When Illness Takes Over a Relationship

Even when people are firing on all cylinders, relationships can be tricky. When there’s a illness in the mix, they can be impossible.

The partner who is sick, disabled, anxious, depressed, or substance dependent deserves special accommodations. You wouldn’t expect your sick partner to be as attentive to you as you are to her. You wouldn’t pout if your paraplegic boyfriend doesn’t take you out dancing. You’d sooth the nerves of a phobic spouse, cheer up a depressed one, you might not drink in front of an alcoholic husband if it is likely to trigger him. You’d get them to the doctor, remind them to take their medicine, not walk so fast if there’s a struggle to keep up. Few partners would begrudge such kindnesses; most are willing to sacrifice quite a lot. Even those who freely break other wedding vows take in sickness and in health quite seriously.

However, there is a danger that, if illness persists, it will take a couple into a dangerous territory where clarity turns gray and selfishness rules the day. This is a place where individuals disappear and are replaced by need; where spouses are objectified, resented, and manipulated; where wedding vows, conceived to guide people to be the best they can be, are subverted into an evil parody that no one intended.

Illness can change character, the character of both the ill person and the one taking care of him. It ain’t pretty.

It starts in a chicken or egg type manner. It’s hard to say what comes first. You have the sick person who needs accommodations, but the needs of the illness are so great that they push aside the needs of the partner. All the time. Then there’s the non-sick partner whose identity, the very core of why they matter as a human being, can be wrapped up in caring for the sick person and in being what they think is a good spouse. To challenge is to provoke an existential crisis.

The illness takes over. Its needs are so great that it pushes aside all other needs. Caring for the illness is so absorbing, nothing else you do matters.

The ill person believes the illness is all powerful, its demands insatiable, so she obeys. This obeyance gives it power. Illness is fed by the accommodations we make. The sick person who doesn’t eat because all she does is throw up, gets weak. The paraplegic who doesn’t push himself in his physical therapy, withers away. The anxious person who lets his fears control him, puts his fears in control. The depressed person who doesn’t open the blinds, does not receive the healing properties of light. The alcoholic who makes everyone else responsible for his recovery will drink again because others cannot stop him.

The non-sick partner, if he does not already find satisfaction in self-sacrifice and helping, finds that’s all he does anyway. The needs of the illness push aside all other needs. The non-sick partner stops listening to his own desires. It makes little sense for him to acknowledge, for instance, that he needs to get out and see friends when he’s not going to be able to do it anyway. He has to stay home with his sick wife. He becomes more attentive to the illness than to himself, until, at last, all he is, is a hostage and there is no self left.

It may look as though this couple is locked in a pattern from which there is no way out, but opportunities to change offer themselves frequently. First of all, it is inevitable that when illness takes over, the patient will be more impaired, until, at last, he ends up in the hospital, or rehab. The pattern can easily be broken then, if it is recognized and the parties do the brave thing and change.

More often, outside people look in on the situation and say to the non-sick partner, what, are you crazy? They can see clearly when the people in it, can’t.

It’s hard for the non-sick person to take action though, without feeling as though he is betraying his partner. It’s a very delicate matter to stop feeding an illness, because it looks as though you have stopped caring for a sick person.

Fortunately, there’s a way out.


Discerning the Person from the Illness

I’ve been talking about how an illness can take over a relationship; just as if it moved into the house, kicked the couple out of their bed, ate up all the food in the refrigerator, and didn’t let them leave.

The illness usually starts by taking over the sick person. You think it’s your agoraphobic wife speaking when she says she can’t leave the house, but it’s not. It’s her fears. The paraplegic who won’t go to physical therapy has been taken over by his disability. Someone who won’t drink fluids because she’s been throwing up with the flu, has had the flu take charge. It’s his depression, not your boyfriend, that stays in bed all day. It’s the alcoholism talking when he says he needs a drink.

In advanced cases, the original person is gone and all that’s left is this imposter. The illness has taken over your loved one. The person you loved has mostly fled and left this shell behind.

Now that evil is coming for you.

The first step in defending yourself and defeating this monster is to be able to discern the difference between your darling and the demon. It’s tricky at first, but even twins can be distinguished by those who know them.

Go through each and every one of your partner’s behaviors. Is this the man you know and love, with all his foibles, or is this the disease? Does the behavior serve health or sickness? Decency or despair? Be sure that you can keep them straight.

If you’re angry with your partner for succumbing to the illness, your anger is justified, but misdirected. It’s the illness you should be angry with.

Now look at yourself and the things you are doing. Do they support your partner or the illness? Be honest. If you’re going to lick this thing, you’re going to need to know what you are doing to promote it.

Don’t blame yourself. You didn’t start the illness, you just reacted to it by doing the natural thing, taking tender care of your partner and accommodating his or her natural needs. It was only later on that those needs became all consuming. It tricked you, until now. You’ve caught on.

Finally, get connected with the portions of your partner that remain illness-free. Look into his eyes and find his soul if you have to. Listen for that still small voice of vitality. Feel around for his strength. Once you’ve got a hold, don’t let go.

The next step is to take action against the illness and support your partner. This is why you need to be able to tell the difference. Everything else you do is going to be based on knowing friend from foe.


Are you a Partner or a Hostage?

Let’s sort this out:

Partners have choices.

Hostages have to do what they are told.

Partners can leave and speak.

