Couples, Couples Therapy, Marriage and Family Therapy

When Jack Sprat and His Wife Go to Couples Therapy: Body Weight as a Problem in Marriage

couple weightOne day, pregnant with my second child, I went shopping for maternity clothes. I was feeling nauseous and suddenly experienced the familiar lightheaded dizzy feeling which accompanied all my pregnancies.  Afraid that I would pass out, I dropped down on the floor in the aisle of clothes, obscured from view.  A married couple walked up a few aisles over. The wife began questioning her husband about apparel and he reacted with indifference, communicating that he didn’t really want to be there. “That’s why I’m here by myself,” I thought, since my husband considers shopping a form of torture.

The wife was somewhat heavyset, and her spouse appeared to be average weight.  While considering different outfits, she suddenly pointed, “Oh, we can look over there in the “petites,” section.  His back was turned, so I couldn’t see his face, but I could absolutely hear the disdain in his voice.  His one-word response was a jab, “Petites?”  His contempt spewed his intended message, which was, “Aren’t you too fat for the ‘petites’ section, Fatty?” She paused a moment and snapped monosyllabically, “Short!” which throbbed, “Petite means short, Dummy, and by the way, I know I’m overweight—you don’t need to keep reminding me about it! Jerk!”

I remember sitting there, fighting nausea, thinking, “I can’t imagine my husband talking to me like that, even if I did fight weight gain.” I knew if anything, this man’s negative message would only heighten her shame and anxiety, likely driving her more toward food as comfort, which is verified by research.

Empirical studies of mixed-weight marriages show that they are at risk for higher levels of conflict. Weight can create sexual and emotional distance. Occasionally, I have a mixed weight couple in therapy in which the average weight partner expresses dissatisfaction with the heavier partner’s weight.  Sometimes it’s about health, but a lot of the time it can impact physical attraction.  Rarely, however, is weight the only presenting concern.  It’s usually just one of a myriad of complaints, but it’s a highly visible one, complex, and challenging in therapy.

For a while now, my husband and I have been answering couple questions in an app called “Happy Couple.”  This was one of my questions last week:

Steve pulls on jeans and finds that he can no longer zip them up.  How do you react?

A. Give subtle hints when he goes for second helping at dinner

B. Dole out a diet mandate

C. Probably wouldn’t be so into sex

D. Shrug it off and tell him to buy a new pair

Any guesses about my answer?  Definitely “D.” In fact, I was asked this question anonymously at a marriage presentation last year and I explained why I recommend the answer be “D.” Or, I might add an option “E,” for “Reassure him that you love him and ask how you can be supportive.”

Here’s why the other responses won’t work:

  1. Your partner doesn’t need a reminder that he/she is overweight. I guarantee that the broader culture is already reinforcing that message.
  2. Threatening a partner only increases anxiety and shuts people down. It’s the opposite of motivating.
  3. Attempting to control a diet makes it your problem, and if you have ownership of your spouse’s weight, your spouse cannot own it and be autonomous in developing healthier habits.
  4. Humiliating or shaming a partner also increases anxiety and hiding behavior.

Don’t get me wrong. I understand that weight gain can create fear about attraction to a partner, or fear for a partner’s health. In my marriage, my husband has always put on weight easier than I do, even though he always exercised more consistently than I while I was having babies. His weight generally fluctuates between 10-20 pounds with external stressors. It bothers him a lot and me not so much. While it has never affected my attraction to him (I simply see the person I married, and I always thought he was good-looking), I have occasionally worried about his health, given his father’s history with heart surgeries.

I know 100% that I cannot control what he does and if I tried he’d feel criticized and resentful. I also know it bothers him and he’s always hyper-aware and working on it, and the last thing he needs is a spouse to make him feel worse.  In fact, throughout our marriage, I have frequently joked that the “teenage girl,” persona is showing up, because he will complain about how fat he is, and I almost never notice if he’s putting on weight. “When did you turn into a 14 year-old girl and what have you done with my husband?” I’ve mused. I think it’s the obsessive cyclist part of him.

So, how do you handle it when a spouse is overweight and it’s scaring you because you are worried about their health or worried about your physical relationship, or that you’ll never be united?

