Relationships and Health
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.

by Jhon Wlaschin

So we are beginning to get a feel for the science of how marriage can impart heath benefits to people. Having a partner who pays attention and nudges us toward health and away from risky behaviors. It is also quite clear that simply being married is not enough to make a person healthier. Much of the benefit comes from quality partnerships and contentious relationships likely add stress, undermining a proximal source of comfort and corrode our health making us much more likely to get sick.
Mob Wives from VH1
One topic that came up is interpersonal communication and conflict. Every relationship experiences conflict at various times. What matters is how you deal with these moments. Do you fight back, become defensive, hurl insults or try and prove you are right, to "win" the argument? Is there a regular dynamic of demand and withdrawal that happens with your partner each time a difficult subject comes up?

Most of us are clueless with how to navigate through these moments. They are emotionally volatile and we naturally want to protect ourselves from harm. But in so doing we often do harm to the one relationship that we need the most to maintain health and happiness.

So what to do?

I have been married a long time to a woman who likes to be combative. I like strong women and Betsey can be very tough. Its no wonder her favorite TV show is Mob Wives. Over the last 20 years we have learned how to prevent arguments from spiraling out of control (most of the time).  has devoted his career to exploring how married couples communicate and has identified a number of warning signs that reliable predict when a relationship is in trouble. He has famously dubbed them "

We know that the style of arguing in a marriage is strong predictor of cardiovascular health. Whether you and your partner have a hostile or a warm style of arguing can have implications for your health just as high cholesterol or smoking can take quality years from your life. 

We all know hostile,  "What's with the checkbook, did you fail 4th grade math?" 

Insulting your partner rarely makes for good conversation. At best you will make your partner defensive and less willing to comply with your needs and concerns. 

A growing body of research that has discovered that partner affirmation helps to reduce defensiveness. By first affirming something positive about your partner before launching into an argument can diffuse much hostility and defensiveness. This is what is meant by a warm style of arguing.

 "You know, you are great with the kids but it would make me less upset if you could be  on time more often."

Much can be learned about this kinder and respectful approach to conflict from  Not only do same sex couples tend to begin and maintain a more positive tone during disagreements than hetero couples but they are less likely to use the demand withdrawal style and are more likely to suggest possible solutions and compromises. Gottman speculates that gay couples value equality more and have fewer differences in power and status between them. This style of communication seeks a win-win solution rather than a win-loose.

Betsey and I just had a bit of a spat on our morning walk today. What works for us is first to try and acknowledge each other's feelings rather than question them. Providing a space to have negative feelings that need resolution. If it seems like things are getting too heated we take a break, (usually I go for an extended walk). Then when it's time to try again, two things usually always work to broker a truce, using humor to mock how ridiculous our disagreement is in the big picture and extending a hand to touch and caress in an affectionate way.

If Jim Coan's research is correct, this might be one of our most effective tools for defusing stress and renewing the warmth and comfort we need from our partner.
by Jhon Wlaschin
Want to stress out a rat? Put it a box with a remote control car and chase it around for a few minutes. That's what Bibb Latane' and David Glass did in a  back in the 60s to investigate fear and attraction in rats. Rats were pretty terrified when experiencing this alone.

How do you measure stress in a rat you ask?

Basically the researchers measured the fear response, freezing, pooping or peeing and how close the rat would come to the car when it stopped.

What was interesting was when accompanied by another rat they both showed much less fear than when alone. It seems the mere presence of another rat calmed the creature down and that having a buddy at your side might be enough to better prepare you for a frightening situation.

Even more interesting, rats were noticeably less freaked out when the experimenters placed an anesthetized rat in the box. So just having another warm body next to you might be enough to measurably reduce the fear response of an oncoming Ferrari. 




by Jhon Wlaschin
At the biological level researchers have identified a neuropeptide that is associated with the feelings of love and care giving. It is called oxytocin and is often used to induce uterine contractions during childbirth. It also is know to flood our brains during moments of intimacy, especially when a mother is breast-feeding her baby or during intimate and loving sex. This is the bio-chemical that promotes attachments.

Oxytocin in the form of a nasal spray has been  of social stress, increase trust and connection with others, especially those of our in-group. Oxytocin and the ability to understand what others are thinking. A shot of oxytocin to the brain will  and help you remember the names of people you recently met.