Hostages are bound and gagged.

Partners share power.

Hostages have no power.

Partners compromise.

Hostages adjust.

Partners are trusted.

Hostages are checked up on.

Partners are loved.

Hostages are blackmailed.

Partners’ boundaries are observed.

Hostages’ boundaries are violated.

People take partners.

Illness takes hostages.

So, which is it? Are you a partner or a hostage?

Which do you have? A partner or a hostage?


When illness takes over a relationship, it can be tricky. It tries to make you believe it doesn’t exist. It tries to say everything is normal. Often it’s successful. When it’s successful, we call it denial. You don’t have to be the one with the illness to be in denial.

There are six varieties of denial.

Denial of fact

It never happened.

He doesn’t drink that much… She can’t be using cocaine… Everything’s fine, No, I haven’t been crying… My wife and I have this understanding… My husband can’t come to work today, he’s feeling ill… This black eye, oh, I fell into a doorknob…

Denial of responsibility

It is someone else’s fault.

He drinks because he’s been stressed at work… She wouldn’t do drugs if there wasn’t so much around… He’s been seeing hookers because I just haven’t been there for him like I should…She keeps forgetting to take that medicine, it’s prescribed so many times a day… He can’t help it that he’s depressed, he has a chemical imbalance…It’s my fault he hit me, I keep on provoking him…

Denial of impact

No harm is done.

At least when he drinks at home, I know he won’t get any more DWIs… Sure, she smokes pot every day, but at least it’s not heroin… We have an open marriage, I’m fine with it; I’m just not that interested in… She’s just having one of her spells… He hasn’t been out of bed in a week, but I’m taking care of everything… You should have seen what my last boyfriend did to me…

Denial of awareness

I didn’t realize it was happening.

He didn’t mean to drink so much, he must’ve lost count… No, I haven’t noticed those tracks on her arm… I’ve been so busy, I haven’t been home much… If she wants my help, she can ask for it…I don’t know how he got so depressed, it just happened…We were doing fine and then he just freaked out…

Denial of cycle

It couldn’t have been prevented.

He ought to be able to go out sometimes, just because everyone else is drinking, it doesn’t mean he has to… She’s doing great, no cocaine for a week, I guess she’s not an addict… That therapist was wrong, she’s not depressed, listen to her laugh… When we’re great, we’re great; when it’s bad, it’s very bad…

Denial of the need for help

We can handle it on our own.

He can’t go to rehab, I need him at home…I used to do drugs, but I stopped cold turkey; she can, too… Everyone gets depressed sometimes… If she can handle the deployment, she can handle it at home… We’re fine…


Feed the Person, Starve the Illness

I never could keep my Grandmother’s advice straight. It is starve a cold and feed a fever, or feed a cold and starve a fever?

It’s just as well that I can’t remember it right; modern medicine discredits the practice of withholding nourishment from any sick person, regardless of whether they have a cold or a fever. Therefore, I propose that we modify the old saying to something that actually makes sense.

Feed the person and starve the illness.

We’ve been talking about how illness can take over a person so that there is little of him left that is unaffected. When the illness is done with the person, when he is mostly overcome, then the illness takes over the relationship. Even the partner who is not ill herself can begin to act in ways against her own self interest. She will nourish the illness and starve the people in it.

You know what he’s like when he drinks too much, so why do you buy beer for him? She gets paranoid when you keep secrets from her and starts to imagine all kinds of wild things, so why do you withhold information? His doctor has told him that, at this point it’s detrimental to his recovery from back surgery for him to lay in bed all day, so why do you bring him things so he doesn’t have to get up? She’s been feeling sorry for herself ever since she lost her legs in that accident. She doesn’t believe she can do anything; so why do you push her wheelchair?

You do it because the illness talked you into it, even though it’s counter to the best interests of both you and your partner.

There are many more examples of how people feed the illness. In my last post we talked about distinguishing your partner from the illness. Now is the time to put that discernment to work. What are the things you do that serve the illness and dis-serve your partner? Be honest. Be ruthless. Get real.

This doesn’t mean that you stop doing all nice things for your partner. Feed the person. Identify those actions that make her stronger, that promote your bond. Continue to do those, or resume them if you have stopped.

Let there be no question about it, starving the illness is a brave thing to do. It won’t seem like you get any credit for doing it from your partner. He, after all, has already been overcome by the illness. He’s going to say he feels betrayed when you call 911 when he is suicidal. No one likes it when the guys in the white coats come for them, but it’s really his illness talking. When he’s in his right, true mind, he’s going to be glad that you made that call.

The fact that you have to take action against the illness is what makes the next step necessary. Get help. At times like these, you’re going to need support to do the right thing.


Getting Help

We’ve been seeing what happens when an illness takes over a relationship. The people in the relationship disappear and the needs of the illness consume everything. If you’re the person with the illness, your job is to recover. If you’re the other person, your job is to recognize the diseased portion of the relationship, stay connected with the healthy parts, and get help.

Once an illness begins to take over a relationship, never try to take care of your sick partner yourself. It’s too dangerous. It took possession of your loved one and now it’s coming for you. You need someone objective, preferably someone who understands the illness and its effect on relationships. Someone who isn’t afraid to tell the hard truth, but also someone who can say it delicately so people can listen.

