Treat the quality of a relationship as a health account: argue about the issue, not the person, and don't insult or sneer

Cost

Free. When arguing, talk only about the matter at hand; don't insult, don't sneer, don't bring up old grievances. The hard part is keeping your mouth in check in the heat of the moment.

What you get

A meta-analysis pooling 126 studies and more than 72,000 (7.2万多) people. The higher the marital quality, the better the health, with correlation coefficients r between .07 and .21. A correlation of 0 means no relationship at all, and 1 means perfect agreement. The one with lower risk of death is r = .11. Cardiovascular reactivity during arguments is smaller, r = -.13. The authors say these effects are all small, about as large as the link between health habits such as diet and health. In another crossover experiment, 42 healthy couples were each admitted to the hospital twice for 24 hours. One visit had a mutually supportive conversation, and the other a discussion of a point of disagreement. After the argument, the blister wounds made in the experiment healed more slowly. Couples who showed more hostility on both visits healed at only 60% of the speed of low-hostility couples. The morning after the argument, their blood inflammation markers (IL-6 and tumor necrosis factor) also rose more.

Notes

The reason for grade B: most of the pooled studies only tracked and recorded, without controlled groups. So it is hard to tell whether a bad relationship makes people sick or poor health makes the relationship worse. In some studies the link remains after subtracting age and income. The original Robles paper also states that some results have publication bias. Studies that explicitly compared men and women found basically no difference between them. This section found no pooled analysis that directly compares death rates in "bad marriages" with not marrying, so "a bad marriage hurts the body more than not marrying" can only count as inference. The wound experiment had only 42 couples. "Argue about the matter, not the person, no insults or sneering" is a practice the author drew from the "hostile behavior" in the experiment, and no study has directly compared it. If you argue fiercely and can't change it, the two of you can go to couples therapy together; see §10.20 (couples therapy). Once arguments reach violence, or there is long-term abuse and threats, it is no longer a communication problem but domestic violence; see §8.43 (experiencing domestic violence). To think through whether to leave, see §10.15 (the cost of getting out).

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

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

Translated from the Chinese original. Original book, section 10, tip 17. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer