Public health gets in bed with relationships and intimacy

Heart-shaped chocolate boxes, roses, and greeting cards smeared with love poems: shops are brimming with Valentine’s Day supplies. Hallmark holiday aside, does public health have anything to say about love and relationships?

To find out, Transmission sat down with David Frost, a social psychologist and assistant professor of Population and Family Health at the Mailman School. His research into how couples experience closeness paints a

complex, sometimes counterintuitive, picture on healthy relationships and intimacy.



What’s a public health researcher’s take on the old adage, “love conquers all”?

It’s hard to really define love. We know when we experience it but it means different things to different people. As researchers, we usually measure love in the ways it shows up in concrete forms in people’s lives.

My research looks at the connection between experiences of closeness and health in relationships. People assume that the closer a relationship is, the better. That’s not always the case. There are moments when one person experiences more or less closeness than they desire from their partner.

Really? Feeling close to your partner doesn’t matter?

Closeness definitely matters. But closer relationships aren’t always “healthier” relationships. People actually differ in the amount and kind of closeness they desire from a relationship partner. We find that what matters most is whether the amount of closeness couples actually experience matches each partner’s ideal amount of closeness.

Feeling not enough closeness and too much closeness—what we call “closeness discrepancies”—are equally bad for mental health, both for the person experiencing the discrepancy and their partner. And the greater the misalignment, the greater risk that the relationship will end.

That’s sad. It sounds like some couples are seriously out of sync.

Things aren’t that bad. We estimate that a little more than half of cohabitating couples in the United States are getting the amount of closeness they desire. Less than half have these closeness discrepancies. Most of the time, it’s someone who isn’t getting enough closeness. This often happens because of stress outside the relationship like financial troubles or problems at work.

The same thing happens with sex. The popular belief is that the more sex you have, the healthier your relationship is. But this isn’t the case if you’re having too much sex or not enough.

Any advice for couples on how to improve closeness and intimacy?

If couples reduce their closeness discrepancy, their health gets better and they’re more likely to stay together, but we don’t yet know how this happens. It’s often the case that one person isn’t aware that their partner is experiencing a closeness discrepancy. That’s something we are currently studying: whether knowledge of the misalignment matters, and whether working with couples to make them aware of the discrepancy can help improve their relationships and health.

So what makes a relationship healthy?

The notion of a “healthy relationship” is tricky one. It's a lot easier for us to say what’s unhealthy in relationships: violence or conflict, for example. But that’s not the complete picture. Relationships are complicated, so there might be other factors that we need to consider when trying to understand the concept of relational health. A couple might be experiencing a high degree of conflict, but they might also be having a great sexual relationship and be very satisfied with their lives together.

Are relationships good for your health?

People in committed relationships like marriage tend to be healthier on average. But that may be due to the social support and legal benefits that come with marriage. The quality of the relationship matters too. The bottom line is simple: good relationships are good for health, and bad relationships are bad for health, regardless of whether couples are married or not.

Let’s talk about sex.

Generally, people are happier after a good sexual experience, but there’s plenty of bad sex. Many researchers are critical of the over-medicalization of sexual dysfunction, because sexual function and desire can naturally wax and wane throughout life. For example, the Viagra approach privileges heterosexual, penile-vaginal intercourse. There are plenty of other kinds of sex that people find pleasurable and satisfying that do not require pharmaceutical assistance.

What’s your perspective on Valentine’s Day?

I think that it’s nice that we set aside a day to encourage people to celebrate their relationship and show their affection for one another, but does it have to be in the same way on the same day for everyone? Giving roses and chocolates any other day might be more appreciated because it’s more of a surprise—and it comes more from the heart.