It might be obvious that a sick person needs a doctor, but when illness is in charge, sick people don’t go. Illness does not like what doctors have to say. Illness would rather be in denial, so that it can work its evil in secret. (Although there are some special conditions like hypochondria and addiction to prescription medication that try to enlist doctors in the pathology.) You can tell how much your loved one has succumbed to the illness by how cooperatively he works with the people meant to help him. If it seems like he’s always fighting with them, it’s really the illness trying to defend itself.

If the sick person is working with a doctor, then the non-ill partner needs to, also. The non-ill partner needs to understand the illness and treatment. The doctor may need information about the condition that only the non-ill partner can provide. You, your partner, and the professionals need to form a team that works together, not in isolation from each other.

There are several factors that get in the way of a treatment team effectively working together.

The first is when the people who are supposed to treat the illness fall under its spell. Anyone who has ever been around an anxious person knows that anxiety is contagious. People dealing with the depressed often fall into despair. It’s easy to get inflexible when you try to cope with a rigid person. Husbands of addicts have been known to score drugs for their darlings, to keep them safe. Wives will wait on a husband hand and foot when he is supposed to get up and be active himself. Divisions are created between the people who are attempting to treat the illness and the ones facilitating it.

The second most common barrier is put up by partners who attempt to protect the sanctity of their marriage. They believe it’s a betrayal of their partner to get help, a violation of boundaries. To be sure, some ill partners will see it that way. He may be angry if you tell on him. However, the sanctity of the marriage has already been violated when the illness moved in and refused to leave. You’re not telling on him, you are informing on the illness. You’re not betraying your loved one when you send him to the emergency room, suicidal; you’re protecting him from a common enemy that has him bamboozled.

If your ill partner will get help to combat his illness, that’s very good. If she won’t, then that should not stop you from getting help yourself. Remember, you’re next in line to succumb to the madness. Meet your friend for coffee, unload to your family, make an appointment with that counselor, if only so you can keep things straight and stay in contact with a rational world.


Calibrating your Compass

Take a perfectly functional compass and put it in a room with an electromagnet and it will forget which way is north. It’ll point to the magnet because the magnet is exerting a force that it cannot ignore, far more powerful than that exercised by the distant, measly north pole.

When illness enters a relationship it exerts a force every bit as compelling as that magnet. You can do nothing without taking a look in its direction. It will alter your attitude, change your course, and make you forget yourself and your values. You can do nothing without checking with the illness first.

You must get free of that interference and recalibrate your compass.

If you’ve ever recalibrated a compass, you’ll know that, for a minute or two, the needle will spin around aimlessly until it finds magnetic north. You’ll be lost if you try to use it then and confused if you rely on it for direction.

When people free themselves of the effects of the illness, for a minute they feel similarly lost and confused. When they discern the illness, starve it, get help, create illness-free zones, take care of themselves, and take steps to their own growth, they feel as though they have lost their bearings. They don’t know what’s important anymore because they’ve been separated from their values for so long. Many go back to having their lives dictated by the illness. It is more familiar and comfortable.

To remain free, it’s important to stay with the process long enough to get your bearings straight. Reconnect with your values as you might find them in your religious faith, spiritual practices, the story of your life, the way you find meaning and purpose, or the things you told yourself you would never do.

The process my cell phone goes through to calibrate its compass gives us hints as to what this is like. Your cell phone compass probably works the same way as mine. In order for it to be correct, you have to tilt it this way and that. As you do this, a graphic in the phone helps you cover each direction completely. You fill up a circle as you tilt it every which way.

The process you will go through as you recalibrate your own internal compass is similar. You have to tilt briefly in every direction. Take a look around before you charge forward or go back. Take stock. Take inventory, first, before you move on.

Create Illness-Free Zones

If illness has taken over your relationship, there’s plenty that you can do, other than succumb to its evil yourself. Just because your boyfriend wants to get piss-drunk every time you go out, doesn’t mean you have to clean him up. Even if your girlfriend picks fights with everyone, doesn’t mean you have to make excuses for her. So your wife has MS and is bedridden, that doesn’t mean you have to be. Get out a little, be healthy, let your partner clean up his or her own mess. Create an Illness-Free Zone.

You can create an Illness-Free Zone in all kinds of places. If your wife is bedridden, the Illness-Free Zone can be the whole rest of the house. Remove all the machines, the medical supplies, the pills, all the stuff involved with the management of illness and confine it to just the spot where it needs to be. Redecorate the Illness-Free Zone to be an area of vitality. Put pictures on the walls and things that are involved with your other interests, activities other than caring for your sick wife. More importantly, keep those other interests. Go to your yoga class, play softball with the guys, stay connected with family as you would cling to a lifeline if someone handed it to you. Even more importantly, confine the attitudes of the illness to the sick room. Close the door on the hopelessness, the irritability, the dependence to where it has to be and don’t let it invade everywhere else.

If your sick, bedridden wife doesn’t want to be alone with the illness, confined to the room just as she is, then you’re very lucky. That’s a sign of health on her part, an indication that her whole personality has not been taken over by the illness. Create an Illness-Free Zone in her own sick room by removing all the medical objects you can off to the side, so that what she mostly sees are things associated with health.

Illness-Free Zones can be created in time as well as space. Play chess with her, watch shows together, let her take care of you however she can. Restrict actions related to care to certain necessary times of the day. Ban complaints of pain, grumblings about the doctor, screams of anguish to particular times when you ask how she feels. Lock up the illness, shove it in the basement, wrap it up in duct tape, and free the person.

