Ep 101: The Marriage Sabbatical - Finding Love and Living with MCI with Leah Fisher

This episode of BrainStorm, by UsAgainstAlzheimer’s, features host Meryl Comer interviewing Leah Fisher, a psychotherapist and author who took a bold year-long solo travel sabbatical at age 60 to explore different cultures while maintaining her marriage. The conversation takes a poignant turn as Fisher reveals that after the events in her book, she received an MCI (Mild Cognitive Impairment) diagnosis with elevated Alzheimer's risk. She candidly shares her journey of recognizing early symptoms like misplacing car keys and developing aphasia, the validation that came with diagnosis, and her current experience living with uncertainty about disease progression. Fisher offers insights on how couples cope with health diagnoses, the importance of curiosity over avoidance, and her desire to be treated with patience, kindness, and continued love as she faces an uncertain future. This conversation is essential listening for family members, caregivers, and anyone navigating aging and brain health. 

Produced by Susan Quirk

Transcript

Leah Fisher (00:01):

People wondered if going away might have been a trial divorce. And I would say to them, if our relationship were at risk, there's no way I would be leaving my man and leaving the country for a year. This had to do with the dream, and I think each of us has a dream and there are the dreams we know we can make happen. And then there are the dreams like, oh, if I could only, well my, oh, if I could only was, oh, if I could only spend a year living in some other cultures.

Introduction (00:34):

Welcome to BrainStorm by UsAgainstAlzheimer's, a patient center, nonprofit organization. Your host, Meryl Comer, is a co-founder, 24-year caregiver and Emmy award-winning journalist and the author of the New York Times bestseller, Slow Dancing With a Stranger.

Meryl Comer (00:50):

This is Brainstorm. And I'm Meryl Comer. Our guest is Leia Fisher, a psychotherapist, author, and lifelong explorer of how relationships evolve over time in sickness and health. Her new memoir, my Marriage Sabbatical, a memoir of solo travel and Lasting Love. Welcome Leia. Thank you so much for joining us.

Leah Fisher (01:13):

I'm delighted.

Meryl Comer (01:15):

Leia, your book focuses on an earlier life chapter, your years of solo world travel, the impact on a long marriage, but it excludes what for our audience, is a later diagnosis of MCI with elevated Alzheimer's risk that preceded the book's release. Was that intentional?

Leah Fisher (01:34):

Well, all I can say is that the two didn't come together until 20 years after I had taken this journey and begun writing the book. It took me 15 years to write the book. And so that was the reason it happened a long time ago. You've

Meryl Comer (01:50):

Been a psychotherapist for more than 30 years, helped many couples. However, recent research describes a graying of divorce among adults, 50 and older, and even higher rates in those 60 plus. Leo. What's going on with our baby Boom generation?

Leah Fisher (02:06):

I can tell you about the ones that I've bumped up against both in my practice but also in my life, friends and and whatever. First of all, women have been in the workforce, so there isn't the feeling of absolute dependency on someone because of their income. What I've seen personally is that couples come in contemplating divorce and unhappy with their marriages. And after working together and conversing together for a while, I've come away with the sense that these partners want a divorce from the pattern of their lives, not necessarily from their partner, but when you've been married to someone for 30 or 40 or 50 years, you got your patterns, your habits, the rules of engagement, and those rules of engagement were probably developed early in the days of marriage, definitely during the child rearing and career building years and they worked beautifully. Then all of us have issues with change. Change is scary, and for couples who haven't changed those patterns, they may find themselves in their fifties or sixties feeling constrained, feeling bored. And who in your line of vision, your partner? So a great deal of my book has to do with shifting that pattern to make it a better fit for me and a better fit for my husband. And both of you. Feeling that your life matches who you are is very good for a marriage.

Meryl Comer (03:36):

Does longer life expectancy have anything to do with couples reevaluating how they wanna spend their remaining years?

Leah Fisher (03:44):

It's referred to as a third age. For some of us it's a fourth age, but with good health or good enough health and with financial security, there are more opportunities. There are less obligations and more space and gradually more permission. The idea has been previously a married woman's role is to show up, be present, hopefully have dinner on the table and be a partner. And the whole notion of what is a good wife or what is a good husband is starting to get shaken up a little bit.

