Your attitudes and actions have a dramatic effect.

If your spouse were diagnosed with cancer or some other life-threatening illness, would you feel fully prepared to deal with the challenge? Virtually no one is.

Someone who knows what works—and what doesn’t—is Dan Shapiro, PhD, a psychologist who has battled cancer twice himself—and helped his wife recover from breast cancer. Here’s what he says spouses should doand should not do…*

YES, YOU CAN!

When you find out your spouse is seriously ill, it’s natural to feel overwhelmed by fear and confusion.

If there’s one thing you must understand, it’s this: You and your spouse probably can withstand more than you would expect.

Professionals who work with seriously ill patients see this all the time—the vast majority of patients and families do manage to cope, even those who were scared out of their minds at first.

What’s most helpful: Remind yourself that you don’t have to cope with everything all at once. Instead of worrying about the big picture, focus on what you have to contend with right now—the potentially painful procedure your spouse has scheduled for this morning or the bandage change you help with every afternoon.

Don’t Overdo Optimism

Some people are naturally optimistic, while others have a darker outlook often described as “realistic.” When couples are out of sync in this regard, friction can result.

What makes things worse is a belief that even a peek at negative possibilities can lead to relapse, complications and worse. The fact is, there’s no hard evidence that optimism makes a real difference in mortality from cancer—and except for some mental-health conditions, it probably doesn’t have a significant effect on other diseases.

Not helpful: Uncalibrated optimism from the well spouse—such as “I’m sure it’s nothing,” while waiting for test results…or “This new treatment is sure to work,” when the last one failed. If the patient’s fears turn out to be justified, it may be hard to forget your too-casual attitude.

What’s most helpful: “Survivor optimism”—a basic belief that”whatever results come back, whatever we have to do, wherever we have to go to get the best treatment, we’ll get through it, and we’ll make the best of it.”

You’re in It Together

When someone you love is scared or in pain, the natural response often is to try to “fix” it. But while this may make you feel better, your spouse may find it much more supportive if you simply show that you understand what he/she is going through.

Example: Your spouse may say, “My surgery scar really hurts!” Rather than responding with, “Let’s take you to the emergency room,” try, “That sounds so uncomfortable…You’ve been so brave!”

And if you’re scared yourself, you may try to keep up a brave front so your spouse won’t worry about you. But if carried too far, this can give the impression that you don’t care, which can be deeply injuring.

What’s most helpful: A balanced approach where you are honest with yourself about your feelings and share them with your spouse—at least some of the time. Don’t overdo gloom and doom, but be open enough about your fears and concerns to convey that we’re in this together.

Dealing with the Doctor

In many couples, it’s common for one person to be highly suspicious of doctors, while the other person tends to trust them and give them the benefit of the doubt.

If this sounds like you and your spouse, consider it a strength rather than a point of contention. By combining your beliefs, you can avoid extreme biases that may prevent your loved one from receiving the best medical care. (And the truth is, sometimes doctors are right, and sometimes they are not!)

What’s most helpful: Plan your doctor visits together in advance. Decide what each of you wants to know, who will ask which questions and who will write things down. You may need to assertively ask the doctor to stay long enough to answer follow-up questions from you and your spouse. When treatment choices must be made, you can help your spouse gather information and weigh pros and cons.

But remember: It’s the person who is sick who should ultimately make the decision.

Set Aside Time

It’s easy for a serious illness to dominate your life together.

What’s most helpful: Compartmentalize. Consider setting aside some time every week (it might be 10 minutes or could be an hour or more, depending on what you need to discuss) to focus on the “business” of your lives and how illness has impacted it.

This may include getting household chores done despite crowded therapy schedules or discussing financial issues. This will allow you to still enjoy your life together.

Even better: Also plan regular “date nights” or “date days” when discussion of illness is off-limits. Go out to a restaurant or a movie if you’re able.

A Word About Sex

Serious illness and its treatment can have a powerful impact on sexual function, but they needn’t put an end to intimacy.

What’s most helpful: Many couples rarely, if ever, talk about their sex lives when they are both healthy—let alone when one of them is ill. What will really help now is having the gumption to simply be candid with each other. Discuss how things have changed and how you can make the best of it.

Intercourse isn’t always necessary for satisfaction, and intimacy in all its forms can express your love and show your spouse you find him/her attractive regardless of change and limitation. Aim for a healthy dose of enthusiasm for new ways of relating to each other.

*This article does not address the complexities of dealing with a spouse who has dementia or some other cognitive illness.