Medical issues

I did postdoctoral training in medical family therapy at the Chicago Center for Family Health and Advocate Illinois Masonic.  I’ve worked with individuals, couples, and families around a range of chronic and acute medical conditions, including infertility, cancer, IBD, traumatic brain injury, dementia, narcolepsy and diabetes.  If you are coming to therapy because of challenges arising from a medical issue, you can expect that I will incorporate whichever of the following elements are relevant to you:

• Collaboration with other health care professionals:  I may want to talk to your doctor and others involved in your care to understand your condition, prognosis, treatment plan and side effects of medication.  It is important for everyone on a treatment team to be working together, but unfortunately our fragmented medical system doesn’t always encourage this.  I can help you bridge communication among various providers if necessary, and we can discuss strategies to empower you around effective communication with those providing treatment.
• A family systems approach:  Illness never affects just one person in a family, but everyone.  Whether it is a parent in a distant city desperately worried about their adult child’s cancer diagnosis, or a child who has witnessed a parent go into a diabetic coma, illness shapes interactions and responses.  Sometimes fear produces rigid emotional responses in us that make it difficult for families to productively and respectfully express their love and desire to help.  Sometimes families become so over-focused on the ill person that the needs of others become neglected.  I can help you think about which family patterns are helpful in dealing with an illness, and which are not.  Illness can provide families with opportunities to learn new ways of interacting, to become newly flexible.  I am always awed by the way our love for each other can force us to grow and learn.
• A human development approach:  The challenge of illness is different at different stages of the life cycle.  A serious diagnosis in childhood can cause families to completely organize around a child’s illness, which can make normative childhood experiences hard to obtain.  For adolescents illness complicates the normal process of seeking independence.  Coping with illness while parenting brings a whole host of questions about information management – how much should a child know?  How much does a child need to know?   I help my clients think about how illness is impacting their developmental needs and those of families, and come up with creative strategies to meet those needs while respecting the demands of treatment.
• A life cycle of illness approach:   Illnesses come with different challenges at different stages.  The emotional and relational skills needed to cope with the crisis of a sudden heart attack are very different from those needed to cope with the daily maintenance of congestive heart failure.  I will help you identify which skills you have and which you want to develop, and your family’s strengths and areas of potential growth, so that you can operate as your best selves at all stages of coping with disease.

Acute or chronic illness affects not just the patient, but everyone in the family.  Just as I do with individuals, I base my approach with couples and families dealing with medical issues on collaboration with other health care professionals, a family systems approach, a developmental approach, and a life cycle of illness approach.  Much like fertility counseling, my approach with medical issues will explore the following:

• How illness interfaces with the outside world:  Couples and families need to negotiate how and when they will interface with the outside world around an illness.  Sometimes one person wants much more or less privacy than others in a family, for example.  Sometimes an illness progresses to a point where a family that has successfully cared for a patient on their own needs outside help.  Illness can affect custody schedules, childcare needs, the ability to plan outings with friends and families.  People who have never relied on others may suddenly find themselves in need of help.  All of these things are normative challenges brought on by illness, and with some flexibility can be handled with grace and ease.
• How illness affects family relationships:  Illness can turn certain things upside down in familial relationships.  Power dynamics can become askew when one member of a couple becomes ill.  Children may need to take on new responsibilities.  Often these changes can bring with them emotions of guilt, anger, or resentment.  These are all normal challenges that can feel super-charged and exacerbated by our feelings about the illness itself.
• Making major decisions regarding disease:  The opinions of family members often differ radically regarding such things as ending treatment, seeking second opinions or experimental options, preparing wills and health care directives.  Mediated conversations with a therapist can help family members approach one another around delicate topics, lower the heat around highly charged topics, and ensure that everyone gets to say their piece.
• Exploring how the illness is affecting the couple relationship, and whether old wounds are making it difficult to effectively mobilize around the illness.  Sometimes “stuck” places in a relationship can make it difficult to tackle issues around medical care.  Acknowledging and working on these places can help to move forward in illness management.