Meryl Comer (04:21):

Health problems always add strain with caregiving stresses and chronic conditions. All from your experience, do they impact the marriage dynamic?

Leah Fisher (04:32):

Oh my goodness, that is a huge question and I'm sure with many different answers. What I am coming to believe is that partners deal with a health issue or a scary diagnosis pretty much in the way they deal with any stressor that the people who don't wanna look and don't wanna think about things, don't wanna look and don't wanna think about this, and the partners who are proactive and let's make a plan. If that's the way they have related to life, they're very likely to relate in a similar way to a diagnosis that nobody wanted.

Meryl Comer (05:08):

Do you see both avoidance and anger in couples when it relates to health issues?

Leah Fisher (05:14):

I think anger tends to come further down the road when if we're talking about cognitive impairment, when it gets frustrating, really frustrating when the same questions asked for times in 10 minutes or the thing you just explained to your partner, they really don't understand as far as avoidance is concerned, you know, you can be avoiding something on Monday and facing it on Thursday. I don't think it's binary, but as I say, people who tend to think that the best solution to a problem is to focus on something else and hope it goes away, of course they're gonna do that. And I think one of the big stressors for couples is when there isn't a match between those coping styles. If the person with the diagnosis really wants to cry, really wants to make plans, really wants to be believed in a situation, talk about avoidance. You tell somebody that you're having cognitive decline, you're having trouble remembering things, and nine out of 10 say, you know, I do too. You get to be this age and you walk into a room and it's like, hello, that's not what I'm talking about. Well, there are spouses who will do the same thing and it's one of the lonelier feelings in the world to be struggling with something this huge and to have your partner try to make it a small deal when it's a huge deal.

Meryl Comer (06:41):

Leia, were you deliberately using your book, the Marriage sabbatical to relate one earlier arc of life experience around identity and partnership and saving the other arc, which is your current diagnosis and living with uncertainty?

Leah Fisher (06:57):

Yes. I think one of the really amazing things about the human mind is how you have so many different experiences and so many different ages and stages, and yet somehow we hold a sense of continuity, a sense of self that can tie all those together. I don't know how it's done. I'm fascinated by the question I ask it a lot and I haven't gotten a good answer back. So in one way I would say, no, it wasn't about that. These things have a way of flowing together and still ending up being a me. Certainly the diagnosis is part of a me I had never expected, but there's a choice, not every day, but some days the choice is to be curious about that too. I kind of think I'm a curious person. It's like there's another side of the globe. Let's go find out what's there. Much as I regret the diagnosis, I'm curious about it.

Meryl Comer (07:55):

Please share with us, if you will, where you are now.

Leah Fisher (07:59):

I knew something wasn't right seven, eight years ago, and it took a number of years for the cognitive testing to catch up with what I knew. There was a sense of relief, well, scary, shaky, scary, and well, now we're all on the same page. It was scary but not really a surprise.

Meryl Comer (08:22):

Describe the behaviors and things you were noticing that were different.

Leah Fisher (08:27):

Here's the one that sent me to get a baseline study. It was finishing having a coffee with a group of people I exercise with, saying goodbye, getting my car key, tossing the cup in the trash and then getting to the car and looking down for my key. And all that was there was an empty cup of coffee. Well, you know where the car keys went. That wasn't normal, that wasn't usual. And that's really different from where are my car keys? I can't find my car keys. So that's when I went and got a baseline study and at this point I'm starting to develop aphasia, which means I can't find the words I wanna say. Well, as a writer and a good talker, that feels like a huge loss. So I don't know if that speaks to your question.

Meryl Comer (09:18):

It does. It's those early symptoms. People also may have a premonition that nothing's quite right or a spouse might have a premonition, but you try to keep things as normal as possible so you play into the moment versus paying attention to things that might set off an alarm or say perhaps we should get tested.

Leah Fisher (09:40):

I think that's true for many people, but I have established myself as a curious person, and I was curious from the moment that the car keys ended up in the trash can

Meryl Comer (09:53):

I had describe any other symptoms.

Leah Fisher (09:55):

Well, my first answer is I can't remember <laugh>.