  1. Ask how you can be a support person. Once my husband tore a ligament in his foot which shut down his exercise for months. He was also working full-time, in full-time MBA school, and being a father to 7 children. He was cranky about it and complained about his weight constantly. I finally reassured, “I want you to know that your weight gain isn’t bothering me—I don’t notice–but you keep talking about it, so it’s bothering you. Do you want me to do something differently to help you?”  I had been trying to make dinner healthy, but I have always despised eating breakfast and usually skip it, so I’m really lacking in that area, and he lunched with his work buddies. We decided if I made up healthy snacks, it would help him stay on track with his eating.
  2. Model behaviors. I’m not going to pretend that I’m a nutrition expert, but I know enough to impact the food choices in my home, and my family takes a lot of cues from what I purchase, eat and prepare.
  3. Understand and respect differences. Cooked spinach and chard with lemon were my sometimes comfort foods growing up. While pregnant with my third child, I planted a garden with a bunch of chard and decided I would serve it to my family without telling my husband because he hates cooked spinach, so I didn’t want the protest. When he showed up, I started serving the kids with my sales job, “Look, daddy, this is the chard we grew, just like Grandpa Cluff—we’re eating it with lemon.  It’s yummy, right daddy?” I put a forkful in his mouth, winking at him to play along.  He did. He ate the serving on his plate with a smile and extolled its health benefits to our sons. I thought I had him sold. Then, he approached me while I was doing dishes, bent down and calmly whispered in my ear, “By the way, that was the most vile, disgusting thing I have ever had to eat; I choked it down because I knew you wanted the example for the boys, but if you ever serve that to me again, my serving is going right in the trash.” OK. Fair enough. I won’t make him eat cooked greens, beets, or cucumbers soaked in vinegar as long as I don’t have to eat melted cheese.
  4. Find a physical activity to enjoy together. My husband is a cyclist and I’m a runner. We don’t usually exercise together, but we do like hiking and tennis, which count. Find something you both like. There’s always walking.
  5. Identify whether the problem is really the weight or something deeper. Usually weight becomes symbolic of dissatisfaction coming from other areas of the marriage. Are there previous relationship injuries or conflicts to address?
  6. If the sexual relationship is impacted, try focusing on other forms of physical affection first. Because weight and attraction and sex are intertwined, I’m not going to pretend like sexual connection won’t be affected. However, couples get hyper-focused on orgasm. Sometimes slowing down and increasing sensuality first can increase sexual desire and/or performance.
  7. Focus on other characteristics you like about your spouse. I know this sounds trite, but it can shape your level of support. When my spouse gains weight, I really rarely notice, because I like HIM–I just like him for who he is, not for weight changes.

In mixed weight marriages, studies verify that many partners try to regulate their spouses’ eating behaviors. A rule of thumb in addressing weight issues is to approach it with positive influences. Negative influences (criticism, nagging, shaming, lecturing, threatening, punishing, stonewalling, withholding) only make the problem worse.

Weight can become like a separate entity in the marriage, either dividing or uniting the spouses.  Think teamwork. If my husband is inspired by a certain program, because the structure gives him scaffolding, I will use the recipes in the program, as long as they’re consistent with the basics and simplicity I think are foundational to a healthy life style. The only way to address weight without compromising the marital relationship is to gain unity—the couple against the weight challenge.

Maybe that’s why Jack Sprat just helped his wife lick the platter clean.

References:

Romantic Relationships and Eating Regulation: An Investigation of Partners’ Attempts to Control Each Others’ Eating Behaviors by Markey, C. M., Gomel, J. N. & Markey, P. M. (2008) in Journal of Health Psychology, 13(3), 422-432.

The Meaning of Weight in Marriage: A Phenomenological Investigation of Relational Factors Involved in Obesity by Ledyard, M. L. & Morrison, N. C. (2008) in Journal of Couple and Relationship Therapy, 7(3), 230-247.

“You’re Going to Eat That?” Relationship Processes and Conflict Among Mixed-Weight Couples by Burke, T. J., Randall, A. K., Corkery, S. A., Young, V. J., & Butler, E. A. (2012) in Journal of Social and Personal Relationships, 29(8), 1109-1130.

Photo credit: Copyright: mukhina1 / 123RF Stock Photo

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Couples, Couples Therapy, Holidays, Humor, marriage, Marriage and Family Therapy, Romance

Humor in Marriage: The Gift that Keeps on Giving

In the hunt for the perfect gift for your significant other this holiday season, why not consider an offering of humor and laughter?

Laughter has many documented immediate and long-term individual health benefits; it essentially increases physical and emotional coping and resilience.  However, shared laughter also generates important bonding experiences in interpersonal interactions and is perhaps the most valuable in close attachment relationships.  When someone shares your sense of humor, it’s a form of responsiveness and a way of feeling understood.

I think many people underestimate the power of humor.  I grew up in a household with a father who was uniquely witty in a way that was classy.  He made people laugh without sarcasm or tearing others down, which is hard to come by, and in the process developed in me a huge appreciation for humor.  I don’t consider myself particularly witty, but I hold humor in high regard.

Negative emotion is so absorbing that it makes sense to actively infuse as much positivity as possible into marriage outside of conflictual moments. Some of John Gottman’s marital research demonstrated that healthy couples were often able to repair rifts in their relationships by using humor.  I think sometimes couples forget that they can use humor intentionally in their relationships to promote bonding and positive affect.  In other words, you don’t need to just sit and wait to come across something that might induce laughter.  You can make it a practice to seek it out.

