Dynamic Choices » Family Wellness

Maintaining Intimacy in a Chronic Illness


When any chronic disease creeps slowly into your marriage, it often robs you of the feeling of being connected to the person you love. There is so much variability from day to day in energy level, emotional stability and ability to be mobile, planning opportunities to connect as a couple is challenging.

How do you prevent your relationship from becoming one of caregiver and patient instead of husband and wife? How can you find that depth of connection that you long for in the midst of a life that is so unpredictable? The only way is to listen with your heart to each other and try to understand what each of you is feeling and what you need.                     

 The basis of a great marriage, whatever the challenges, according to John Gottman is a strong friendship, a healthy way of managing conflict, and honouring each other’s dreams.

Building a strong friendship

  1. Ask your spouse what matters to them then take time to listen carefully to the answer. Words of understanding and acknowledgment should come before advice.
  2. Create small opportunities often for connection. These are the day to day things that you do for someone you love. Simple things like commenting on the great dinner speak volumes about how much you care.
  3. Receive graciously the positive comments your spouse makes and offer something positive in return.
  4. Avoid turning away from your spouse by ignoring their comments to you or turning against them with an unkind response.
  5. Strive to follow Gottman’s suggestion of a 5:1 ratio of positive to negative comments to keep your marriage healthy.
  6. Build up an “account” of positive comments to make handling the negative ones easier.
  7. Focus on your strengths as a couple rather than your weaknesses.
  8. Offer love and connection in the way that feels best to each other. Ask for what you need.
  9. Create ways to allow each of you to get a break doing something you love. You will be more willing to give to your spouse if you are not burned out and exhausted yourself.

Managing conflict in a healthy way

Marshall Rosenberg offers wonderful wisdom that helps us find ways to deal with challenging topics or areas of potential conflict in a way that fosters connection with the person we love. These are his suggestions:

  1. Start any conversations that might lead to conflict in a gentle way.
  2. Speak about things in a way that does not imply blame or criticism.
  3. Structure your introduction to the issue in the following format:
  • State what happened without blame
  • State how it made you feel
  • State what you need
  • Make a request that would help you feel better.

It would look like this:

  • When I share with you my challenges as a caregiver and you become defensive
  • I feel alone, exhausted and unappreciated.
  • I need to feel that you know how hard I am trying to do a good job.
  • Would you be willing to listen to me tomorrow as I talk about my concerns and ask me questions about how I am doing?
  1. Take a break if you feel your blood pressure and heart rate rising. When your heart rate rises above 96, you are unable to process what is being said. Take a 30 minute break to relax before discussing the topic again.
  1. Don’t store up animosities and issues. Plan a time as soon as possible to discuss the topic so it doesn’t build up and cause an explosion later.

Honouring each other’s dreams

  1. Ask lots of questions. Don’t assume you know what your spouse wants.
  2. Look underneath to see what dream is being stepped on when you find an area where you consistently experience conflict. We are all very sensitive to criticism in places where something really matters to us.
  3. Allow each other space to dream. This is important in chronic illness because so many dreams are altered for both people. Support each other to find other ways to honour what you long for. What have you always wanted to do? What would be exciting about that? What piece of that could we make really happen?

Rather than let your relationship shift into one where you as the care partner are simply “caring” for your spouse, create something more. Small moments of intimacy throughout your day will make you both feel loved all over again.