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Living up to the "in sickness and in health" component of the wedding vow

Updated on August 12, 2014
Placing of the wedding band symbolizes a covenant between married couples.
Placing of the wedding band symbolizes a covenant between married couples. | Source

In Sickness

The wedding day is a special day in a person’s life. Some people cry while making their wedding vows. I have seen males and females cry. Most people would agree that couples while making their vows actually believe that they will be able to live up to them. However, despite making this covenant before god and others, many individuals seem to have difficultly complying with the “in sickness and in health” portion of the wedding vow.

According to experts, chronic diseases such as cancer are strong predictors of divorce in married couples.

A Fred Hutchinson Cancer Center research study revealed that the divorce and separation rate for cancer patients is 11.6%, matching the national divorce rate for the entire population. [1] However, the divorce and separation rate increased to 20.8 when the woman was the patient compared to 2.9. when the male was the patient.

A sick spouse needs love and support.
A sick spouse needs love and support. | Source

A Woman is more likely to Stay and Care for a Sick Spouse

According to one study a cancer diagnosis caused some men to feel abandoned and to feel need for a replacement. [2] Have you you ever found yourself in this position? As a Registered Nurse, I have seen many cases where the females were present in a hospital and fussing over their spouses who were diagnosed with chronic illnesses. Some would spend hours at the bedside. I know husbands who have placed their wives with chronic conditions in nursing homes when based on my professional evaluation, home care would have been a more appropriate option. In one case, I observed a young wife who kept her ventilator dependent husband at home and would not allow him to be institutionalized until she became financially unable to pay for his home care services.

There are some chronic conditions that may wreak havoc within a marriage that women are still more willing than men to tolerate. For example, HIV. How many men would stay in a marriage if their wives became HIV positive while they remained HIV negative? Magic Johnson’s wife stayed. Magic Johnson's wife is not the only one. I knew two young women whose husbands were diagnosed with HIV years after their marriages. Both women, who were HIV negative, stayed and cared for their husbands. On the other hand, I have seen one wife who was abandoned by her husband and forced to struggle alone after being diagnosed with HIV.

The wedding vow contemplates these moments.
The wedding vow contemplates these moments. | Source

Are Women More Compassionate than men?

The argument has been made that women are more compassionate than men. However, one expert believes that there are no differences in the level of compassion between men and women, just that women tend to report more of their experiences and may express compassion in different and more overt ways. [3]

Another argument is that because women usually assume the role of nurturers they are expected to stay even when their male counterpart would have abandoned them.

Some argue that a woman are more sensitive. Women may feel more guilt than a man in walking away from a sick spouse and may not be able to focus on a new relationship. Women cry more easily than men and are more difficult to console when they become emotional.

As a nurse, I have observed that women seem to have a greater ability than men to deal with wounds, feces, dressings, mucus, disfigurement and other health related conditions. A woman is more likely than a man to grab a bed pan in a hospital and offer to help a nurse provide care to her sick spouse. The fact that there are more female nurses than male nurses suggests that caring for others comes more naturally to women than men.

The nurturer theory above is corroborated by the Fred Hutchingson Cancer Center research study that revealed that the primary reason that men left marriages affected by cancer was because they were less prepared to assume the nurturing roles and the burdens of maintaining a home.

Despite the scholarly arguments that men (for whatever reasons) are more likely to abandon their spouses during chronic illnesses[3], there are still large numbers of women who are also willing to “throw in the towel” when the going gets rough.

As such both men and women need help in leaning how to abide by the "in sickness and in health" component of the wedding vow.

There is a mutual expectation that each person will live up to his or her wedding vow.
There is a mutual expectation that each person will live up to his or her wedding vow. | Source

How married couples can live up to the “in sickness and in health component” of the wedding vow


Married couples can live up to the “in sickness and in health component” of their wedding vow by developing empathy for each other. Empathy is the ability to recognize another person’s pain from his or her perspective. It is a departure from one person’s sub consciousness into the mind of another human being. An empathetic person is able to experience another person’s thoughts, experiences and emotions. Do not confuse empathy with sympathy. Sympathy allows you to show compassion about person’s distress without feeling the distress. In contrast, empathy allows you to internalize and feel another person’s distress.

The bond that is created by marriage is powerful. Couples with religious backgrounds are familiar with the biblical teaching that couples become “one flesh” upon marriage. Because married couples are merged into one being, it is logical to conclude that married couples have the greatest ability to feel each other’s pain.

Have you lost your empathetic capacity? If you have lost the ability to be empathetic you can regain it. Empathy is a learned human behavior as such you can be conditioned into becoming empathetic. [4]


In order to regain empathy for your spouse you should explore your feelings and ask yourself these questions:

  1. Why did I marry my spouse?
  2. What did I love about my spouse when we first met?
  3. Have I stopped loving my spouse?
  4. Can I separate my spouse from his or her illness?
  5. Is my spouse less of a person because of the illness?
  6. What is my spouse thinking about this situation?
  7. What are my spouse’s thoughts about me?
  8. Would I expect my spouse to support me during my illness if the roles were reversed?
  9. How would I feel if my spouse abandoned me due to an illness?
  10. What does God expect from me?
  11. What do I expect from me?