A few years into marriage, my oldest son was born, and 3 weeks later I started a fairly rigorous graduate program.  He was extraordinarily colicky for almost the entire first year of his life, SCREAMING full force whenever he was put down in a baby carrier or swing, despite all the well-meaning advice I received from countless people.  Every shower I took during that year was accompanied by his blood-curdling serenades.

I was constantly trying to balance coursework, my client caseload and my fussy baby.  I was experiencing more stress than I ever had previously (which I think is sort of the point of a combined clinical and research program WITHOUT the new baby), and I had literally never been so tired in my life.  I was so depleted and fatigued during that year that my weight dropped to well under a hundred pounds and I developed shingles and mononucleosis, yet I still had to attend school and see clients and nurture a baby.  There was absolutely no time to be sick.  My husband would leave his full-time day job and come home at night and take over baby duty so I could see clients and study, but I was still constantly spinning in a tornado of demands.   I’m not even sure how I got through it, looking back.  It’s not something that I EVER recommend.

At one point, my mother was visiting to help out and offered to stay with the baby while my husband and I went on a date (As an aside, my son was her 28th grandchild or so, and she commented that she had never seen such a fussy baby—just sayin’).  My husband asked what I wanted to do and I replied, “I really, really just need to go laugh,” because I couldn’t remember the last time I found anything funny.  We purposely sought out a comedic movie which tapped into many of the absurdities of parenthood, and I laughed harder than I had laughed in a long time.  After the movie, I suddenly felt like I could handle life again.

Since that time, there have been many occasions in our marriage and family life that my husband and I have used humor together to reinforce interpersonal bonds.  We regularly share humor by watching particular shows, listening to podcasts, or even reading books together that make us laugh.  I am always excited to show him something that I find amusing.  In the spirit of good fun, we even play jokes on each other.

Once, I purchased a picture frame with the words, “My Mr. Wonderful,” emblazoned across the bottom.  It is equipped with a button which activates one of several stereotypic phrases from the “ideal guy.” I will include a photo and type out the phrases uttered by the frame-o-male-perfection.

My amateur photo of the frame
My amateur photo of the frame (my husband is going to be thrilled when he sees it on my blog)

Here are the various phrases:

  1. Why don’t we have lunch together more often?  I miss you so much during the day!
  2. Enough about me….I want to know how your day’s going.
  3. Anytime you need me, just call. You know I’m always ready to listen.
  4. I wish I was there with you right now. I bet you could use a shoulder rub.
  5. Of course I want to spend more quality time with you. I’ll just cancel that big night out I had planned with the boys. [if this were really accurate, it would say, “bike ride”]
  6. Let’s go dancing tonight!
  7. Do you want to go see that movie you were talking about? There’s nothing on TV but ball games.
  8. I’m sorry we argued. I knew you were right all along.  I just couldn’t admit it.
  9. I found this great cozy hideaway with no TVs. Let’s make plans to go!

Plus one more that’s too stupid to put into print.

I waited until just the right moment to set it up.

While he was out of town, I told him that I missed him, but that I had found a surrogate who said all the right things and didn’t take up as much room in the bed and didn’t snore.  When he came home, he found the picture frame on his nightstand with his photo inside.  When my husband first started pushing the button, he rolled his eyes at me, but it was couple comedy gold.  It is the gift that keeps on giving, because just when I forget it exists, we will be in the middle of a conversation (sometimes heated), and suddenly my husband will pull it out and push the button, eliciting one of the many phrases.  It never fails to make me laugh.  The funniest is, “Let’s go dancing tonight,” because for someone who used to move like a gazelle across the basketball court, my husband is astoundingly clumsy on the dance floor, by his own admission (and he is correct, which has completely delayed my bucket list item of mastering the Argentine Tango).

Differences in marriage can often be managed with a sense of humor.  It’s no secret that my husband and I have different tastes in music.  For his birthday, I was excited when I found a song composed entirely of sounds made from bicycle parts.  When I presented him with “Bespoken,” by Johnnyrandom (no, I’m not making that up) I told him I finally found a song speaking a language he understands – from Johnnyrandom’s garage and heart, to my itunes account, to him.  His response was “Of course you did…,” laughing, which was exactly the response I was looking for. The song is surprisingly mesmerizing, and I occasionally pull it out and announce, “Let me set the mood,” which generally elicits more laughter, and it is now an inside joke that we share.

If you’re stumped about how to incorporate more levity into your marriage, you can always try “Laughter Yoga.”  I’m considering registering my husband and me for a class just to see the look on his face when I surprise him with it.  I believe laughing about laughter yoga is a meta-process, and therapists love nothing more than meta-processes.

