Marriage and Family — 18 May 2005
Is staying healthy a marital obligation?

Health is a personal matter, you say. Indeed it is. Every person must decide for him/herself how much energy to invest in staying well. However, when one is in a committed, permanent relationship, is it still only a personal choice, – or does one’s health become a family obligation?

In the past, we knew much less about the relationship between illness and lifestyle choices. Today, there is an abundance of data suggesting that our behavioral choices play a major role in the duration and quality of our lives. We are advised to eat right, exercise, not smoke, maintain normal weight, sleep well, reduce stress, recreate, relax and relate well.
All of these are behaviors within our control.

As empowering as this may be, the details of the recommendations may become very confusing because of their ever-changing nature. For example, about weight: “Be of normal weight or thin”, they used to say. Now, a recent research found that slightly overweight people may live longer than those of normal weight.

Recommendations about eating right are also constantly changing: first they recommended eating fish four times a week, now fish intake is to be limited since it may be contaminated. The recommended nutritional pyramid has been changed several times in the last thirty years and now is not a pyramid at all- just parallel sections, available only on the Internet.

With all the advances in medicine, testing and treatments, preventative medicine has come into favor. We are given guidelines for safeguarding our bodies and becoming more quickly aware of treatable conditions through a series of responsible regiment of tests. For example: breast self-examinations, mammograms for women, prostate examination for men, colonoscopy for all, to name a few.

Despite the changes in specific health recommendations, the encouraging message is that we are not necessarily doomed by our genetics, gender, environment, and modern day life’s demands. We have the power to influence these given factors toward greater health and longevity.

If indeed all this is true, why is health maintenance a marital obligation? Does the marital vow ‘for better and worse’ hold us to maximizing the chances for ‘better’ through our actions?

More and more couples in therapy talk of their frustration with a mate who is not following the recommended health routine. One wife, who has altered her eating habits ten years ago, described with deep concern, her frustration at her husband’s food choices, excessive weight, inactivity, smoking, and avoidance of regular medical check-ups. She felt “betrayed” by his insistence that it is his body, life and business, and not hers. Her husband doubted the validity of health advice and preferred to ignore it for now, until “the doctors can make up their minds”. He also saw his wife’s concerns as her attempts to control him.

Another husband was distressed by his wife’s neglect of her body to the point of her inability to walk, care for the children, climb the stairs at home, and be a full partner to him. He felt that her self-neglect needlessly jeopardized his life’s happiness.

Other common problems for couples regarding health habits are: disagreements about food choices for their children, viewing exercise as a compulsive behavior, conflicts about labeling some behaviors as addictions, such as alcohol, food, cigarettes, T.V. or computers.

Some couples also have issues with each other about: use of vitamins, use of medications, avoidance or excessive medical visits.

Some people refrain from medical services due to the inconvenience, not liking doctors, believing they are well and do not need to worry about their health or fear of possible frightening finding. Their partners may not appreciate the emotional aspects involved and repeat all the logical reasons to do so.

Medical research findings and new technologies have brought greater hope for health and survival. Yet, new areas of conflict have arisen for couples as a consequence of these developments.

Some new philosophical questions also came to light:

• Does a partner have the right to run his life anyway he/she chooses, or does each individual carry a responsibility to stay healthy for the sake of his/her partner and family?
• To what extent, if any, does a partner have a say about the other’s personal health choices? Is managing one’s body a private or a family matter?
• Is it acceptable for a parent to neglect his or her health and possibly become ill, expecting the other partner to provide the caring and handle the family matters as well? Or worse, die young of a preventable malady?
• Do parents have the obligation to their children to do all that they can to stay healthy as long as possible?
• Should possible future health benefits dictate the individual’s behavior to the exclusion of present pleasures?
• At what point does one’s perspective violate the privacy rights of the partner?

Being in a relationship, means being connected to another person. Every action taken or not taken by each partner, (including one’s health care), impacts the other partner’s well being. You may want to ask yourself the following questions:

• Are the anticipated health and well being benefits achieved through life choices worth the efforts involved?
• Does your commitment to your mate also include staying healthy?
• Do you owe it to your children to maintain and model healthy life habits and be a healthy parent?
• Can you respect your partner’s right to manage his/her life as he/she sees fit? Getting angry, hateful, nagging or despairing are unhelpful motivators for change.
• Would you be willing to not judge your partner, but offer help, if asked?
• Can you deal with your partner’s health choices as to not accumulate anger, resentments or fears? If not, please deal with these feelings immediately. Untended to hurt or painful feelings are hazardous to your marriage.
• If your differences seem unbridgeable, seek professional assistance.

Ideally, couples should keep an active dialogue about the balance between health and privacy.

May 15, 2005

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About Author

Offra Gerstein, Ph.D. is a licensed psychologist in clinical practice in Santa Cruz, California for over 25 years, and specializes in relationship issues for couples and individuals for improved quality of life. Her work includes: mate selection, marriage, long term relationships, gay and lesbian couples, work relationships, parenting issues, family interactions, friendships, and conflict resolutions. Offra has lectured extensively to various groups, conducted support groups for several organizations, and has been writing a weekly column "Relationship Matters" for the Santa Cruz Sentinel since 2001.

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