Patricia Morales: "Relationship problems can harm mental health"

When we talk about the subject of emotional well-being, it is very common (and in many cases, useful) to differentiate between psychological problems of an individual type and those that have to do more with the dynamics when it comes to relating to the rest of the people in our around.

However, this differentiation is, to some 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 is even clearer.

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

• Related article: "The 5 types of couples therapy"

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

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

Taking into account that all types of psychological disorders have part of their causes in the experiences that we have gone living, can relationships be a context in which the probabilities of someone developing a psychopathology?

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

To my patients I explain the simile with an onion; if you go on removing layers from an onion, you never get to the real onion, because it is itself made up 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 that shapes us as a person.

A psychological disorder does not appear out of nowhere, but there are already predisposing factors to suffer it. We cannot say that being in a relationship poses a risk for developing a psychopathology, but there is the possibility possibility that problems within the couple relationship lead one of the members or both to suffer any psychopathology.

In fact, it is not strange that in consultations the relationship of a couple appears as a stressful factor and/or precipitating factor for starting psychotherapy, especially related to anxious symptoms and emotional.

Conversely, what aspects of couple relationships do you think are most important as protective factors for mental health?

There are many aspects that help maintain good mental health as a couple. Have a good way of communication, not so much in quantity as in quality; the assertiveness, being able to express what one thinks, feels and wants without offending the other; respect for oneself and for the other; being able to share one's own happiness and the happiness of others, which makes us feel full and emotionally satisfied; the protective factor of belonging, of 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 this type of interaction...

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

From what you have been seeing throughout your experience as a psychologist, is it common for the most frequent psychological disorders to give way to crises in relationships? For example, because the person who suffers the psychological disorder tends to isolate himself and the other person feels alone or overloaded with responsibilities.

In my experience in consultation, it is quite common that the overload, the lack of knowledge about the pathology and not knowing exactly what it implies, 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 own happiness, it will greatly influence self-esteem, the concept that one has of oneself, feeling fulfilled, having autonomy and freedom in decision-making, among others things.

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

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

In these cases, the psychoeducation It is very important for both, both for the person who suffers from the pathology, and for the one who accompanies it.

And taking into account that one's psychological well-being also affects coexistence and the love relationship in general, is it Conflicts often arise when, for example, the person with a disorder does not want to go to psychotherapy and the other cannot convince her? To what extent is psychopathology an individual problem and not a couple's?

This above all generates frustration on the part of the person who cannot convince, in their intention to seek external support to help and not achieve this purpose.

The line that separates psychopathology as a solely individual or couple problem is very fine, due to all the factors that I mentioned earlier. 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.

Many concepts and dimensions influence the mental health of the couple, the couple evolves throughout the time and the circumstances that surround it, as do the members who make it up individually. form.

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

In the first place, it will be important to evaluate at what point the couple is and what dimension is affected, we could classify them into 4 large areas.

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

As for the intervention, we can take a tour of those things that went well for the couple, what works currently, how they met, what they liked each other, that is, take a tour of the positive aspects of the relationship, in this way we will also avoid entering into possible confrontations between the couple.

Work is done on communication skills, active listening, empathy, tolerance and conflict resolution.

At a cognitive level, intervention is made on irrational ideas or distorted thoughts that may exist.

With regard to emotions, favor the expression of emotions of both. And something fundamental, for the improvement of mental health, as a 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 in a marriage?

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

I would summarize them in 5 keys that every couple can put into practice: openly express positive aspects of oneself and of the couple, assessing how they have felt when expressing it and hearing it from the couple; Write on a piece of paper what you like most about your partner. How did you feel writing it? And when reading it?; express to the couple everything that is appreciated. Do something by surprise that makes the other excited. How did you feel while preparing it? How has the reaction been when receiving the surprise?; express to the other the most special moment lived together. Have they matched? Has the choice the couple made surprised you?

How is it usually done to combine individual psychotherapy sessions with couples therapy with both partners present, if both intervention modalities are necessary?

If possible, it is better for couples therapy sessions and individual psychotherapy sessions to be carried out by different therapists, since performing them with the same professional, in the same period of time, can interfere with the functioning of the same.

Due to confidentiality issues, the topics dealt with individually should not be shared in the discussion sessions. couple, if it is not that the person in question wants to expose them, this can influence the handling of situations by the partner. therapist.

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

There would be the possibility of carrying them out, as long as the therapist can disengage and work both types of interventions in parallel without one influencing the other, and both members of the couple show compliant.