The shared emotional themes of illness

Illness is both an individual and a relational issue. This paper describes the emotional impact of physical illness on families. We describe 10 themes that represent common affective responses to the challenge of a biological problem. They are: denial vs. acceptance, despair vs. hope, secrecy vs. sharing, guilt vs. forgiveness, burden vs. relief, isolation vs. connection, passivity vs. taking charge, fear vs. courage, loss vs. renewal, and senselessness vs. meaning. Treatment can be targeted to one or more of these themes as they emerge in medical family therapy. Therapists' own experience with illness also may play a role in facilitating, or impeding, interventions with patients and families.