Relationships and Health
 
Just returned from the IARR conference in Chicago and while the majority of the 700 or so attendees are dedicated to researching interpersonal attraction, sexuality and the challenges associated with maintaining long term romantic relationships, a few bold souls presented health related findings.

This is a fun conference since there are few places on earth where people can gather to report on the scientific aspects of close relationships from the serious: Abuse and Violence in Close Relationships, the silly What Makes You Hot,  &  Exploration of the “F*ck  Buddy”  Relationship  and the sublime, The Expression of Compassionate Love in Newlyweds.  Despite all the talk about love, sex and attachment, I made a special effort to check out research that explores health related themes.

Although health and relationships research is still relatively new, a growing number of researchers are investigating how our close relationships affect health behaviors. As much as relationship research focuses on what happens (or doesn’t happen) in the bedroom, how much sleep we get each night can certainly affect health and may depend on the person we share a bed with.

Heidi Kane from UCLA described new data that shows how daily experiences in relationships influence sleep.   Mothers and fathers of young children were tracked daily for two months reporting on their interactions and sleep patterns.  It turns out that when mothers disclosed more thoughts and feelings to their partner they got a better night’s sleep.  It also helped that mother’s felt understood and accepted by their partner. 

Self-disclosure was not a significant predictor of men’s sleep quality suggesting that women may require a greater sense of intimacy throughout the day than men in order to sleep well.  This may be especially true for mothers who likely spend more time monitoring her family dynamics. A solid sense of commitment and love from a partner would be a psychological cue that the family is functioning well and she can rest easy.

For women who are not connecting well with their husband, they might feel the family is at increased risk and may worry or ruminate about the consequences well into the night.  It would be interesting to see if self-disclosure plays a similar role for couples who do not have children. Family role is key since traditionally women are caregivers and focus more attention on relationships whereas men might lose more sleep when they are worried about their careers and their role as resource provider is under threat.  As these roles change in the modern world will some men (stay at home dads) require more self-disclosure in their marriage to sleep well if their wife is the primary income provider?

Sleep is necessary to health as part of the daily rhythms that renew the body for the demands of the following day.  Lack of sleep may make a person less able to cope with daily stressors such as commuting, pressures at work, and dealing with a chaotic family life. Casey DeBuse and colleagues at UMass have investigated how newlyweds cope with stress by examining a biological marker tracking the regulation of the stress response known as anabolic balance. Measuring the ratio between two hormones (DHEA-S to cortisol) shows how flexible a person is at responding to stress and relaxing after a stressor has passed.

 As I have discussed before in this blog, chronic stress is widely known to lead to increased risk of illness.  The better people cope with stress, allowing for a directed response followed by rest or calm, rather than long periods of high arousal or chronic stress, the better chance they may have for avoiding illness. has shown how attachment is associated with the stress response  such that insecurely attached individuals  cope with interpersonal stress in less optimal ways than securely attached. 

The folks at UMass have found that husbands and wives who were low in attachment anxiety showed a more variable ratio of the anabolic balance hormones after a stressful conversation.  In other words, during interpersonal conflicts securely attached couples tended to get more aroused initially by the conflict to focus and deal with it but were better able to chill out after the conflict was over.  The cool thing about this study is the objective measure of anabolic balance that describes a person’s adaptive response to stress.  Casey told me that they have video of the stressful conversation that should yield insight into behavior and communication styles that accompany the more adaptive stress response. 

These were only a couple of the interesting health and relationship studies presented in Chicago. While people will always be fascinated by what draws couples together and what threatens to divide them, I sense that investigating how relationships impact health will continue to grow as young researchers find innovative new ways to test how close relationships influence health in both positive and negative ways. 

 
 
by Jhon Wlaschin, Ph.D.

Michael Bloomberg, the mayor of New York City is proposing a ban on sugar-sweetened beverages larger than 16 oz.  The mayor has made progress as a public health advocate by being among the first in the nation to enact a total ban on smoking in bars and restaurants and later restricting the use of trans-fats for restaurants serving fried food.  

