When a couple are unhealthy for each other

QUITE a few years ago, I visited London to spend the weekend with an old friend, his partner, and their newly-arrived son (who is now in college, so quite a few years ago).

He and I went for a drink, and he told me that, on obtaining a positive result on a pregnancy test, they pretty much spontaneously moved to the window, opened it and smoked a last cigarette together.

Some time later, a more recent acquaintance told me pretty much exactly the same story from her life.

As a then smoker myself, I was horrified at the ‘last cigarette’ idea, and as a psychologist i was intrigued - firstly by the decision (when all knew smoking was highly discouraged during pregnancy) and secondly by the joint nature of the transgression. Neither slunk off to smoke their last alone; it was an experience shared.

That latter point fascinated me; they both behaved in this same way, did it together.

A recent research paper by Theresa Pauly of the University of Zurich, and colleagues in Switzerland, Canada and Germany, found evidence of a pattern of behaviour within couples that reminded me of those conversations.

They were investigating ‘symptom-system fit theory’, which proposes that negative behaviours are maintained within social systems because they lead to short-term positives.

To revisit the example of smoking, none of us is ignorant of the harm it can cause, but that can seem very much in the hypothetical future while right now they can offer relaxation or an immediate opportunity for a break or a chat.

The research team looked at three separate groups of couples - 82 couples who smoked, 117 physically inactive couples, 79 couples with medical advice to avoid unhealthy eating. They gathered information on smoking, being inactive, and eating poorly in the three groups respectively, and also looked at relationship closeness and satisfaction as experienced each day.

In the first two cases, they found a medium-to-strong association between the negative behaviour and greater closeness and satisfaction.

Perhaps a little surprisingly considering this, they didn’t find it for the unhealthy eating. But when they had looked at the extent to which the unhealthy behaviour took place in one another’s company, they found that the smokers and inactive people were more likely to be behaving like this as a couple, while unhealthy eaters were far more likely to be eating separately.

So, it wasn’t just the behaviour that was important here - it was the behaviour occurring in one another’s company.

This obviously raises the question of why.

We know we are social animals and we rely on one another in many ways. Plenty of evidence shows that being part of an exercise group or a study group increases the likelihood of us actually doing what we’re supposed to.

The presence of others acts as a prompt, ‘this is what we do together’. The same could be true of negative behaviours - there’s also plenty of evidence for example that recovering addicts are at increased risk of relapse if they fall in with the same company they kept when using.

But the relationship satisfaction and closeness is a different matter. What’s going on there? One explanation comes from what we know of the therapeutic, or doctor-patient or therapist-client relationship. One of the three key features of a successful therapeutic relationship is unconditional positive regard - that we feel we are accepted, respected, esteemed, irrespective of what we say or do.

This increases intimacy, brings people closer, creates trust.

A related point is that we are more likely to end up in a relationship with someone who is like us - more ‘birds of a feather flock together’ then ‘opposites attract’. if we see that we share characteristics with someone, we are alike, that can bring us closer to one another.

A third point comes from Social Identity Theory - we are very inclined to identify with groups, and to the derive our sense of self from that shared identity; a couple may be enough to constitute a group, and more shared features will make the group feels tighter and make us feel closer and more supported.

And finally, the fact that the shared behaviour is a transgression perhaps makes it more delicious and satisfying.

Pauly and her colleagues discuss all of this in light of the obvious health implications. In general, being partnered is good for your health - people in relationships tend to be happier and to live longer. But if the behavioural patterns established as part of a coupled relationship are unhealthy, then this could be turned on its head. So what to do?

I’m a great believer in self-reflection. Socrates said “the unexamined life is not worth living”; yet we do so much in our lives on unthinking autopilot. It’s always worth asking “is this helping me or is it hurting me?”

If you see unhealthy patterns, talk about it; try to find solutions. It’s hard to just stop a behaviour - try to find something enjoyable but healthy to replace it. And if the unhealthy behaviour has been as a couple, try changing it as a couple.

After all, if a life and relationship are positive experiences, they may as well be kept going as long as possible, right?