Gary McClain, PhD, is a therapist, patient advocate, and writer who specializes in helping clients—as well as their family members and professional caregivers—deal with the emotional impact of chronic and life-threatening illnesses.

Family relationships can seem a lot like dances. The music plays in the background while everyone steps to the rhythm, using the moves that they have learned over the years.

But a chronic illness can shake up those dance routines.

Common family "dances": Do these sound familiar?

Mom and dad are always bickering. He complains about something she did wrong and she complains that he never does anything around the house. Hardly a week goes by that a blow-up doesn’t occur. The kids are getting used to the hollering.

One child is always having problems, and everyone else in the house seems to always have to jump in and fix things for them. It’s becoming easier just to do it for them than to help them take better care of themselves.

Two sisters, now grown up, have had resentments with each other since they were in high school, and as adults make it a point to alternate between ignoring each other and tossing out nasty comments at family events. And it wouldn’t be a family event without the tension they create.

Mom and dad constantly play good cop, bad cop. One gets mad and gives orders, the other gives in and makes everything okay. The children have learned how to work around both of them to get what they want.

Chronic conditions break the mold

A chronic condition has a way of giving us a push to look at life in a different way, whether we are the one experiencing the illness or a family member who is. Routines have to change. Family members have to get involved with each other in ways they never expected to. Maybe the “rock” needs the emotional support, and can’t jump in to help everyone else with their emotions. The givers have to do some taking. The takers have to give. The “listened to” have to do some listening.

Sure, illness presents a lot of communication challenges. But illness can motivate family members to look at what’s really important in a relationship. How we work together, how we don’t work so well together, how we help each other… and those patterns of communicating that are hurtful or dis-empowering.

And that perspective can cause us to question the value of our dances around, for example:

Being right for the sake of being right (over and over and over).
Always being the one being rescued, or doing the rescuing.

Picking each other apart with criticism and never offering praise.

Treating one family member like the bad guy or the loser.
Holding onto slights from the past and reliving them in the present.

Chronic illness provides an opportunity to relate to the people we love in new and more productive ways. We learn that the future is not promised and that the way things are today may be different tomorrow. The day-to-day challenges push us to develop new priorities. This may bring us to the realization that we don’t have the time or energy to play the old games with each other. To create a less stressful home life. To avoid unnecessary conflict. And to feel valued and to want other family members to feel valued.

The dances have to change. Chronic conditions cause life to change for everybody in the family. So maybe it’s time for some new choreography. How do you change those old established ways of dancing with each other? They change when one member of the dance squad decides to change up the way they move. That person can be you.

Ideas for changing the "dances"

Recognize your family dances. Take a look at how you communicate with other family members. Identify the family dances, the ones that make for a positive relationship and the ones that seem only to cause pain, over and over and over.

When the music starts, pause before you jump in. Ask yourself, is this a pattern that helps us to communicate better—that promotes teamwork and harmony—or one that gets in the way of communication? That might also mean not taking the bait. Responding to a criticism with “I understand how you feel,” or “Let’s let go of that,” can take the conversation in a new direction.

Suggest some new steps. Maybe it’s time for someone to lead the way away from those familiar but destructive dances. Decide to lead and not follow. Focus in on the issue. Identify what the other person seems to be doing. Ask, “Can we look at this another way and not automatically assume…?” or “How about if we stop… and try to be show more concern for each other?” Or maybe, “How can I help?”

Keep the tempo upbeat. Family dances are often anything but happy. You can change the tempo by staying optimistic and positive. Stay open to what’s possible instead of what seems impossible. Assume the best of intentions in other family members.

Remember that it may take time to learn new steps. A chronic condition is a new experience for everybody in the house. Everybody is on a learning curve. Be patient with yourself, and it will be a lot easier to be patient with everybody else. Compassion is a boomerang—send it out and it comes back to you.

Chronic conditions demand that we take a look at how we are living and create changes that promote well being. Family communication is a critical element in your self-care. Take care of yourself; take care of your relationships.

Next dance?