I had said or done something differently."

Dr. LeslieBeth Wish, ED.D., MSS is a noted psychologist and lic. clinical social worker, specializing in relationships.  For her book about women and love, she welcomes women to take her 17-20 minute online research survey at www.lovevictory.com.