Sunday, July 01, 2007

The Adult Loving Relationship Ills of “Nurse-Patient Relationships”

In my December 12, 2006 Post entitled “Being Romantic Involves Loving, Caring and Skills,” I said, “being romantic minimally requires three things: (1) you have to feel love (toward the person); (2) you have to care (about him or her and how they feel); and, (3) you have to have skills. Being romantic necessitates knowing how to be romantic.” Thus, when you love someone and are in a romantic relationship with him or her, when they need your help and ask for your help you take care of them. And in most cases, the same would be true if you needed their help, wanted their help, etcetera. The question, nonetheless, is: When does helping each other and taking care of each other become a “Control Issue” (which I discussed in my May 2, 2007 Post, “‘Control’ in Romantic Adult Loving Relationships”) and when does it become a dysfunctional control issue (which I discussed I my March 2, 2007 Post, “Functional and Dysfunctional Relationship Controls”)?

Sometimes individuals in a romantic adult loving relationship fall into a pattern in which “taking care of each other” almost becomes a necessity – a way of life – in their relationship. In most cases, moreover, it develops into a less than healthy, meaningful, “good” relationship. In one of the two companion self-help books I currently am writing with a colleague, Our Adult Loving Relationship, the current draft of Chapter Three includes a section entitled “Nurse-Patient Relationships.” Below is that section in its present form as I have drafted it:

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Nurse-Patient Relationships

“The two of us seem to have a wonderful loving relationship as long as one of us has something wrong with him or her!” said Regina during our first session.

Her husband, Carlos, quickly added, “Yes, we sure do know how to take care of each other when one of us is sick.”

I have repeatedly been amazed at the extent to which some couples will tend to fall into a relationship mode in which as long as one of them has a problem, is ill, needs help of some kind, or “has to rely on the other one in order to make it,” they have an excellent relationship. However, whenever a situation arises when both of them are “doing well,” then their relationship tends to have problems.

“Could it be possible, Dr. Emener,” they asked, “that in this little nurse-patient relationship that we have, we subconsciously try to perpetuate it?”

I said to them, “I do not know that I have the answer to that question, but I can offer you a possibility. One thing you might want to think about is that in your nurse-patient relationship the patient can’t afford to get well! It could be that both the patient and the nurse are perpetuating this relationship because the patient, for fear of being abandoned by the nurse, may not want to get well, and the nurse, for fear of not being needed anymore and therefore being abandoned by the patient, may want to make sure that the patient never fully recovers. Does that make sense to you?”

Regina said to me, “In other words, what you are suggesting, and this very well may be true for us, is that we may be feeling so incredibly insecure with each other that as long as one of us feels needed by the other person, then the other person will not leave us, and as long as one of us is sick and being taken care of by the other person, then we can continue to have the sense that the other person loves us and won't leave us.”

I turned to Carlos and asked him, “Does that make any sense to you?”

“Yes it does, and in many ways I think that’s what we tend to do.”

At that point, the two of them began to discuss the extent to which each of them feared that the other person would leave them and the extent to which at times each of them felt unworthy of each other’s love. As they began to feel more comfortable with each other and felt more trusting of their emotional commitments to each other, their “nurse-patient” game playing actually began to subside.

Earlier in this chapter, we were considering the various kinds of “dances” in which individuals in adult loving relationships can become involved. Essentially, the “nurse-patient relationship” is a form of dance: First I'll get sick and let you take care of me. Then you get sick and I’ll take care of you. This type of interaction in adult loving relationships assuredly can have numerous negative side effects, and when such a relationship pattern emerges it is important to pay attention to it.

