The cost of being in a marriage or love relationship when you do not know whether you can count on your partner or spouse may surprise you. Tara Parker-Pope writes in the October 26, 2015 issue of the New York Times about new research from Brigham Young University showing that relationships where one or both partners can’t count on his or her spouse for love and support affect that partner’s health negatively (NYTimes). This is not a surprising finding in my twenty years of experience working with couples as a marriage therapist in New York City. The body can easily be flooded with adrenaline during a conflict, especially when high levels of anxiety are present. When partners are distressed, anxiety can take over every element of the dynamic. Research shows that after two minutes of adrenaline being pumped into the nervous system, cortisol is released, a damaging hormone that lowers the immune system. Distressed partners have a lot of cortisol releases, and a lowered immune system takes a toll on overall physical health.

Some key findings from marriage and couples researchers include:

• Harsh startups almost never end well: 96 percent of the time the outcome of a conversation can be predicted by the first three minutes of a 15 minute conversation

• When all four ingredients of criticism, contempt, defensiveness, and stonewalling are present in a relationship, the chances of the marriage or love relationship ending increase to 94%, unless there is an active intervention to change the dynamic

• Criticism boils down to: what is wrong with you?

• Defensiveness sends a message to a partner that “the problem isn’t me, it’s you”

• Contempt is feeling disgust toward a partner or spouse: it is the result of a repeated pattern of negativity in a relationship. The recipient of contempt in a relationship is physically ill 33% more than a partner in a healthy relationship

• Stonewalling involves tuning a partner out, emotionally. The partner often sees this pattern as a way to stave off the worst affects of a conflict, without realizing how stonewalling escalates most fights—until both partners enter this stage, usually when a relationship is hanging by a thread)

A Happy Heart: Calming Effects

Additional research backs up the findings from the Brigham Young University study, including observations of couples having a conflict showing that marital fights lacking warmth or including a controlling tone were as predictive as smoking or high cholesterol for poor heart health. A University of Virgina study by James A. Coan showed that couples in satisfying relationships had a calming effect on the brain similar to pain-relieving drugs, while couples in distressed relationships did not show the same calming benefit. In some ways, being sometimes supportive and sometimes not is more difficult for our brains to accept than knowing the response won’t happen.

Problems in a Marriage Can Become Intractable

As the lead researcher in the University of Virgina study, James Coan, suggested, even couples in distressed relationships could seek counseling before the problems in the relationship became intractable. This is echoed by John Gottman’s findings, warning that the average couple enters marriage or couples therapy after a disconnection has become nearly insurmountable. Yet, dramatic change in love relationships can happen, and often relatively quickly, when both partners are motivated to make their relationship better. As long as one or both partners have not “checked out” of the relationship, couples can shift from distress to happiness in a relatively short time period.

A Clear Path to Positive Predictability in a Marriage

From my experiences with couples seeking marital therapy, they have gotten stuck in patterns that are all too familiar in their life histories, and just need to first understand how they got into the pain, and find a way out through experiencing each other differently, repeatedly. This is the dynamic couples focus on in therapy: understanding negative patterns, and creating new ways of connecting that can be healing and securing. Although painful at times, the reward of couples therapy can far outweigh the discomfort when often years of hurtful experiences get supplanted by positive responses in a marriage or love relationship–changes that help both partners feel the other is predictable in a positive way.

Are you in an ambivalent relationship? Take the online quiz: AMBIVALENT?

Sources: the New York Times, October 26, 2015, and The Seven Principles for Making Marriage Work by John Gottman (Harmony, 2015).

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