If your ill partner is not a bedridden wife, you might have to be more inventive about establishing Illness-Free Zones. Alcoholic husbands, or angry, paranoid spouses tend to make messes and spread their illness everywhere they go. In that case, go somewhere they don’t go; somewhere they would never go. Most alcoholic husbands wouldn’t be caught dead at a tea party, so acquire a taste for having tea with your friends. Paranoid partners are apt to dislike therapists, so find a therapist and create a zone in that office where you can be yourself. If your husband drinks too much whenever you go out with him, don’t go out with him. He can go himself, while you go to your tea party. If your wife fights with your mother every time they get together, suggest doing something different for Thanksgiving.

Creating an Illness-Free Zone is really very easy, though it might take some imagination. It’s all about knowing the difference between sickness and health and drawing lines between them. It might look like a selfish thing to do, but it makes you a better caregiver and a more loving spouse. An Illness-Free Zone will ground you and nourish you so that you can better defeat the illness and maintain your relationship with the person you love.


Put On your Own Oxygen Mask Before Helping Anyone Else

You’ve heard it. You’ve been on airplanes when they go over the safety procedures. They always say put your own oxygen mask on before helping anyone else. I’ve never been in a situation in which the oxygen masks are needed, but I think it’s good advice. It’s even good advice when you’re dealing with a sick person.

There’s are lots of ways in which illness takes over a relationship, but the surest way is when the caregiver forgets to take care of herself. She becomes entirely preoccupied with what the sick partner needs. For good reason. The sick partner’s needs scream the loudest. They’re the squeaky wheel that gets the grease. Your needs can wait, you think.

No, they can’t.

I’m not talking about emergencies, of course. If a carotid artery is severed, then, yes, forget that you need to go to the bathroom. Call the ambulance and apply pressure to the wound. You can pee later. You can pee in your pants. In fact, you might be peeing in your pants anyway if someone’s carotid artery is severed in front of you. Other than carotid arteries, there may be a few other kinds of emergencies that require you to forget your needs completely; but not many. Not everything is an emergency. In fact, very few things are. I know, I used to work in an emergency department.

When I worked in the emergency department, I was the guy who handled all the psychiatric emergencies. There were the suicidal people who came in, the homicidal people the police brought in, the domestic violence people who wouldn’t settle down, the psychotic people who were about to fly off buildings. Often the people who brought them in, the friends, the relatives, and the Good Samaritans, were breathless with excitement and trepidation. People couldn’t wait to help. I had just the thing that would make them all feel better. I had a waiting room.

We even had a name for it: waiting room therapy. There’s a change for the better that occurs when people don’t do anything; provided they’re safe, of course. When you don’t do anything, your heart stops beating so fast, your adrenalin wears off. You have time to think, to talk, to reconsider options. When someone else doesn’t rush to solve your problem for you, you often solve it yourself, you discover your own abilities. You learn that you can bear most things, they are tolerable, you develop endurance.

It’s not like I purposely made people wait. Far from it. I was always gung-ho about seeing people in a timely fashion. Most of the time I was interested in learning about new cases and, even if I wasn’t, it was in my interest to conclude it. Sometimes I would see them when my bladder was bursting, when I needed to eat, when I should have taken a break. But all the waiting couldn’t be helped. We were in a emergency department, after all. It’s busy. It’s understaffed. There are a bazillion forms to fill out. That’s what people do there, wait. I was forced to learn the therapeutic properties of the waiting room.

When you rush to take care of your sick partner’s needs while neglecting your own, you are not only doing yourself a disservice, you are also doing a disservice to her. You don’t give her a chance to solve her own problem or, at least, to learn that it doesn’t have to be solved right away. If you make her dependent on you, she’ll resent you for it and her illness will get stronger. You’ll hold all your sacrifices against her, especially the ones she never asked you to make. Furthermore, by neglecting your own needs, you decrease your own effectiveness. How good a listener do you think I was when I took a case when I really needed to pee, to eat, or take a break?

So that’s why you should always put on your own oxygen mask before helping others, literally and figuratively.


What Walking Can Teach Us about Relationships

Stand with your feet comfortably together. If you’re going to walk, what do you do? You take one foot and put it forward until you throw yourself off balance. Then, when you’re ready to fall on your face, at the last instant, you bring the other foot up to meet it, until you are back in balance. Repeat this dangerous operation as long as it takes to get where you’re going.

What are you, nuts? Why would you throw yourself off balance and risk injury when you are perfectly fine standing in one spot?

Because you want to get somewhere.

Relationships are like that. You and your partner are like two feet. Standing together, things are perfectly comfortable, but you can’t stand there forever. You want to try different things, be someone different, do something with your life, develop, grow. It’s inevitable. You feel stuck standing in one place too long. It’s static, suffocating. The blood pools in your legs. It’s bad for the heart. It’s safer to be a moving target. You have to move or everyone else will leave you behind. Can you wait for your partner, your other foot, forever?

Sad to say, people do. It happens all the time.

Normal marriages cycle through two phases: comfort and growth, standing still and moving forward. When you first meet, you take great strides as you get to know and accommodate to each other. Then you are comfortable. Then one partner gets a wild hair to do something outrageous, uncharacteristic, and steps out into perilous space. In healthy relationships, they’re not afraid to do so, because they know their partner will follow. In healthy marriages the partner will come along and they will soon be back into balance.

