When chronic pain gets between you and your intimate partner

People living with chronic pain often turn to their intimate partners for emotional and physical support.  Partners may also be deeply affected by the chronic pain.   Providing support, every day, to someone with chronic pain can add a great deal of stress to a relationship.

What happens between intimate partners when one is living with pain?

Research with couples has shown that some people living with chronic pain report improvements in their intimate relationships, such as feeling closer, because they have faced a challenge together.  Other people report that pain leads to problems in their intimate relationships, especially difficulty communicating, and difficulty managing feelings like anger and frustration.

When a person with chronic pain feels distressed, the unhappy feelings and tension they experience may also crop up in their intimate relationship.  When this happens, several things may occur.  The care giving partner may become overwhelmed by their loved one’s pain and sadness, and find it is more difficult to provide support.  This in turn, may leave the person with pain feeling like they are not getting enough support. This can start a vicious cycle.  Many couples report that pain disrupts their relationship, limits what they can do together, and interferes with the quality of the time they spend together.

While pain severity affects the lives of people with chronic pain the most, care giving partners tend to be more affected by the mood and activity level of the person with pain.  That is, care givers may be more “tuned into” their loved ones’ feelings and activity level, rather than the severity of their pain.  When pain does not affect a person’s level of activity, and they don’t communicate any distress, their partner may not recognize the need for support.  The care giver may assume that everything is OK if they don’t see decreased activity, and a clear expression of distress.

Sometimes, when a person with pain feel distressed, they think more negatively about their lives, including their intimate relationships.  Negative thinking in a relationship can add stress and tension and leave both partners feeling angry or frustrated.  The care giving partner may become overwhelmed by their loved one’s pain and sadness, and find it is more difficult to provide support.  The person with pain may end up feeling like they are not getting enough support or attention.  Again, the couple ends up in a negative cycle of unmet needs, and unappreciated effort.

The time of day when pain occurs can also affect a couple’s relationship.  Researchers have found that when people report greater levels of pain in the morning, they report being more tired and less active during the day, and more problems in their relationships in the evening.  If a couple can recognize that it is going to be a “bad pain day” early on, and take steps to manage and cope with the pain right away, they may be able to prevent symptoms from worsening.  This may help the person in pain to be more active later in the day, and help the couple feel less stress in the evening.  While researchers are uncertain whether morning pain is more harmful to the health of a relationship than pain that occurs at other times of the day, effectively managing pain in the morning may prevent other problems in the evening.

Poor communication is the main problem

Poor communication, or lack of communication about pain, can also lead people living with pain to experience problems in their intimate relationships.  For example, poor communication about pain severity can lead a caregiver to underestimate or overestimate their loved one’s pain, and make it difficult to provide the right amount of help and support.  Sometimes a person living with pain may exaggerate their pain as a way to be sure they will get the help they need.  When under-estimation, over-estimation, and exaggeration occur frequently, couples may get frustrated, and each may withdraw from the relationship, or become angry.  Disagreements, bad feelings, and misunderstandings can easily arise from a lack of clear communication about pain.  Not knowing how severe the pain really is makes it harder to respond in helpful ways, and makes it more difficult to judge how helpful their efforts to support the person in pain have been.

What to do?

Couples who remain aware of the ways that pain can impact their relationship, and who actively work to maintain or improve their relationships while coping with pain, experience fewer problems and adjust better in the long run.  Many of the issues that pain can cause in an intimate relationship can be overcome with good communication.  Making time to talk about how pain affects your relationship is an important step, as is being open and honest with your partner.  Don’t assume you know everything that’s happening in your partner’s head before you begin a discussion.  Some couples benefit from counseling aimed at helping them learn how to continue to relate as loving partners, as opposed to simply relating to each other as patient and caregiver.