If you were able to answer these questions without deep contemplation, then you possess aspects of relational and cognitive empathy. Relational empathy allows you to act and process information based on a significant emotional relationship with another.[5] Cognitive empathy is the capacity to take on the perspective of another in order to understand his or her experiences.[6]

The final process requires temporarily stepping outside of your body into your spouse’s physical being. As such, after changing places with your spouse, try to convince yourself that you are the person diagnosed with the chronic condition. If you are feeling your spouse’s pain at this point, then you have developed emotional empathy and have come full-circle.

Loving husband dedicated his life to caring for a sick spouse who suffered a stroke


Make intimacy a priority.

If your spouse is still able to participate in intimate activities then set up a schedule for making love.

Be patient and never act as if you are trying to "get it over with."

Ways to Support a Sick Spouse

A sick spouse needs attention and support. Reiterate to your spouse that you will always be there for him or her. Share as much quality time possible with your spouse.

Depending on the level of debilitation you may support your sick spouse in the following ways:

  • Make intimacy a priority. If your spouse is still able to participate in intimate activities then set up a schedule for making love. Be patient and never act as if you are trying to "get it over with."
  • Sit by the bedside and hold hands
  • Give back rubs and massages
  • Work with a physician and pharmacist and make sure that your spouse is pain free
  • Get a wheelchair and take your spouse out of the house
  • Have meaningful conversations about your day, life and current events
  • Listen to your spouse as he or she express fears
  • Play cards or scrabble or other games that do not require physical exertion
  • Watch movies and listen to music together
  • Read to your spouse
  • Laugh together
  • Do not minimize your spouse’s role in the family
  • Include your spouse in all decision making

Smile, be there and show support.
Smile, be there and show support. | Source
Art can help release emotional tension.
Art can help release emotional tension. | Source
Group therapy allows you to interact with and share experience with others who are similarly affected by chronic illnesses.
Group therapy allows you to interact with and share experience with others who are similarly affected by chronic illnesses. | Source
Christians believe in the healing power of prayer
Christians believe in the healing power of prayer | Source

How to heal the emotional pain caused by a spouse's chronic illness

A chronic illness may cause changes in your daily routine. Remember that chronic conditions are difficult in all relationships. A chronic illness should not change who you are. The psychological pain caused from watching your spouse go through physical changes or pain associated with an illness is tremendous. However, keeping your feelings bottled-up will worsen the situation. These are a few suggestions for managing your pain:

  • Get counseling from a clinical psychologist. A psychologist will help you explore your feelings about yourself, your husband and your marriage. A therapist can also help you attain a higher level of functioning.
  • Share your feelings with other family members. Let family bear some of the burden.
  • Talk to close friends about your concerns. Friends are usually willing to help lighten your emotional load.
  • Discuss your feelings with your minister or priest. Spiritual leaders have the innate ability to understand human pain.
  • Explore with others to determine how your needs (that your spouse can no longer fulfill) can be met.
  • Contact other individuals who have sick spouses and learn how they are dealing with their situation.
  • Remember and cherish the good times.
  • Pray. If you are a Christian continue to believe that prayer heals.
  • Develop a hobby that does not require spousal participation. Example of suitable hobbies are:
  • Poetry: Poetry is a powerful tool. You can release stress and emotional trauma by writing poems and sharing your thoughts with others including your spouse. You don't have to be an expert to write a poem. Just start writing. According to experts, poems can help individuals soothe, heal and transform themselves. [7]

  • Painting or Drawing: Paint or draw when you are stressed and need release. You don't have to be an expert to paint or draw. Research shows that art can heal emotional injuries, allow self-reflection as well as change behaviors and thought patterns. [8]
  • Join a support group

Support groups: A support group will allow you and your spouse to meet and share experiences with others who are similarly impacted by chronic conditions. A support group will help you to identify coping mechanisms. Many support groups have volunteer psychologists, physicians and nurses with whom you can talk about a chronic illness. Some support groups also offer social activities and fun events that are therapeutic. Try to participate in as many events with your spouse if possible. This will allow you and your spouse to focus less on the chronic condition.

