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Prostate Cancer & the Man You Love

Talking to Your Partner in Times of Crisis

by Anne Katz, RN, PhD

Prostate Cancer Image

So you’ve been with this same man for 10 or 20 or even 50 years and you each know how the other thinks, right? Per­haps at times you even say the exact same thing at the exact same time and you both laugh at how well you know each other. But when illness occurs, those automatic and familiar ways of communicating often don’t work any longer or as effectively. Times of crisis require great communication, not just good communication; these times re­quire the use of words rather than looks or telepathy.

Studies have shown that the partners of men with prostate cancer are often more distressed than the men themselves. Cancer changes everything – how con­fident we are in the future, our notions of certainty in the world – and prostate cancer has the added stressor of affect­ing masculinity and the sex life of the couple. Death and sex are two difficult topics to talk about – and prostate can­cer brings both to the forefront.

Over time, our communication patterns become entrenched, and not always in a good way. One of you may be the “talker,” and the other the “silent partner.” In times of stress, the talker may need to hear what the other person is thinking or feeling; he or she may need the silent one to be more communicative and sharing. But the silent partner may find solace in keeping quiet and trying to figure out things for him- or herself. So the talker talks more and demands more, and the silent part­ner withdraws more and more. These are old patterns that are not effective in new and difficult situations.

Before you start talking, figure out what exactly you want to talk about.

Author of Article photo

Dr. Anne Katz

The meaning of the illness can have a significant impact on the communi­cation of the couple. If the man treats the disease as a minor inconvenience that will be dealt with quickly and effectively with surgery but his partner interprets the diagnosis as a threat to his life that therefore puts her at risk of becoming a widow, you can see how they would think about it quite differ­ently and, of course, talk (or avoid talking) about it differently too. Want­ing to talk, and in turn avoiding talking, can reduce relationship closeness and increase distress. It is in times of stress and crisis that partners need to be con­nected to each other, what we call relationship intimacy, but communica­tion problems can drive the couple apart. This is why it’s important to actively work on improving communication.

Make time to talk.
Whatever needs to be said is important, so treat the con­versation like you would a meeting or appointment. Sit down together with no distractions: cell phones off, house telephone going to the answering machine, and TV and radio off – not just on mute. Sit down; you’d be sur­prised at how standing to talk makes the conversation feel intimidating to some.

Talk in “I” statements.
You’ve probably heard this a thousand times – but we often talk about what the other person has done or assume what he is thinking and we are completely wrong. When you start a sentence with, “You make me feel …,” the other person feels picked on and will naturally get defensive. A much better way of saying something is, “I feel so alone when you keep quiet and don’t tell me what you’re thinking.” This puts the emotion (and blame) on yourself and allows the other person some wriggle room instead of feeling like he’s in a corner of the boxing ring and you’re in front of him, swinging away.

It is in times of stress and crisis that partners need to be connected to each other.

Name the problem.
Before you start talking, figure out what exactly you want to talk about. That might sound a little silly, but we often avoid these conversations, and so when we eventu­ally have them, we can’t really remember what the major issue is. We instead present a smorgasbord of issues to our partner, and this feels overwhelming and even threatening. Is the issue that you are worried about him because you don’t know what he is thinking? Or are you mad at him because he opted to just watch his cancer instead of treating it aggressively?

It sounds simple, and I bet you thought you were doing that all along. But we often don’t really listen to what our partner is telling us, and we often don’t pay attention to his body language and nonverbal behavior. After you’ve said what you want to talk about or what is bothering you, make a conscious effort to stop talking. Silence can be uncomfortable for many people, and if one person just keeps quiet, the other one will often jump in and say something to break the silence. But when he starts to talk, don’t jump in. If you just let him talk, he will tell you what you need to know, most of the time.

Be flexible in your response.
You may not get exactly what you want from the conversation – he may be determined to avoid surgery, and if you give him a chance, he’ll tell you why. It may not be what you want to hear, but you’ll be hearing it from him, and that was the point of having the conversation in the first place.

Avoid nitpicking.
There is a big difference between having a fight or argument and slowly and consistently picking away at minor issues without seeking resolution. Pick­ing on multiple small issues instead of ad­dressing one or two (or even more) big issues is not productive. It may cause him to withdraw even fur­ther and leave you feeling frustrated and bitter.

Control your emotions.
This is a difficult one because you may be very upset and worried and frustrated, and when you start to talk, you may cry or shout or hyperventilate. Remember that men, particularly those of a certain age, have been taught how to respond to others’ emotions by the messages they received growing up as children. Their tendency is to “suck it up” and not show their emotions, so they have a hard time dealing with emotion in oth­ers. It makes them feel helpless and they don’t know what to do, so they often withdraw, which is exactly what you don’t need.

Concerns stemming from a diagnosis of prostate cancer may very well challenge the way you and your partner function as a couple. But with good communication, you can get through this difficult time together.

♦ ♦ ♦ ♦ ♦

Dr. Anne Katz is an author, a sexuality counselor at CancerCare Manitoba, and an adjunct professor with the Faculty of Nursing at the University of Manitoba in Winnipeg, MB, Canada.

Excerpted with permission from Prostate Cancer and the Man You Love: Supporting and Caring for Your Partner, by Anne Katz, RN, PhD, copyright © 2012 by Rowman and Littlefield Publishers, Inc.

This article was published in Coping® with Cancer magazine, July/August 2013.