Meryl Comer (09:58):

That's

Leah Fisher (09:59):

Fair. Oh, I know when it was getting worse. I'm working on my book, I'm typing away and I can't remember where the L key is, and I have to look at the keyboard and wander up and down those letters till I find the L. Now, I learned to type when I was 13, I haven't had to look for the L key in decades. So it was things like that.

Meryl Comer (10:23):

Leia, they say the women actually do better on the MOCA test because we're verbal and you've said you're a good talker. It also means that women can hide out longer in the early stages of the disease, but it also means that toward the backend it becomes more precipitous.

Leah Fisher (10:40):

Wow. Well, I gotta tell you, I would say in the last two months, precipitous is what's been happening and curiosity blends into fear real fast at that. So I have known something was going on for seven years, but it was pretty stable. And there's something else that's called cognitive reserve, I think, which is a fancy expression for if you start out smart, you are not gonna be diagnosed as quickly because you're riding on good gray cells for a longer time.

Meryl Comer (11:19):

Leia will visit those challenges with MCI more in depth later. But let's focus on your memoir, the marriage sabbatical at 60, you leave home for a year alone. Did you and your husband choose this sort of radical experiment over divorce and was it designed as a test?

Leah Fisher (11:36):

People wondered if going away might have been a trial divorce, and I would say to them, if our relationship were at risk, there's no way I would be leaving my man and leaving the country for a year. This had to do with a dream. And I think each of us has a dream and there are the dreams we know we can make happen. And then there are the dreams like, oh, if I could only, well my, oh, if I could only was, oh, if I could only spend a year living in some other cultures, finding out how other peoples handle the universals of raising children, of relationships, of facing death, all these commonalities that may be expressed in different ways, I've always wanted to immerse myself in that and see what was going on. I wanna segue a minute to say that travel was my dream.

Leah Fisher (12:30):

Other people have really different dreams and I would hate for my book to give the impression that being bold means going traveling alone for a year. That traveling alone had everything to do with the fact that my husband had other priorities and he loved taking two week vacations, but no way was he going to sign off from his career for a year. And I was willing to, there was something I wanted so much I could taste it. My husband did not like the idea of being left on his own for a year. And at first he was pretty negative about it, but he wanted his wife to be happy and he knew that this dream had been percolating since I was in my early twenties. And so we're good negotiators, we're good talkers, and after many years of marriage, we're even good friends. And so I talk about marital negotiation, it sounds very businesslike, but it's really a structured way of dealing with problems or big decisions in a way that isn't you versus me, but here's this issue, what are we gonna do about it?

Meryl Comer (13:37):

So Leia, what does a marriage sabbatical actually look like in practice? And what are the boundaries in agreements that you better figure out right up front to make sure it will or hopefully that it will work out.

Leah Fisher (13:49):

I know what you're getting at and I'm sure everyone listening does too. <laugh>, let's go back to your first question. You were saying, what does it look like in

Meryl Comer (13:59):

Practice?

Leah Fisher (14:00):

I don't think there's any recipe for this. We personalized it to what we wanted and what we needed. And I structured it on the quarter system the way in college I would travel for four months and then come back home. I had a elderly mother with cognitive decline and two grown children and lots of friends. And so I would spend a couple weeks or a month between trips. I jokingly said I would visit my friends and children, remind my husband he was happily married and pack for a different part of the world. <laugh>. What we agreed is that he would come during each of these three, four month travel segments for two weeks and he would take a holiday visiting me. And we did that. And it got to the point where he would say, okay, where are we gonna go now? I had helped him have good enough times that he would leave it up to me. So one time it was meet me in Guatemala and one time it was Meet me in Bali and then it was Meet Me in Columbia.

Meryl Comer (15:03):

That's making it sound very romantic.

Leah Fisher (15:06):

We all hear absence makes the heart grow fonder. And it was really only a little bit of that. What made the heart grow fonder I think, was that we were each doing what we wanted and loving it. That we were getting to have our cake and eat it too, which is to do what we wanted most and still have the security and comfort of a sturdy marriage. Not always a sweet one, but a sturdy one that could go the distance.

Meryl Comer (15:33):

Despite the best laid out plans, unexpected things always happen. Were there any personal surprises?