It’s always one partner who takes the first step. People don’t often get places by jumping with two feet at the same time. Whoever takes the step sets the direction and the pace. The other has to follow.

In unhealthy relationships, people are afraid to change. They wait around for the other to be ready before they take a step. Conditions have to be perfect before they try. If they want to get someplace, they feel obligated to convince their partner to jump with them.

When illness enters a relationship, people get stuck waiting for their partner to change. If one of your feet is injured, the other foot takes the weight. You nurse the bad foot. You don’t go anywhere. Standing on one foot for a long period of time is very hard; just as hard as taking care of a loved one subsumed by illness, but you could do it a very long time if you thought you had to. People have done it forever.

At some point, even a broken foot will be mended. The bone will fuse together, but the muscles will be weak, the tendons stiff, and the spirit uncertain. You’ll put weight on it gingerly and there will be some pain even though the bone is fine. Your first steps will be tentative. You might not even try, but it’s important that you do, because the other foot has been bearing the burden and is getting tired. When illness takes over, people don’t try, even when they could. They avoid pain, dodge uncertainty, and let the other foot carry the weight, even when there is no need.

So, if you are the non-ill partner, in order to prevent illness from taking over your relationship, you will have to take a step. Distinguishing the difference between your loved one and the illness, getting help, creating illness-free zones, and putting on your oxygen mask are all important steps, but the most crucial is to grow. Don’t let the illness prevent you from growing. When he sees you change, he will have to follow along or be left behind.

How to be a Lookout

When illness takes over a relationship, it takes hard work to eradicate the intruder and eternal vigilance to keep it away. Relapse can be expected. When we are talking about addiction, it takes an average of seven real attempts before recovery feels solid and, even then, you won’t know if he’s going to need eight. Mental illness also tends to be episodic, and each new episode is worse than the last. People who have succumbed once to the allure of violence, sexual recklessness, self harm, suicide attempts, or self pity are more likely to do it again. Moreover, illness will often go into hiding when it feels threatened, so that what appears to be recovery is really a more pernicious hidden phase of the same madness that troubled you before.

You and your partner are going to want to beef up your security, stake out a perimeter, and set up a few trip wires to activate an alarm if the illness comes close again. Addiction, mental illness, violence, sexual recklessness, self harm, suicide, and the hopeless behavior that accompanies physical illness have such onerous consequences that you’re going to want a warning, so that you can take steps to prevent a reoccurrence. You and your partner are going to need a lookout. And guess what? As the partner not directly affected by the illness, the lookout will probably be you.

Here are your instructions:

Accept your assignment

You might be wondering, why do I have to be the lookout, watching out for her illness? Can’t she look out for it, herself? Ideally, yes, she should be looking out for her own illness. She should understand what triggers her and what loads the gun. She should have a plan to prevent relapse. But the fact of the matter is that she is more vulnerable to it than you are. When the illness tricks, it tricks her first. This particular illness was custom-made just for her, to sneak up in her blind spots. It fits her like a glove. It wasn’t custom made for you, so you can see through the deceptions more easily.

Paid professionals can help, they have the knowledge, they have the objectivity, but they don’t have the access you have. They don’t see your loved one on the weekends and at night when illness often strikes. They also, unlike you, have little to lose.

Can you resign from the security detail? Sure you can, but here’s the thing. The only way to do that is to end the relationship as you know it. We’re talking about divorce. You’ve probably already thought of that. Maybe you’re still thinking, unable to decide. Well, put this on your scale of pros and cons. If you stay, you are going to have to be a lookout, if only to guard your own interests. Are you ready?

Stay awake

Don’t give everyone the impression you are watching out for the illness and then fall asleep on the job. That’s worst than leaving the security detail, altogether. Don’t watch your alcoholic husband like a hawk in the first month of recovery and then forget about it later on. Don’t keep it up just until you get busy. This has got to be a priority. It’s tempting to believe that the hardest part of recovery is the beginning, but that’s often not the case. Many people in early recovery ride on a pink cloud and don’t run into problems until later on. The first anniversary of recovery, for one, is often a critical time. Don’t assume that the illness is only likely to return when things are hard. Sometimes good fortune can trigger it, too. The one thing that you can be certain of is that it will intrude when you are not looking, when you let down your guard and stop watching the door.

Patrol the perimeter

A good lookout doesn’t keep looking in the same place. You should understand how the illness arrived in the past, that’s the main thing to look out for. It is likely to come that way again. If, for instance, your wife gets depressed at Christmas time, then make preparations for Christmas time. Don’t let it catch you off guard. But understand, it can come other ways, as well. Factors present at Christmas that might result in depression any time there is busyness, family contact, alcohol use, overeating, darkness, or an imperative to be merry.

Don’t be deceived

Illness arrives in disguise. No one starts off drinking three six packs a day just to feel normal. No, they start off with a glass of wine at dinner, a beer during the game, or doing a shot with a friend. These things are all good things, there is nothing wrong with any of them in themselves. They are only evil because of where they lead. A good lookout sees through the disguises. Know the masks that your loved one’s illness wears. Talk about their masks with him in advance. Listen to what he knows about it.

The next section, When Illness Takes Cover, will have more about the cloaks illness puts on. Study it well.


