Sunday, October 09, 2016

Donald Trump: the psychological impact of toxic masculinity and how healthy, happy men diversify

I want to begin this piece by sharing how challenging it can be for me to understand the underpinnings of American masculinity as an American woman of color. Even after 10 years of experience as a clinical psychologist, coach and professor I still feel stumped sometimes in helping men navigate their career development and improve their interpersonal relationships, particularly as it relates to their masculine identity. I have a deep sense of curiosity and motivation to understand the perspectives of all my clientele. Public figures can also also stir my intellectual curiosity, especially when similar issues are cropping up among those I’m helping in my practice. I write as a way to synthesize the research and consultation I do with professional colleagues and members of various social groups to increase my understanding of particular clinical issues. By improving my understanding of how men operate within their gender framework, I can more effectively support their goals for happiness and achievement while respecting their values and world view. Donald Trump’s entire public life provides a rich opportunity to examine how male gender expression, at it’s extreme, can lead to a toxic psychological crisis in masculine identity. In this article I’d like to set aside drawing conclusions about his potential to effectively lead as President of The United States of America. Why? Just imagine for a moment, what it would be like to be Donald Trump’s therapist. You see, as difficult as it may be, therapists must aim to reserve judgment in order to understand and assess how to be helpful in creating healthy change and growth. If we can we understand Donald Trump’s psychological make-up as it relates to masculinity, surely we can learn something about the gender confines that men face in getting their psychological needs met as they strive for fulfillment and achievement. Why is this important? Trump reflects the toxic side of American masculinity, and if we don’t take a close look at how and why toxicity develops and festers within male culture, we can’t begin to stop it from infecting others in small or large ways in men everywhere. Imagine for a moment, a four way street intersection, where gas fueling stations are housed on each of the four corners. At each fueling station, you can ‘fill up your tank’ on: Physical Aggression/Strength/Athleticism Money/Influence of Financial Wealth Control/Influence Upon Others (at work or in personal relationships) Sexual Prowess and Virility/Sexual Satisfaction These four fueling stations can be seen as representing the most traditional, socially acceptable, even socially celebrated opportunities for men to fuel their sense of masculinity. Whether or not you personally agree with this, the vast majority of American men are measured by others against these four standards of traditional masculinity at various points in their life. While men also aim for other forms of achievement (e.g. intellectual development, family life development, practice of religious faith) those strivings aren’t typically seen as embodying strength of masculinity in and of themselves. Traditional masculine-affirming pursuits do not have to be at the expense of other’s rights, take on a quality of malicious manipulation and oppression, or require a man to rely on them as his sole means for fulfillment. Masculine identity serves men best when it allows space for them to thrive in these traditional areas should they choose, but also allows them ample space to enrich their lives through other areas of fulfillment and connectivity. Some men whom I’ve worked with appear to be ‘stuck‘ in the relentless pursuit of boosting one or more of these traditional areas of masculinity in the hopes of achieving lasting happiness. The theory of masculine overcompensation dates back to Sigmund Freud’s notions of ‘reaction formation‘ and ‘defense mechanisms‘. Some men respond to having their masculinity questioned by emphasizing their expression of traditional masculine traits. In 2013, a group of sociologists put this theory to the test. In Overdoing Gender,” a study for the American Journal of Sociology, men were given feedback suggesting they were ‘feminine’, which led to an increased support for war, homophobic attitudes, interest in purchasing an SUV, support for, and desire to advance in dominance hierarchies, and belief in male superiority. Research from The American Journal of Men’s Health and a host of other studies conclude that the expression of traditional masculine traits can be hazardous for men’s health functioning. William Ming Liu, editor of the journal Psychology of Men and Masculinity describes toxic masculinity as providing a very limited way for men to relate to each other- when boys are socialized to avoid feelings and weakness it increases their overall psychological stress. As a woman and mental health professional, it can be tempting to say “hmmm…have you considered seeking fulfillment from OTHER areas? You’ve already experienced objectively high levels of achievement through these traditional areas, and you’re telling me you’re still unhappy/unsatisfied. Why not pivot and diversify? See if some other areas of personal development could help you feel better/more fulfilled for the long term?” In my professional experience, toxicity can take root in a man’s masculine identity when he gets stuck searching for fulfillment from these 4 traditional areas of masculinity only. Without diversification, it can lead to toxic overdose! In Donald Trump’s case, he keeps going back for more and more like an addict- all of his accomplishments are no longer getting him that desired high, so he keeps upping the ante. Overdosed on orange self-tanner and sporting a shellacked comb over, surrounding himself with garish gold interiors, aggressively forcing himself sexually upon countless women, accruing more debt in the relentless pursuit of financial return, publicly decrying ideas of racial superiority that benefit himself at the expense of others, and finally, seeking political office as the world’s most powerfully influential men. He is feeding his own internal beast and he does not appear to be slowing down. I suspect there is a deep, empty abyss inside his sense of identity that is always starving for increasingly grandiose, self-serving displays of ‘success’. This particular phenomenon of toxic masculinity is not only psychologically unhealthy, but socially destructive when public figures like Donald Trump effectively normalize misogyny, sexism, racism and xenophobia. donald-trump While many American men aspire to experience some degree of his accomplishments in the areas of wealth, power, influence, access and opportunity with beautiful women, it’s important to underscore that these gains alone may very well NOT lead to the level of fulfillment and happiness one might imagine. Encouraging a more well-rounded sense of masculine identity, one that allows room for pursuits that go beyond the traditional male gender constructs will increase men’s opportunity for lasting and balanced happiness. Research by Levant and other psychologists reveal healthy aspects of masculinity might actually protect and improve men’s health. These healthy aspects of masculinity include: Self-Reliance Responsibility (personal, familial, societal) Emotional maturity/emotional intelligence Investing in making a positive impact on society/the environment that is personally meaningful Aiming to grow and diversify oneself in these key areas can help men achieve lasting personal fulfillment beyond traditional masculine pursuits for success. Each are common treatment goals I work on with the high-achieving men in my executive coaching practice. Many have shared with me how rewarding it feels to build upon what they’ve already mastered and thrive in these important life aspirations. Dr. Christina Villarreal is a mental health expert, executive coach, professor and writer practicing in the San Francisco Bay Area. Professional inquiries may reach her at www.drchristinavillarreal.com

