2.2 How symptoms can create misunderstandings in relationships
“The emotional world becomes quieter, not absent.”
Elena:
Caregivers often say things like:
“He doesn’t look at me… maybe he doesn’t care.”
Or,
“She reacts so strongly… she must be angry on purpose.”
How often do these situations turn out to be misunderstandings?
Dr. Stein:
Very often.
What we see is that behaviors are interpreted through a relational lens, when in fact they may be shaped by the illness.
Elena:
So what looks like a message… may not actually be one.
Dr. Stein:
Moments that appear distant, intense, or even hurtful can have a very different meaning internally. Someone may seem quiet or withdrawn, but actually be overwhelmed or trying to regulate what they are feeling.
Emotional reactions may appear unusually intense to others, not because of intention, but because they may be harder to regulate in that moment.
Elena:
The reaction we see on the outside doesn’t always reflect what is happening inside.
Dr. Stein:
That’s right. And this is where many painful misunderstandings begin.
Partners often describe looking back and realizing, “At the time, I took it personally. I thought I was being pushed away.”
Elena:
Which is a very natural reaction.
Dr. Stein:
It is. But when we begin to look at these moments differently, something important shifts.
Instead of asking, “Why is this happening to me?”
We may begin to ask, “What might be happening for the other person right now?”
When distance looks like rejection
Sometimes behaviors that feel hurtful or distant are not signs of rejection, but ways of coping with internal stress.
What it may look like
• Less eye contact
• Brief of quiet responses
• Spending more time alone
• Limited emotional reactions
• Slower responses in conversation
What it may reflect
• Feeling overwhelmed by social or emotional input
• Difficulty expressing emotions clearly
• A need to regulate internal tension
• Emotions that are present but less visible
• More time needed to process interactions
What may help partners
• Gentle curiosity – “You seem quiet today. I’m here if you want to talk.”
• Patience – allowing time for emotional expression
• Presence – being nearby without pressure
• Reassurance – showing that closeness remains welcome
Emotional withdrawal may be a form of self-protection rather than a loss of affection.
Understanding this difference can protect the relationship and keep communication open.
Elena:
The meaning behind a behavior is not always what it seems.
Dr. Stein:
And when partners begin to see symptoms rather than intention, relationships often soften.
Elena:
Some caregivers also say, “They tell me they want closeness… but they don’t seem to feel it.” Why does that happen?
Dr. Stein:
That’s another difficult experience.
Sometimes there is a gap between emotional desire and emotional experience.
A person may still want connection, but feel less emotional intensity in the moment.
Other times, internal anxiety competes with that sense of closeness, or the brain’s reward system responds less strongly.
Elena:
The wish for connection is still there, but the feeling may be quieter.
Dr. Stein:
That can be confusing for both partners. It may look like a loss of interest, but in reality, it is often the illness affecting how emotions are experienced.
It does not necessarily indicate a lack of love. It may reflect a change in how affection is experienced or expressed at that moment
Elena:
So the emotional world becomes quieter, not absent.
Dr. Stein:
That’s a very important distinction.
