Treat relationship quality as a health account: argue about the matter not the person — no name-calling, no sarcasm

Couples with a better relationship tend to have somewhat better health and somewhat lower death risk. The association is not large — about as large as diet’s link to health. In one experiment, couples who kept hostility in arguments had experimentally made small wounds heal at only about 60% the speed of calmer couples.

Cost

No money. When arguing, speak only about the matter at hand — no name-calling, no sarcasm, no dredging up old scores. The hard part is holding your tongue when angry.

Benefit

Pooling 126 studies and more than 72000 people (a meta-analysis). Higher marital quality went with better physical health; the correlation r was between .07 and .21. A correlation of 0 is no relationship; 1 is perfect lockstep. The correlation with lower death risk was r = .11. Smaller cardiovascular reaction when arguing was r = -.13. The authors said these effects are all small — about as large as the link between habits such as diet and health. In another crossover experiment, 42 healthy couples each stayed in hospital twice for 24 hours. Once they had a mutually supportive talk; once they discussed a disagreement. After arguing, experimentally made blister wounds healed more slowly. Couples who showed more hostility in both sessions had wound healing at only 60% the speed of low-hostility couples. On the morning after arguing, their blood inflammation markers (IL-6, tumor necrosis factor) also rose more.

Notes

Grade B because most pooled studies were follow-up only, with no randomized comparison groups. So you cannot tell whether a bad relationship makes people ill, or poor health makes the relationship worse. Some studies still found the association after subtracting age and income. Robles’s original text also notes publication bias in some results. Studies that clearly compared men and women mostly found no sex difference. This section found no pooled analysis that directly compared mortality for “a bad marriage” versus “not marrying.” So “a bad marriage hurts more than not marrying” is only an inference. The wound experiment had only 42 couples. “Argue about the matter not the person — no name-calling, no sarcasm” is the author’s practice inferred from “hostile behaviour” in the experiment; no study compared it head-on. If you argue fiercely and cannot change, go to couples therapy together — see item 20 of this section (couples therapy). If arguing turns to hitting, or long-term insults and threats, it is no longer a communication problem; it is domestic violence — see Section 8, item 43 (when you are subjected to domestic violence). To think through whether to leave, the cost of leaving is in item 15 of this section (cost of leaving).

Sources · 2

1. Robles TF, Slatcher RB, Trombello JM, McGinn MM (2014). Marital quality and health: a meta-analytic review. Psychological Bulletin. doi.org/10.1037/a0031859
2. Kiecolt-Glaser JK 等 (2005). Hostile marital interactions, proinflammatory cytokine production, and wound healing. Archives of General Psychiatry. doi.org/10.1001/archpsyc.62.12.1377