O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

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Amour: Keeping Marriage Strong After a Stroke

How Marriage Can Survive Health Problems

The French film Amour is a touching, realistic window into the world of a committed marriage in which one partner has suffered a stroke.

The elderly couple are music lovers, their apartment chock-full of music books, records, and CDs, plus a concert-size grand piano. Yet the film has no musical score, just the mundane sounds of everyday life. The couple’s need to cope with change is so profound that the music of life fades, replaced by the clinking of forks against plates, sweeping away crumbs from the kitchen table, or shower noise as a caregiver washes Ann’s back. The story gently unfolds, depicting the couple’s commitment and love as the outside world shrinks, startlingly magnifying their life lived in three rooms. There is no shaking of fists at their plight, no angry outbursts from either partner.

How Stroke Affects Marriage

When giving talks on how stroke affects marriage, I say, “When one partner has a stroke, both partners have a stroke.” The stroke survivor grapples with loss of bodily function, speech, and often dignity, and the caregiving spouse must come to terms with the magnitude of the change in their lives.

A stroke can alter two people’s lives in an instant. For the person with the stroke, simple tasks suddenly become difficult or impossible. For the person’s partner, life revolves around the stroke survivor’s needs, requiring many adjustments.

And while stroke (like any chronic medical problem) affects marriage, it can also open a gate to improving communication and building and strengthening skills that were taken for granted.

Empathy on both sides is needed for the marriage to survive. Learning new ways to communicate fondness and appreciation serve as protective factors. Building new rituals of connection and remembering the positive aspects of your marriage before the stroke are necessary to keep your relationship healthy.

Coming to Terms with Suffering

While stroke can create strain, frustration, and distance in your marriage, coping with its effects is an opportunity to reset your priorities and goals. You may be able to strengthen your marriage as you and your spouse work together on common problems you will face. It is by accepting the limitations that life imposes on us that we can overcome them. As we learn to carry our burdens well—in the yielding and in the striving—we become whole.

Viktor Frankl was a psychiatrist who survived the Holocaust; his parents, brother, and pregnant wife did not. In his remarkable memoir, Man’s Search for Meaning, he discusses how people face unavoidable burdens. Why did some crumple beneath the horrors of the death camps, while some comforted others and gave away bread?

“When a man finds that it is his destiny to suffer, he will have to accept his suffering as his task; his single and unique task. He will have to acknowledge the fact that even in suffering he is unique and alone in the universe. No one can relieve him of his suffering or suffer in his place. His unique opportunity lies in the way he bears his burden. . . . The way in which a man accepts his fate and all the suffering it entails, the way in which he takes up his cross, gives him ample opportunity—even under the most difficult circumstances—to add a deeper meaning to his life. It may remain brave, dignified, and unselfish. Or in the bitter fight for self-preservation, he may forget his human dignity.”

I do not mean to minimize the great accommodations that must be made in marriage when a stroke occurs. But there is a phenomenon seen in marriage counseling that often predicts good prognosis; therapists term it “glorifying the struggle.” This describes a couple that comes to therapy with a crisis, but they can talk about how they see the struggles that they have gone through as ways to grow and that they can grow together. The likelihood of that couple being able to keep their marriage whole and strong is better than when there is bitterness and resentment toward their marriage struggles.

Of course, sometimes caregivers can’t look after a stroke survivor at home. In Amour, the husband was the caregiver until he could no longer tolerate bearing her pain for her. In the United States, if a caregiver is no longer available and/or funds have run out, the best option is a skilled nursing facility (or SNF in the medical jargon). But in many families, life must go on: living together, but with tremendous challenges for both partners.

Ways to Cope When Stroke Strikes

Here are some issues to consider in coping with the aftermath of a stroke.

1. Spousal support: This is a powerful aid to stroke recovery for several reasons, including a spouse’s ability to improve the stroke survivor’s mood and increase physical and social activity levels.

2. Role changes and division of labor: Most couples must change their usual division of labor. Tasks and duties that were previously performed by one spouse may need to be reassigned. Outside help should be considered when possible.

3. Emotional support: High levels of emotional support lead to the best possible recovery after a stroke, and support is most effective when it is seen by the stroke survivor as meeting his or her particular emotional needs. Empathy—your ability to see things from the other person’s perspective—is important for both partners. Even a stroke survivor with speech problems (aphasia) can still listen. To truly listen is a great gift, even when your replies are non-verbal.
4. Counseling and group support: Both partners can benefit. There are many great agencies that offer classes following a stroke, and ongoing groups to help maximize coping.