Has the Mayor gone too far?
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Photographer: Chang W. Lee/The New York Times. Click the photo to read more about Lee's work.
Some serious debate is going on among the city’s residents and although some obesity researchers like Kelly Brownell from Yale support the idea, others like Cornell’s Brian Wansink who’s book “Mindless Eating” describes how most of us consume far too many calories without realizing it, believe the proposed ban is too confrontational and “doomed to fail.”

Reading comments posted on the NY Times website attached to the news stories, I am struck by the passion people have for this issue on both sides.  Part of the emotion comes simply from a well known phenomenon called reactance.  People do not appreciated and become angered when limitations are made on their freedom to choose.  that spouses who try and control their partner’s health behavior such as a weight loss attempt often fail and harm the relationship if done in a way that makes the person feel bad about their behavior.

People also feel that this removes value from the way money is spent on drinks.  It is certainly cheaper to buy the extra large sizes.  Food companies and others who sell soft drinks such as movie theaters have relied heavily on the profit margin that come from selling sweetened water.  Gas stations and fast food establishments use the lure of the giant soda as a way to keep customers coming back for what seems to be a good deal for the pocket book in the short term but the quickly consumed excess calories pile up and contribute to weight gain in the longer term.

Many people feel the Mayor  would be wiser to educate his citizens about the hazards of excess soda consumption or spend more on programs like subsidizing gym memberships.  One opinion writer in the Times criticizes the mayor for not creating programs to help people to make better choices and then offers examples such as the changes school lunch programs have made by offering lower calorie drinks, and salad bars.   Aren’t these the same type of environmental controls the Mayor is prosing with the large size soda ban?

The problem is that unless you are living in a cave, you already know that drinking too much soda can lead to weight gain and in fact there has been a substantial decline in soda consumption over the last 15 years.  and other’s have pointed out, size matters, and people will consume most of what is given them without thinking.  Once smaller soda sizes become standard, people will not likely pine for the “Big Gulp” and they may be thinner for it .

The Mayor cannot throw money at this problem.  Making gym membership cheaper will not cause enough people to exercise.  More informational public health campaigns are welcome but do little to change behavior long term.   It is the environment that we as a society have constructed in the name of capitalism and instant gratification that has had the unfortunate consequence of making the population fatter.   We were smart enough to create such a system to solve the problem of hunger and now we should attempt to build a new culture that feeds people responsibly. 

Unless we don’t really care about our children becoming obese before they reach middle school. 

Limiting the size of soft drinks is a cost-effective nudge at encouraging people to make better choices.  New Yorkers hated the idea of a smoking ban in bars when it was first proposed and now breathing cleaner air on a night out in the city is universally accepted and applauded.    Bloomberg is not saying you can’t drink soda, he is just putting a speed bump in your way to get you to slow down.

 
 
by Jhon Wlaschin

Satisfying wants and desires is the American way.  Watch a typical television show and your mind will be under assault from marketers  and the sexy, stylish, quirky characters that live out our fantasies on the screen.  We are programmed from very early on to want the things we see on TV and to covet the material gains of our friends and neighbors. 

We value the relentless pursuit of the  material world and think that it will bring us happiness. Yet the joy found in material things has a rapid half-life and has shown that we are often very poor at predicting how happy our purchases will make us in the future.

I often recall a phrase that my great Aunt Margaret said about our rich and somewhat snobbish cousins who drove nicer cars and wore finer clothes, “They may love their diamonds and pearls but those things do not love them back.”

When you think about it, we chase after material wealth not only to possess flashy things but to gain the status that might bring increased attention from others.   But as happiness researcher Mihaly Csikszentmihalyi says, “we derive our greatest happiness from our interactions and relationships with others.” 

Think about your happiest moments.  How many of them occurred when you were alone? 