A good lookout has got to be a little bit jumpy. You’ve got to be vigilant, but keep your finger off the trigger or you’ll shoot a friendly. When you see something that looks like the illness, seek confirmation before conclusion. If your husband keeps driving by that place where he used to score drugs, you should be seeing red flags. This may very well be the way the illness creeps up innocently. Your husband may be getting a contact high from just driving by, but that’ll lead to a real high. He might have already resumed using drugs, but hasn’t admitted it to you yet. You have reasons to be concerned, but don’t go in with guns blazing, accusing him of using drugs. No, get confirmation before you shoot.

One way of doing this is to ask him what it felt like for him to drive by his own drug house. Engage in conversation, not an accusation. If he is using, then he may well give you additional reasons to be concerned. If so, then put the reasons up for confirmation, also.

In the case of chemical use, you and your partner may very well find it helpful to use a home drug or alcohol testing kit to confirm your suspicions. It can provide an objective measure, so that you don’t have to rely on he said or she said. For this, or other kinds of illnesses, you may want to get a second opinion from a professional; sort of like calling in another lookout and asking what she sees. At any rate, ask questions first, and shoot later.

Don’t shine your flashlight in your partner’s eyes

In the past, you may have felt like you were a doormat for the illness to wipe its feet on. Now, you are no longer a doormat, you’re a flashlight. Use yourself as a flashlight to illuminate things, not to shine in your partner’s eyes. In other words, now that you have more awareness and a vital job, use this awareness and your role for the greater good, not to punish your partner or hit him over the head with his transgressions. Now that you are no longer a doormat, don’t start wiping your feet on your partner; it was not him who did all this, it was the illness; and now, by gratuitously punishing your partner, you are behaving no better.

Keep yourself safe

Don’t be so busy being a lookout, watching out for your partner’s illness that you get overcome by your own.

What’s that you say? You don’t have an illness? Everyone has an illness. You may not know what it is yet because it has not grown strong enough to overcome your defenses, but we all get to the point, when under sufficient stress, that the defenses break down. That’s when you discover your own tailor-made demons.

Maybe you know what your illness is. Either it took you over as much as your partner’s illness took over him, or you’ve seen small glimmers of it. If that’s the case, you know what to look out for. Don’t watch for it yourself. Let your partner be your sentry, just as you are his. Watch each others’ backs. He can see it more clearly than you can for the same reasons you are well suited to be his sentry. The only thing is, you have to tell him what to look for.

If you’ve been dealing with your partner’s illness for a long time, you probably worked very hard to keep yourself strong. Someone in the house had to function. The laundry, the cooking, the kids, the relatives, the shopping, and going to work don’t get done by themselves. You haven’t had the luxury of indulging in, or even paying attention to, your feelings. That doesn’t mean you don’t have them. You, too, are at risk. You may not be accustomed to relying on your partner for anything; she just hasn’t been reliable. That’s going to have to change. This is how you learn to trust her again.

There are many cases in which your particular illness makes it difficult for you to be an effective lookout. If you are excitable, paranoid, or pathologically suspicious, for example. Chicken Little and the Boy who Cried Wolf were ineffective lookout; there were just too many false alarms. Then there’s the cases in which his illness creeps up under cover of yours. You know you’re paranoid, so you don’t say anything; your partner, in his illness, accuses you of being paranoid and dismisses your report. It can get really confusing and difficult to know what to think. All the more reason to get independent confirmation. All the more reason to reconsider the terms of your relationship.

Raise the alarm

If you have been doing your duty as a lookout and patrolling the perimeter, there will come a time when you detect the presence of the illness. Then, after you get confirmation, you’re going to have to raise the alarm. You may not want to do it, no one wants to be the bearer of bad news, but this is what you’re there for. If the illness has given the two of you a lot of trouble in the past, you might not want to believe it’s back. If the illness has already taken over your partner, you might get an argument.

When you raise the alarm, follow the regulations on constructive conflict:

· Pick the right time and place

· Start with the easy stuff

· Stay relevant

· Learn something

· Acknowledge feelings

· Call the four fouls of an unfair fight: defamation, defensiveness, stonewalling, and contempt

· Don’t be evil

· Repair injuries

· Detect dreams

· Compromise

· Commemorate what you have accomplished

Go back and re-read my series on constructive conflict (you can click here) if you don’t remember how to follow the regulations.

Remember, relapse is the rule, not the exception. It happens. You don’t want to make it happen, it’ll happen on its own; but, when it does happen, you’ll want to learn something new from the experience, something that you can use against the illness if you take your post as lookout again.

Lookouts don’t steer the ship

You have a very important job to do as lookout, but remember, you’re just the lookout; you’re not the captain. It’s your partner’s life, remember. He’s the captain of his own ship, as you are the captain of yours. Don’t try to be the lookout and the captain at the same time.


When Illness Takes Cover

Your partner has stopped drinking, or drugging, or gambling, or whoring around, or whatever. Her depression seems to have lifted. His anxiety no longer makes all the decisions. She’s up in the morning and dressed when she needs to be. The illness seems to have gone away.

Has it, really?

You will be the last person to believe that it has disappeared. Everyone else will celebrate her recovery when you’re still waiting for the next shoe to drop. There’s a reason for your skepticism. You have the most to lose.

