Program applies couples therapy to heart patients

The bickering didn’t start until nearly 40 years of marriage.

But it soon escalated so much that Doug and Bonnie Main wondered if they’d be married much longer.

“She’d put something wrong in the dishwasher and I’d go in and change it. Just anything (started an argument) because we were so on edge,” recalls the 67-year-old Doug Main.

“We were fighting a lot. We were wondering if even our marriage was breaking down. And this is just because we’re both anxious about the same thing.”

Neither was willing to address the elephant in the room: Bonnie’s health was failing.

After decades of heart problems, doctors said it was time to consider a transplant. Last year, the 67-year-old was put on a years-long waiting list and told to stay within three hours of the Ottawa Heart Institute.

Doug eagerly stepped in to take on more domestic chores, and that’s when the arguments started.

The couple needed help, and they found it last fall in a pilot project at the institute, which focuses on strengthening marriages and romantic partnerships.

Healing Hearts Together is an educational program based on the groundbreaking work of Ottawa psychologist Sue Johnson, who says marital strife is a little discussed possible side-effect of serious health problems.

“You can give people little booklets to take home when they’ve had a heart attack but the bottom line is, when they go home and they don’t know how to talk to each other and they start having enormous fights, well forget it,” says Johnson, whose book on marital bonds, “Hold Me Tight,” forms the basis of the program.

“It makes no sense for us to pour money into giving people leaflets and … not give them anything at all to help them go home with their partner and learn how to face this problem together.”

While support services are generally available to patients and caregivers individually, it’s rare to find something geared towards couples, says Johnson, who hopes to make Healing Hearts available to every cardiac program in North America.

Johnson says survivors are much less likely to have a heart attack if they are in a strong relationship. The program’s approach to couples therapy has also been adapted to help people with Parkinson’s disease in Tennessee and diabetes in the Netherlands. She’d next like to see it help those with breast cancer.

Relationships can change drastically after a traumatic health scare.

Psychologist Heather Tulloch notes that patients are often put on new medication and encouraged to exercise, reduce stress and change their diet. It often falls on the spouse to make sure those things happen.

“There’s a lot of role changes and testing of identities. And people cope differently,” says Tulloch.

She says patients often want to get their affairs in order and worry about the burden placed on their spouse. The spouse, meanwhile, can be wracked by fear their partner will die.

Doug Main knows that first hand.

“You’re laying in bed and reach over and touch her to see if she’s still breathing. It’s really hard,” he says.

“I watch her and say, ‘You sure you should be doing that?’ Because the doctor said don’t let her get over-tired because she has no reserves left in her heart, so you’re constantly (wondering): How far do I let her go? When do I intervene?… And of course I don’t want her to feel like an invalid.”

Meanwhile, Bonnie Main felt unable to discuss her health fears freely, knowing that if she cried it would upset Doug even more.

But his concern over her health was also hard to take.

“I’ve always been one to do a lot — running with the kids here and there and everything — and for him suddenly to want to do the cooking for me and do everything for me, or say, ‘Don’t go up and down the stairs,’ you know, then I really felt confined.”

Tulloch says that’s why a program like Healing Hearts is sorely needed.

“The goal is to help them work better together, help them communicate better together, enhance that relationship so that if they are coping differently that we can get them back on the same page so that they can manage their health better.”

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