He Says I'm a Hypochondriac

Gwen has been plagued by one medical problem after another, but Alan can't stand to listen to another complaint. Can this marriage be saved?

Her Turn

"I am so lonely," sighed Gwen, 41, an attractive woman in jeans and a sweater. "I've been depressed for months, and whenever I try to talk to Alan, he zones out.

"Lately, I get the feeling he's avoiding me entirely, telling me he has work to do or pretending he's so exhausted when he gets home that all he can do is eat before flopping into bed. As soon as I open my mouth to say anything, Alan rolls his eyes. I can't even talk to him about something practical, like the fact that the roof is leaking. I just get that here-we-go-again look.

"His attitude infuriates me, and before I know it, I'm yelling and screaming. I happen to have some very real medical problems, and I don't appreciate the fact that he takes it all so lightly. We've been married for ten years, but I've started to wonder if he cares at all anymore.

"You know what really scares me? I'm afraid I'm becoming more and more like my own mother. She hardly ever talked except to criticize, to complain about her arthritis or relate some woe-is-me tale.

"Our family looked good from the outside — prosperous husband, good-looking kids, the whole white-picket-fence lifestyle. But inside the house was a different story. My father was a university professor in Indiana, where I grew up; he was also an alcoholic, and he died from the disease about 15 years ago. I never knew from one day to the next whether I would come home to the funny, open, encouraging father I loved, or the horrible, verbally abusive man I feared.

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"My mother, a housewife, never paid a whole lot of attention to me. I always felt I was somehow the reason for her unhappiness, and I still feel guilty. My two siblings were much older, so I felt like an only child. 

"I was a real extrovert, though still a good student. I got a master's in social policy and management, and moved to Washington, D.C., where I found a job in a government agency. After about five years I met Alan when we were assigned to work on a project for a Congressional committee.

"Alan was totally different from the other men I had dated. I used to fall for your drop-dead handsome guys who were basically jerks. Alan is good-looking but quiet and shy. We dated for two years and then got married and moved to Denver, where Alan is from.

"Alan went to work as a systems analyst for the energy company, and I started doing public-relations counseling and some freelance writing. Our marital problems started about two years ago, around the time my medical problems snowballed. First, I had two miscarriages, which were very hard on me; then I began an early menopause, which was horrendous. My gynecologist put me on estrogen-replacement therapy, but it took months to get the right balance.

"While I was still experimenting with the right combination of hormones, I developed fierce pain in my hands and hips that turned out to be severe osteoarthritis. An orthopedic surgeon prescribed an anti-inflammatory, which relieved the pain, but then that medication apparently triggered an underlying asthmatic condition. I know this is hard for Alan to deal with—his mom died of asthma and my condition is a constant reminder. He either tells me I'm a hypochondriac, or he simply gives me the silent treatment.

"Believe it or not, our sex life has been fine. We don't make love as often as we used to, since I'm in pain a lot, but at least in bed I feel close to Alan. I want to be close in other ways, too. I don't see how we can go on like this."

His Turn

"Gwen is probably right," says Alan, 35, a tall, lanky man who spoke slowly and chose his words carefully. "I haven't been very supportive of her. After two years of listening to one complaint after another, even a saint would lose patience. She's a hypochondriac, and I can't deal with it anymore.

"Gwen calls the doctor for any ailment — just in case. I think that's ridiculous. Minor ailments are things you put up with. She must have twenty-five prescription bottles in her side of the medicine cabinet.

"I suppose it all has to do with the way I was brought up. I come from a large family — six kids, including two sets of twins. My father was the town doctor, but neither he nor my mom was very caring. If you were sick, you were considered weak. If I fell off my bike, I would never mention it to my parents. We learned to tough it out. Dad's standard response to any injury was, "Well, if that's the worst that ever happens to you, consider yourself lucky."

"On the other hand, as the oldest boy I was his favorite, and I knew it. I adored him, too, even though, like Gwen's father, he was an alcoholic. Of course, we never said that in so many words, but we all knew. Dad was never physically abusive, but he was verbally abusive to Mother. We could hear them yelling at each other long after we'd gone to bed.