There’s another reason. Illness takes cover sometimes when it feels threatened. It’ll hide in the bushes and come roaring out when you least suspect it. Make no mistake, illness is cunning, baffling, and very, very patient. While your partner has been collecting key rings at his NA meeting, his illness has been doing pushups in the dark.

Illness prefers the dark. It likes to perform its dirty deeds in secret. The night belongs to Michelob. However, the illness is rarely ever a real secret. It’s kidding itself when it believes it leaves no trace. You can tell when the illness is still afoot if you are willing to read the signs.

Your partner hasn’t done the things promised for his or her recovery

If the problem behavior is gone, but he still hasn’t been to see a therapist, attended meetings, written that letter of apology, changed associates, or done any of the things he promised, then the illness is just hoping you wouldn’t notice.

The behavioral changes have been minor

The longer that illness has been part of the relationship or the more serious it has been, the more excited everyone will be when there has been a slight improvement.

She was drinking every day, now you’re thrilled that she cut down to once a week. He used to gamble away all his paycheck, now he only buys a few scratch-offs. He used to beat you, now he only puts holes in the wall. The underlying attitudes towards drinking, gambling, or violence have not changed; the only thing changed is the frequency and severity.

When gardeners trim bushes back a little, they call it pruning; it doesn’t destroy the bush, it makes it grow more. The same thing happens when only minor changes are accomplished. You wouldn’t be satisfied with your surgeon if you had a mastectomy and he left some cancer behind, so don’t be fooled by minor behavioral changes.

Other problems have arisen

Sometimes the illness plays whack-a-mole by extinguishing one problem behavior, only to transfer it to another. We see this frequently with addicts who will use one drug until the heat is on, and then switch to a different drug. Instead of scoring heroin on the street and using dirty needles, they get their narcotics from a doctor. You’ll think that’s an improvement, until they start to abuse those pills, too. The underlying issue remains.

Thinking has not changed

If the rationalizations that have justified the illness are still in evidence, then the illness has not gone away. He used to say he needed to drink, so he drank. Now, he doesn’t drink, but he still says he needs to. Guess what? He will drink again. If he were truly in recovery he would no longer believe he needs it.

No fence has been built

It is not enough just to change the problem behavior to eradicate an illness. You also have to know the route that it takes before it arrives. You need to put up a gate and shut out behavior that, in itself, is not problematic, but leads up to the problem.

Illness comes masquerading as something harmless so that you will not see it coming. Pedophiles start off by making friends with a child. There’s nothing wrong with making friends with a child, right? But, then they gradually groom the child to accept more and more sexual behavior. We protect children from pedophiles by not permitting them to live near schools. This is not because it is bad to live near a school, but it is bad for pedophiles to live near schools.

Authentic recovery means that you and your partner can see through all the disguises.

History is minimized

If the story your partner tells about the illness differs significantly from your own, then the illness is still lurking about. If she talks about her depression only in terms of her suffering and leaves out how it affected others, then she has not incorporated your point of view into her own. Her limited perspective is still all she has. She has an incomplete appreciation of the costs of her choices. She should be able to tell your side of the story as well as her own.

Your partner is withdrawn

If your partner is virtually unreachable, emotionally inaccessible, or sexually uninterested, then the illness may be in hiding. It doesn’t want you to ask too many questions, know too much, or get too close.

Your partner always seems to be angry with you

The illness may be blaming you for calling it out and challenging it. It may be using anger as a way to keep you away, off balance, and uninformed. Your partner may still be taking sides with the illness, against you.

You’re working harder at recovery than your partner is

You’ve been on your partner like white on rice. Ever since he had that affair, you’ve been monitoring his phone, checking his whereabouts, scanning his emails, opening his letters. You’ve met every single female acquaintance he has and gave them all the stink eye. You’ve scrutinized his expression when every waitress approaches. You’ve tried every new position he wanted in an attempt to reawaken your sex life. You found a therapist for him, set up the appointment, gone to every session, paid, and did the homework assignments. You are working harder than he is.

If he has not taken responsibility for change, then he will not make the right choices the moment your back is turned. The recovery is yours, not his. He is still chums with his illness.

You’re careful not to upset your partner

If you still feel like you are walking on eggshells, then maybe you’re picking up on something. You’re still getting bad vibes; not bad enough to talk about, but just enough to make you uncomfortable.

Your partner declares everything is changed

Your partner is not the one to judge whether anything has changed. When the illness fools people, it fools him first.

Your partner wants to move on and not get stuck in the past

That’s the illness talking, trying to convince you to not learn from the past. Truly recovering people remind themselves of the past regularly, so that they’ll not repeat it.

Your partner wants credit for improvements

An adult straightens the house every day. He scrubs the toilets when they need it and mops the floor when it’s dirty. He doesn’t expect a medal for it. He just does it because it needs doing.

A toddler tickles the furniture with a feather duster once in a while and everyone will fall all over him, saying he was very helpful. That’s what you do for a child. Is your partner a child?

When illness takes over: the less you do, the more credit you think you deserve.

In a healthy world: you don’t earn special points for doing what you should have been doing all along.

It’s still all about him (or her)

You ought to be happy, but you’re not. There still seems to be something wrong. Not only has your partner stopped the problematic behavior, but he’s been going to therapy, attending AA, writing in his journal, and getting in touch with his feelings. These are all good things, but he’s still as self-involved as ever.

Real change means taking action to being more loving, generous, caring, and empathetic towards others.