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Trust me, there are numerous negative side effects of this kind of relationships. For example, in my first contemporary romance novel, My Sweetpea: Seven Years and Seven Days, as Troy continued to take care of Sheila, even when she didn’t need him to or want him to be taking care of her, she began feeling smothered and trapped. In my second contemporary romance novel, Fear of Feeling Loved, Marcia’s ex-boyfriend continually got into trouble – drunk and hung-over – and expected her to take care of him; understandably, she began feeling used and unappreciated. And in my latest contemporary romance novel, If Ever Again… It’ll be for Love, one of the main reasons Diane divorced her ex-husband was because when he said, “I’m taking care of you,” what she was feeling was, “you're just doing what you're doing to control me.”

Question: Have you ever been in a nurse-patient relationship?



Julia Phillips Smith said...

I'm in a perfect set-up for a nurse-patient relationship - my husband has rapid-cycling bipolar disorder - but we have never gone there. Instead, I get comments a lot of times about how both of us light up when the other one enters the room, how we hold hands like newlyweds, etc., etc. I think my husband and I have a stronger-than-normal romantic relationship because we never know when the bipolar thing is going to rear its ugly head. I could leave the apartment in the morning and come back to find the Invasion-of-the-Body-Snatchers version of my husband. Looks like him, sounds like him, but it's the bipolar version of him.

Because of that, we rejoice every minute we have together. Every moment is precious, every moment is special. And we're about to celebrate our 15th anniversary. Considering I once read that 95% of bipolar marriages disintegrate, we're proud of that.

It also helps that my husband is not your average bipolar person. He never convinces himself he's suddenly ok and won't need his meds anymore. He is very in-tune to his mood fluctuations and works VERY hard not to let his own disorder spill into another person's day. This comes from his having had an alcoholic father who didn't make that choice about his own moods. We have shared his reality with friends and family, so when they know he's 'having a bad time', no one tries to 'cheer him up'. Everyone accepts his reality and they go with the flow, because that's what we do.

And he is always in my corner, is my best friend and sees inside me. I never feel that I take care of him, that it's one-sided. Nurse-patient relationships are definitely about power and my husband and I recognize each other as equals. We wrestled at the beginning, just to make sure!

Dr. Bill Emener said...

Hello Julia,
Thank you so much for sharing the challenging details of your wonderful marriage. Fifteen years – oh yes, you’re well ahead of that curve! I am happy with and for you and your husband.
As you clearly point out, a bi-polar disorder, especially a rapid-cycling one, is a tremendous challenge. There’s no doubt that you and your husband love each other incredibly – but as you well know, it takes more than love to have a good relationship (especially when one person has a biochemical issue). Firstly, he is careful to stay on his medication – taking ones lithium regularly is certainly better than self-medicating with alcohol (as you also well-know). And not hiding your heads in the sand, you and your husband (and your family) appropriately and lovingly attend to the realities of his disability. “Denial” is a horrible river, no matter how beautiful Egypt itself may be.
And you are so on the money – nurse-patient relationships are not about love (which by the way is a noun)… they’re about insecurity, power and control.
I applaud both you and your husband, Julia – over the years you didn’t quit and you learned how to be loving toward each other and take care of each other without expecting or forcing each other to live in your shadows.
Thanks again!
With all best wishes for continued success and happiness,

Susan Hatler said...

Interesting post about the nurse-patient relationship. Don't think I've done that one. I do enjoy having my feet rubbed though, but it doesn't happen as often as I'd like ;)

Dr. Bill Emener said...

Hello Susan,
Thanks for stopping by and offering your complimentary and gracious comments.
There is a serious perspective to your feet-rubbing though… your hubby is rubbing your feet because (I assume) he know you like it, he feels good making you feel good, and if he doesn’t rub your feet your relationship is not in jeopardy. He’s doing it because he wants to… not because he feels like he has to. (And I would bet that you do similar things for him… “because you want to and it’s a win-win situation.)
I also sense that if you would like to have your feet rubbed, you tell him (albeit at times possibly subtly). That’s important… I love the cliché: “If you don’t tell me what you want, don’t complain about what I’m giving you.”
“Ah, yes… right there… a little more on the left side…” she softly said, her eyes again closing…
Thanks again, Susan,