A 15-minute relationship fix [PODCAST]

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“Depression involves withdrawal, withdrawal from oneself and others. Feeling safe enough in a relationship to reveal our innermost feelings safely is connective and should be considered a valued part of the anti-depressant lifestyle. Continued relationship satisfaction is based on respectful openness and validation, the kind of communication that built love in the early days. To do otherwise is to risk a relationship with no real relating, and to miss out on a factor that may not only be part of the treatment for depression but a powerful deterrent.”

Joel Block is a psychologist and author of The 15-Minute Relationship Fix: A Clinically-Proven Strategy That Will Repair and Strengthen Your Love Life.

He shares his story and discusses his KevinMD article, “Personal intimacy as an overlooked antidepressant.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Joel Block. He is a psychologist, and he’s the author of the book The 15-Minute Relationship Fix: A Clinically-Proven Strategy That Will Repair and Strengthen Your Love Life. Joel, welcome to the show.

Joel Block: Great to be here, Kevin.

Kevin Pho: So we’ll get into your KevinMD article in a little bit, and the one that we’re going to talk about today is titled “Personal intimacy as an overlooked antidepressant.” Now, before getting to that article, just briefly share your story and journey to where you are today.

Joel Block: My story is interesting, because I was standing in the lunch line at State University in my first week there, and these two girls in front of me were talking about relationships and about psychology. I thought, “What a bunch of junk. I learned more about psychology in the crap game in a Brooklyn apartment house basement than they’ll ever learn.” I was wrong, and I had a professor that basically turned my life around, going from “relationships are silly and it doesn’t take much to fix them” to really learning about how to fix relationships.

Kevin Pho: So as your career progressed, what are some of the biggest things that you’ve learned about fixing relationships?

Joel Block: One of the biggest things, and the research really supports this, is that validating is extremely important. When someone says about someone they’re living with, “He or she gets me,” that’s a great sign. The opposite, “He or she doesn’t get me,” is not a great sign. It’s trouble. So feeling understood doesn’t mean that the person agrees with you, but feeling that you’re understood is extremely important. It’s the heart of a relationship.

Kevin Pho: And over the past few years, especially during the pandemic, there’s been a tremendous amount of stress in a lot of our personal relationships. So tell us, what have you seen during the COVID pandemic in terms of how it’s affecting a lot of our personal relationships, and what are some ideas you have to get us out of those issues?

Joel Block: Well, first, what I’ve seen is that with people who haven’t been used to spending so much time with their partners, in the best cases, they’re learning things about their partners that they didn’t know before, because they didn’t take the time to know. In the worst cases, I had a dentist come in my office for relationship issues who said he had a lot of teeth to fix, more so than usual. Yes, broken that way, in terms of violence, by people who are living together and not used to spending that much time with each other.

Kevin Pho: So what are some ideas you have to get us out of those relationship issues, especially during the pandemic? What are some high-yield things that you could recommend?

Joel Block: I would say one, and these are very simple things that you could say you learned in kindergarten: Talk one at a time. Let a person finish their thought. That seems very simple, and it’s simple, but it’s not necessarily easy. People interrupt each other; there’s a lot of frustration.

I also have had a situation where a guy said to me, “You know, I listened to my wife. She was on the phone with a friend, and I’m saying to myself, ‘I didn’t know that. I didn’t know that. I didn’t know that.'” And he talked to his wife. She says, “She actually listens. That’s why I can tell her more, because she’s listening. As soon as I start speaking, you’re ready to give me advice, so I’m careful about what I say to you, because I don’t necessarily want your advice.” So again, a simple thing: listening and validating. The person feels, “Yes, you understand.”

Kevin Pho: All right, so we’re going to talk more about relationship issues. One of your KevinMD articles that we’ll talk about is titled “Personal intimacy as an overlooked antidepressant.” Now, for those who do get a chance to read that article, this was back in 2018, and just to give a little reminder, what’s that article about? And share the story of why you decided to write it.

Joel Block: Well, first of all, it came out in the Daily News on Valentine’s Day. The article was about how, for depression, we have pills, we have various suggestions, but one of the things that’s been missing from the literature is relationships. People who have good relationships don’t have full protection from depression, but they have more so than people that don’t have good relationships. So this is looking at some research that suggested that people’s relationships improving really made a big impact on their depression. It’s not the only treatment for depression, but it’s a treatment that’s been left out. That’s what the article is about.

Kevin Pho: So let’s delve a little bit deeper. When you say a good relationship, what are the characteristics of a good relationship in your eyes?

Joel Block: One is what I’ve already mentioned, and I don’t mind mentioning it again because it’s important: feel understood and count on the other person. The other thing is there’s something called the four factors of calamity. There are four factors that have a very high prediction for divorce, or at least unhappiness: criticism; contempt, which is criticism on steroids; defensiveness; and withdrawal. That’s the fourth factor. All those four factors have a 90 percent prediction rate of divorce, just those four factors alone. A lot of the research that’s been done isn’t really that good. This is good. It’s well done, and it makes a big difference.

Kevin Pho: So are you saying that you have to have all four of those factors, and that has such a high predictive value of divorce? Because I’m sure that a lot of couples have perhaps one or two of those factors.

Joel Block: Or four. And there are couples that aren’t divorced, but they may as well be, in terms of they have all those factors going on to a large extent, and they’re unhappy, but they don’t get divorced because of religion, children, finances, various reasons. But they’re unhappy.

