My Dad died of cancer at age 62, my mother decades later from a stroke following years of increasing dementia. So I have some experience being the adult daughter of a parent diagnosed with a life-altering medical condition. And I’ve also seen the faces of my own grown children right after they flew home to be with me right after my heart attack. Honestly, I don’t know which felt worse.
The majority of heart patients in North America have adult children. And when heart disease strikes, it can affect not only the patient, but the immediate family of that patient. If one of your parents has a cardiac event, as psychologist Dr. Wayne Sotile warns, you might have the makings of what he calls “the best hidden victims of heart illness: the patient’s adult children”. In his highly-recommended book call Heart Illness and Intimacy: How Caring Relationships Aid Recovery, Dr. Sotile offers wise counsel to both sides:
- to the adult children of freshly-diagnosed heart patients (who must now cope with this in-your-face reminder of a parent’s mortality)
- to the patients themselves on how to help all of their family members (and themselves) adapt to their diagnosis
Dr. Sotile also advises that regardless of the ages of one’s children or of the parents, highly stressful times (either during serious illness or just day-to-day life) carry with them the risk of what social scientists call “triangulation patterns” of behaviour.
Triangulation happens when mounting anxiety and tension in a relationship cause us to focus on a third party instead of on the source of the tension itself. It’s common in all human relationships, and not just in families coping with illness: the greater the tension, the more we want to draw other people into the mess.
How might this look in families coping with a heart illness?
An adult child might support the parent who is the most vocal about being mistreated or misunderstood by the other parent.
Or the adult child might side with the spouse of the heart patient parent by trying to soothe that parent’s anxieties and fears about the impact of this diagnosis on the marriage and their life together. In either case, warns Dr. Sotile, the adult child may develop closeness with one parent at the expense of closeness with the other.
Here are some problems with triangulation:
- interferes with the person’s ability to resolve differences
- puts family members into marked physical and psychological alarm due to conflicting loyalties between two parents
- can draw grown children so far into parents’ problems that their own lives suffer
- interferes with rehabilitation from illness
- may include several generations of children, grandchildren and other family members
This is even more complicated in couples already having marital problems before one of them was diagnosed with a serious heart issue. As Dr. Sotile writes:
“If a heart patient is having marital problems, tensions can increase the odds that one of more of your children will become involved in the drama.”
He also adds a truism that’s too often ignored:
“The drama will continue forever.”
We sometimes see examples of heart patient couples – particularly older patients – in which the heart patient appears to be less concerned about the diagnosis than the spouse does. The over-responsible spouse thus becomes the de facto cop in a relationship with an under-responsible patient/spouse: Take these pills! Quit smoking! Eat this! Don’t eat that! Hurry up so we’re not late for your doctor’s appointment! What do you mean you don’t want to go to cardiac rehab?!
Here’s Dr. Sotile’s suggested sample conversation, for example, in order to maintain a non-judgmental, non-reactive position if responding to a parent who complains about the “non-compliant” heart patient/parent:
“You know, Mom, it’s uncomfortable for me when you talk with me about Dad that way. I know you’re worried, and I do want you to feel better. But I love both of you, and I don’t know how to solve your problems.
“When I come to visit, I like it best when you and I talk about you and about what’s going on in my life. When I’m with Dad, I like to talk about him and about me. I don’t like to gossip about either of you to the other.
“So why don’t we talk about ______?”
Sometimes, says Dr. Sotile, the adult child can even feel like they’re becoming a counsellor to both parents if each of them (the heart patient and the spouse) turns to one or more of the grown offspring rather than to each other for support and encouragement.
Even well-intentioned Big Kids may be tempted to offer “parental” advice on how to deal with the problems affecting their parents.
If you have a parent who is a heart patient living alone, you may feel a unique responsibility to respond in a very specific way to help out. Some grown children like this may have become the primary emotional (and even physical) caretakers of such parents even before a cardiac diagnosis hits. These Big Kids can also become caught in a web of family stress during that in-between sandwich stage of life that involves attempting to fulfill their own career and family obligations while at the same time trying to remain loyal to one’s parent.
It’s also important to remember, adds Dr. Sotile, that for some grown children, stepping up to help out after a parent’s cardiac event does not necessarily come naturally:
“The unfortunate truth is that many adult children do not choose to be lovingly connected with aging parents; they feel compelled to do so out of some deep sense of guilt or concern. These uncomfortable feelings often fuel poor choice-making for grown children.”
Dr. Sotile has this advice for you:
- try to stay out of multi-generational emotional triangles
- speak openly and lovingly to your parent about your need to balance your energies among all your family members
- accept that you cannot be the perfect son or daughter even if your parents have difficulty believing it
- be loving
- be available
- be clear that your primary energies must be directed to living your own life
But his most helpful wisdom, in my opinion, was this reality check:
“No family fulfills all the glowing descriptions of healthy functioning, and no family is all bad. A steady state of perfection is never attained or maintained in family teams. Remember that ‘normal’ health families are those that continue to grow and change together.”.
Q: How has a parent’s heart disease diagnosis affected your own life?
NOTE FROM CAROLYN: I wrote much more about adjusting to your new diagnosis in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 20% off the list price).