Some  who were avoidantly attached found that after only one dose of oxytocin they were more likely to respond as secure when assessing attachment images and phrases linked to security, comfort and safety with others. Even though this was a momentary shift, the researchers suggest that it could be used effectively in therapy sessions to promote changes toward secure attachment relationships over time.

So why isn't oxytocin more widely available for use to promote love and kindness? Well, as noted above the effects are temporary and only tested on men since oxytocin is can induce labor in women. Also oxytocin may have a dark side. In one study oxytocin was shown to promote ethnocentrism (the tendency to favor your in-group and disparage members of the out-group). So it seems that when people gather for a football game with other fans of a favored team oxytocin levels are driven up. Not only is there a feeling of solidarity with the other fans, but also there may be an increased dislike for those who are fans of the opposing team.

It seems that oxytocin evolved as a biological mechanism that helped our ancient ancestors identify whether others had a long -term commitment to the group.

A more  has shown that an external dose of oxytocin can change memories of how nurturing a person's mother was. The researchers found that the effects of oxytocin depended on the attachment representations people possess. Securely attached individuals remembered their mother as more caring and close after oxytocin (vs. placebo). In contrast more anxiously attached individuals remembered their mother as less caring and close after oxytocin. 
by Jhon Wlaschin

We are often at our best when surrounded by people that put us at ease. When we feel loved, understood and cared for we are less likely to be adversely affected by stress and perhaps even other types of disease. Although most of us are fortunate to have many secure relationships like this, sometimes we have relationships that evoke more problematic interpersonal dynamics.

Anxiously attached individuals often struggle to find a secure base with their close relationships and frequently turn to other means to feel soothed or distracted.  have shown that anxiously attached individuals tend to overeat and be overweight. Some are more likely to abuse drugs and alcohol as a means for dampening their over reactive attachment system that causes them to focus on those things that stress them out about their relationships.

Avoidantly attached individuals may also experience adverse physiological changes in social situations. A securely attached child experiences distress when a caregiver leaves them with a stranger, their heart will race and they often cry out. But when Mom returns the child will calm back down. Avoidantly attached children in a similar situation will not show any overt signs of stress when Mom leaves but will experience accelerated heart rate and will not calm down as quickly on the inside when Mom returns even though on the outside they appear aloof and unaffected.

I am sure we have all experienced relationships with others who tend to fall in one of these three categories. Secure attachments with others are valuable relationships that bring out the best in us, allow us to spread our wings and explore the world with confidence. As much as I sought out those types of relationships as a young man, there were some friendships and romances that tended to evoke anxious attachment. Where your partner's behavior was unpredictable. One day going to the movies would be and awesome time and the next it would be awful and confusing. And then when I would give her some space and not call for a while, she would become upset and feel abandoned.

I also know that I have had romantic relationships where I have acted more like someone who is avoidantly attached. I would pretend not to care when my lover threatened to leave, all the while worried that she would call my bluff. Although I have been married 20 years tomorrow and feel my wife and I are securely attached and have built a relationship with strong companionate love, there are moments even with her that seem like we are evoking both avoidant and anxious attachment systems. 
In a new  researchers have added insight into when support from a partner is helpful and when it  can actually undermine achieving goals.  The implications are important not only for managing a successful effort to achieve health related goals such as getting more exercise or eating healthier meals, but unhelpful support could also lead to relationship conflict, dissatisfaction and frustration.

It has been known for some time that not all social support is beneficial or welcome.  We tend to think that getting support from a partner would help us achieve our goals and make us feel cared for.  Yet support that is not skillfully provided can make things worse.  Often times, the best type of support you can provide your partner is when he or she does not even realize it; otherwise known as “invisible support.”

In the current study, volunteers were couples who were dieting  and were asked to describe: “How much my weight loss was an important goal for my partner.”  Ironically the more a dieter perceived that their partner was invested in their weight loss, the less likely he or she lost weight and in fact actually gained weight!

Further experiments found that when a person was uncertain about achieving a goal, they were more likely to request that their partner leave them alone.  In contrast, feeling confident about achieving a goal and getting support from a partner led to increased effort and greater goal success.  

