Divorce stress exacts long-lasting toll

Press, 3 February 1984, Page 26

Divorce stress exacts long-lasting toll

By

JANE BRODY,

of New York Times, through NZPA New York

Divorce can exact a greater and, in many cases, longer-lasting emotional and physical toll on the former spouses than virtually any other life stress, including widowhood. Recent studies are expanding on earlier research showing that, compared with the married, nevermarried, and widowed, divorced adults have higher rates of emotional disturbance, accidental death, and death from heart disease, cancer, pneumonia, high blood pressure, and cirrhosis of the liver.

One often-cited analysis of national mortality data showed that for deaths that could be related to psychological functioning, the divorced were worse off than the widowed in eight of 10 categories. For example, in comparison with the suicide rate for married women, which was the lowest, the rate was one and a half times higher for single women, more than twice as great for widowed women, and almost three and a half times higher for women who were separated or divorced.

Yet, experts say, relatively little professional attention has been paid to the health consequences of divorce and to helping people avoid them. According to Dr Gerald Jacobson, director of the Didi Hirsch Community Mental Health Centre, in Culver City, California, author of “The Multiple Crises of Marital Separation and Divorce” (Grune and Stratton), there has been a “disproportionate emphasis on the impact of divorce on children” and not enough attention to how divorce affects the former spouses. In particular, few studies have looked into the longterm emotional effects of divorce, Dr Jacobson said in an interview. When a longdivorced person enters psychotherapy, the possible connection between the divorce and the present emotional problems rarely gets adequate attention, Dr Jacobson believes. “The distress of marital separation and divorce is a common reason for consult-

ing a mental health specialist,” he said. Divorce required a profound readjustment that in the immediate aftermath could produce symptoms that resemble deep-seated psychopathology- . ~ Dr Jacobson and Dr James Lynch, a psychologist at the University of Maryland, author of “The Broken Heart: the Medical Consequences of Loneliness,” draw close parallels between the reactions to divorce and the grief that typically results from the death of a spouse. Similar emotions are experienced, especially anger, guilt, and depression. However, in divorce, with the former spouse still alive and frequently in contact, and with typically angry feelings between spouses being expressed, it is usually much harder for people to accept the reality that the relationship has come to an end.

The biological links between emotional stress, such as that caused by divorce, and the development of physical illness are only just being uncovered. Stress-induced damage to the cardiovascular system and abnormal immunological responses have recently been demonstrated in people as well as laboratory animals.

These changes can render divorced people more vulnerable to all kinds of illnesses, including cancer. The risk of developing cancer is increased further by the higher rates of smoking and drinking among the divorced.

A long-term study of a million people showed that, even at the same level of cigarette smoking, divorced men had higher death rates than married men. As for cardiovascular effects, Dr Lynch has found that in the course of normal conversation, a person’s blood pressure can rise dramatically. However, the rise is minimal when people are talking to their pets, spouses, or close friends. “It seems as if friendship and love involve physiologically cost-free communication,” said Dr Lynch. “For the bereaved and the divorced, however, communication takes place at a great physiological cost. They may actually talk

themselves into high blood pressure.” Dr Robert Segraves, a psychiatrist and marriage and divorce counsellor at the University of Chicago Medical Centre, said that, in addition to higher suicide rates, the divorced had higher rates of admission to psychiatric hospitals and outpatient clinics and made more visits to non-psychia-tric physicians than people who were married, single, or widowed.

Although pre-existing emotional problems may have contributed to the risk of divorce in some people, Dr Segraves said the preponderance of evidence indicated that most emotional difficulties among the divorced resulted from the marital break-up, rather than caused it.

He said that “an ignored finding of the famous Midtown Manhattan Study of 1962 was that divorced men and women had the highest ratings of mental disturbance.” He said that later studies had resulted in similar findings. In a recent survey by the National Opinion Research Centre, for example, divorced people rated themselves less happy than those who were married, single, or widowed. However, said Dr Segraves, a thorough study in California that also looked at happiness within marriage found that “the divorced were miserable but not as miserable as the people who stayed unhappily married.” “There’s a lot of evidence that divorce is an overwhelming stress for most people, even if they are getting divorced for the right reasons. There’s tremendous internal and external reorganisation required after a divorce,” said Dr Segraves. “The effects are not just short-term. We see a lot of people years later who are having trouble reconnecting with the opposite sex. Men, for instance, often have problems with impotence four or five years later because they are scared to death to be reconnected.”

Dr Jacobson, too, has seen some long-lasting emotional consequences of divorce. In a study of 79 men and 159 women who were separated or divorced and who went to a psychiatric crisis clinic,

he found that time did not necessarily heal the wounds of divorce.

While depression peaks immediately after the initial separation and then subsides, he found, those who are separated 14 months or more, whether or not they have filed for divorce, “do not tend to improve further and may even worsen.”

He also found that while women were most disturbed just before separation, “men tend to be more depressed, anxious, and suicidal after separation.” Generalisations about the divorced population as a whole from Dr Jacobson’s study, and others like it, are not possible because the findings represent only those people who are distressed enough to seek professional help.

Dr Mavis Hetherington, a psychologist of the University of Virginia, in Charlottesville, has studied a large group of divorced families who were not in therapy and compared them to families that were still together. The families, all of which included preschool children, were followed for six years.

She found that both adults and children were usually emotionally disturbed for the first two to three years after divorce. But if the stress of divorce is not further complicated by other stresses, such as poverty or continued fighting between the former spouses, “most people recover after two to three years,” she said.

Those who form new intimate relationships are most likely to recover, Dr Hetherington found. She said that this meant that most divorced people eventually did recover, since 75 per cent of divorced women and 80 per cent of divorced men ultimately remarry.

“But if men have not remarried by six years after divorce, their rates of car accidents, alcoholism, drug abuse, depression, and anxiety increase,” she said. “Men have a harder time living alone than women do.”

However, divorced mothers who must deal with such added stresses as poverty, continued conflicts

with their former husbands, or problems in child-rearing also face long-term risks to their emotional health.

Divorced mothers of teenage sons have an especially hard time, she and others have found, but mothers of very young children usually have difficulties, too, particularly if they do not have outside jobs. “It’s hard raising children

alone,” said Dr Hetherington. “There’s no time out from parenting. The single parent feels trapped in a child’s wOrld. In the immediate aftermath of divorce, parenting breaks down and becomes inconcistent and erratically punitive. The children start acting up, and the result is often a battle for survival. One divorced mother said the constant harassment was 'like being bitten to death by ducks’.”

Although children can greatly complicate the lives of the divorced, Dr Jacobson found that their presence reduced the suicide potential of the parents.

Dr Jacobson and Dr Hetherington both found that the “bonds of attachment” between former spouses last much longer than either of them would have expected, even for the one who most wanted the divorce. Dr Segraves said people with dependent personalities and those with a tendency toward depression and helplessness were especially at risk of emotional disturbances after divorce.

Contrary to the assumption of many professionals that divorced spouses can continue to be valuable resources for one another, Dr Jacobson found that “more often than not, continued reliance may not be associated with better levels of mental health, particularly in women.”

He said that his findings indicated that “disturbance will be less when there is a moderate amount of contact between the spouses and when emotional reliance is acknowledged when it exists.”

As for outside relationships, he reported that lack of friends or social contacts was associated with anxiety and depression among the

divorced and seemed to be especially important in the longer run. However, friendships that shut out the former spouse were associated with more, rather than less, disturbance.