Now I need to go think of a great comeback for when my husband discovers that I have plastered a photo of him on my blog…  I think I’ll consult with my surrogate picture frame husband.  He is, after all, “always ready to listen.”

Attachment, Couples Therapy, marriage

Just a Spoonful of Sugar Helps the Divorce Rate go Down

Holly.couple kissing baby making face.SalmonI walked out to the waiting room the other night to witness a somewhat rare event in my practice: a couple holding hands!  I immediately felt just a little…..happier?  More hopeful?  Less burdened?  I’m not quite sure, but the gesture sent a non-verbal message that things were good, at least for that moment.  As an observer, it just made me feel better.

With the preponderance of sexual messages surrounding us, it is unfortunate that we don’t learn more about healthy, non-sexual, affectionate touch;  it is such a powerful form of connection, yet so often underutilized, often because couples just get busy with competing demands and drift apart.  Sometimes I think if we understood the power of warm, affectionate, non-sexual touch, we would promote its expression as readily as physical exercise, and its benefits might mitigate many common marital challenges.

On many occasions, when partners are distressed and I have asked them what they thought they needed in such circumstances, they have replied, “just a hug.”  If the other partner responds in kind, the couple leaves the session feeling more bonded and connected.  Every time.

Recent research around human touch is demonstrating that safe, warm touch in a close, pair-bonded relationship like marriage has particular health advantages and is actually influenced by the quality of the relationship.

In one study, women were exposed to pain stimuli alone and when their partners took their hands, if they were in happy relationships, the hand-holding decreased their stress responses in the brain as measured on an fmri.  The effect was drug-like.  In another study, married couples were taught to engage in warm, supportive touch, and the activity had beneficial effects on physiological responses like blood pressure and stress hormones.  Some researchers speculate that this kind of touch in marriage has advantages over being massaged by a stranger, because there is some evidence showing, for example, that the benefits of oxytocin only increase significantly when the touch is repetitive over a period of days, as with a secure attachment partner.

Bottom line: there is something uniquely beneficial about warm, supportive touch in the context of a stable, high quality marital relationship.  For couples who have high quality relationships and don’t take the time to hold hands, hug, or generally express physical affection, this seems like wasted marital capital.

Easy Ways to Increase Warm, Supportive Touch:

  1.  Take a walk and hold hands.
  2. Look into your partner’s eyes and touch his/her face like you might have when you were dating (it has to be authentic–don’t make it weird).
  3. Sit on your partner’s lap.
  4. Find excuses to hug your partner.
  5. Rub your partner’s back.
  6. Sit with your arm around him/her.
  7. Give your partner a shoulder massage.
  8. Play footsie under the table or in bed.
  9. Draw words in your partner’s palm and have him/her guess what it is.
  10. Whisper something affectionate to your partner, and linger in the close distance whispering requires.

On several occasions, I have had husbands in front of me in the therapy room in tears, explaining that their wives “never touch,” them at all in affectionate ways, and that they are envious of husbands whose wives touch them, just by holding hands or rubbing their backs, etc. I suspect this is because of a pattern that develops in which women start avoiding touch because they’re afraid it will lead to sex, but the pattern is nevertheless harmful and rejecting.

Most importantly, I’m going to propose that perhaps the greatest beneficiaries of a couple’s consistent engagement in warm, supportive touch are not the couple themselves, but their kids. 

Couples who hold hands, hug and touch in a warm supportive way model positive behaviors, and convey a sense that things are going well in the marriage and family.  Children are absolutely affected by their parents’ marital quality.  They garner a felt sense of security from parents who display marital happiness.

Remember how I said when I saw the couple in the waiting room holding hands, I just felt better?  I’m not even related to those people.  Can you imagine the impact viewing that behavior would have on the couple’s children?  To demonstrate this point when I make presentations, I will show audiences pictures of marital couples seemingly getting along, and seemingly arguing, and ask them to just yell out their their emotional responses.  It’s an easy way to see how much we are influenced by these displays.

“Get a room!” has become and oft-repeated cliché by my children whenever my husband and I display any kind of physical affection in front of them.  If I didn’t have a lot of confidence in those moments, I might be tempted to withdraw.  However, knowing what I know, I shoot back with, “I’m contributing to your mental well-being, so you should be thanking me.”

Then, they say something like, “Stop talking to me like a therapist,” and walk out….but then at least we are alone…..

If you are interested in a few of the studies to which I am referring, I will add a few links.

For a study about safe touch and decreased response to threat, see Jim Coan’s explanation here.

The link to his study is: here.

Julianne Holt-Lunstad headed up a study demonstrating how upregulating warm touch in marriage can have a beneficial influence on stress response.  It can be found here.

And now, go hug your spouse!