The Taconic Counseling Group

Elisha S. Fisch, Ph.D.

Do Spouses Really Have To Talk About Serious Illness?

Should couples facing a serious illness such as heart attack or cancer openly discuss the disease? It has been commonly thought that patients facing serious illness and their families who openly discuss their concerns adjust better to the illness than those who stay silent.


Recent research with cancer patients by Howard Little, a psychologist at Temple University, has revealed that what is important is not how much partners talk but rather how much their desire to talk is similar. Using a family-systems model to study 90 couples in which one spouse had either lung cancer or colon cancer, Little found that the more couples share the same desire about talking, the more likely each partner is to maintain his or her psychological well being. This is so whether the desire is to talk a lot or a little. Couples with divergent communication needs are more likely to experience conflict and distress.


In short, it is not necessary for couples to talk about the illness if talking is something both wish not to do. However, a problematic situation will likely arise when one partner has the need to talk while the other partner wishes not to talk.


Not unexpectedly, couples who adjust least well to a diagnosis of cancer were often unhappy with their marriages prior to the cancer and the illness simply makes a bad situation worse. This is in sharp contrast to relatively happy couples who almost always say that the cancer brought them closer together.


Our own experience also suggests that couples facing serious illness who have had prior marital trouble or dissimilar communication needs are candidates for increased stress. As a result, these couples, and their management of the illness, would benefit from early help that reduces marital tensions and enables them to develop a rhythm of communication that accommodates their diverse needs.