Talk To Me: My husband has become anxious about his health since his heart attack 

Psychologist Caroline Martin is here to answer your questions on whatever issues you are dealing with in life, from work pressure and stress to loneliness and grief

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My husband, who is in his 60s, had a mild heart attack two years ago. He had a stent fitted and has made a good recovery. However, he has become anxious about his health. It's gotten worse since he bought a watch with a heart monitor. I support him as much as possible but it's a drain listening to him going on about every niggle. What happened to the carefree man I married?

A heart attack is often a traumatic experience. For some, it's seen as an existential event and they may make radical life decisions reflecting a renewed sense of purpose or identity. Others may become hypervigilant about their health as a natural response to a serious medical event. Regardless, the ripple effect can be felt within their relationships and social networks.

When we experience a shock like a heart attack or our existence is under threat, our stress response system gets activated. This reaction is connected to our innate drive to survive but can create difficulties if we get stuck in a stressed state. It can take a while for us to restore our system to equilibrium. Positive relationships can be critical in our psychological recovery from grave life experiences.

As his spouse, you are undoubtedly part of his healing but this will also require you to mind yourself. I wonder if you have been able to process how your husband’s health scare has impacted your wellbeing. With his hypervigilance, you may not have had the time to fully assess the toll his heart attack and subsequent behaviour has had on you. It may be essential to set some boundaries around communications so that you can continue supporting him sustainably. Don’t be afraid to lean on close friends who can offer you comfort and distraction.

Engaging the support of a therapist will give you the space to navigate this challenging situation and identify tactics for managing your stress and responding to his anxiety. You can only provide a safe harbour for your husband if you have had a chance to rest and reset your internal stress system. These will be important self-care habits to create as recovering from a traumatic event can take time and is not always straightforward.

Understanding how we respond to traumatic events can help us to approach the situation with empathy and compassion. When we experience an event such as a heart attack, we must first regain our sense of safety. Sometimes, we can do this by ourselves but sometimes the threat is so big we need others to reassure and soothe us. Only then can we begin to make sense of what happened. 

Caroline Martin, psychologist. Photograph Moya Nolan

Your husband’s purchase of a watch with a heart monitor is perhaps an attempt to reassure himself. Paradoxically it may also be maintaining his heightened alertness as it reminds him of his heart attack. Before suggesting he simply take it off, it would be wise to consider alternative sources of comfort and reassurance. It might be helpful if he limited his use of this watch to particular days or specific times of the day.  Additionally, he might find it beneficial to engage in mindfulness-based stress reduction, building his ability to perceive the internal state of his body.

Mindfulness is not for everyone and it would be a good idea to encourage your husband to work with a therapist specialising in trauma.  The therapeutic space will help him to process the range of emotions he has continued to experience since his heart attack. He can also develop coping strategies that will help him not only discern changes in his stress response system but also identify ways to self-regulate, increasing his sense of agency.

Relearning how to trust his body will be key. You can encourage your husband to reintroduce physical activities he enjoys that promote wellbeing. These can be as simple as going for a walk together or connecting with his friends, wider family and social groups. Increasing his time with others will bolster his confidence and give you space to take care of yourself. When we become anxious, we tend to shrink our worlds to control what's happening. We tend to focus on negatives or deficits within our lives for myriad reasons. It is important to cultivate the habit of identifying all that is positive. Take time to focus on the small wins - they all contribute to an increasing sense of belief in our ability to achieve. This could be noting how lovely it is to hear him laughing on the phone with his friends or children.

Your husband may need reminding of all the things he used to enjoy,  whether this is a hobby, a sport, or time with loved ones. Focus too on activities that allow him to lean into his strengths. Keeping a gratitude journal or using a gratitude app can be a powerful practice. The more chances he has to experience joy and mastery the more his resilience will be enhanced.

With patience, understanding and support your husband will learn to integrate his traumatic health experience. He may not revert to the same ‘carefree’ person you married. You may instead discover, as the Japanese art of Kintsugi teaches us, that he emerges stronger and better than ever.

Take care. 

• If you have a question for Caroline, please send it to [e-mail]