There are no signs

You looked over this list and you did not find a single thing that indicates the illness may be lurking. There seem to be no signs. Well, that’s your sign. If you are not seeing signs, then you’re fooling yourself. There are always signs.

The road to recovery is the same road as the road to ruin; you’re just traveling in a different direction. You pass by the same markers as when you were heading to ruin. You should be seeing them now and recognizing them for what they are. You should also be seeing some signs that indicate you are heading in the right direction. You should be seeing meaningful change.

Can It, Should It, Be Saved?

Should you be in this relationship to begin with?

Related questions are: Is it worth it to work so hard to save a relationship? Aren’t some beyond help? Might it be better to scrap it and start over somewhere else? What if you sacrifice everything to save your relationship, admit your faults, learn to listen, start therapy, quit all your bad habits and change into the person your partner wants you to be, and he doesn’t make his own changes? Will it be worth it or would you have become a better person for nothing?

Yes, it would be worth it, but let’s go on.

You say all your friends are telling you to leave. He’s a loser. There’re plenty of fish in the sea. Your parents claim they never liked him anyway. You regret ever getting involved with him. Wouldn’t it be easier to give up on relationships entirely and live out your life single and celibate?

Then, in the next breath, you say something I’ve heard time and time again, even in the most dysfunctional situations. You say it,

“But I still love him.”

I ask, but you are not sure what you mean.

What should you do? Can your marriage be saved?

I believe it can, in a manner of speaking. Any marriage can be saved, depending on what you mean by marriage.

The boundaries of the legal institution of marriage do not correspond directly to the concerns of the heart. There are plenty of people deeply in love who are not married and plenty of people married who are not and never have been in love. Furthermore, the language of the heart does not even correspond directly with the feelings of the heart.

The institution of marriage has changed greatly through history. In our own time, in much of the United States, we’ve seen it expand to include gay marriage. In the last two generations, women have risen to have equal rights within marriage. There is more cohabitating; more marriages between members of different races, ethnic groups, and religions; more divorces freely given; and more remarriages and shuffling and re-shuffling of child custody. Wives are almost as likely to earn as much as their husbands as the other way around. Guys are taking care of children and doing the laundry, although, perhaps not as much as they should to be equitable.

You would have had to have been living under a rock not to have noticed the revolution. The pace of this social change is probably accelerated, but the changes have gone on for centuries. Go back a couple hundred years and arranged marriage was the norm, as it often is in some countries today. Go back a couple thousand years and many men had more than one wife. Clearly, the human institution of marriage has many, many manifestations. Give us some more time, I think we will think of many more.

So, on one hand, you have the legal institution of marriage, codified and circumscribed by family, tradition, and religious authorities, like property lines in the middle of the sea. Then, on the other hand, you have the spiritual, or if you prefer, emotional, side. One is the map, the other is the territory. The one is in constant need of revision, it’s always out of date; the other is eternal, inviolable, and holy.

Spiritual people have, forever, testified to the sacred bonds of marriage. I don’t think they were referring to the forms of marriage that civil authorities legislate, or even the proclamations that lovers make. I think they’re talking about this other side, the part that is beyond words and defies explanation.

Stay tuned to the next post as I try to explain it.

Relationships are Eternal

Once you are in a relationship with someone, you will always be in a relationship with that person. It’s like the Hotel California, you can never leave. I don’t care if you never speak to her again, if you move to the other side of the world, put up a dartboard with her face on it, refer to her only as, The Bitch; you will always be in relationship. There will always be a corner of your brain, I dare say, a corner of your heart, that has her name on it.

This is doubly true if you are in photos in Facebook together. This is triply true if she met your parents. It’s quadruply true if you were married. It’s doubly, triply, quadruply true if you have kids together. You are hitched.

Love may not be eternal, but relationship is. The legal end of a marriage is not the end of a relationship.

Relationship, at its minimal level, means that your partner rents space in your head. You think of him sometimes, happily or unhappily, with fondness or regret. He’s part of your story and you are part of his. You have to account for him if you’re honest. You’ll be flooded with memories, good or bad, after the most trivial cues. He will affect the way you relate to anyone else. He will be an item to compare and contrast.

Former relationships rarely exist at this minimal level. Usually there are more feelings. Many more. They may be negative feelings. You might hate her, but there will still be feelings. At some point, time and time again, for the rest of your life, after the right buttons are pushed, you will be transported by your passions.

You’ve seen this in others. You’ve had beers with the man who, at the mere mention of his ex, goes on a ten minute tirade about the shrew. You’ve drained a bottle of wine with a friend who combs over every detail of her ex’s pervasive perfidy. These are people still in relationship even though their divorces are final.

By the way, love and hate are not that far apart. They are both intense. They are both very, very far away from indifference. You’ll never be indifferent about a former partner, no matter how hard you try to fake it.

If you agree that you will always be in relationship, then the question is: what kind of relationship will it be?

2 Responses to When Illness Takes Over a Relationship

  1. Thank you for this very detailed guide to navigating a partner´s illness. My boyfriend suffers from paranoid delusions and his illness has indeed, as you put it, “come for me.” There is much in your words that I find relevant and I think it will be helpful to us going forward. Jesse

  2. Thank you for thanking me. It’s feedback like this that keeps me going. I hope you know what keep you going, so the illness does not catch up.

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