Conversely, the strictest form of punishment when in prison is solitary confinement.

To illustrate this point at a deeper level, recent describes the distinction between behavior done purely for immediate pleasure and behavior that leads to longer lasting satisfaction.   Hedonism describes behaviors like getting drunk, gluttony and conspicuous consumption as our tendency to seek instant gratification, the quick hit of pleasure.

In contrast, behaviors such as volunteering, expressing gratitude, giving to charity and listening carefully to others to gain understanding have been found to be more satisfying.  Aristotle originally coined the term eudaimonia, which refers to a life lived to its fullest potential.  Today happiness researchers refer to eudamonic behaviors as pleasurable but because they are meaningful and often relational they tend to lead to enduring happiness. 

This distinction relates to what describe as  self –image goals and compassionates goals.  Jennifer Crocker and Amy Canevello have found that in terms of relationships, individuals tend to have goals that emphasize either compassion (to be supportive and helpful to others) or self-image (get others to acknowledge your positive qualities, convince others you are right and avoid making mistakes).   Their research finds that those with stronger compassionate goals create more supportive social networks and developed greater amounts of interpersonal trust.

Those who are preoccupied with self-image goals tend to undermine the positive effects of social support and trust. Focusing too often on one's own needs and engaging in support only when expecting something in return creates a “me-first” dynamic that might weaken the trust in a relationship.

If we truly want to be happy, it is clear that the best place to start is by supporting and caring for our close relationships.  When we forgive rather than blame, accommodate rather than demand.

Finally, has demonstrated that spending money on others instead of oneself  leads to greater happiness.
So you can choose to invest in those $600.00 shoes thinking that they will make you stand out at a party but when you choose to invest in the hopes and dreams of a close partner you may find it leads to longer lasting joy.

 
 
Many of the posts that are presented here originated from the Relationships and Health class that Maryhope Howland and I created and taught this summer at the University of Minnesota.  We had students read a key article to prepare for each class.  We also created a private blog for the students to summarize the findings and then attempt to describe how it applies to their own life.  The students have agreed to allow some of their posts to be presented here in this more public forum.

So from time to time I will reblog (is that a word?) their ideas about their reactions to current science involving how relationships affect health and well-being.  

This is a commentary from a on how relationships can influence our goals and affect self-regulation written by two young superstars in social psychology :  and .  
Discover more at this link
 
 
by Lynn Tarkow

I really liked this article. The first idea that struck me in it was the idea that people will remember goals they have when reminded of people in their lives whom they associate with those goals. This could serve as a function to help maintain social networks - when I think of my friend, it makes me want to maintain that relationship, and a goal, whose completion presumably would involve being together if it was associated with him or her, would serve to strengthen that relationship. 

I was also very interested in the author's finding that performance was impaired on the Stroop task at different times depending on the race of the interaction partner. When the same-race interaction partner mimicked the subject's behavior, indicating affiliation, the subject's performance was better than when the partner did not mimic them. However, when the partner was of a different race, subjects performed better when the partner did not mimic them. The researchers attributed this to people expecting better treatment from members of their own race than from members of a different one. The finding was not explained any further. 

Why were the subjects' resources more depleted? More importantly, where had the resources been used that they were unavailable for the cognitive task? Did they go to combat the unexpected treatment by the partner? Or were they somewhere else, creating a new heuristic that could be called upon the next time the subject was in a similar situation? It would have been an interesting follow-up to see if, put in the same situation of non - mimicry by the same race partner, and mimicry by the cross race partner, the subject still had depleted performance, or if their expectations (if those were the culprit) had adjusted themselves. 

On a lighter note, I was happy to read that the study showed that romantic partners were more likely to achieve their goals if they had more social support, especially from their romantic partners. It is a heartening thing to hear that all those "We can do anything - together!" stories have some basis in reality.
 
