Having an injury or developing a health condition that results in chronic pain can potentially cause a lot of stress within a marriage. Researchers have examined correlations between chronic pain and divorce. Here is a summary of what the studies found:
Many large-scale health surveys measuring the prevalence of chronic pain in the population have found associations between chronic pain and divorce. This has been the case across several different countries, suggesting the correlation to be a worldwide phenomenon.
For example:
- This large-scale 2011 study in Hong Kong found significant association between chronic pain and being divorced or separated.
- A 2004 population study in Norway found that a greater proportion of those who were divorced or separated had chronic pain.
- This large-scale health survey in the US in 2010 found that divorced/separated people to be somewhat more likely to have chronic pain.
- A large 2003 Danish health survey found that divorced or separated people had 1.5 higher odds of chronic pain, compared with those who were married
These health surveys of populations across the world appear to highlight the experience of many couples – the arrival of chronic pain can potentially place a lot of strain on a marriage.
In this post we’ll have a look at how chronic illness can affect a marriage, and whether the arrival of chronic pain means that a married couple will likely be destined for divorce.
How does chronic illness affect marriage?
Chronic illness can impact a marriage in many ways, including socially, financially and in terms of the traditional role of each partner. It can affect intimacy and marital satisfaction. Research shows that coping skills training for both spouses can increase the level of marital satisfaction.
Chronic pain can impact many areas of a person’s life. When someone is experiencing persistent pain, it can potentially cause them to struggle with some daily activities that they’d previously taken for granted.
Having severe pain can perhaps lead to them needing help at times with basic routine tasks or household chores. In a marriage, this can often mean that the spouse has to take on new caregiving duties.
It might also mean that a spouse becomes responsible for jobs or tasks that the person with pain was previously responsible for, leading to a change in roles.
People with chronic pain can find this challenging, as it alters this aspect of their self-identity around social roles. Perhaps they’d always been the one in the home who took care of everyone, while their spouse worked to earn an income to support the family.
In this case, the person with chronic pain will likely have to grapple with a new sense of self in relation to others. Meanwhile, the spouse has to grapple with all of the extra responsibilities, many of which they won’t be used to doing.
My post on relationships and chronic pain also covers how our sense of identity around social roles is affected by chronic pain.
“The family may adjust and make changes in roles to accommodate the individual in pain. Eventually, these changes in family functioning may become entrenched and difficult to modify.”
(Cano et al., 2005)
If one spouse is unable to work, it can have a huge impact on the finances within the household. Along with loss of earnings, there may be extra healthcare expenses, caregiving costs or specialised equipment needed for someone with severe chronic pain.
Financial strain has the potential to put pressure on the marriage, with loss of security and perhaps a big change in lifestyle.
This 2013 study with a large sample of adults with chronic pain in the US showed that employment status was significantly associated with marital status.
Aside from possibly affecting employment status and financial status, chronic pain can potentially impact a marriage in a number of other ways.
Chronic pain can be an isolating experience, both within a marriage and socially isolating in terms of spending less time with others outside of the home.
Within the marriage, it can sometimes be difficult for the spouse to fully understand the experience of chronic pain. They might not understand how severe persistent pain can affect a person’s mood.
When experiencing severe pain, a person may sometimes feel anger, frustration, despair or other challenging emotions, and it can be tough on them mentally at times. Their spouse may feel these feelings are directed at them, which can put distance between them.
Both partners may be experiencing grief. The many losses associated with chronic pain can interfere with the hopes and dreams previously imagined together.
Chronic pain also has the potential to affect aspects of sexual intimacy, which can further strain a marriage.
This 2006 scientific review of marital functioning and chronic pain found that the husbands of those with chronic pain felt more loneliness, stress, fatigue and had lower activity levels than husbands whose wives had no pain.
Spouses reported a decline in marital satisfaction after the onset of the pain condition. Sometimes the spouses reported more dissatisfaction than the individuals experiencing the pain.
Can a marriage survive when a person has chronic pain?
This seems like a whole bunch of bad news. Can a person’s marriage survive when they have chronic pain?
Couples say that they’ve become closer within their marriage after the onset of chronic pain. When they pull together to overcome the challenges, they say that the experience bonds them together closer than ever before.
“We’re fighting a common enemy.”
Researchers in this 2005 study looked into couples where one spouse had chronic pain, to find out what the topics of disagreement were between them. Sexual relations and demonstrations of affection were the most frequent topic of disagreement.
