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An exploration into the benefits and limitations of Ring Theory. Key points:
👉 In Ring Theory, the ill partner becomes the priority, and the other partner cannot reveal their angst and grief to them.
👉 Ring Theory may benefit the person earlier in the illness, but other approaches should be considered for the longer term.
👉 The most important tool in a relationship is a couple’s ability to communicate. No single paradigm can take its place.
Daniel Miller, M.D., has been caring for people with advanced illnesses for many years. He has worked in the medical field for many years, including as a primary care physician, urgent care doctor, hospital doctor, and as a hospice and palliative care doc. He hosts community groups that meet both in-person and online; topics include living with advanced illness and philosophical/theological issues such as faith at the end of life or the difference between the sacred and the profane.
video transcription: Hi everybody. I’m Dr. Daniel Miller and one of the medical directors of Hospice of the North Coast. I’m so thrilled to be able to start a video log exploring topics in palliative care and also hospice care. I’m very passionate about these topics, so I hope that you can gather, uh, and explore. Topics with me.
Um, today I wanna be able to talk about a concept that I’ve been thinking a lot about. It’s more of a paradigm actually called Ring theory. I wanna give you a little bit of a context behind it. I was thinking and reflecting on our patients and family and friends. I had the experience of having a terminal illness, and then I had a question, I had a question for myself that I wanted to answer, which is, how does a partner of a person who has a terminal illness respond to that person with a terminal illness?
So I wanted to to reflect on that, and I wanted. See what qualities a partner should have in response to that. How should they be there for that person who has that new diagnosis, a life limiting diagnosis? What I realized was that that question was inadequate in itself because I limited it to only one person, which is the.
But I didn’t take into account that there’s a relationship in that, a couplehood, a di sometimes we call it psychology. So I expanded my search and reflection to involve couples meaning and couples work. And I’ve created a, a blog that I’ve since published in Psychology Today exploring exactly that issue, which is how does a couple deal with a terminal illness when one of the partners has a terminal?
So that became more of a passion of mine recently. One of the things that I’ve explored is that paradigm of ring theory. If you haven’t heard of it, ring theory essentially states that the person who is at the center ring, and if you take the example of one internal ring and you imagine. External rings around there, kind of orbiting that central ring.
Where the central ring is. The person who has a terminal diagnosis or just has a terminal diagnosis, just was diagnosed. All of the central rings, all of the central rings around their friends, their family, and depending on your relationship to that central ring, to that person with a diagnosis, that’s your distance from that, from that source, from the.
So the immediate central ring around that person, that’s the central ring. It could be the immediate family, your kids, your parents, this consensual ring around. That could be your close friends. The consensual ring around that could be your medical team, could be your hospice team, whatever actually it means for you, because that’s the.
Relationships are all different, and only you know what that meaning that that person holds for you or that team holds for you. So I wanted to explore that ring theory paradigm and what it means. And essentially what that paradigm states is that comfort has to always flow into the core. So comfort, nurturing, understanding.
Reflection, ability to empathize. Ability to help process. Always has to go in from the outside rings to the inside rings. It makes sense on first blush. If I was the one with a terminal illness, I would need as much processing and help for my loved ones as humanly. It’s difficult enough as it is to be able to understand it for myself and process it on my own without having the support of somebody close to me.
But it would definitely help to be able to have that support from somebody who’s in my immediate outer ring, such as my wife.
So that is, that is essentially the concept of ring theory. I gave it some exploration and I. That’s incredible. How would I be able to advise somebody to be able to help somebody else in times of need? Cause a lot of people don’t know how to show up and be present, and I was thinking that’s a good start.
That Ring theory is a wonderful way to explore how a partner who has a terminal diagnosis can be helped by their loved ones in their ability to process. And their ability to cope. One of the things that I do here is that there’s amazing positives when we look at that. Some people, for example, some partners are so enthralled with their ability to give to their partner and to be able to help them cope and nurture that.
They just find that that paradigm to be super filling. Some of the negatives in that paradigm, and I just want to go over with you are as follows. I think in the immediate stages of having a terminal diagnosis or of having any significant trauma, without doubt, one needs to have the support of their family.
It’s imperative, I think once somebody has had a chance to cope, however, it becomes difficult to be able to have that family member or a friend who’s close to. Not being able to share with you the difficulties that they have with the diagnosis. So the concept of of ring theory essentially states that comfort only flows in, but all of the negatives that you feel from the concentric rings can’t flow in.
They have to remain into the outer circles. They have to be quote, dumped out. And that kind of creates a little bit of a challenge because as a. As people in, in a committed relationship, loving relationships of whatever form people want to share, and they have a hard time limiting themselves to only being able to set a positive tone because as you know, couples in relationships go through a lot.
There’s no just positive affect. Relationships are difficult and. Being able to only express positives is at best superficial and doesn’t take into account the complexity of a relationship. And I think giving it more reflection when a partner who has a terminal illness has had a chance to cope and process, they want to be able to grow and mature and still have the negatives that we would call.
Of the difficult emotions and the feelings that their partner has, I think they wanna be able to process it with them. So that ring theory I think is a good start. Comfort in totally works. I think initially dumping out I think works initially as well because the partner who with the terminologist has to have that support in nurturing.
However, you has to be nuanced and it has to be thought of. In a complex fashion and whatever that is will work for you, but just comfort in is probably not going to do it completely. In a committed relationship, that’s a loving relationship where growth, nurturing, and acceptance of who we really are is at the forefront.
We want to have that comfort, but I think we also want to have that c. And complexity that’s built into all relationships. And as much as I want to support completely ring theory, I mostly support good communication, whatever that is for you. But complexity relationships, I think deserve good communication.
And if Ring theory works, that’s wonderful. And if it doesn’t completely, I’ll totally understand that as well. So for this venture, for this initial, Video log. I leave that with you and until next time on other topics in palliative care and hospice. Thank you.