Friday, January 30, 2015

New Year's resolutions have come and gone: getting 'unstuck' in 2015

The end of January has arrived, and for many, the enthusiasm for New Year's resolutions has waned. How does the song go? 'Back to life, Back to Reality'. This can be a discouraging time, especially if you're still feeling as 'stuck' as you did in 2014. A few weeks ago, just back from a European trip I came down with the flu. Stuck in bed, I decided to start watching the series Downton Abbey after enjoying London while abroad. I proceeded to watch 4 full seasons in 2 week's time. That's about 32 hours of Amazon instant stream binging. I'm actually not sharing this with you here to impress you with my television watching abilities (though they are now well honed) I want to pass on some wisdom from the character Violet Crawley, Dowager Countess of Grantham in Downton Abbey. A razor tongued, hilarious matriarch with brilliant one liners, she said something that struck me as impressively simple, yet an invaluable outlook to adopt in life. She said "All life is a series of problems which we must try and solve. The first one and the next and the next, until at last we die." This message was directed towards her discouraged granddaughter, who was feeling overwhelmed by the ongoing string of unfortunate events of her life. While some may take her advice as grimly pessimistic, it struck me as both calming and reassuring. We must try to take a step back from our current circumstances and keep in mind, we're always going to be facing a "thing" to overcome or achieve, big or small. No need to harbor shame in the process, or adopt a sense of personal defectiveness, it's the nature of life. Resolution will come and/or 'that thing' will pass, because change is inevitable. In the meantime, try to find a bit of joy. Reach out to friends, find humor in the process, remind yourself that you are not the only one. One of the many things I love about helping people when they feel 'stuck' in a bad place, is hearing from them down the road, long after we've worked through those darkest hours. Nothing brings me more joy than finding out they are now flourishing and past that difficult phase when they came to me for professional support and skill building. It's concrete evidence that even when things completely fall apart in someone's life, things will turn around in time. Resolution has a way of happening, one way or another. I am reminded that life goes on, and my confidence is renewed in helping others find their way too. The hardest moments pass, we find a way to work through those dark hours, and there are surely joyful times to come. Life is a series of highs and lows. We can't change that inevitably and in knowing that we can find some peace and comfort as we get though it. Dr. Christina Villarreal is a mental health expert and coach in the San Francisco Bay Area. For professional inquiries please visit www.drchristinavillarreal.com

