Dan Shapiro - And in Health: A Guide for Couples Facing Cancer Together

Shapiro is a triple threat: a psychologist who has been both a cancer patient and the spouse of a patient. He brings these perspectives to this terrifically helpful book that will assist couples as they face the challenges of serious illness. Lucid, practical, and informed by research and interviews with patients and their spouses, Shapiro provides a blueprint for managing the illness and succeeding as a couple.

Andrew Weil, MD, author of 8 Weeks to Optimum Health and Spontaneous Happiness

ABOUT THE BOOK

This book offers engaging and digestible lessons for couples navigating the life change that a cancer diagnosis brings. Dan Shapiro draws on his more than twenty-five years of clinical work as a health psychologist who has researched and worked with couples facing cancer, and on his own experiences of being both the patient (having and beating Hodgkins lymphoma in his twenties) and the supporter/advocate (when his wife was diagnosed with breast cancer) to weave together insights on facing cancer while maintaining a strong relationship. And in Health gives advice in short lessons on the main areas of concern or conflict that can come from life with cancerfrom diagnosis to treatment and life post-treatment.

Topics include:

• How to forge yourselves into a powerful team and evade common conflicts
• Dealing with physicians and getting the best care possible, along with tips for navigating the medical world
• Strategies for coping with the emotions that can interfere with your relationshipanger, mood swings, spouse fears, and depression
• Distinguishing between supportive and draining people in your lives, and learning to invite and accept help
• Opening to new types of intimacy and making peace with dependence

DAN SHAPIRO, PhD, is the Arnold P. Gold Foundation Professor of Medical Humanism and the Chair of the Department of Humanities at Penn State College of Medicine. He earned his PhD in clinical psychology at the University of Florida and went on to Harvard Medical School, where he completed his fellowship in medical crisis interventions. Shapiro is the author of Moms Marijuana, about his personal cancer experience, and Delivering Doctor Amelia, on his psychological treatment of a physician.

AND IN HEALTH

A Guide for Couples Facing Cancer Together

DAN SHAPIRO, PHD

TRUMPETER

Boston & London 2013

TRUMPETER BOOKS

An imprint of Shambhala Publications, Inc.

Horticultural Hall

300 Massachusetts Avenue

Boston, Massachusetts 02115

www.shambhala.com

2013 by Dan Shapiro

Cover design by Kathleen Lynch/Black Kat Design

Cover photographplainpicture/tranquillium

All rights reserved. No part of this book may be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.

Library of Congress Cataloging-in-Publication Data

Shapiro, Dan, 1966

And in health: a guide for couples facing cancer together / Dan Shapiro, PhD.First edition.

Pages cm

eISBN 978-0-8348-2890-2

ISBN 978-1-61180-017-3 (pbk.)

1. CancerPatientsFamily relationships. 2. Couples. 3. Caregivers. I. Title.

RC262.S458 2013

616.994dc23

2012043419

For Terry, who held my hand when the storms came.

And came again.

He is the cheese to my macaroni.

Diablo Cody, Juno: The Shooting Script

Contents

I am grateful to the many couples and individuals who shared their experiences and generously allowed me to tape and quote them. Notably, every person I spoke with contributed a piece of wisdom. Over the years Ive also learned a great deal from courageous patients who came to me for couples counseling. Their insights formed the backbone of the book. I thank Alma Jeanne Brandt and Dee Bailey, who transcribed all of the interviews. Dee Bailey developed an organizational scheme and while doing so noticed a few themes Id neglected, and those became chapters. Dr. Kimberly Myers read the entire manuscript and provided line-by-line suggestions and, as always, optimistic, practical, and insightful feedback. I am also grateful to my agent, Rebecca Friedman, who gave early input, and to my hard-working editor, Jennifer Urban-Brown, who helped sculpt the manuscript. Finally, I am grateful to my family, who are, by now, accustomed to being exposed in my writing and still live with me despite this.

Cancer will take you places you never thought youd go.

NANCY N.

She had a double mastectomy eight days ago. The surgery recovery has been painful, but now, for the first time in weeks, she feels frisky. And on a deeper level, she wants to feel sexy and attractive after spending the past week in hospital gowns tethered to IV poles.

Maybe these painkillers are loosening me up a little too. No matter, shes going to have some fun. She carefully puts on the black underwear he likes with the cut that runs high on her thigh and wears a sweatshirt so that she can still move despite the tight bandages wrapped around her chest over the drains.

When he comes back into the bedroom she makes that little music sound she makes when its time. The one they always joke about that sounds like an X-rated movie soundtrack. She stands near the bed and swivels her hips, throwing her long hair back even a little more aggressively than usual so there can be no mistake.

He hovers in the doorway to the bedroom and squints at her.

She makes the sound again, louder, and this time, swivels her rear while looking away.

Are you crazy? he asks her, gruffly. Damn, Susan, he says. He spins on his heel and disappears into the recesses of the house.

And with these five words her sexy mood evaporates like vapor in a desert. Suddenly, her chest throbs. She quickly changes underwear, pulls on sweatpants, and climbs back into bed. He will never long for me again, I will never be sexy again. He called me crazy. What does that mean? Am I crazy for thinking that all of my sexiness wasnt just in my breasts? This conviction etches itself into her consciousness and stings.

She forges a brave face for the outside world, but she knows that her sexual side is gone and it haunts her more than fear of recurrenceit is harder than the burn from radiation, and it chips away every time she sees a romantic scene in a movie or watches a couple touching at the real estate office where she works when she feels well enough. She doesnt worry that hell leave, but she tries to quietly say good-bye to that part of herself.

When I met the couple in my office, the dry had settled around them. It was a few months after treatment had ended. I gently asked each of them to describe their lives since the diagnosis, and on this, they agreed. It had been hell. Neither would talk much, which is uncommon in the beginning of couples therapy. Usually at least one member of a couple has a lot to say. I knew I couldnt barge in with recommendations until we shared a better understanding of their experience, so I went slowly and sent them on date nights to stoke up the romance. I told them that when they were ready, wed have some honest conversations. Before we could do that, we needed to find a small seed of affection and nurture it awhile.

And then about a month into therapy, while they were both outside raking leaves, he made the sound of that music. It had been more than eight months since theyd been sexual. Eight months of misery. She was angry at first, but then he looked so silly strutting around his rake, his flannel shirt flailing out like a girls dress. He offered his hand, and, confused, she took it, and then they were back up in the bedroom and it was awkward but OK, even though he didnt seem to know what do with his hands anymore. And after, in the quiet, the anger and hurt lifted like a storm and poured down.