 
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by Maryhope Howland

I once took a self-defense yoga workshop. That might sound counterintuitive--we don't often think of yoga types going kung-fu style on their attacker--but my sister and I liked the sound of it, a more emotionally healthy way of defending ourselves in the big city.

The instructors in this class taught us a bunch of moves, how to stand so it's harder to push you over, how and where to hit someone else for maximum impact, and how to take a hit. But they also talked a lot about how we might go throughout the world to invite conflict less. One thing they said, that stuck in my mind, was that we have to give and take in order to be a "whole" person. We can't expect others to behave how we want them to if we don't tell them what our expectations are. We can't get mad when someone doesn't do something we think they should do if we didn't communicate that well. In other words, we have a responsibility to show people how we feel so that they can react accordingly.

There is a psychological study that always reminds me of that advice from the butt-kicking yoga instructors. The researchers (Diamond, et al., 2006) brought couples into the lab and hooked them up to heart rate machines, and then they asked them to have a conversation about their relationship. For some people conversations that bring up relationship issues can be very stressful, and this is definitely true for individuals who are insecurely attached. For securely attached individuals--those who trust that their partners will always be there for them--these conversations weren't stressful, and their heart rates didn't really go up. Folks who were anxiously attached on the other hand, that is they are never sure if their partner is really there for them or not, reported being very stressed out during the conversation, and their heart rates went way up. The interesting thing was what happened for avoidant individuals, who generally don't believe their partners are there when they need them. These folks reported that the conversation wasn't stressful at all, not one bit. But when the researchers looked at their heart rates, they were through the roof! This is what the researchers called "repressive coping,"--they were experiencing a lot of emotion, but were denying it even to themselves.

Research shows that this is an unhealthy coping strategy. If you don't express your stress to your partner you're denying yourself the opportunity to get their support and love, and you're probably not doing much to calm yourself down. This means your heart rate is elevated for longer, which can cause wear and tear over time. It's just like my yoga teachers said--we need to own up to our feelings and share them in order to get from the world what we need.

Diamond, L. M., Hicks, A. M., & Otter-Henderson, K. (2006). Physiological evidence for repressive coping among avoidantly attached adults. Journal of Social and Personal Relationships, 23, 205-229.

 
 
by Jhon Wlaschin

Sex is a good thing.  It is essential to the survival of the species and comes with all kinds of incentives like increased intimacy and the release of a host of neuro-chemicals that bathe us in joy.  Yet when we consider the science linking sex to health, the vast majority of studies involve the health problems associated with sexual behavior and almost completely ignore how sex might enhance health and well-being.   

When we consider how relationships affect health, sexual behavior should have significant effects on the quality of a romantic relationship and also play a role in overall health.  We know that married people live longer and somewhat surprisingly married couples have, on average, more sex than singles. 

Could sex have something to do with why married couples are living longer?

The idea that sex may benefit health is not new yet historically many cultures have warned that frequent sex might result (at least for men) a loss of an "essential essence" that would cause a reduction of strength, memory, and even reason. Freud theorized that sex was necessary to relieve tension and that masturbation was not sufficient to avoid heightened stress reactivity.  There is some that intercourse is required for the bursts of oxytocin and improved heart rate variability that might be the physiological routes to improved health from sex.

In one  researchers found that frequency of sexual activity was related to lower stress reactions when preparing to speak in public.  Volunteers who reported having no sexual relations or masturbation had the greatest spike in blood pressure during the task. Those who had frequent sex but no masturbation had the smallest increase in BP before speaking in public.

Another  found that middle age men who engage in frequent sexual activity with a partner were 50% less likely to die than men with little or no sexual behavior over a 10 year period.

Given these results you might imagine that the medical profession would start prescribing more nookie for stressed out and unhappy couples.