You can see how these findings might play out in your own relationships especially when you are trying to help your partner and it only makes things worse.  I am especially aware of this when trying to help my teenage daughter achieve goals that she may feel uncertain about.  Often times, I believe she sees my support as my own goals for her and interprets my advice as controlling and unhelpful.  

It’s no wonder she often replies with “Just leave me alone Dad.”  It may be especially important to recognize when our partner feels less confident about achieving a particular goal so that we provide them the space to figure it out and not get in the way.  Not only do we risk undermining our partner’s effort when they are uncertain by providing overt support, we also are likely to feel hurt and misunderstood when our support is unwanted.    
So we have all been there.  That horrible moment when our beloved tells us that this is the end.  The dreaded breakup.  For many of us, this ranks among the worst emotional experiences of our lives.  Painful.  Yet how does this type of emotional pain differ from the pain we experience when we stub our toe in the middle of the night or scald our tongue on molten pizza?

 about a  that uses brain imaging to discover how these experiences might be related. Previous research has found that there is indeed similar neural areas that light up on the fMRI pictures of brains experiencing  both physical and emotional pain.   Although the brain seems to process  the emotional component of painful experiences similarly, there are known to be distinct areas that process the bodily sensation of pain-  my aching toe, my blistering tongue.  

What the new study suggests is that if the social rejection is powerful enough,  a devastating break up for instance, the brain may in fact engage areas that process painful physical stimuli.   We may not feel a specific pain in our toe after a breakup,  but perhaps the physical pain is more diffuse,  an overall ache.  The researchers in this study found that when testing people who had recently broke up with a partner activated similar brain regions for physical pain when looking at their lover and recalling the moment when they were dumped as when they experienced hot coffee being spilled on their arm!It has been thought that people may experience various forms of chronic pain such as fibromyalgia after a history of social rejection.    

It's not too difficult to imagine that a person who too often experiences the feelings of anger, sadness, shame, and anxiety after a break up or even a bitter argument with a friend or family member might also start to feel declines in physical health.  We are social creatures,  we thrive on the comfort, safety and joy we experience when we are with those closest to us.  When that source of nourishment and security is often threatened we may be more likely to actually feel physical pain.   
One way I thought would engage students right away toward thinking about how relationships impact health is to ask my wife Betsey to come in on the first day and have us briefly talk about how we help each other meet fitness and health goals.  

Recently we purchased a new product called Fitbit that is basically a very small accelerometer that tracks your steps and even records your movements while sleeping to track how often you wake during the night.  With some nifty software to track food intake and other activities you can quickly see why you are adding pounds to your frame each month.  

I have always known that weight gain is a simple formula of  calories consumed over calories burned.  There are many products/apps on the market now that track this for you.  Fitbit seemed to work right away for Betsey and me.  Last month, once the weather started improving, we decided to walk together with our crazy Boston Terrier Pearle every morning,  rain or shine.  

This turned out to be a great thing not only for our health but for our relationship as well.  Since we are both busy with various projects, we often spend too much time in front of the computer and not enough quality time with each other.  Our morning walks became a time to reconnect, share our feelings and plans for the day, tell each other about interesting news, and sometimes even work out a disagreement.  Pearle never seemed to mind.

Well that's all great, I was enthusiastically entering my food consumption each day and I even noticed that I started to cut down on some of the excess snacking that I typically do when I am mindlessly trying to avoid work.  Being aware of what I eat and challenging myself and Betsey to get our 10,000 steps seemed to be pushing that that equation more in favor of the calories burned.  Even a little competition started to set in when Betsey realized that I had 20,000 steps one evening and she only had 8,000.  She promptly got up and took a walk with Pearle even though it was already well after dark,  something she would have never considered in the past.

So I'm thinking, this would be great as a research tool for my roommates study in the fall.  Its so easy to use.  Only one problem.  Two days ago I woke up and got dressed and realized I had not worn the fitbit to bed.  I went to retrieve it from the shorts I was wearing the day before and to my horror, it was not there.  I looked everywhere but realized that the tiny device had likely brushed up against something either when I was working in the yard or riding my bike.  A $100 investment gone in a week!   Snakebit again.  

Its not the cost really but the sense of control I was feeling about my health and how that was nicely dovetailing with my wife's health goals.  It sucks being an out of work PhD.   I can't  easily fork over another 100 and yet I value what the device was helping me achieve.  What to do...