Katie Willard Virant

Family is powerful. Within families, we discover who we are and what we can expect from other people. We learn how to navigate group identity (how we are alike) and individuality (how we are different).

Family relationships spark joy, sorrow, anger, tenderness, and everything in between. It makes sense, then, that the illness of a family member affects and is affected by the family system.

A family resilience perspective recognizes the importance of family in managing stressful life events like chronic illness. Resilience—defined as the ability to live well in the face of challenges—is a quality that families can cultivate. A family resilience perspective acknowledges that every family has strengths and limitations. Developing resilience involves building on these pre-existing strengths and shoring up limitations.

Let's walk you through an analysis of your family's resilience. You’ll be asked to think about the strengths and limitations of your family concerning coping with chronic illness. Taking stock of where you are will allow you to identify where you would like to be.

Analyzing Resilience in Three Domains of Family Functioning

Resilience in families can be analyzed over three domains: family belief systems, organizational patterns, and communication processes.

Family Belief Systems. Every family has complex belief systems. Some beliefs are conscious; others are unconscious; and sometimes family beliefs contradict each other. In the context of chronic illness, family beliefs about illness and adversity become relevant.

Take a few moments and reflect on your family’s beliefs. Is illness feared? Accepted? Minimized? What factors do your family believe cause and cure illness? In general, how does your family make sense of suffering?

You may find that your family holds multiple beliefs, some of which contradict each other. Some beliefs may be stated; others may be unspoken but communicated obliquely. You may be ashamed of certain family beliefs. Try to be honest and nonjudgmental as you sort through your family’s belief systems around illness. You want to understand the full, complex picture.

Now go back in time and reflect upon your family of origin’s beliefs about illness. What messages did you receive as a child? Which beliefs have you carried forward into adulthood? Which beliefs have you discarded?

If you have a spouse or partner, ask them to do this exercise with you. How do your beliefs about illness and adversity line up with your partner’s? How do they differ? How were your childhood belief systems similar/different?

Organizational Patterns. Organizational patterns are the “dance steps” families take as they move through life. These dance steps are so habitual and ingrained that we often don’t recognize them as choices we are making.

Identifying family organizational patterns allows us to notice that family functioning is comprised of a series of small interactions that reverberate throughout the system. Tweaking any of these steps can have a powerful effect, changing the system as a whole.

Think about how your family responds to illness. How do individual family members react? How do these individual reactions interact with those of other family members? Each family member has a unique way of relating to illness affecting the family. Is there conflict around these differences? How is conflict managed?

A piece of organizational patterns in chronic illness that often gets overlooked is how the family approaches seeking outside help. The illness of a family member demands an enormous amount of resources. Is the family able to access support from extended family, a friend network, or the community at large? If not, what are the barriers impeding this?

Communication. Communication is the glue that connects family members. Communication enables us to know and be known by other people in the family system. In reflecting on how your family communicates about illness, think about what gets said and what is left unsaid.

Is communication clear or ambiguous? Is there acceptance of the full range of emotional experiences, or do some emotions feel taboo to express? What kinds of communication create connections in the family? What kinds create conflict?

Moving Forward

I hope that thinking about these questions gives you a fuller picture of your family’s response to chronic illness. Use this as a base to think about the most important question of all: What would you like your family to look like as it navigates the illness of a family member? What would you like family beliefs around illness to be? What would you like family organization around illness to look like? What would you like family communication about an illness to sound like?

Dream big as you think through what you would like. If you are partnered, work with your partner to write a family mission statement. Be realistic about what gets in the way of cultivating a more supportive and helpful family system. Problem-solve those limitations and develop concrete steps to improve functioning.

Remember, psychotherapists are trained to help you do this important work. Please reach out for support as you work to improve family resilience around illness.