Intimacy: A Prescription for Health and Longevity

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When beleaguered couples come to my office for counseling, it’s usually helpful to start the therapeutic ball rolling by empathizing with the couple‘s presenting complaints and to duly compliment them for their humility and their courage to come in for treatment.

During this initial rapport-building phase, I’ve also found it helpful to gently inquire about what it was like for them to agree to come to therapy and if there's anything we might learn from this potentially relationship-saving, and perhaps exceptional, act of cooperation.

The Deepest Reasons

Then when it's timely, I‘ll zero in from a slightly different clinical perspective by asking each partner to thoroughly search themself for a complete parsing of their deepest motives and reasons for seeking therapy at this time.

Tasked in this way, some partners sink into a deep abyss of self-reflection from which they don't always seem to fully emerge. Others go blank or are puzzled by questions that would seem to have obvious answers. And yet for others, this "soul-searching" exercise is as enlightening as it can be labor-intensive.

Nevertheless, I find it clinically useful to patiently work with partners to unearth the breadth, depth and strength of their motivations for wanting to heal their relationship as these will likely be put to a rigorous test if we are to be a successful team in repairing their bruised, stress-filled relationship.

Description vs. Explanation

Throughout their struggles to probe for answers to these pertinent questions, a significant number of partners default by succumbing to fault finding where verbal darts of this sort get flung: "She nags and complains way too much...He doesn't communicate at all, not like he once did...He's become a stranger...She won't agree with me on anything...She's not affectionate...she's distant, detached," and the like.

However, this bristling litany of accusations and complaints partners aim at each other is way off target. That is, by launching their attacks partners deny, dodge or otherwise obfuscate answers to the hard questions before them, yielding to the shallow veneer of description over deeper causative explanations.

The Harder Questions

Without doubt, their despairing, heartfelt complaints evoke my concern and compassion. But their partner-damning accusations, as "evidenced-based" as they may be, fail to address the precise reasons or motives for entering the difficult process of couple’s therapy. Instead, their deeper motives can only be inferred from the clarion "distress call" trumpeted by their fiery complaints and, of course, their sheer presence in my office.

Digging even deeper though, partners leave a critical, unanswered question as to what the quality and sustainability of their motives are for choosing to be partnered in a relationship as complex and challenging as the intimate one.

The Task at Hand

A large part of our initial work together is to identify which underlying motives partners may already possess but need buttressing and perhaps with little more than a fresh dosing of hope. As a collaborative team, we scout out those motives which may have been instrumental in preserving their relationship up to the present despite the rough-and-tumble turbulence of their prior conflicts. Or of necessity, "piggy-backed, add-ons" may become necessary. That is, a helpful stack of additional reasons may provide further support and better serve and help sustain their efforts to repair, preserve and strengthen their relationship.

A Valid Bottom Line

With some gentle, nudging encouragement, many partners fairly quickly arrive at a patently valid bottom-line reason: They choose to be tightly coupled in a close relationship as opposed to being without one and alone. Once these moments of clarity and self-transparency are achieved, partners frequently go on to elaborate on their desires for the emotional security of a close, stable and satisfying relationship but they also painfully acknowledge they lack the right "set of tools" for attaining these fulfillments, especially on a continuous, long-term basis.

Unfortunately, in many cases, these strong, fundamentally valid needs for emotional security and closeness are obscured by the encrusted layers of stockpiled acrimony from long-standing, unresolved conflict. Notwithstanding, these valid desires and out-of-reach aspirations still exist and can be mined throughout therapy to further our purpose of repair and rehabilitation. Arguably, the same basic needs persist even where previously intimate partners parted company and/or divorced rather than do the arduous work of mending their relationships.

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Our Happiest and Healthiest

I'm convinced, as are most, that loneliness and social isolation are anathema--our universal foes. Contrarily, rapidly amassing scientific data strongly suggests that we are happiest and healthiest when nestled within the warm, securing embrace of our closest relationships. Indeed, throughout the ages, we’ve culturally and legally enshrined the one social institution—marriage--that attempts to permanently weld a lifelong union of committed partners as an accepted and effective panacea for loneliness and isolation.

A Health Crisis

Social isolation, the logical opposite of social connectedness, has taken its place under a dismal spotlight for its role in a range of high-ranking disease processes leading to premature death. Topping the list is heart disease and stroke, followed by cancer and type 2 diabetes, dementia, suicide, depression and anxiety, to name the more notoriously familiar.

Convincingly, social isolation is a "disease" in itself.

One study, published in PLOS Medicine, cited the health risks of loneliness to be comparable to smoking 15 cigarettes a day. Sadly, to our collective discredit, social isolation has become so widespread it's been declared a “health crisis.“

The Missing Antidote

The "plain-as-the-nose-on-your-face" engine that should drive the prevention of social isolation is the formalized development, preservation and enhancement of our capacity for social connectedness. For example, imagine these possibilities: The surgeon general makes a public health announcement (like the warning label on a package of cigarettes) declaring loneliness a health hazard. Or colleges and universities that offer courses entitled "Creating and Maintaining Social Connections" and "Intimacy 101," And for those who don't heed the warning, hospitals and physicians with specialties in treating isolation and loneliness.

Unfortunately, however, formalized social skills education, much less specialized training in the skills of intimate relating, is largely and conspicuously absent, there's a gaping educational hole in our conventional institutions.

The Harvard Grant and Glueck Longitudinal Study on Longevity

The impressive, well-worth-our-attention, eighty-year-old Harvard longitudinal study on health and longevity finds strong correlational evidence between health and the quaility of participants' relationships. Remarkably one of its most compelling and consistent findings is that being partnered in a healthy intimate relationship delays the onset or buffers against a broad range of diseases thus promoting our health and longevity.

Molecular and Molar

Interestingly, on a molecular level, researchers have identified the positive influence that healthy relationships exert upon the on-off expression of our genes. Naturally, hitting the "off switch" on an oncogene predisposed to cancer is yet another compelling reason to nurture our relationships in the same way we attend to our diet, physical exercise, sleep quality and psychological stress. And on a larger molar or behavioral level, positive lifestyle factors, especially healthy relationships, activate biopathways involved in improved immune function which promotes physical health and psychological well-being.

The Best Reasons

Back on the couch, the motives and reasons couples may already have or are able to take aboard for keeping close relationships well-cobbled together in health and happiness are, of course, the best reasons. My own top choices, both personally and clinically, are encapsulated in these basic premises: Our closest relationships, particularly the intimate one, are incomparable in that they reveal our level of emotional development through countless daily interactions that bring to light our attributes, dispositions and sundry individual differences--often those that spawn partner conflict.

Inevitably, when our weaker, lessor-developed attributes are surfaced or revealed we are afforded a unique opportunity to take full responsibility for them by correcting them and as we take on this very personal enterprise, we earn the rich endowments of emotional maturation which, in turn, directly contributes to the quality, health and longevity of our relationships.

It's conceivable that optimal health, both physical and mental, may not be fully attainable outside the context of our closest relationships.

This is a good reason. What are yours?