La Coop P.A.- General and Forensic Psychiatry - Boutique-Private Psychiatric and Forensic Practice in Tampa-Clearwater-Florida


February, 2011

Love Is In The Air!


Love is in the air this month and so I wanted to send out an article about love and Psychiatry and what some believe is a medical/hormonal basis for love and bonding.

One thing that I do know for sure, love and how to get it, hold onto it and sustain it over the long haul is something that people struggle with regularly. With that being said, let me give you a few tips on how to maintain love in a relationship.

  • The first thing you need is trust - without that you have nothing. Trust isn't easy to achieve in a relationship and once it's broken, it rarely is regained. Once you have trust, the relationship can flourish because then you can be fully exposed to that person and that person only.
  • Honesty - this goes along with trust. You can't have trust without honesty. In an intimate relationship - there should be no secrets between one another. That is not to say that there won't be some little secret about your past that you don't disclose until you are ready to, but overall there needs to be this honesty there.
  • Teamwork - As a couple, you are one person. You can't be a team if one is holding back. When you make a decision about yourself and you are in a couple - you make a decision for the team. This is how you need to see it. When you do things just for you - this is where problems with selfishness, etc. come into play and dismantle what could be a solid relationship.
  • Physical Intimacy - this is another one that seems to get lost in the shuffle. A patient of mine once told me, "sex is the most important 5% of a relationship." I've never forgotten that, and it's true. It's not the only thing, or even the biggest thing, but if it's not there - it's a problem. If you've lost this in your relationship - you need to get it back one step at a time. First, add in physicality that you would do with any friend and then put that into your relationship. Use that as a foundation to build more intimacy back into the relationship.
  • Humor - this is an important facet of any good relationship and the intimate relationship is no exception. If you can't laugh with one another - it's not going to work. It's a side effect of all of the other factors (trust, honesty, teamwork, and intimacy) coming into play.

I hope that this has been helpful to you and I look forward to seeing you again in the office soon. Please let me know if there are topics that you'd like to see covered in this newsletter via email and I'll see about putting it in here soon.

Dr. L

Intranasal Oxytocin Increases Positive Communication and Reduces Cortisol Levels During Couple Conflict
Ditzen B, Schaer M, Gabriel B, et al. Biol Psychiatry 2009;65:728-731.

Now, I want to start off by saying it was a patient that actually got me to look into this after he saw it on Oprah. So, that's a funny way to get to this, but honestly, it's where I get a lot of questions.

The article came out in 2009 and it lead to a lot of hoopla. The reality is, that Oxytocin is important in interpersonal relationships, but the way that the study was done it couldn't be replicated in real life because we can't prescribe intranasal oxytocin. So, this is only a research study under study conditions. In the study, they took 47 heterosexual couples and each person in the couple (92 people) were given either oxytocin or placebo (inactive substance) before a "standard instructed couple conflict discussion" in a lab. All of the behaviors and emotions were tabulated by trained on lookers and then they tested the salivary cortisol (stress hormone) level. Now, also, keep in mind they selected what they considered to be "healthy" couples. These are people with no longstanding medical or psychiatric illness.

The outcome is that oxytocin decreased cortisol concentrations after the conflict compared with placebo. This is equated to the amount of stress that the task (the argument) created in the person. Now, with the oxytocin, the effect was stronger in the men than the women. Overall, oxytocin tended to increase the duration of positive behavior in relation to negative behavior during the conflict. This ratio is supposed to be a predictor of positive long term relationship outcomes.

Bottom line, there is really no long term data here - so it's applicability to long term relationships hasn't been studied. Also, it isn't practical because we can't even get that substance in our marketplace. So, the take home message from this and other things you watch on Oprah is to realize that people take little bits of research that they find is interesting and can make a story about. Once you really read the research, you find that though there is some truth to the news story - it's much less newsworthy than what is on TV. You are better off using some of the practical strategies that I spoke about in the beginning of the letter than to look for external, medical interventions.

Until next month!

Dr. L

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