Patricia Morales: "Couple problems can damage mental health".

Patricia Morales explains the link between couple problems and psychopathologies.

When we talk about emotional well-being, it is very common (and in many cases, useful) to differentiate between individual psychological problems and those that have more to do with the dynamics of how we relate to other people around us.

However, this differentiation is, to a certain extent, artificial: all psychological phenomena are influenced by the social context, and vice versa. And when these relationships are with the people we love the most, the link between these two dimensions becomes even clearer.

To learn more about the relationship between mental health and relationships, we have interviewed an expert in this field: psychologist Patricia Morales.who works helping people in both facets of life.

Interview with Patricia Morales: mental health in the couple, and keys to improve it.

Patricia Morales is a psychologist and Director of the psychological assistance center El Barret, located in Granollers. This professional performs both individual and couple psychotherapy, and in this interview she talks to us about how these two worlds interact: mental health and love relationships in the field of courtship and marriage.

Bearing in mind that all types of psychological disorders have part of their causes in the experiences we have been living, can couple relationships be a context in which the probabilities of someone developing a psychopathology are nurtured?

All psychopathology must be contextualized, precisely for that reason, because part of its origin may be due to environmental factors and lived experiences.

I explain to my patients the simile of an onion; if you remove layers of an onion, you never get to the real onion, because it is itself composed of layers. The same thing happens with people, as Ortega y Gasset said: "I am me and my circumstances", experiences add layers to us and this shapes us as a person.

A psychological disorder does not appear out of nowhere, but there are predisposing factors to suffer from it. We cannot say that the fact of being in a couple supposes a risk to develop a psychopathology, but there does exist the possibility that problems in the Heart of the couple relationship, lead to some of the members or both to suffer some psychopathology.

In fact, it is not uncommon for the couple's relationship to appear in consultation as a stressor and/or precipitating factor for initiating psychotherapy, especially in relation to anxious and emotional symptoms.

And in the opposite direction, what aspects of couple relationships do you think are most important as protective factors for mental health?

There are many aspects that help to maintain good mental health in a couple. Having a good communication channel, not so much in quantity as in quality; assertiveness, being able to express what one thinks, feels and desires without offending the other; respect for oneself and for the other; being able to share one's own happiness and the happiness of the other, which makes us feel full and emotionally satisfied; the protective factor of belonging, knowing that you are part of that bond and that you are an important part of it; the mutual care of the couple, knowing that someone cares about you; love and the need for contact, very necessary for human beings, we are social beings and we need that kind of interactions. ..

All these factors that occur in couple relationships, among others, can be protective and symptoms of good mental health.

From what you have seen throughout your experience as a psychologist, is it common for the most frequent psychological disorders to give way to crises in couple relationships? For example, because the person suffering from the psychological disorder tends to isolate him/herself and the other person feels lonely or overburdened with responsibilities.

In my experience in consultation, it is quite common that overload, lack of knowledge about the pathology and not knowing what it implies in particular, can lead to a couple crisis.

It is key that for the couple to function adaptively both seek their own and joint happiness. Regarding the feeling of happiness, self-esteem, self-concept, self-fulfillment, autonomy and freedom in decision-making, among other things, will have a great influence.

These aspects are very affected in any type of psychopathology, therefore, this unbalances the balance of the couple and is what can provoke a crisis.

On many occasions, the person suffering from the psychological disorder feels incapable of responding to his or her own needs; consequently, he or she cannot cover the affective needs of the partner, "if I am not there for myself, I cannot be available for another person", the resources are saturated to be able to give an adaptive and functional response.

In these cases, psychoeducation is very important for both, for the person who suffers the pathology and for the person who accompanies him/her.

And bearing in mind that one's own psychological well-being also affects cohabitation and the love relationship in general, is it common for conflicts to arise when, for example, the person with a disorder does not want to go to psychotherapy and the other person is unable to convince him/her? To what extent is a psychopathology an individual problem and not a problem of the couple?

This above all generates frustration on the part of the person who does not manage to convince, in his intention to look for an external support to help and not achieve this purpose.

The line that separates the psychopathology as a problem only individual or of couple is very thin, for all the factors that I commented previously. As long as the personal well-being of one part of the couple is affected, the rest of the system also suffers the consequences, directly or indirectly.

The mental health of the couple is influenced by many concepts and dimensions, the couple evolves over time and the circumstances that surround it, as do the individual members of the couple.

What therapeutic tools can psychologists use to help improve mental health in the context of the couple?

First of all, it will be important to evaluate where the couple is and which dimension is affected, we could classify them in 4 main areas.

The affective dimension (love, affection, intimacy, sexuality, acceptance of the other); the mediating dimension (communication, which allows the expression of feelings, thoughts, emotions, concerns...); the management dimension (power relations within the couple) and finally, commitment, understood as the desire and desire to continue with the relationship and to have common goals.

As for the intervention, we can make a tour of those things that went well in the couple, what things work today, how they met, what they liked about each other, i.e., make a tour of positive aspects of the relationship, in this way we will also avoid entering into possible confrontations between the couple.

We work on communication skills, active listening, empathy, tolerance and conflict resolution.

At a cognitive level, we intervene on irrational ideas or distorted thoughts that may exist.

Regarding emotions, we favor the expression of emotions of both. And something fundamental, for the improvement of mental health, in couple or in any other psychotherapeutic context, is the motivation towards change.

And beyond psychotherapy, what are the main tips to follow to ensure psychological well-being in a dating relationship or marriage?

Beyond psychotherapy, we can implement some little tricks that can help to solve some couple crisis and, without any crisis, they will also be useful to help maintain a satisfactory couple relationship.

I would summarize them in 5 keys that every couple can put into practice: openly express positive aspects of yourself and your partner, evaluating how you felt when expressing it and hearing it from your partner; write down on a piece of paper what you like most about your partner. How did you feel when you wrote it and when you read it; express to your partner everything you are grateful for. Do something by surprise that makes the other person happy. How did you feel while you were preparing it? How did you react when you received the surprise; express to the other person the most special moment you had together. Did you coincide? Were you surprised by the choice made by your partner?

How do you usually combine individual psychotherapy sessions with couple therapy sessions with both people present, if both modalities of intervention are necessary?

If possible, it is better that the couple therapy sessions and individual psychotherapy sessions are carried out by different therapists, since doing them with the same professional, in the same period of time, can interfere in the functioning of the sessions.

For confidentiality reasons, the topics treated individually should not be shared in the couple's sessions, if the person in question does not wish to expose them, as this may influence the therapist's handling of the situations.

The bond that is established between therapist and couple must be neutral, if one of the parties of the couple is treated, the other may feel at a disadvantage, with less confidence towards the psychologist.

It would be possible to carry them out, as long as the therapist can disengage and work the two types of interventions in parallel without one influencing the other, and both members of the couple are in agreement.