In the best of circumstances, marriage is challenging. When couples face chronic medical problems such as stroke, the marriage vows -in sickness and in health are tested to the limit. Compassion by both partners for each other, as so tenderly shown in the film Amour, is imperative to preserving love.

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10 Things Parents can do to Help Their Kids Engage in School

 

Helping your child in school
Monday can’t come fast enough!

My daughter posted this photo and comment on her Facebook page after purchasing her textbooks for winter term. She is a full-time senior at a university and works part-time at an independent bookstore. Yet she can’t get enough of reading and learning. Her twin is equally passionate about learning. After seeing my daughter’s Facebook post, I reflected on what we did to encourage and support their love of learning.

We survived the homework battles and our daughters are now months away from finishing their undergraduate degrees. It wasn’t always easy. We didn’t have many of the challenges that some families face, like those with ADHD, depression, anxiety, or medical problems, but over the years we found ways to support them in school.

In his February 15 New York Times editorial, David Brooks commented on President Obama’s agenda for getting kids better prepared to start school by providing early educational opportunities before kindergarten. Brooks wrote:

Today millions of American children grow up in homes where they don’t learn the skills they need to succeed in life. Their vocabularies are tiny. They can’t regulate their emotions. When they get to kindergarten they’ve never been read a book, so they don’t know the difference between the front cover and the back cover. . . . This is rude to say, but here’s what this is about: Millions of parents don’t have the means, the skill or, in some cases, the interest in building their children’s future. Early childhood education is about building structures so both parents and children learn practical life skills. It’s about getting kids from disorganized homes into rooms with kids from organized homes so good habits will rub off. It’s about instilling achievement values where they are absent.

The Importance of Reading

These are lofty goals in a world where there is much inequity in income, lifestyle, and education. Raising kids is challenging in the best of circumstances; just getting dinner on the table after work can be exhausting. But even families from affluent homes struggle to find time for family when screen time takes over or heavy work schedules make direct parental attention scarce.
A good story is captivating even to unpracticed readers. A friend of mine volunteers at a juvenile hall a couple of times a week, reading books for incarcerated teens. Many of these kids have never been read to. She tells me that in the five years she has done this, no kid has complained. Many are there for weeks at a time and so they hear bits of the stories and look forward to the reading even without the benefit of continuity of the story.
David Brooks is saying something important: raising kids who possess the necessary skills to find jobs or go to college requires not only affordable educational opportunities but family involvement as well.

What can you do to help your child in school?

1. Read to them every night. Start when they are very young, and continue until they ask to read out loud to you. They will stumble over words, one page taking a long time to finish, but stick with it and try not to show impatience. (In the long run, it’s a lesson in more than just reading.)

2. Talk about what you read. Discuss what the characters might have been feeling or doing.Reflect on the stories together.

3. Continue reading as a family; take turns reading aloud to each other. There are many young-adult (YA) books that are great for adults—look at the worldwide popularity of Harry Potter among readers of all ages. My daughter’s bookshop holds an adult book group that meets monthly just to read YA titles.

4. Download books or borrow the audio CDs from the library and listen to them on car rides and in place of video games, movies, or TV.
5. Make a place for study and homework (this could be just the kitchen table) that is a dedicated quiet area: TVs and smartphones off.

6. Limit and monitor all screen time, including texting, gaming, and Facebook. Screens can consume inordinate amounts of time for all family members, but just as in marriage, turning away from preoccupations and toward your child in little and big ways every day will help them feel loved.

7. Make a family plan about how much is okay and stick to it—adults, too. Some families do well by limiting TV/screen time to one hour a night once all schoolwork is complete, but not too close to bedtime. Save the hour before bed for quiet time—reading or listening to books—or talking about the day together.

8. Keep growing and learning through hobbies, reading, classes, or learning to play music. Follow your own passions and your child will see that learning throughout the lifespan is valued.

9. Never let your kid have a TV in their bedroom. This will surely lead to nighttime TV, inappropriate shows, or staying up late—leading to trouble getting up for school the next day.

10. Eat together several times a week. Having dinner conversations that are not forced or stiff is a skill. Don’t just talk to your kids but to your partner as well.

We weren’t always perfect but we tried to follow these guidelines, and now we are enjoying our daughters as they graduate from college—entering the next chapter in their lives.