Leah Fisher (15:40):

I could have guessed what would be the most meaningful parts of my trip, but some of them we wouldn't have guessed at all. We each felt so proud of our independence of being on our own and coping really well. Me traveling to places I'd never been before with people who spoke languages I didn't know, and my husband for feeding himself for a year and making social arrangements and just being proud of himself and proud of me and I was proud of myself and proud of him. That's different from absence makes the heart grow fonder. We were growing.

Meryl Comer (16:15):

Were there issues that disturbed you or that you really had to work on to make work?

Leah Fisher (16:20):

You were hinting at what did we do about sex and so let's just go <laugh> right to the issue. Being apart for a year sounds impossible in terms of sexuality and even being apart for four months. The arrangement that we had meant that we would be getting together every six weeks or so. So that was romantic, absolutely, but it was still a long time to go without sex. And so part of our negotiation, and it was definitely a loving, respectful negotiation, was that I felt pretty comfortable that if while I was away, if he wanted a one night stand, my life would go on just fine. And he was totally surprised, but kind of titillated by it. It's been a long time. I hope this is appropriate to say. But what I told him is that there were three things I needed about that. I needed safe sex, don't get involved and teach me anything you learn.

Meryl Comer (17:26):

Were there any non-negotiables, yours or his that almost derailed the plan?

Leah Fisher (17:32):

Part of the negotiation was that my husband did not want me to be sexually involved with anyone else. And he said, you know, I know this isn't fair, but this is how I feel. And I said to him, we're not the same people, we don't have the same needs. And if I were to get sexually connected with someone, it would be because I wanted to get involved, not because I didn't <laugh>. So that was it. Yeah, we surprised ourselves as my husband met someone that he thought he could have a harmless interaction with. I got a little freaked out and too curious to wanting to know what was going on and to a point where I saw it was a distraction. It was a distraction from my adventure and it was a distraction from my 30-year-old reliable relationship. And I ended up telling him that I misspoke myself that the sexual revolution was, was over for me and could we go back to just being each other's partners and and calling it an end. That was frustrating and my husband very quickly let go of it, said that he had enjoyed the possibility and he had enjoyed romancing someone and we needed to just be us a couple.

Meryl Comer (19:01):

Well, thank you for sharing. Any other non-negotiables?

Leah Fisher (19:05):

Is there something that you wondered about that was non-negotiable?

Meryl Comer (19:08):

You've taken care of the intimacy, you know it's money, it's communication. This is an age where it's easy to stay in touch. So how often did you talk? Was that a planned engagement?

Leah Fisher (19:22):

So here I am heading off to learn Spanish as a 60-year-old and pretty much my vocabulary was limited to those <inaudible> and which means too cold beers and there isn't any toilet paper. The treat at the end of the day of studying Spanish and speaking in Spanish, terrible Spanish was getting to email my husband and read the emails he sent me and we did end up communicating just about every day.

Meryl Comer (19:57):

If a couple came to you today wanting a marriage sabbatical, what are the three top questions you would insist that they answer before even considering it

Leah Fisher (20:07):

First? I would definitely wanna know what each one considered a marriage sabbatical. My great hope about this book is that people will understand that traveling for a year alone was my dream, but there are lots of other dreams that a partner may not share. And as I say, the cultural expectation is if you don't both want it, it doesn't happen. Now when you've got toddlers at home, that's a really good idea when you're closer to the goalpost than you've ever been before. And there are things you want to do to fulfill yourself to complete who you are, that here's a possibility to be creative or original that you haven't done but could. So I would wanna know what's the dream? I'd wanna know how sturdy their relationship is and how committed a couple that were struggling in their relationship, a couple that were contemplating separation, stay home and deal with it. Think about it. Maybe you do want to separate and be part of that gray divorce cohort, but do it straight up. Don't just wander off. So there's two. And what would be a third one? Well, it would be what does this mean about the marriage that you're pursuing this dream? Whether it's taking art classes that involve not being home at dinner time or traveling, those would be the three

Meryl Comer (21:38):

Leia. Had you not gone on a year long sabbatical and tested the durability of your marriage, where do you think you might be right now in this transition period post MCI diagnosis?

