How Do We Start Talking About This?

A Conversation Guide for Couples After Prostate Cancer

I found that communication became harder during and after my husband's treatment. It has taken us almost two years to become more comfortable having some of the conversations we needed to have.

I don't think there was one thing that changed it for us. Over time, I began paying more attention to the conversations that went well and the ones that didn't. I learned more about how much we could talk about at one time, when we had talked long enough, and how important it was for both of us to understand what we were actually trying to accomplish.

Some of what works in our house may not work in yours. We all listen and process information differently. What I can share is what we have learned along the way and some of the changes that have made our conversations better.

Too Much Information Is Still Too Much

I can have six things on my mind that I think we need to discuss, but if I give my husband all six at once, I am probably going to lose him somewhere along the way. In our house, three is about the limit, and sometimes one is plenty.

That has required some adjustment on my part because when something has been bothering me, I may have already spent several days thinking about it. By the time I bring it up, I have gone over the problem in my head, thought about what I want to say and probably come up with a few possible solutions. He hasn't been part of any of those conversations going on in my head, so it isn't reasonable for me to unload all of it at once and expect him to keep up.

I have become more selective about what really needs to be discussed. If I have several things on my mind, I decide which ones matter most and leave the others for another day. I also ask myself whether something really needs a conversation at all. There are times when I am tired or frustrated and something feels much more important tonight than it will tomorrow morning.

Give the Conversation a Reason

I know that saying, “We need to talk,” would not go over particularly well in our house. It is too open-ended. My husband has no idea what I am about to bring up, how serious it is or how long I expect the conversation to last.

I have found that it works much better when I tell him what I want to discuss and why we need to discuss it. For example, I might say, “Can we take some time today to talk about getting the vehicle tags done on time so I don't get another ticket?”

Now he knows what the conversation is about and why it matters. We also have something specific we need to accomplish rather than an open-ended discussion that could go anywhere.

The same idea works with more personal subjects. I don't have to give him the entire conversation before we have it, but I can give him enough information to know what I need. Most of us are probably more willing to sit down and talk when we know what we are being asked to talk about and why the conversation matters.

Be Clear About What You Are Asking For

This is something I have had to work on because what seems obvious to me may not be obvious to the person hearing me.

If I ask my husband, “Would you make dinner tonight?” I may have a picture in my head of what that means. Dinner gets prepared, we eat, the leftover food is put away and the kitchen is cleaned afterward. My husband may hear exactly what I said and believe I asked him to prepare dinner.

If I walk into the kitchen later and see food still sitting out and dishes that need to be cleaned, I can become irritated because I thought he was taking care of dinner. From his point of view, he did what I asked him to do.

A clearer request would be, “Would you prepare dinner tonight, clean the kitchen and put the food away afterward?” We both know what I am asking, and there is much less room for frustration later.

This isn't about giving another adult instructions for every little thing. It is about recognizing when I have an expectation in my head that I haven't actually communicated. I can't expect someone else to know all the details of an agreement that I never said out loud.

Know When You Have Talked Long Enough

There is a limit to how long my husband can stay engaged in a difficult conversation, and I know him well enough now that I can usually tell when we are getting close to that point. I used to continue because I wasn't finished. I still had another point I wanted to make, something I needed to explain or another question I wanted answered.

Eventually I realized that I might still be talking, but that didn't mean he was still taking in what I was saying. Once we reach that point, very little good comes from continuing.

I am much better now at recognizing when we have done enough for one conversation. The subject may not be settled, and there may still be things we need to discuss, but they don't all have to be discussed that day. We can come back to them when both of us are better able to participate.

I think this can apply to many couples. Illness, fatigue, medications, stress and everything else going on in our lives can affect how much any of us can take in at one time. Continuing a conversation simply because one person hasn't finished saying everything they wanted to say doesn't necessarily make that conversation more productive.

Keep One Problem From Becoming Every Problem

It is very easy for one disagreement to collect every other disagreement along the way. You begin talking about something that happened this morning, then something from last month suddenly seems relevant, and before long you are discussing things that happened years ago.

I have done this, and I have learned that it usually doesn't help us resolve the problem we were trying to discuss in the first place. It also leaves the other person feeling as though they are being handed a list of everything they have ever done wrong.

If we are talking about what happened this morning, I try to stay with what happened this morning. Something else may come to mind that really does need attention, but it can have its own conversation. This is another reason limiting how many things I bring up at once has worked well for us.