The sad truth is that many of us do not get the love and affection we crave. A  in 27 countries revealed that sexual dissatisfaction is widespread, with 58% of women and 57% of men reporting that they are not fully satisfied with their sex life.  Sex, like wealth, seems to be unevenly distributed with a relatively small proportion of couples having the most frequent sex.  The researchers found strong evidence demonstrating that sexual intercourse is a significant predictor of satisfaction with life in general, satisfaction with partnership, and satisfaction with one's mental health.

Finally, we can't ignore the way sex might help us connect and treat our partners better, facilitating a closer and more satisfying relationship.  A found that when couples engaged in physical affection or sexual activity  they were more likely to experience  positive mood and less likely to experience negative moods and stress afterwards and into the following day.  Masturbation did not affect mood in the same way but was related to a reduction in stress.  Most marriage counselors will point out that a non-existent sex life is a strong sign that a marriage is in trouble and that improvements in a couples sex life are some of the best methods for improving the relationship.

So plenty of questions arise here.  What about gay sex?  Why doesn't masturbation have the same health benefits?  How much sex does a couple need to have for it to benefit health?  Since there are so few studies on sex and health, there really isn't enough good evidence to answer these questions yet.  Perhaps when academics get a little less squeamish about studying sexual activity and can convince funding agencies of the health protective function of sex, will we be better able to understand how "getting busy" is also helping us toward staying healthy and connected to our closest partner. 
 
 
by Jhon Wlaschin

We all should be beginning to appreciate just how much social contact affects our health. A major question that often arises concerns the relative value of our online social connections vs. face to face relationships. Do our social ties through Facebook and Twitter provide the same health benefits as face to face interactions?


It's probably too soon to say definitively but a number of interesting studies have been assessing the effects of social media on health and well-being for more that a decade now. An early study called  set off alarm bells in 1998 after following teenagers who used the internet for 2 years. They concluded that teenagers who spent more time online experienced declines in social and psychological well-being and those who were lonely and depressed beforehand were not necessarily more attracted to the internet. Perhaps heavy internet use for online communication led teens to forsake critical relations with local friends and family for weak relations with strangers.
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Online advocates often claim that online communication may be a particularly safe way to communicate for certain teens with poor social skills. Indeed, a 3-year follow-up study of the HomeNet sample showed that these negative effects on well-being had dissipated over time.

From these early studies, a great deal of research has blossomed to examine the effects of Internet use on well-being. Unfortunately many of them are cross-sectional studies and can not make firm conclusions about the effects social connections have on health. Of the few longitudinal studies that have been done, results tend to show that online communication is related to a decrease in psychological well-being among introverts and those who received low levels of social support. Extroverts on the other hand, and those with more social support tend to benefit from online communication.

 in the flagship journal of social psychology  found somewhat of a paradox in internet use claiming that frequent users felt both more connected and more disconnected. The authors speculate that people who are lonely use Facebook more to fulfill a basic need of relatedness and perhaps as a coping strategy.

Yet many others use Facebook frequently not because they lack social connections but because they really enjoy interacting with their friends online. To show this another way, volunteers in the study were restricted from going online for 2 days. Everyone felt lower levels of social connection during the blackout but those who were previously lonely and seeking connection had greater internet use after the cessation period.

This suggests that the motivation to seek relatedness is a more basic need than deriving pleasure from interacting with established friends. It may turn out that those who need to feel more connected may not truely get there online. I would bet that these virtual social connections would provide less in the way of health benefits for lonely people.

If you already feel socially connected and use Facebook and other online tools to stay in touch with your peeps then it seems likely that online interactions will provide similar health benefits as face to face relationships. Perhaps by reducing stress and providing a greater sense of support.
 
 
by Jhon Wlaschin

How often did you eat dinner together as a family growing up? Are you currently eating most of your meals alone and on the run? Do you believe that eating together as a family would impact your health?

