Sunday, January 25, 2009

The Tie That's Stressed

When we take our vows, most of us think of them romantically. For better or worse (Insert image of him snoring, or an image of her frantic scrubbing when the in-laws are due.) For richer or poorer (Image of Caroline Ingalls leaving the cushy town life to follow Charles into the Big Woods, the Prairie and so on.) In sickness and in health. (An image of an elderly couple entering a retirement home together).

But very few of us are lucky enough to stay healthy until we're a ripe old age. And for some of us, that "sickness and in health" bit doesn't just refer to the common cold. Nor does it mean anything out of a Nicholas Sparks novel.

When diagnosed with food mediated illness, most people are given a few dietary pointers, a reassuring smile and a few lists to bring with them to the grocery store. They can buy as many cookbooks as they want and there are many support groups out there to help them learn to navigate society with a food restriction. But there aren't many guidebooks that address how devastating a food restriction can be to your relationship.

Your marriage partner signs up to love you despite your faults (and sometimes because of them.) He (or she) is supposed to be the rock that you lean on when you just aren't strong enough to go it alone, and in return, you are supposed to be healthy and strong when they need you most. This give and take is tantamount to any relationship.

So, what happens when one partner suddenly can't hold up their end of the bargain, for an extended period of time? Both partners are frustrated. The dishes don't get washed, the laundry isn't done "right" and a few bills might slip through the cracks. Tension mounts. Eventually, one or the other may get fed up.

It can be especially frustrating when a diagnosis takes a long time coming. Celiac Disease can take 11 years, on average, to diagnose. One study found that half the patients involved had suffered for 28 years from unexplained symptoms and abnormal lab results before finally being properly diagnosed. Although education among doctors is rising, and they are slowly chipping that average down, years upon years of "stress" diagnosis and trips to the hospital (not to mention the innumerable pit stops) wear a person, and a couple, down. The suffering partner may begin to doubt themselves, or distance themselves. They are embarassed at their weakness and their physical symptoms. (No one, and I do mean No One, wants their lover to know how much time the need to spend in the bathroom. Any abdominal attack is a huge romance killer.)

The healthy partner may be frustrated by their own helplessness, and after awhile start to resent their suffering counterpart. After all, most people bounce back after a bout of the flu. So why aren't they? They may harbor secret fears that there's something more sinister about the malady, or they may take the low road and suspect that the real culprit lies somewhere in the head, rather than the gut. Such a diagnosis is devastating to someone who is suffering.

Not only is it miserable to be sick day in and day out, but the one person you should be able to count on, the one person who you can let your hair down in front of and break down in tears of frustration or rage against the latest doctor who shrugged you off is your spouse. And if they suddenly "take sides" against you, then you really start to feel like it might be hopeless.

Then comes the diagnosis. There is elation, for both parties. There is an adjustment period. And for some, that's all there is. Sure, it will take two to prepare dinners and both spouses will need to double check ingredients and be willing to make sacrifices, but there's hope.

Unfortunately, not all couples are able to come together and be made stronger by suffering. And the resultant dietary restrictions (which impact the freedom of eating out, the customary food bonding rituals, the parties and many holiday traditions) make it difficult to find common ground. Most magazine articles dealing with the subject of how to re-connect suggest relaxing with a regular date night. A relaxing dinner out is great for some...but not if your allergies are severe or if you're still learning how to manage them. For dietary-restricted individuals, a restaurant meal can be a nightmare. And it certainly won't bring you closer if you can't relax.

There are numerous counselors who suggest that a spouse spontaneously bring dinner home, another nightmare. Chocolate? Well, if he gets the "wrong one" she might end up crying, and not with happiness.

Dinnertime conversation can be difficult as well. After years of suffering, and then a period of learning, food restrictions may be paramount in your mind or theirs. There is a steep learning curve, and most people share what they are learning and excited about. (Trust me, it's exciting to learn that you aren't "just" stressed.) Sometimes that learning period lasts longer for one spouse or the other.

Parents of food allergic kids have the added stress of trying to balance their approach to the restrictions. One parent may focus on simply keeping the child safe, while the other wants to make sure that they don't "miss out" on life. And sometimes, one parent takes a stronger role in educating themselves in the restriction. There are many cases where a parent of a food allergic child chooses to "fight" the diagnosis, to the child's danger and obviously the detriment of the marriage. Our allergist says he hates being called as a witness in custody disputes, because he doesn't know which parent is right. He can only state in a court of law the same thing he's told both parents in person...avoid the offending substance.

And yet, still there remains little emotional support for those who are dealing with food restrictions, especially food allergies. There are groups such as FAAN and POFAK; but these focus on educating the masses and encouraging the food allergy sufferer to continue to live. Very little effort is put into preserving a relationship.

After all, it's just food. And once you know the problem, you're healed. It sounds easy. And from a simply medical standpoint, it is. Problem identified, treatment initiated. Problem solved.

Well, one problem is solved, but that problem opens the door to several more.

I've known several people who go through a divorce or end a long term relationship and cite their food restrictions as the final straw, if not the trigger. Many healthy partners feel that they didn't "sign up" for dietary changes and restrictions. They have their own pressures in daily life.

They don't seem to see that just because their loved one is suffering doesn't mean that they can't be a sounding board. And they may have spent a long time dreaming about "when things get back to normal". Not only are they needing to adjust to the their partner's new diet, they have to deal with the staunch reality that it will never be "the same". Their dreams need to change, too. They need a mourning period, and unfortunately, they usually feel guilty for it.

I wonder why there aren't more support groups for spouses of food allergic individuals? Or couples counselling designed for couples who are dealing with dietary restrictions. Googling has revealed very little on the subject. Even asking for help just dealing with the emtional aspect of food restrictions reveals that there is not nearly enough known about the psychological aspects of not only imposing self will to protect yourself from well meant peer pressure (Pizza! Ice Cream!) but a prolonged misdiagnosis of "stress" or "eating disorder".

If we really want to help people with food restrictions, we need to address all their needs, and work with the loved ones who are supporting them, too.

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