Family conflict

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The news of a serious diagnosis very often draws family members to the patient’s bedside. Realizing that time may be limited, relatives will often go to great lengths to be with their loved one. This closeness has the potential of providing warmth and social support. It can also generate tension. As the family gathers in this difficult circumstance, tempers can be short and old patterns of interaction can become more extreme. Below are insights that may be helpful in resolving family conflict.

Difficult Relationships

Serious illness tends to refocus not only the priorities of the person with the diagnosis but also those of the patient’s family. Yet reconciliation, if necessary to be made, is not easy. Although it may be worthwhile to process past history, most of the time, when faced with the possibility of losing a family member, relatives decide that their feelings of love are more important than their feelings of anger and resentment. Focusing on a positive closure to the relationship becomes the highest priority.

Only the peace of Christ can bring healing and reconciliation to these situations. Jesus has reconciled us to God in spite of our separation from God – which began and persisted since the Garden of Eden. Jesus came not to call and reconcile those who are “perfect” and “holy” by themselves, but those who are spiritually sick. Even if a loved one’s physical healing is no longer a possibility, there may be time to heal the “sickness” within relationships. Forgiveness flows from the cross of Jesus, through us, extending to those whom we love even in the most difficult of situations.

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Amongst family, friends, and other relations, forgiveness is one of the hardest things to consistently offer. It is, in a lot of ways, easier to forgive someone you hardly know than to forgive someone who is close to you. The reason is simple: the person close to you (whether family or friend) should have never wronged you in the first place. They should be the people, out of all others in this world, who should not wrong you. Yet they do. Over time, being continually wronged by a loved one can weaken the bonds of even the closest of family and friends.

Our sense of justice gets in the way of forgiving one another. St. Peter had the same problem. He asked Jesus, “’Lord, how often will my brother sin against me, and I forgive him? As many as seven times?’ Jesus said to him, ‘I do not say to you seven times, but seventy times seven.’” (Matthew 18:21-22, ESV) Peter was willing to forgive but, like us, wanted to limit that forgiveness.

Jesus doesn’t want us to only forgive 490 times, but wants our forgiveness to be without limit. He can do this because His forgiveness is without end. Jesus is “the Lamb of God, who takes away the sin of the world.” (John 1:29, ESV) He takes away not only the bad things our family and friends do, but also the bad things that we do.

Forgiveness is never easy. The wounds of past sin run deep, especially from those closest to us. But Jesus won forgiveness for us by wounds that brought Him death. He was forsaken by His friends, relatives, and even His heavenly Father so He could say, “It is finished.” (John 19:30) Forgiveness won for you. Forgiveness won for ALL.

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Saying good-bye

Saying the final good-bye to someone we love can be the most difficult thing we have to do. We push death to the back of our minds. Even when the reality of death looms closer we still want to deny it. Death is the ultimate “taboo” subject; the proverbial elephant in the room. Surprisingly, talking about death with a terminally ill loved one – and even healthy loved ones! – can go a long way toward bringing closure and comfort after death has come.

God did not create us to die. The original plan, in the Garden of Eden, was to live in this flesh while walking with God forever. When Adam and Eve ate the forbidden fruit, however, that beautiful plan was destroyed. Adam and Eve and all their descendents were cursed with, among other things, death. It was tragic news then, and receiving death – be it our own or that of a loved one – is just as difficult today.

Through faith in the Father, Son, and Holy Spirit, we have the comfort of knowing that our good-byes are not permanent. From the cross Jesus said good-bye to His mother by giving her over to the care of St. John.(John 19:26-27) Three days later Jesus was raised from the dead. His good-bye only lasted three days.

Just as Jesus was raised to new life and reunited with friends and – after His ascension – all believers, we too have the comfort of knowing we will see our loved ones again. In the Old Testament, death is often beautifully described as being “gathered to one’s people” (Genesis 25:8; 35:29; 49:33 et al) When Christians say good-bye to their loved ones, we know it is not permanent. Christ’s death conquered sin and death for us; His Resurrection conquered the grave’s hold on us as well. Our loved ones will die and we will die, but our Living Lord will return to earth bringing with Him an eternal reunion where “good-bye” is never needed.

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The "gift" of a terminal illness

It is easy to see the positive aspects of life as gifts from God, but when bad things enter the picture, we may feel tempted to believe God has abandoned us. St. James says, “Every good gift and every perfect gift is from above, coming down from the Father of lights.” (James 1:17, ESV) When the gift doesn’t seem “good,” we despair. A terminal illness as a gift from God? We can pray with Job, in faith, “Shall we receive good from God, and shall we not receive evil?” (Job 2:10, ESV)

Many people find that spending time with someone who is dying actually teaches them quite a bit about living. For instance, we don’t have to wait for a terminal diagnosis to resolve conflicted relationships. Anytime is a good time to wipe the slate clean and start anew with people who have been important to you. Whether you have a terminal condition and are actively dying or seem to be healthy with decades yet to live, the truth is that we will all die someday. Our time here is limited. One gift of a terminal illness is that it encourages both the patient and family members to live their remaining days as they wish they had lived all along. Keeping relationships open, clear, and loving on a daily basis is one way to limit your regrets when your own time comes.