Monday, January 26, 2015

Prescription medicines: asking the right questions to keep you informed

Prescription medicines: asking the right questions to keep you informed This week is National Drug Facts Week (January 26th-February 1st), and in partnership with The American Recall Center, I’d like to highlight some key tips for better understanding the prescription medicine you’ve been prescribed. It’s not uncommon for people to leave their medical appointment without genuinely understanding why they’ve been given a prescription, and/or how it will work or feel if taken regularly. As a mental health provider I may help people explore the possibility of taking a medicine to help them better manage their mood, ability to sleep, etc. in conjunction with psychotherapy, coaching, and/or other health modifications like exercise, changes in work-life balance, or diet. I support them in taking an active role in managing their health, and understanding the risks and gains of the various decisions they may choose. Over the past 15 years in my work in healthcare, some of the most common concerns people have expressed to me about taking an antidepressant is the impact it may have on their sexual functioning, weight gain/loss, ability to experience ‘normal’ emotions, or fear of becoming ‘dependent’ on it over time. Others are concerned it could interfere with their active lifestyle or prevent them from enjoying alcohol or other recreational choices. It’s normal to have reservations about starting any new medication. If you don’t feel comfortable discussing your concerns with your prescribing provider you may miss out on the significant benefits it could provide you, by opting not to take it out of misunderstanding or fear. The following list is a helpful guideline to have with you during your health appointment, and/or when you pick up your prescription from the pharmacy. It can help to bring it to your appointment, and write down your provider’s responses as a way to make the most informed decision possible. Be proactive: gather as much information as you can before you leave your appointment What is the name of the medicine, and for what specific reasons should I take it? What is the name of the condition this medicine will treat? How long will it take to work? How should I store the medicine? Does it need to be refrigerated? Can the pharmacist substitute a cheaper, generic form of the medicine? Will the medicine create conflicts with other medicines, herbs or supplements or recreational substances I use? Find out how you are supposed to take it for optimal effect: When and how often should I take this medicine? As needed, or on a specific schedule? Do I take the medicine before, with, or between meals? How long will I have to take it? Know what to expect while taking this new medicine: How will I feel once I start taking this medicine? How will I know if this medicine is working in the way that it should? What side effects might I expect to experience? Will they go away? How long might it take for any side effects to subside, if at all? Ask how this new medicine fits in with any other other medicines or substances you take: Are there other medicines or activities I should avoid while taking this medicine? Will this medicine change how my other medicines work? (Ask about both prescription AND over-the-counter substances you take, even if it’s only occasionally or rarely) Will this medicine change how any of my herbal or dietary supplements work? Ask if your new medicine interferes with eating or drinking. Are there any foods or liquids that I shouldn’t drink or eat? Can I drink alcohol or other use recreational substances like marijuana while taking this medicine? How much is generally safe/unsafe? Is it OK to eat or drink food before or after I take the medicine? Other important questions to ask: If I forget to take it, what should I do? What should I do if I feel I want to stop taking this medicine? Is it safe to just stop or do I need to gradually stop taking it? Always call and check in with your doctor or pharmacist if: You have questions or you are confused/uncertain about the directions for taking your medicine. You are having side effects from the medicine. Do not stop taking the medicine without telling your doctor. You may need a different dose or a different medicine. Your medicine looks different than you expected. Your refill medicine is different than what you usually get. Dr. Christina Villarreal is a clinical psychologist practicing in the San Francisco Bay Area, CA. For more information about her practice, please visit her website at www.drchristinavillarreal.com
References Your medicine: Be smart. Be safe. Patient Guide. AHRQ Publication No. 11–0049-A, April 2011. Agency for Healthcare Research and Quality, Rockville, MD, and the National Council on Patient Information and Education, Rockville, MD. Accessed May 10, 2014. NIH Senior Health. Taking medicines safely. January 2011. Accessed May 10, 2014. Update Date: 5/11/2014 Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