List of Support Group for people with Chronic Illnesses

Name of Support Group
Contact Information
1. Autoimmune Diseases Support Group of Boulder
Boulder, CO
2. A Healthy Billion in San Francisco,
San Francisco, CA
3. Chronically Awesome in DC
Washington, DC
4. Coping with Chronic Illness
Roscoe, IL
5. Chronic Pain Anonymous
San Jose, CA
6. Chronic Conditions Peer Support of MN
St. Paul, MN
7. Coping with Dysautonomia, POTS/(and other invisible illnesses)-
Grand Rapids, MI
8. DMV Pain Connections
Rockville, MD
9. DFW-area Hope-keepers
Richardson, TX
10. Entrepreneurs Living with Chronic and Invisible Illnesses
Providence, RI
11. East Bay Chronic Support Group
Berkeley, CA
12. Flight or Fight!!! MS Lady in Hamilton-Fights
Trenton, NJ
13. Howard County Fighting Chronic Illnesses with Resilience
Columbia, MD
14. Invisible Illness Support Group of Hampton Roads
Chesapeake, VA
15. MS Meet Up Get Involved
Cheshire, CT
16. Support Group for Breast Cancer and Other Illnesses
Merrick, NY
17. Project Hope
Denver, CO
18. Sonoma County Hope for Chronic Pain
Santa Rosa, CA
19. Transforming the Lyme Journey-Snohomish Support Group
Snohomish, WA
20. The Truth about Gastroparesis, Dysautonomia, Ehlers-Danlos
Laurel, MD
21. Michigan Fungal Meningitis Support Group
Milan, MI
22. NW Houston Mental Health Support Group
Tomball, TX
23. Positive Solutions Chronic Conditions Support Group
Minneapolis, MN
24. People in Transition
Denver, CO
Spend quality time together and become best friends. Don't wait for illness to occur
Spend quality time together and become best friends. Don't wait for illness to occur | Source

Find ways of Strengthening the marriage before illness occurs

According to the above mentioned research by the Fred Hutchinson Cancer Center, the likelihood of divorce in cancer patients was also affected by the length of the marriage. [10] This meant that couples who spent more years together were more willing to remain in the marriage and offer support.

As a married couple, you should find ways of strengthening your marriage to prevent the likelihood of divorce during an illness. Suggestions on keeping a marriage intact are as follows: frequently convey to your spouse that is or her feelings matter; learn what makes your spouse happy or angry; listen to your spouse’s concerns; give compliments and positive reinforcement instead of criticizing; learn your spouse’s expectations; don’t shout at or ignore your spouse; try to see things from your spouse’s perspective; don’t belittle your spouse; discuss parental responsibilities; manage financial responsibilities as a team; make time for each other; have fun together; attend church together if you are Christians.

Wedding rings
Wedding rings | Source


Marriage is a partnership that exists for better or worse during sickness or in health. Wedding vows should not be taken lightly. If you are contemplating marriage you should examine what you want from the relationship and determine how much you are willing to give or tolerate. Remember that empathy is a necessary ingredient to maintain a strong marital relationship.


1] Men leave: Separation and Divorce more common when wife is patient. CancerNews Retrieved on March 15, 2014 from:

[2] In Sickness or in Health-Does a Cancer Diagnosis Up the Divorce Risk. Retrieved from:

[3] Nauert R. (2009). Men More Likely to Abandon Partner during Illness. Psych Central. Retrieved on March 15, 2014 from:

[4] Emma M. Seppala, PhD. Are women really more compassionate. Psychology Today. Retrieved from:

[5] Suzanne Robin. My child is unable to show empathy. Retrieved from:

[6] Empathy. Wikipedia. Retrieved from:

[7] Empathy. Wikipedia. Retrieved from:

[8] Carroll R. Finding the words to say it: the healing power of poetry. Evid Based Complement Alternat Med 2005;2(2):161–172. [PMC free article] [PubMed]

[9] Stuckey H, Nobel J. The connection between art, healing, and public health: a review of current literature American Journal of Public Health. 2010;100(2):254–263. [PMC free article] [PubMed]

[10] Men leave: Separation and Divorce more common when wife is patient. CancerNews Retrieved on March 15, 2014 from:

Other Resource:

Updated March 15, 2014. Cecile Portilla

Do you believe that women are more compassionate than men?

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    • cecileportilla profile imageAUTHOR

      Cecile Portilla 

      4 years ago from West Orange, New Jersey

      Thank you for your comment Jtrader. I hope that my hub will help others.

    • jtrader profile image


      4 years ago

      This was really helpful Cecile. You have lots of practical things here that couples can do. Voted up and beautiful.

    • cecileportilla profile imageAUTHOR

      Cecile Portilla 

      4 years ago from West Orange, New Jersey

      Thanks for commenting billybuc! I too believe that this is a difficult topic for many people.

    • billybuc profile image

      Bill Holland 

      4 years ago from Olympia, WA

      I wasn't sure how to vote on the poll. I think women show their compassion more than men...not sure if that is the same thing. As for the sickness and in health issue, I have known some incredible people in my lifetime who believed completely in that part of the wedding vows, and it was a beautiful thing to see. This is an important topic; maybe one that many don't want to discuss, but important nonetheless.


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