This is not to say that we are ever exceedingly happy with a terminal diagnosis. It doesn’t suddenly become easy. What this tells us is that God sends all things for our good, all things as gift. We pray that terminal illness causes the patient, family, and friends to look toward God for comfort rather than turn away from Him. In this way, the Lord uses what the world sees as a curse to strengthen His people in faith and fellowship.

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One day when comedian Steve Martin was sitting in silence with his dying father, out of the blue the father said, “I wish I could cry. I wish I could cry.” Despite his discomfort, Martin pushed through and asked his father, “What do you want to cry about?” To his surprise, his dad said, “For all the love I received and couldn’t return.” Later, when describing their interchange, Martin reflected that it was “as though an early misstep had kept us forever out of stride. Then, two days from his death, our pace was aligning and we were able to speak.”

In the face of pending death or later during the mourning period, one of the most-often heard regrets is “I never got to tell him I loved him.” In her book Facing Death and Finding Hope, Christine Longaker notes that the deepest pain is often the love we held back. Although there may be many valid reasons for holding back, people who work with the seriously ill have found that priorities change, especially near the end of life. One of the greatest gifts of the process is realizing that it is our social relationships that give life meaning. This realization is as powerful for the patient as it is for family members. Expressing our love becomes a top priority.

Although we may not feel comfortable letting go of old positions and risking vulnerability, most families find that taking this risk yields unimaginable positives. If you are uncomfortable sharing your feelings in person, you might want to write them in a letter. For those patients who lack stamina, dictating the letter to a friend or hospice volunteer is also an option. Interestingly, dictating to someone who is uninvolved or whom you hardly know may make it easier to express what is deepest in your heart.

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Thank-yous are free, and there are not enough of them being passed around. Many terminally ill patients have jokingly wished they could be present to hear all the nice things people will say about them at their funeral. So, why wait? Any one of us deserves to be thanked for the many good things we have done during our lives. As well, there are undoubtedly people in our lives who should be acknowledged for their positive contribution.

If you or someone in your family is seriously ill, write a letter, make a phone call. One family held a dinner while the father was still moderately strong, and each of them told him what they appreciated about him and how he had touched their lives. Whether you are the patient or a family member, saying thank you is one of the most powerful gifts you can give.

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Conflict over medical decisions

Frequently in serious illness, treatment decisions must be made quickly. It is not uncommon for relatives to have differing ideas about the best course. Some may feel their loved one should pursue aggressive treatments. Others may feel that therapies such as radiation and chemotherapy do not offer enough benefits given their negative effect on the limited time their family member may have.

It is medical custom for the physician to turn to the patient for a decision. Many cultures would agree with this protocol. However, many cultures consider treatment decisions a family matter. When relatives disagree about how the patient should proceed, or the patient feels differently than does the family, it might help everyone to examine their assumptions about treatment and illness. The more each understands the other’s position, the easier it will be to communicate and to respect the final decision. Medical anthropology sheds insight into this process with the questions below. There are no “right” answers. These questions are simply a means to generate deeper understanding and appreciation for each person’s point of view:

  • Who should be involved in decision making?
  • What do you think this illness does? What is its natural course?
  • Why do you think this illness or problem has occurred?
  • How do you think this condition should be treated?
  • Who do you think is the most appropriate to turn to for help with this condition? (Depending on the person’s interpretation of the condition, practitioners other than medical doctors may offer more-appropriate treatment.)
  • What does the patient feel is necessary in order to have an acceptable quality of life? How will that be accomplished given the current situation?

In addition to working toward mutual understanding, gather all the medical information you can from your doctor or from reputable sources such as the national organization dedicated to your loved one’s condition (e.g., the Alzheimer’s Association, the American Cancer Society, or the American Heart Association). However, as much as information from the medical side can supplement the conversation, understand that these facts alone are not the only considerations. Beliefs and emotional responses, no matter how unscientific or irrational, are a significant part of how humans make decisions. If treatment decisions do not match with the patient’s attitudes and beliefs, he or she is unlikely to adhere to them. To get cooperation, it is important that the patient feel comfortable with how the decisions were made.

If your family is having trouble with the decision-making process, you may want to call in an objective third party for assistance. Social workers, clergy and counselors are professionals who can help clarify values and open lines of communication.

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