I look at it in terms of, I’ve been dealing with couples for many years. There’s a 50 percent divorce rate, approximately, but half of the people that stay together are unhappy, and again, they stay together for the children, for religion, for finances, for various reasons. So it’s, of people who really have a relationship that works for them, would you go for elective surgery where you have a 25 percent chance of surviving? And it’s elective. So marriage is a difficult position to be in. You really need to know what you’re doing.

And I come from a household where, I grew up in a very working-class area of Brooklyn where it was Italian and Jewish, and no one got divorced except my mother. She was married three times. So if you wonder how this guy got into this field, that’s how.

Kevin Pho: Now, let’s say you have one of those couples in your office, and they have one, two, three, or four of those factors that may lead to divorce. You mentioned in your article how personal intimacy may be one of the solutions in terms of fixing that. So talk more about some of the solutions.

Joel Block: Well, one of the things I do that most people don’t do, most therapists who practice couples therapy: I ask a couple who wants to go first, and someone will volunteer in this first session to tell me what’s going on. Before they start, I say, “I have an idea. Why don’t you tell me what’s going on from the other person’s point of view?” That could be a showstopper, and they usually get it wrong, but that’s our start.

So again, I’ve mentioned this a number of times because the research is very strong on this. In fact, I’ll give you an example. I did a book recently, my first academic book, on infidelity. I started thinking, “I wonder if there’s ways of predicting that.” I looked up every kind of thing, ethnicity, type of occupation, all kinds of factors, and the only factor that made a difference, a big difference, was couples where they felt validated by their partner. There was much less infidelity than in couples where they didn’t. So I do mention that, but it’s very important to feel like there’s someone who’s on your side.

Kevin Pho: So I want to ask you about dual-physician couples, because I read a lot of physician boards, and there are a lot of questions when it comes to relationships between two physicians who are married. Talk about some of the added stress that these types of couples face when you have that burden of practicing medicine on top of whatever relationship issues they already have. What’s your experience, and what are your observations when it comes to dual-physician couples?

Joel Block: First, when I first started, it surprised me. You guys are very bright, educated people, yet how little they knew about relationships, really relating. But the other part is, I’ve seen, and I just talked with a couple recently, they said they owe half a million dollars. Each of them had $250,000 in education bills and living expenses during their education, so they’re burdened with a half a million dollars of loans to pay back. So there’s a lot of stress.

I think I like the idea of the 15-minute relationship fix for them, because they don’t have much more time than 15 minutes, but if they did that conference once or twice a week, it would keep them connected. Just to give you a quick overview: One, tell me something that happened. Tell the other person something that happened, very briefly, that the other person was involved in, that happened between them. Two, talk to me about the psychology, your psychology, how it impacted you, so the pronoun is “I” or “me” rather than “you.” Three, see if you can connect it to your childhood. You’ve developed a blueprint for relationships, and that blueprint is going to follow you the rest of your life. And four, don’t think linear; think systemic. You form a system with the other person, so it’s not about just the other person. It’s how you react to that person and how the other person reacts to you. So given that, what part did you play in what went on with your partner?

And we don’t learn about relationships in school or any place else. So I look at part of my job as educating people in terms of, here’s how relationships work, and here’s what you have to do to make it work for you. And to think that, well, something happened, it hurt your feelings, but you’re not ready to talk about it, and you may never be ready to talk about it: Don’t think it’s not with you. If you don’t clean house, it’s going to come back and bite you, and that’s one of the factors, withdrawal, of the four factors.

Kevin Pho: We’re talking to Joel Block. He’s a psychologist, and he’s the author of the book The 15-Minute Relationship Fix: A Clinically-Proven Strategy That Will Repair and Strengthen Your Love Life. We’ve been talking about one of his KevinMD articles, titled “Personal intimacy as an overlooked antidepressant.” Joel, let’s talk more about your book, The 15-Minute Relationship Fix. What are some of your top tips that one can take away from reading your book?

Joel Block: Listening, again, is very important, but instead of making it an issue between the two of you, where it’s a difficult issue, talk about your feelings. So the challenge I had in the book is helping relationships work better while at the same time teaching them about EQ, emotional intelligence.

So here’s how it works. I ask them to have a conference with themselves. Let’s say they’re going to meet, because I like them to have a date with each other every week, 15 minutes. In preparing for that, think about what occurred, how you felt about it. Prepare yourself for the emotional conference: What was your part in it? So when you sit down for the emotional conference, you’re prepared.

So here’s what happens. I speak about all those factors: Here’s what happened, here’s how it affected my psychology, here’s the impact if I can make a connection to my childhood, and here’s what I own in the experience that we had together. While I do that, the other person listens, then summarizes and validates what you said. Then the other person goes and does the same four factors: what happened, how it made you feel in terms of emotions, your psychology, your childhood factors, how it played into it, and what you own. After they’ve finished that, after they each do that, it’s done.

I want them to build the emotional muscle so that once it’s done, if they want next week, in their conference, to do it again and explore it further, fine, but in the meantime, hold on to it. Deal with it in terms of yourself. Don’t make it all; you’ll get tired if you try it every night or something like that. So I think for people who are very busy, and most of us are, having something that’s efficient, that’s empirically based, that makes sense, is extremely important.

Kevin Pho: And my final question, Joel: What are some of your take-home messages that you want to leave with the KevinMD audience?

Joel Block: Listen better. If your partner is asked, “What do you like about your partner?” what I want the partner to be able to say is, “He or she gets me.”

Kevin Pho: Joel, thanks again for sharing your time and insight. Thanks again for being on the show.

Joel Block: My pleasure.

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