Monday, August 18, 2014

Gen-Y's tech twist on engagement, weddings and parenthood

While Gen-Y is still getting married at much lower rates than previous generations, some millennials are finally beginning to grow up, entering the world of marital engagements, wedding planning, and parenthood. True to form, their choices reflect advancements that set them apart from Gen-Xers, who were the first to utilize technology to chronicle their love stories on websites like theknot.com, build wedding registries online, gift personalized CDs with digitally remastered music as wedding favors, show spliced video montages of the bride and groom's childhood at wedding receptions, and research honeymoons on websites like tripadvisor.com. As a card carrying member of generation X, I can proudly say we thought we were so cutting edge! Our kids were the first to be born with smartphones and tablets in their hands, and we posted their baby pictures on our social media pages and texted them to their grandparents. But time nor technology stands still, and Gen-Y has begun to put their own tech twist on engagements, weddings and baby plans. As a mental health treatment provider and consultant who works almost entirely with millennials in the San Francisco Bay Area, I have taken note of the following trends: Their romantic relationships have an online life of their own. As the saying goes, no one really knows what happens behind closed doors, but in the personal lives of millennials, we can certainly take a look at their online activity to see what they'd like us to believe about their relationship status and history. The internet has become their forum of choice for chronicling romantic highs and lows, functioning as a means to gain public support, air grievances, compete for attention, and display markers of success (not to mention deleting away failures.) From public playlists on Spotify, hashtags on Twitter and Instagram, Pinterest boards and Facebook's 'Relationship Status' updates, Gen-Y leaves little to the imagination when it comes to sharing their stories of romance. They crowd source their decisions when it comes to navigating relationships. Millennials are used to solving problems fast, arriving at optimal solutions with the least resistance possible. Millennials have been groomed to work in competency-based teams, and this concept is frequently used for managing their personal lives too. They prefer to avoid conflict, and are more comfortable than previous generations relying on others to help them make decisions. Jeff Snipes, CEO of Ninth House, a provider of online education, including optimizing team effectiveness, says a hierarchical, leader-oriented team was more appropriate for earlier generations: “Traditionally if you worked up the ranks for twenty years and all the employees were local then you could know all the functions of the workplace. Then you could lead by barking orders. But today everything moves too fast and the breadth of competency necessary to do something is too vast.” When faced with life-changing decisions about relationship commitment or endings, Gen-Y seeks the opinions of their team of friends, family and experts to help them navigate and solve problems. When problems are deemed too private to share, websites like popular sites like Whisper and Secret are put to use by millennials as a way to air their private thoughts, share their hidden behaviors and ask for advice completely anonymously, so there is no threat to their carefully constructed online image. Their engagement stories, weddings and honeymoons reflect their brilliance and investment in personal branding. While previous generations aimed to establish their worth and reputation through self-improvement, author Dan Schawbel of Me 2.0: Build a Powerful Brand to Achieve Career Success points out that Gen-Y has discovered that in the dawn of the internet, admiration and success comes from self-packaging through a carefully concocted personal brand. From the days of Myspace to Tumblr, millennials have grown up managing their self image like celebrity publicists. Gen-Y has turned self-portraits into a way of life- 'selfies' have become one of the internet's top forms of self-expression. Their overall online presence has been a way to uniquely distinguish themselves from everyone else, and they are highly invested in making their relationship milestones ideally memorable as part of their personal brand. Whether they capture and share these milestones via Snapchat's Our Story, Instagram, Twitter, Facebook, or personal blogs, millennials are sure to control how the world sees their love stories unfold through brand management. One San Francisco Bay area millennial shared with me she got engaged via FaceTime, since her long-distance boyfriend was living in abroad and couldn't wait to pop the question. To his credit, her (now fiance) also created an iMovie that he shared with her, depicting him staged in funny scenarios accompanied by a personalized musical score that specially captured their romantic history. They're comfortable resisting tradition, understanding that 'following the rules' doesn't necessarily bring 'happily ever after.' Author Paul Hudson of Elite Daily, The Voice of Generation Y observes that millennials are far less likely than past generations to buy into the notion that marriage is the gateway to a future of stability and happiness. Harry Benson, research director at the Marriage Foundation, describes the strong link between parental divorce and a reluctance to get married. “If your parents split up then most people are more likely to be quite skeptical about the value of marriage,” he explains. “So as there’s rising divorce rates, you can imagine how when the next generation appears, people will be more dubious about marriage.” Bobby Duffy, leading market researcher on generational analysis, says there are also far more financial pressures on millennials than previous generations. They have more educational debt in a less stable economic climate, and face an incredibly buoyant housing market. According to CNNMoney, twenty-somethings are transitioning into adult life at a more gradual pace, opting to cohabitate and co-parent without traditional marriage at a much higher rate than previous generations. They anticipate their babies' future in a world where technological identity matters. One website says it all: awesomebabyname.com, a new online tool that allows parents to choose a name for their child based on website domain availability. Yes people, this is happening. I heard it first a few months ago when a pregnant patient of mine found out she was having a girl, the first thing she and her cohabiting boyfriend/expecting father-to-be did was buy website domains and establish email accounts in her name. Of course, now there's an app for that! "It's important to give your children a fighting chance of having good SEO (Search Engine Optimization) in the 21st century," says Finnbar Taylor, who created this website together with Karen X. Cheng. "We use search engines all day long to answer our questions and find things, including people. Imagine being called John Smith and trying to get a ranking on Google search. It's important to give your child a unique name so that people, like potential employers, will be able to find them easily in the future." Granted, millennials are still in their 20's, a time when it's still developmentally common to be preoccupied with self-image, and an idealized future that looks different than previous generations. The question is, as Gen-Y ages, which of these trends, if any, will change? Dr. Christina Villarreal is a clinical psychologist in the San Francisco Bay Area, CA. She produces web articles, televised and print/web interviews on current issues in mental health and tech culture. She offers consultation and strategy to start up founders and employees.

