THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Transcripts: 553-2 & 553-3

Week: 553.2 Guest: Rhoda Levin, Counselor, Author of Heartmates, a Guide for the Cardiac Spouse and Family Topic: Changing dynamics in homes facing serious illness- Part One of Two Producer/Host: Steve Girard

NEMA: Let's talk about the way families can change when serious illness strikes...specifically, coronary disease and heart attacks. We're with Rhoda Levin, a counselor and the author of Heartmates, a Guide for the Cardiac Spouse and Family. Can you describe the changing dynamic of a household when a parent becomes a patient....?

LEVIN: There's the first shock of, "Wow, we're not this normal, healthy family that I thought we were". And then there are the lifestyle changes...there are the role changes...there are the communication changes, the patient doesn't usually want to frighten the spouse...so the patient will begin to withhold information, or they're in denial...and they want to look like they're doing just fine, and so they don't want to talk about anything that's going on. What's changed for the spouse is that the spouse is terrified that they're going to lose the patient. And so, the spouse is very overprotective, and wants to know everything....but doesn't tell the patient how terrified he or she is...because what we're trying to do is protect each other. Then there are role changes...kids having to take over the snow shoveling or the outdoor work because Dad can no longer do it. And the difficulty that that is emotionally for the father, it is a symbol of, or a metaphor for..."you're no longer whole"...that you're damaged in some way. And then there's the feelings that the kids have about either the over responsibility they feel to protect their parents...or the resentment that they may feel that their Dad is not perfect like other parents on the block. So, there are tremendous numbers and levels of shifts and changes that happen...that unfold over time.

NEMA: How do we deal with these changes...what is a good first step toward relaxing with the situation...getting a handle on what problems we're facing...and avoiding those feelings of isolation and helplessness....as you said, it's very tough to reveal everything to the cardiac patient, because you want to protect them....

LEVIN: Well, one of the things that I think is most important is for people to get that they don't have to do this alone...and they really can't do this alone. So, my recommendation is that they find someone who can be supportive of them. Often, you would like for it to be your partner, your heartmate...but it can't be, because of the different dynamics that are going on. So, it might be a clergy person, it might be a friend, it might be a relative, a sister, a cousin...because part of the healing, part of the grieving is telling our story, and making meaning from what has happened to us. And the second thing is, so often, I hear from cardiac spouses, "I'm feeling this, and I know that means I'm crazy and I need therapy". And the truth is they don't need therapy, they just need to understand that they're not isolated and alone... and the feelings and the reactions that we have to the experience are normal.

NEMA: As with any serious family issue, dealing with serious illness requires understanding and compassion all around, as everyone faces change and potential loss. Rhoda Levin's book is called HeartMates, a Guide for the Cardiac Spouse and Family, from Minerva Press at 800-946-3331. I'm Steve Girard.

Transcripts:

Week: 553.3 Guest: Rhoda Levin, Counselor, Author of Heartmates, a Guide for the Cardiac Spouse and Family Topic: When women are the cardiac patients- Part Two of Two Producer/Host: Steve Girard

NEMA: We're with Rhoda Levin, counselor and author of HeartMates, a Guide for the Cardiac Spouse and Family. Your popular and helpful book shows how being a cardiac patient affects everyone in the family, as they face changing roles when a father becomes ill. Are things different when a woman is the cardiac patient?

LEVIN: The new attention to women and heart disease is what led us to do a complete chapter in the revised edition of HeartMates for the male cardiac spouse. I think that all of the things that happen, happen even when the gender of the patient is different. For example, we have cardiac spouse who are men who are complaining that they are trying to do the housework for their wives, and all they get is criticism. It's the issue of, "my role has been taken away, the thing that I was in charge of, the thing that I was counted on to do"...and that's not necessarily conscious, but that happens and it causes strain between the partners...a shift in the whole family dynamic.

NEMA: We mentioned that the spouse should find someone other than his or her HeartMate to talk to...in order to sort things out without the pressures of the spousal relationship. What about the kids? Going to the parent is natural, but again you have those parental concerns, "what should I tell them, what should I hold back to protect them", and that may stand in the way of good communication and information....

LEVIN: It's very true that when the parents are in crisis, not only do the kids get it, but they can't ask the parents for that kind of support...the parents may not even realize that the kids are being affected in the way that they are. But what you can do is acknowledge to your kids that you know that they have needs and feelings that you're not equipped to deal with...and to help them reach somebody that is a person who can be a supportive person to them...it might be a teacher, it might be a coach, it might be a clergy person, it might be an uncle...you know, someone, that has a special relationship with that child or adolescent. Also, we need to think about the adult children, who are struggling in the same way...it doesn't matter if you're four or 14 or 40, that's still going to be a big issue.

NEMA: What are the signs that the family is not handling the pressures of the situation, and may need to seek counseling?

LEVIN: If you get it, that what you're experiencing is normal in a crisis, and that there is a normal process of recovery/grieving, that needs to happen, then I think that 99% of people don't necessarily need professional help. I think that if depression exists for a very long time...months, without relief in either the patient or the spouse, they need to contact their primary doctor.

NEMA: You also told me you have to keep your spirits up....

LEVIN: Nothing feels as good as being able to laugh. And also, to celebrate...that each milestone passed, each success during the recovery period needs to be celebrated.

NEMA: Learning to deal with serious illness is a tough job... resiliency and compassion go hand in hand with communication to get families through it ....you can visit with Rhoda Levin on the Internet...go to heartmates@aol.com