Summary

NVC in Action

A Wife Connects With Her Dying Husband

A patient had just been diagnosed with an advanced stage of lung cancer. The following scene at his home, involving the patient, his wife, and a visiting nurse, represents a last opportunity for him to connect emotionally with his wife and discuss his dying before being admitted to the hospital. The wife began the conversation with the nurse by complaining about the physical therapist who was part of the home health care team assigned to her husband’s care.

Wife:	She’s a bad therapist.
Nurse:	(listening empathically to what the wife is feeling and wanting) Are you feeling annoyed and wanting to see a different quality of care?
Wife:	She doesn’t do anything. She made him stop walking when his pulse got high.
Nurse:	(continuing to hear the wife’s feelings and wants) Is it because you want your husband to get better that you’re scared if the physical therapist doesn’t push him, he won’t get stronger?
Wife:	(starting to cry) Yes, I’m so scared!
Nurse:	Are you scared of losing him?
Wife:	Yes, we’ve been together so long.
Nurse:	(listening for other feelings behind the fear) Are you worrying about how you would feel if he dies?
Wife:	I just can’t imagine how I am going to live without him. He’s always been there for me. Always.
Nurse:	So you’re sad when you think of living without him?
Wife:	There is no one else besides him. He’s all I have, you know. My daughter won’t even talk to me.
Nurse:	It sounds like when you think of your daughter, you feel frustrated because you wish you had a different relationship with her.
Wife:	I wish I did, but she is such a selfish person. I don’t know why I even bothered having kids. A lot of good it does me now!
Nurse:	Sounds to me like you might be somewhat angry and disappointed because you want more support from the family during your husband’s illness.
Wife:	Yes, he’s so sick; I don’t know how I am going to get through this alone. I haven’t anyone … not even to talk to, except with you here … now. Even he won’t talk about it…. Look at him! (Husband remains silent and impassive.) He doesn’t say anything!
Nurse:	Are you sad, wishing the two of you could support each other and feel more connected?
Wife:	Yes. (She pauses, then makes a request.) Talk to him the way you talk to me.
Nurse:	(wishing to clearly understand the need that is being addressed behind the wife’s request) Are you wanting him to be listened to in a way that helps him express what he’s feeling inside?
Wife:	Yes, yes, that’s exactly it! I want him to feel comfortable talking and I want to know what he is feeling.

Using the nurse’s guess, the wife was able to first become aware of what she wanted and then find the words to articulate it. This was a key moment: often it is difficult for people to identify what they want in a situation, even though they may know what they don’t want. We see how a clear request—“Talk to him the way you talk to me”—is a gift that empowers the other person. The nurse was then able to act in a way she knew to be in harmony with the wife’s wishes. This altered the atmosphere in the room, as the nurse and the wife could now “work together,” both in a compassionate mode.

Nurse:	(turning to the husband) How do you feel when you hear what your wife has shared?
Husband:	I really love her.
Nurse:	Are you glad to have an opportunity to talk about this with her?
Husband:	Yes, we need to talk about it.
Nurse:	Would you be willing to say how you are feeling about the cancer?
Husband:	(after a brief silence) Not very good.

The words good and bad are often used to describe feelings when people have yet to identify the specific emotion they are experiencing. Expressing his feelings more precisely would help this patient with the emotional connection he was seeking with his wife.

Nurse:	(encouraging him to move toward more precision) Are you scared about dying?
Husband:	No, not scared. (Notice the nurse’s incorrect guess does not hamper the continued flow of dialogue.)
Nurse:	(Because this patient isn’t able to verbalize his internal experience easily, the nurse continues to support him in the process.) Do you feel angry about dying?
Husband:	No, not angry.
Nurse:	(At this point, after two incorrect guesses, the nurse decides to express her own feelings.) Well, now I’m puzzled about what you may be feeling, and wonder if you can tell me.
Husband:	I reckon, I’m thinking how she’ll do without me.
Nurse:	Oh, are you worried she may not be able to handle her life without you?
Husband:	Yes, worried she’ll miss me.
Nurse:	(She is aware that dying patients often hang on due to worry over those they are leaving behind, and sometimes need reassurance that loved ones can accept their death before they can let themselves go.) Do you want to hear how your wife feels when you say that?
Husband:	Yes.

Here the wife joined the conversation; in the continued presence of the nurse, the couple began to express themselves openly to each other.

In this dialogue, the wife began with a complaint about the physical therapist. However, after a series of exchanges during which she felt empathically received, she was able to determine that what she really sought was a deeper connection with her husband during this critical stage of their lives.