Saturday, May 31, 2014

Tech in dating: decoding the social rules of text, online dating & social media, by Dr. Christina Villarreal, Clinical Psychologist

Let’s face it: flirting, finding love and managing relationships have always been complicated, but with the involvement of countless forms of technology now impacting every little step of the way, the social rules of love and sex have only gotten more confusing. The role of tech in dating is a primary topic in psychotherapy sessions I conduct with young singles in the Bay Area of California- the world’s hub and backbone of tech culture. Part of my role as their clinical psychologist is to help them decode and navigate the emerging social rules of text, online dating and social media to help them achieve fulfilling relationships. I recently spoke with Tech Crunch journalist Sara Buhr, who was investigating dating trends among people immersed in the tech industry. Some of the questioned she asked of me were: How are the norms and expectations different? Are young men in tech less likely to follow traditional social rules of dating? How has the proclivity toward using dating websites changed the dating game? This article was born from that conversation, and aims to illuminate the challenges of social connection in the 21st century. So what do we already know? If you want to communicate personally with anyone these days, you’ve got to text them. Casual, easy and non-threatening, text messaging is upending today’s dating culture. The cellphone is the gateway: swiftly and radically changing the way people interact, meet and move forward (or not) in a relationship. According to a report released in 2013 by Nielsen based on actual phone bills of mobile contract subscribers, about 764 text messages per person were sent/received each month in the USA in 2012, compared with about 165 mobile calls per month. A new survey of 1,500 daters provided to USA TODAY reveals how deeply mobile technology has rocked the dating world. The daters, ages 21 to 50, give even greater insight into mobile behaviors and a new range of dating questions: Do you check your phone during a date? How soon must you reply to a text? Should a friend call or text you to see how the date is going? Among the findings: •Approximately one-third of men (31%) and women (33%) agree it’s less intimidating to ask for a date via text vs. a phone call. •More men (44%) than women (37%) say mobile devices make it easier to flirt and get acquainted. “Texting is kind of an ongoing conversation. It does make it easier to flirt. Maybe you’re talking every day,” says Alex Pulda, 27, who works in product research in San Francisco. “It’s not like text conveys a ton of emotion, but you are getting a little more comfortable with each other.” Pulda says he texts for everything, including dates. “I don’t love phone calls,” he says. “They have all the downsides and don’t have the benefit of face-to-face communication. It’s kind of this in-between. And part of it is, it’s a lot more work than a text.” Millennials’ love of texting is rubbing off on other generations, suggests Naomi Baron, a linguistics professor at American University in Washington who has studied electronically mediated communication in five nations, including the USA. She says telephone calls are often thought of as an intrusion, while texting affords a way of “controlling the volume,” a term she uses to describe the sense of control that text gives users that they can’t get with a voice conversation. “We tell ourselves we don’t want to disturb someone. Sometimes it’s true, but more often, it’s because we can’t get them off the phone,” she says. In texting, “we don’t have to talk to people or listen to what another person has to say. We decide how we want to encounter or whether we want to encounter other people. Technology gives us tools for controlling our relationships.” In the modern world of dating, it’s becoming increasingly difficult to know how our electronic messages