It does indeed but in more ways than you might imagine. Recent studies have shown that parents have a great deal of influence on their children's health behaviors and that a basic way to reinforce healthy behavior might be making it a priority to sit down at least once a day to share a meal together as a family.
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and her colleagues at the University of Minnesota have been investigating the health benefits of family meals for the past decade. Her research as well as other replications have clearly shown that although family meals are still quite common for most of today's youth, a growing number of children experience fewer than two family meals a week. Fewer family meals are associated with poorer diet quality especially eating fewer fruits and vegetables. Children eating fewer family meals also tend to be more sedentary and report watching more TV especially during meals.

This much seems obvious but other studies have shown that family meal frequency is also strongly linked to a number of important behaviors such as substance use, academic performance, self-esteem, depressive symptoms, even attempts and thoughts of suicide! Eating with the family on a regular basis was found to be a potentially protective factor especially among adolescent girls.

Certainly many other factors might explain these findings but the researchers were careful to control for factors such as family connectedness, family support and communication. So what's so special about having regular meals with Mom and Dad?

Is it simply spending time together, having positive role models, discussing health issues and how to deal with them that happens at the dinner table?

A  examined a large 10-year data set of adolescents looking for the active ingredients that promote health during family meals. They discovered that frequent family meals at the beginning of the study resulted in closer family ties later and may be helpful in teaching children beneficial coping skills. For example, girls who exhibited higher levels of problem-focused coping in Years 7/8 exhibited lower levels of stress, were less obsessed with their weight and had fewer bulimic symptoms in Year 10.

A critical piece then might be that eating together promotes family cohesion. When families feel close and supportive it likely helps children feel more connected and willing to seek advice when dealing with adolescent concerns. Eating together also likely makes children aware of what their parents value in terms of health. If a teenager is eating most meals in front of the TV they are likely to be exposed to the values of the marketplace to buy and consume more snacks, fast food and soda.

If a majority of a teenager's social meals are with their peers, they may be more likely to reinforce bad habits of eating sweet and high fat foods. 
 
 
by Jhon Wlaschin

Relationships can be stressful at times and those who are unfortunate to have their closest relationships also be their primary source of stress are likely to be experiencing corrosive effects on their health.  Shelley Taylor and her colleagues  have summarized a  that demonstrate how the sex hormones estrogen and testosterone are deeply linked to the stress response.  Most of our understanding for how both humans and animals reacted to stress was from the classic “fight or flight” model. 
Relationships and Health: Gender Differences
Researchers have only recently noticed gender differences in the stress response perhaps because research in this area has traditionally been limited to male participants. In many studies even the rats were all male!

What we now know is that women are more likely to seek out social support and engage in care giving when stressed whereas men are more likely to engage the fight or flight response.  You can start to see that what women and men start out with biologically might be a source of misunderstanding when couples are under stress. 

Once an argument starts, the stress response engages.  She wants to affiliate, draw closer, and talk about the problem.  His body is preparing for increased aggression and since modern society discourages spousal abuse he may tend to be more inclined to seek avoidance by disengaging.

Sound familiar?

Again, oxytocin is involved here but as the  points out the pathways are complex and somewhat contradictory.  Oxytocin appears to work together with endogenous opioids, our own feel good neurochemicals, to make social bonding pleasurable.  Sex hormones play a critical role since androgens inhibit the stress-induced release of oxytocin, while estrogen enhances the stress buffering effects of oxytocin.   

Interpersonal situations matter such that when her affiliative efforts are unsuccessful, the biological stress response increases by way of the sympathetic nervous system and HPA axis activation.  When support seeking is reciprocated the opiod system engages to reduce sympathetic nervous system and the HPA axis limiting the amount of cortisol and other stress hormones in the bloodstream.

Oxytocin can therefore be at high levels when we are bonding with loved ones and also when we are feeling rejected, perhaps as a signaling system to increase efforts to seek out secure relationships.  Often times when we fight with our partner there is no one else to turn to for satisfying the body’s need for compassion and caring.  Perhaps this is the reason we turn to alcohol, drugs, cigarettes and comfort food when we are stressed, especially when that stress involves our closest relationships.