Leah Fisher (21:51):

You know, my life on the outside would be the same. I had wanted to do this journey since I had been in my twenties, flirting with the Peace Corps and curious, but far too terrified to do it. So the biggest change I think would be between me and me in that that promise I made to myself was kept and my appreciation to my partner that he knew how important it was and was willing to do something that was somewhat uncomfortable for him in order to let me live that dream. What I think is we'd still be married, I'd be grou here, and he'd be more tucked in his own pocket more, more keeping his own privacy, which would frustrate me and I'd be more prickly and he would duck and cover and we'd get by fine. We had gotten by adequately. And in this case we've fallen in love, we feel like friends, really good friends and lovers. And he is telling me more about not just what he's done, but who he is, how he feels about it. And I am so much nicer

Meryl Comer (23:06):

As a therapist. Leia, how do you juggle the emotional work of coping without knowing if or when you'll transition to a more definitive Alzheimer's diagnosis?

Leah Fisher (23:17):

Well, to some extent I do it with humor. I have a funny bone and I was in a Alzheimer's association support group for people early in their diagnosis. And every week I would think this phrase kept coming up, I will always love you if I don't forget. And it amused me enough that I found a singer songwriter and we put together a song called If I Don't Forget. And it's very much the song is both poignant and funny. And it's about learning how to live with uncertainty, which is a very Buddhist notion is we want things to be solid and they aren't. They flow, they change, they move. And our diagnoses can take us places. An MCI diagnosis is especially tricky because for some lucky people, they stay at the same cognitive level of mild cognitive impairment and that's where they hang out. And for others it's the beginning of a slippery slope.

Meryl Comer (24:24):

But aren't we all at a certain age living with the ambiguity of increased risk unless we step forward and take the test and decide it's important and especially important now with the ability to diagnose earlier.

Leah Fisher (24:41):

Yes, that takes courage. That does take boldness because it's like, it's like peeking into a box. You don't really know what's there. And as I say, I think temperament has a lot to do with it. And if the partner who cognition seems to be changing is I don't wanna look, we'll wait and see, married to somebody who says, let's find out what's going on, there's gonna be friction. It can even be the other way where the person who has the change behavior says, Hey, I wanna know what's going on. And their partner is, let's cross that bridge when we come to it. So there are big benefits to knowing, to having time to get used to the idea before it comes and gets you.

Meryl Comer (25:27):

Leah, you were quoted as saying that getting the MCI diagnosis brought a kind of relief because quote, the outside world met your inside world. How did that moment of validation affect your sense of professional competence in your identity as a psychotherapist?

Leah Fisher (25:45):

My whole body shivered that cold shivery feeling if somebody gives you bad news, and my being a therapist had absolutely no relevance. This was an animal response of just shaking and and cold. I had retired by the time I got my MCI diagnosis, so it didn't have an impact on clients. On the other hand, people tell me that when you've been a psychotherapist, you walk through your life seeing the world as a psychotherapist. So I try to be there for my friends. And the impact is most people who love you want it not to be so, and everybody your age does that is the fallback. This isn't, this isn't. So

Meryl Comer (26:38):

Leah, what advice do you give to friends and family on how someone with a diagnosis likes to or deserves to be treated?

Leah Fisher (26:47):

Wow. Well, I would start by saying it isn't one size fits all that. It really is important to know who that person is. I am really comfortable asking for help and as a consequence, I meet a lot of people who are happy to be of help. For other people. Asking for help is saying, I'm one down, you're better, I'm worse. But I've started telling my loved ones and as I say, it's only been the last couple months that it's getting pretty clear to me that this MCI is gonna become something else, is be patient with me, be kind to me and keep on loving me. That's what I want.

Meryl Comer (27:27):

That's a beautiful way to end this conversation except for me to ask, is there another book still in you about this other chapter?

Leah Fisher (27:37):

No way, Jose. I wrote the book, I thought there really was a story to tell. It's out in the world. I wrote a song, it's on YouTube and it's called, if I Don't Forget, by Laura Fannon. And I wanna go back out in the yard and play in the Dirt

Meryl Comer (27:54):

And Live life.

Leah Fisher (27:55):

Well, there are lots of ways of living life.

Meryl Comer (27:58):

Leia, congratulations on your new book, the Marriage Sabbatical, and thank you for your advocacy with Voices of Alzheimer's. That's it for this edition. I'm Meryl Comer. Thank you for brainstorming with us.

Closing (28:12):

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