are being perceived and paced by others. It’s not uncommon (and quite the norm) for my patients to save texts, tweets, status updates and Gchats to discuss and analyze during our psychotherapy sessions. These digital exchanges are often at the root of their increased anxiety and worry, social tension, and depressive symptoms such as decreased concentration and irritability at work and other important areas of functioning. Life coach Debra Smouse explains “when a response [from others] doesn’t come, we begin to worry. When we don’t hear back, our minds start to spiral, creating crazy scenarios and we begin to believe that something is wrong. We know logically that a friend may have left his or her desk or a colleague may be on a call, but when we’re on the other end and stress hits, an unanswered chat box is discomforting, and logic goes out the window.” [Technologies like Gchat] “make us think that because the technology is ‘instant’ and free, people should respond instantly — and there’s something wrong when they don’t,” adds Alex Soojung-Kim Pang, author of “The Distraction Addiction.” It’s not just the frequency and pace of our electronic messages that are difficult to decipher. The content of these exchanges can also be equally confusing in the context of modern dating (a.k.a ‘hanging out‘), getting to know each other, (a.k.a ‘internet stalking‘) and sex (a.k.a ‘hooking up‘.) Ambiguous, common messages like “what’re you up tonight, anything fun going on?”, “I’m out drinking with some friends if you’re around”, and “hey” are all commonplace in the current dating marketplace, can make it difficult for people to gain traction towards building a committed relationship. The normalization and proclivity toward using dating websites in recent years contributes to a pattern of non-comittal social ties. Mobile apps like Tinder, okcupid and plenty of fish supply people with a never-ending source of new social opportunities. The problem is that “young people today don’t know how to get out of hookup culture” Donna Freitas explains, author of the forthcoming book, “The End of Sex: How Hookup Culture is Leaving a Generation Unhappy, Sexually Unfulfilled, and Confused About Intimacy.” “Dodging vulnerability cheats us of the chance to not just create intimacy but also to make relationships work”states Brené Brown, a University of Houston researcher whose work focuses on the need for vulnerability and what happens when we desensitize ourselves to it. In this light, people can utilize psychotherapy as a way to build social skills to help them find, evolve and navigate romantic relationships. Dean, a Millennial who writes about her generation (generally born 1982 to 2000) says, “We really see this generation as having a huge handicap in communication. We have our heads down in our smartphones a lot. We don’t know how to express our emotions, and we tend to hide behind technology, computers and social media.” she says. With diminished opportunity for healthy social relationships, this generation is at increased risk for anxiety, depression and isolation. As a mental health professional, I help people identify the relationship between their thoughts, feelings and behaviors that are leading them to feel ‘stuck’ in unfulfilling social patterns. It’s a slow process- teaching pacing and managing expectations are key to lasting progress. Participating in psychotherapy can help people increase their ability to establish and maintain fulfilling relationships. With these relationships come the superior health benefits of physical contact and emotional intimacy, love, trust and not-so-cyber sex. Dr. Christina Villarreal is a licensed clinical psychologist in the Bay Area, CA with offices in Oakland and San Francisco. For professional inquiries, she may be contacted at christina.villarreal@gmail.com or visit her website at www.drchristinavillarreal.com

Tuesday, April 29, 2014

Cohabitation: a generational trend that’s here to stay, but does it work?