These topics of disagreement were followed by family finances, friends, household tasks, recreation, conventionality, religious matters, in-laws and time spent together, as the most often disagreed upon.
But the researchers point out that this 2003 study found a similar pattern around topics of disagreement in couples where neither of them had chronic pain.
If all couples (with chronic pain or not) are disagreeing over the same kinds of things, then why is chronic pain related to a higher likelihood of divorce?
“The chronic pain may make it more difficult to address and solve these issues. Couples may need help addressing the pain problem and other conflicts in their marriage.”
(Cano et al., 2005)
Couples have different ways of coping and dealing with the arrival of chronic pain. This team of researchers analysed the effects of chronic pain on spouses.
“Effects are related less to the existence of a chronic pain problem… but rather to patients’ and spouses’ manner of coping with the situation.”
(Flor, Turk and Scholz, 1987)
Coping skills training for spouses was reported to have led to long-term improvements in marital satisfaction and less distress for the chronic pain patients.
So perhaps the effect that chronic pain has on a marriage depends on how a couple cope with it. And the good new is that it’s possible to learn coping skills that can increase satisfaction within a marriage with chronic pain.
My post on chronic pain and relationships talks more about marriage and family.
conclusion
Population surveys from across the world show an association between chronic pain and divorce. It’s been a topic that many researchers have been interested to understand.
When one partner develops chronic pain it can impact on many areas of a marriage, although everyone’s experience of pain is different.
Couples with chronic pain show little difference between other couples in the topics of disagreement in the marriage.
Researchers found that couples vary in their ability to cope with the problems around chronic pain, and that coping skills training increased marital satisfaction long-term.
References
Cano, A., Johansen, A., B., Leonard, M. T., & Hanawalt, J., D. (2005). What are the marital problems of patients with chronic pain? Curr Pain Headache Rep, 9(2):96-100. doi: 10.1007/s11916-005-0045-0. PMID: 15745618.
Flor, H., Turk, D. C., & Scholz, O. B. (1987). Impact of chronic pain on the spouse: Marital, emotional and physical consequences. Journal of Psychosomatic Research, Volume 31, Issue 1, Pages 63-71. ISSN 0022-3999. https://doi.org/10.1016/0022-3999(87)90099-7.
Johannes, C. B., Kim Le, T., Zhou, X., Johnston, J. A., & Dworkin, R. H. (2010). The Prevalence of Chronic Pain in United States Adults: Results of an Internet-Based Survey. The Journal of Pain, Volume 11, Issue 11, Pages 1230-1239. ISSN 1526-5900. https://doi.org/10.1016/j.jpain.2010.07.002.
Karoly, P., Ruehlman, L. S., Okun, M. A., (2013). Psychosocial and Demographic Correlates of Employment vs Disability Status in a National Community Sample of Adults with Chronic Pain: Toward a Psychology of Pain Presenteeism. Pain Medicine, Volume 14, Issue 11, November Pages 1698–1707. ,https://doi.org/10.1111/pme.12234
Keefe, F. J., Caldwell, D. S., Baucom, D. et al., (1999). Spouse-assisted coping skills training in the management of knee pain in osteoarthritis: long-term follow-up results. Arthr Care Res, 12:101–111.
Leonard, M. T., Cano, A., & Johansen, A. B. (2006). Chronic pain in a couples context: a review and integration of theoretical models and empirical evidence. The journal of pain, 7(6), 377–390. https://doi.org/10.1016/j.jpain.2006.01.442
Rustøen, T., Wahl, A.K., Hanestad, B, R., Lerdal, A., Paul, S., & Miaskowski, C. (2004). Prevalence and characteristics of chronic pain in the general Norwegian population. European Journal of Pain, Volume 8, Issue 6, Pages 555-565. ISSN 1090-3801. https://doi.org/10.1016/j.ejpain.2004.02.002.
Sanford, K. (2003). Problem–solving conversations in marriage: Does it matter what topics couples discuss? Personal Relationships, 10, 97 – 112.
Wong, W.S., & Fielding, R. (2011). Prevalence and Characteristics of Chronic Pain in the General Population of Hong Kong. The Journal of Pain, Volume 12, Issue 2, 2011, Pages 236-245. ISSN 1526-5900. https://doi.org/10.1016/j.jpain.2010.07.004.