"When I met Gwen, I was struck by her energy and take on life. She was so much fun and so caring. I couldn't believe she was even interested in me. She's outgoing and all-American and I'm, well, bookish and kind of nerdy. For the first few years, I think we were both happy. Then Gwen's medical problems surfaced and, like I said, she obsesses about every little ailment.

"The night she told me about her asthma is a perfect example. I came home from work and she immediately launched into this lengthy explanation of how her doctor had told her she had a subclinical asthmatic condition. Now, to me, subclinical means not really much of a problem. I know she expected a lot of sympathy, but I just didn't feel it. This is a particularly painful subject for me since, fifteen years ago, my mother died of an asthma attack. My father had died a year before, and none of us was aware how serious Mom's condition was. So to hear Gwen go on and on about her barely existent ailment hit all my buttons.

"I can't stand her total self-absorption. I'm as lonely as she is, but I can't talk to her about anything. She has so many problems, I wouldn't dream of bringing up one of my own.

"Weekends are really hard for us. We can't get in sync. I don't particularly like to go out, but Gwen wants to fill up every minute. We hardly talk during the week, but Saturdays and Sundays we have nonstop arguments. I love Gwen, but I'm beginning to wonder if we're fundamentally incompatible."

The Counselor's Turn

"Dogged by chronic medical problems, Gwen felt angry, hopeless and without support," said the counselor. "What's more, she was convinced that she was responsible for the difficulties she was having with her husband. However, it soon became clear that Gwen and Alan were locked in a power struggle triggered by their very different styles of communication and resolving problems. Gwen's health problems had become a constant source of friction.

"Compounding their difficulties was the fact that, as children of alcoholics, both Gwen and Alan had learned to bury painful issues, pretending all is well. However, Gwen and Alan had different ways of coping: Gwen talked incessantly but superficially, often filling up the pauses in her husband's conversation in an attempt to connect with him. Alan, on the other hand, withdrew completely. His terse, black-and-white approach to solving problems was infuriating to Gwen.

"Gwen interpreted Alan's silence as rejection. In fact, maintaining an emotional distance or avoiding discussion altogether is often an unconscious strategy: Alan's withdrawal was a sign of his frustration at not being able to make her feel better, as well as the only way he knew to protect himself from her verbal onslaughts. However, by backing off from conversation he was also backing away from intimacy and, ultimately, from the marriage.

"Gwen's task was to learn how to approach her husband and ask for help in a way he could hear and respond to positively. Alan was to listen to the needs behind her words, instead of immediately pulling away. Couples can do this by learning a three-part communication technique I call 'braided dialogue.'

"In this technique, each partner first says how he or she feels, and then, after listening, adds additional information piece by piece, in much the same way you braid a child's hair. When beginning the dialogue, couples must use such phrases as 'I want, I would like, I'm concerned, I feel' instead of 'I don't want, I hate.'

"For example, if Gwen said, 'The roof is leaking, and I'm concerned we may need a new one,' Alan learned to say 'I'll take a look and then we'll see what our options are,' instead of ignoring her or saying, 'That's ridiculous; it's only leaking in one little spot.'

"Another important communication technique that these two had to learn was to stick to the pattern of 'yes, and…' rather than, 'yes, but…' Whenever you get in the habit of using the word but, you shift the original conversation away from one partner's initial concerns.

"Alan also used this technique to discuss weekend plans. When Gwen told him she had accepted an invitation to dinner with friends, he learned to say, 'Whatever you plan for the weekend is fine, as long as I have a few unstructured hours.' He had never made this straightforward request; instead, he'd say, 'I'll think about it,' which was in fact quite provocative to Gwen.

"About a year after they started counseling, Gwen's doctor thought she needed a full hip replacement. 'Alan really came through for me,' Gwen reported. And when Alan was more responsive to her pain, Gwen no longer felt compelled to give regular readouts of her condition. In time, she also learned to laugh at herself and to stop focusing solely on her medical problems. The fact that she and Alan no longer spent every moment fighting helped her accomplish this.

"Gwen and Alan ended counseling after a year and a half, having learned that conflict doesn't hurt a marriage as long as it's accompanied by communication, affection, humor and active listening."

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