Couples Counselling for a Cancer Diagnosis

When a person receives a cancer diagnosis it is like a tsunami has hit. One day you wake up and hear news which means life will never be the same again. It’s a shock and it’s surreal.

This article addresses the impacts on a couple, when one of the partners has been diagnosed with cancer.

What are the impacts of a cancer diagnosis on a couple?

• People process things differently and on different time frames, which means their emotional responses and needs are different. If you add extremely high emotion, fear, grief, and the disruption of normality, it’s understandable that misunderstandings, conflict and disconnection between a couple can occur.
• The person with cancer is often confronted by their own mortality, and can have a range of reactions to this that may not be ‘in character’.
• One partner may need to move into a carer role – which can change the dynamics in the family system and impact everyone including children.
• Couples may have to spend long periods apart while one is having treatment.
• The word cancer can dominate everything – every conversation, every major decision, every interaction with other people. This can feel all-consuming and confronting.
• The person with cancer can become anxious, depressed, negative and/or very demanding. Their partner may become extremely reactive to this, and feel they need to compensate or ‘fix’ things.
• The partner/carer can become highly anxious, protective and controlling when it comes to dealing with health professionals, family and friends. This can leave the patient with a lack of control or agency.
• Intimacy and sex are often disrupted between the couple.
• Social interactions are stopped for the couple. Lack of support, fun connecting with others can leave the couple feeling isolated.
• Couples can be in a state of constant hypervigilance when it comes to new information and scenarios leaving them both in a high state of stress.
• If there were already issues in the couple’s relationship, a cancer diagnosis can intensify them.
• Both people can feel guilty, lonely, angry, resentful, deeply sad and burnt out.

What difference can Couples Counselling make?  

The role of couples counselling is to support the couple through their cancer experience, providing a space to discuss difficult topics, make decisions, receive guidance and ensure that both the patient and the partner/carer feel supported and heard.

For the person with cancer:

• Couples Counselling can help them express their thoughts, feelings and wishes to their partner. In our work at the Sydney Couple and Family Specialists, we often hear the patient talk about their partner meeting their practical needs well but not their emotional needs leaving them feeling lonely. An example of this is when the patient is told to be positive when at times, they just want to communicate their fear, sadness, and stress about the situation.
• The process can help give a person with cancer some agency in a situation that generally feels out of their control.

For the ‘carer’

• Couples Counselling can support them to set boundaries, have their feelings heard, and ask for help – so they do not suffer burn out.
• It can give the carer ‘permission’ to have their own emotional needs heard and met. This is important as sometimes a carer feels guilt if they step away from their partner for a brea

For the relationship

• Clear communication is vital between the couple, and this should be a regular occurrence. This is where couples counselling really comes into its own because it’s designated time, away from the everyday demands of cancer, for the couple to have safe and productive conversations.
• Couples counselling can help the couple to stay connected physically and emotionally.
• This is not the time to solve family disputes or underlying resentments in the family – the couples counsellor can help you manage these family situations.
• It is vital that the couple takes time out (where possible) from the cancer to do “normal things”. This includes socialising with others where conversation and activities are not cancer focused. Couples counselling can help you find a way to do this.
• If there are children involved, it’s a good idea to look for a Couples Counsellor who is also a qualified Family Therapist. They can help a couple make sure their children are being supported.
• Couples counselling can help the couple with boundaries so that significant people in the journey have an opportunity to rest, have time out and support.
• Couples counselling can help the couple think about things they may need to address or put in place for themselves or for their children or significant others.

How do you choose a good Couples Counsellor for this situation?

 It is important that you find someone who you both feel comfortable with and who is able to hold a space that meets the needs of both partners.

If there are children involved, it’s a good idea to look for a Couples Counsellor who is also a qualified Family Therapist. They can help a couple make sure their children are being supported.

I think it is important that you see a Couples Counsellor who has life experience and ideally understands aspects of a cancer journey, but not someone who could be potentially triggered by your situation. Don’t be afraid to check this out in advance.

A cancer diagnosis is deeply distressing and disruptive, and it puts intense pressure on even the best relationships. Getting the right medical treatment is crucial, but professional support for the emotional impacts of cancer is important too. It can help a couple weather the storm of cancer, and come out the other side with a healthy, intact relationship.

About Jacqueline Jacqueline has been in private practice for more than two decades, helping individuals, couples and families.  She has extensive experience in couple and family therapy and is considered a specialist in these areas. In her clinical practice, she has helped people deal with complex trauma, affairs, complex mental health issues, eating disorders, adolescent behavioural problems (including self-harm and suicidal ideation), behavioural issues in young children which are impacting parents and families, relationship issues and post-separation work. Jacqueline works with many different dynamics: couples, parents, families with young children, same-sex couples, foster/adopted families, families with teenagers and also adult families.  She is particularly interested in helping parents of children with behavioural issues, or with diagnosed conditions such as anxiety, ADHD, ASD and so on. Although Jacqueline’s work is supportive and friendly, she will challenge her couples and families to make the necessary behavioural changes, to repair relationships and to move towards healthier communication styles in the future. Jacqueline’s style is direct and fast paced and she is known for quickly getting to the heart of the matter.  Clients report that they feel safe and understood with Jacqueline.