Once in a while a treatment issue pops up so frequently among young adult patients in my psychotherapy practice, I begin to feel like it’s a generational trend, or perhaps specific to living in the Bay Area. More and more people are struggling to make their romantic relationship work while cohabiting. Like many desirable urban areas, Bay Area rent prices continue to soar with no end in sight. In spite of having well-paying jobs, many young adults are weighed down with hefty student loans, and have learned to enjoy an expensive lifestyle where smartphone bills, an expectation of recreational travel, eating out, and ‘networking over drinks’ are the norm. Many couples start moving in together in their mid-twenties, reasoning “it’s too early to get married, I need the freedom to make life decisions and consider what’s best for me before settling down” or “we were staying at each other’s places all the time anyway, it made sense to save money on rent and get a place together- living together will give us a chance to see if our relationship will work before making bigger decisions about engagement or marriage.” Cohabitation among young adults appears to be here to stay, but does it work? Cohabitation in the United States has increased by more than 1,500 percent in the past half century. In 1960, about 450,000 unmarried couples lived together. Now the number is more than 7.5 million. The majority of young adults in their 20s will live with a romantic partner at least once, and more than half of all marriages will be preceded by cohabitation. This shift has been attributed to the sexual revolution, the availability of birth control, and in our current economy, sharing the bills makes cohabiting appealing. In a nationwide survey conducted in 2001 by the National Marriage Project, nearly half of 20-somethings agreed with the statement, “You would only marry someone if he or she agreed to live together with you first, so that you could find out whether you really get along.” About two-thirds said they believed that moving in together before marriage was a good way to avoid divorce. Premarital cohabitation allows couples to experience a “trial run” before making the real commitment of marriage. Following this logic, those who cohabit before marriage are more prepared for marriage having already lived together, and reducing their risk of divorce. Research studies have shown however that premarital cohabitation should be considered with caution if marriage is the desired outcome, particularly for serial cohabiters. “People who live with multiple partners have higher divorce rates. If you’ve only lived with the person you are going to marry, you have no greater chance of getting divorced than a couple who hasn’t lived together” says Sharon Sassler, a professor of policy analysis and management at Cornell University who has extensively studied cohabiters. Couples who opt to live together before marriage, engagement or otherwise clearcut commitment, tend to be less satisfied with their marriages and more likely to divorce than couples who do not. These negative outcomes are called the cohabitation effect. Researchers originally attributed the cohabitation effect to selection, or the idea that cohabiters were less conventional about marriage, and therefore more open to divorce. As cohabitation has become a norm, however, studies have shown that the effect is not entirely explained by individual characteristics like religion, education or politics. What contributes to the cohabitation effect? Relationship inertia. Some couples who would not (and likely should not) have gotten married do so because they were already living together. The threat of having to separate complicated living arrangements and shared belongings may be enough to keep some couples together. Some couples may find themselves on a path toward marriage because it seems more palatable than the alternative. Conflicting agendas. Researchers discovered that in heterosexual relationships women were more likely to view cohabitation as a step toward marriage, while men were more likely to see it as a way to test a relationship or postpone further commitment. This gender asymmetry was associated with negative interactions and lower levels of commitment even after the relationship progressed to marriage. There is a dearth of information on same-sex couples who choose to cohabit; their circumstances should be distinguished from heterosexual couples since same-sex relationships continue to be impacted by discriminatory laws prohibiting same-sex marriage in the United States. Sunk costs and cognitive dissonance. How do these concepts apply? The more time and energy people invest into a relationship the harder it becomes to end the relationship, even if cutting their losses will save them more heartache in the future. Further, people tend to strive for consistency between their feelings, behaviors and circumstances. Even if there are plain signs a relationship is no longer rewarding or even functional, living together can lead people to adjust their views so that their current living arrangements continue to ‘make sense’. Decreased