We Don't Rely on Memory for Everything

We use calendars and reminders because there is already enough to remember in everyday life. During cancer treatment there was even more, with appointments, medications, questions for doctors and things that needed to happen by certain dates.

If something has a deadline, it makes sense to put it somewhere we can both see it. If we agree that something needs to happen next week, writing it down is much easier than arguing later about who was supposed to remember.

I also don't want to become responsible for remembering everything for two adults. There is a difference between helping each other and having one person become responsible for every appointment, deadline, household responsibility and reminder. When that happens long enough, the person doing all of the remembering can become exhausted and resentful.

Using a calendar, a written reminder or another system takes some of that responsibility out of the relationship. The information is there for both of us, and neither person has to become the other's memory.

Ask When You Aren't Sure What You Heard

There have been times when something my husband said upset me, and later I discovered that what I heard wasn't what he meant. The reverse has happened too. When a subject already carries some emotion, it doesn't take much for a comment to land very differently from the way it was intended.

I am trying to get better about checking before reacting. I might say, “I'm not sure I understood what you meant by that,” or, “Tell me what you heard me say because I don't think it came out the way I meant it.”

We all hear things through our own experiences and through whatever we are feeling at that moment. If I am already worried or hurt, I may hear criticism in something that wasn't intended as criticism. Asking one more question is often much easier than spending the next several hours angry about something the other person wasn't trying to say.

Taking a Break Doesn't Mean the Conversation Is Over

We still have conversations that don't go well. There are times when one of us becomes frustrated, we begin repeating ourselves, or I realize that neither one of us is really listening anymore. I don't think anything is gained by forcing ourselves to keep going simply because the subject hasn't been resolved.

We can stop and come back to it later. What matters is that we actually come back.

That may mean later in the day or the next day. There isn't one rule for how long a break should be. I think the bigger difference is between taking some time because the conversation has stopped being useful and walking away from every uncomfortable subject so that nothing ever gets discussed.

I have also learned that I can come back and admit when I didn't handle something very well. There have been times when I was upset and didn't say what I meant very well, or I became defensive instead of listening. Going back and saying that doesn't take anything away from me. Often the second conversation goes much better because we are no longer trying to talk while both of us are upset.

Better Communication Still Takes Two People

I think this is especially important for caregivers. We can spend so much time trying to keep everything together that it is easy to take responsibility for fixing the communication too.

I can pay attention to how I bring something up. I can choose a better time, limit how much I try to cover, explain clearly what I need and recognize when the conversation is no longer going anywhere. Those are things I can control.

I can't have both sides of the conversation. My husband still has a responsibility to listen, answer honestly and make an effort, just as I do when he needs to talk to me. Changing the way I communicate does not mean accepting responsibility for every misunderstanding or difficult interaction between us.

There may also be subjects that a couple cannot work through by themselves. An oncology social worker, counselor or another professional can sometimes help when the same conversation keeps going in circles. One person can also seek support even when the other person isn't ready or interested.

Learning How the Other Person Communicates

My husband and I don't communicate in exactly the same way. I have had to learn how much information he can comfortably take in, how long we can stay with a difficult subject and how to be clearer about what I am asking. He has had to learn things about the way I communicate too.

I think we sometimes put so much attention on learning how to express ourselves that we forget there is another person on the receiving end. Some people need time to think before they answer, while others work things out by talking. Some can discuss several things at once, and others become overwhelmed. One person may want every detail while another needs you to get to the point.

Knowing those differences doesn't mean one person always has to adjust to the other. Both people need room to communicate in a way that works for them, and somewhere in the middle you figure out what works for the two of you.

After almost two years, I don't think better communication for us has meant becoming better at having long conversations. In many ways, it has meant the opposite. We are learning to talk about what actually needs our attention, be clearer about what we need from each other and recognize when we have done enough for one day.

What You Might Take From Our Experience

If there is something you need to discuss with your partner, decide what really needs attention rather than bringing everything that has been bothering you into the same conversation. Let your partner know what you want to discuss and why it matters, and if you are asking for something, be clear enough that both of you understand what has been agreed to.

While you are talking, pay attention to whether you are still hearing each other. There may be more you want to say, but that doesn't mean it all has to be said at once. If the conversation needs to stop, come back to it rather than allowing the subject to disappear.

These changes have taken time for us, and we certainly don't do all of them perfectly. What I can say is that our conversations are better than they were two years ago. We understand more about how the other person communicates, and we are learning that a productive conversation doesn't have to be a long one.

Sometimes one subject is enough. Sometimes three things are enough. And sometimes realizing that you have both had enough for today is just as important as knowing what you wanted to say.