opportunity to meet other (potentially better suited) partners. Couples who live together are likely spending more time together, narrowing their exposure to other people who frankly might be a better match, romantically. Some people end up investing years of their 20′s and 30′s into relationships that might have lasted only months had they not been living together. One thing men and women do agree on, however, is that relationship standards for a live-in partner are lower than they are for a spouse. Young adults in psychotherapy treatment illuminate the dilemma of cohabitation: “It’s true, I make about 30 thousand dollars more annually than my girlfriend does. But I don’t think I’d be ready to pay more of our bills than she does, unless we were married…but we’re not, we’re living together.” James, age 29 “My [live-in] boyfriend doesn’t like that I go out and stay out so late drinking with my friends. It’s like he expects me to stay in, just because he’s tired from working all the time. Why shouldn’t I go out and have fun with my friends? I think once I’m actually married to him things will be different, I’ll want to do different things when I’m married. I’ll be thinking about having kids, and my friends will be married too.” Audrey, age 27 “Everything is going really well with my girlfriend, we’ve been living together for almost a year now. Except she has made it very clear she wants to move back East to be close to her family once she’s married and ready to have kids. Her mind is made up. But my career in tech is growing here, the company I founded is based here in Silicon Valley and my family is here too. So what should I do doc? Enjoy our relationship for now since we’re so young? Or break it off now rather than avoid the inevitable?” Mark, age 26 What is the impact of the cohabitation effect on one’s mental health? Dr. Lloyd Stockey, a board certified primary care physician at Kaiser Hospital’s flagship medical center in Oakland, California weighs in on the topic. “[Cohabitation] is like a lease or practicing to see if you really want to commit. Unfortunately, it sets the bar low. There’s no real commitment with living together. It’s an opt out clause, and it’s never equal. It’s a roommate situation after 2 years. Everyone ‘goes for self’ when cohabiting. Career, freedom, and personal success comes before commitment and family. The younger generation thinks it’s commonplace to upgrade partners, and is satisfied being single parents. The landscape has changed. There’s blurring in Gender roles, household leaders, finances, and expectations. Playing house is exactly what it is. It’s monopoly money. Looks good on paper and everyone is playing, but not worth anything when the game is over. Codependency and living arrangements cause a majority of adjustment disorders and depression in family medicine. It’s messy in a lot of ways. It’s just like Facebook says–single, married, or it’s complicated.” The bottom line: cohabitation is here to stay, and there are things young adults can do to protect their relationships from the cohabitation effect. Meg Jay is a clinical psychologist at the University of Virginia and author of The Defining Decade: Why Your Twenties Matter — and How to Make the Most of Them Now advises – it’s important to discuss each person’s motivation and commitment level before opting to move in together, and view it as an intentional step toward, rather than a convenient test for marriage or partnership. It also makes sense to anticipate and regularly evaluate constraints that may keep people from leaving the relationship. Couples who communicate openly and regularly will likely reduce ambiguity about their partner’s commitment, and have realistic expectations about the future of their relationship. Sassler says the takeaway from her research at Cornell is that couples need to talk about situations such as the possibility of pregnancy, whether they’ll split household expenses evenly, and general expectations about gender roles. Understanding the role of cohabitation in the success and failure of relationships has far-reaching implications for generations to come. Recent estimates suggest that about 33% of all children of unwed parents are born to parents in a heterosexual cohabiting relationship, and more than 50% of all children born in the United States will live in a house headed by at least one unwed parent. Those who contemplate cohabiting can benefit from educating themselves about the benefits and risks, and utilize resources on how to make a smooth and successful transition to cohabitation (couples workshops, relationship books, working with a family/couples therapist). Whether or not people subscribe to traditional societal expectations for marriage, choose to cohabit or not, my aim for the individuals in my psychotherapy practice is that they become better equipped at participating in happy, functional and rewarding romantic relationships. Dr. Christina Villarreal is a licensed clinical psychologist in the Bay Area, CA. She has a private psychotherapy and forensic assessment practice with office locations in Rockridge and San Francisco.