Passionate Love, Lust, and Attachment: The Neurochemistry of Falling in Love, Bonding, and Staying Lustful!

We are all hardwired to fall in love, share lustful moments, and bond with others. In fact, there are complex neurochemicals that are released during all of these different phases of relationship development. In this 2-part blog series, I will share important information with you about the neurochemistry of falling in love, how falling in love influences lust, how lust influences falling in love, and how all of this leads to attachment bonding in relationships!

Passionate Love, Lust, and Attachment: The Neurochemistry of Romantic Passionate Love (Blog 1 of 2)

Have you ever found yourself tightly gripping and constantly checking your cellphone awaiting contact from your new love interest? If so, you may be in the phase of the universal experience of adult romantic passionate love. Across history and cultures, we have fallen in love, lusted for others, and attached to them as a result of innate emotion-motivation systems in the brain that drive us to create relationships. In her book Why We Love: The Nature and Chemistry of Romantic Love, Helen Fisher (2004) describes the adult romantic passionate love phase as an initial phase in the formation of an adult attachment bond. Read on to find out how the neurotransmitters in our brain – dopamine, norepinephrine, and serotonin – are implicated in you falling in love.

First, Fisher described the universal experience of romantic love based on her research. When falling in love, our new partner is imbued with special meaning (i.e., unique, all-important, novel). We also develop strong focus as our beloved becomes the centre of our attention and we pay special notice of our shared events, messages, music, etc. During this period, we also aggrandize our new love. We may magnify positive aspects of our adored one while minimizing flaws and exaggerating our similarities. We experience intrusive thoughts as we just cannot stop thinking about our new loved one. Emotionally, Fisher describes us as being “on fire.” We experience intense emotions and find ourselves feeling anxious, shy, and awkward at times. We have an increase in energy as well. All of a sudden we find ourselves staying up late, having sex all night, and still making it to work … then doing it all over again the next day. This energy burst also comes with a loss of appetite and sleeplessness. Driven by a deep stirring to connect, our moods can shift rapidly from ecstasy to despair depending on whether our beloved is as responsive to us as we would like. We also become hypersensitive looking for clues about whether our beloved is into us or not! Finally, Fisher noted that when we are infatuated, we are more likely to change elements of our personal identity like clothing and music preferences, alter our mannerisms and habits, and even take on new values, all to win over our new love interest.

Once you fall in love, it is hard to turn back, as a result of the numerous neurotransmitters at play. Fisher’s research using fMRI studies found that dopamine, serotonin, and norepinephrine are the neurotransmitters at the root of passion for our new love. She found elevated levels of dopamine, which is at the root of the hyper focus, high motivation, high energy, and exhilaration, sleeplessness, and loss of appetite. She claims that this neurotransmitter, when heightened during romantic passionate love, creates something within us similar to an addiction process, intense dependency, and cravings to be with our lover. High levels of dopamine are also found in fMRI studies of individuals experiencing a drug addiction. Love becomes so addictive at this point that when you do not have access to your new loved one, more dopamine is released to energize you to focus on further pursuing the reward of being with them. Testosterone, the hormone at the root of sexual desire, is also increased in our bodies as a result of the higher levels of dopamine. In other words, increases in dopamine come with novelty and passionate love, which then increases sexual desire through a heightening of testosterone.

Finally, the neurotransmitters norepinephrine and serotonin are also implicated in romantic passionate love. Increased norepinephrine adds to the high, exhilaration, energy, and sleeplessness we experience, and fuels us to remember the smallest details about our lover. Serotonin is lowered, which results in the obsessiveness and racing thoughts we experience. With increases in dopamine and norepinephrine, and decreases in serotonin, we enter into positive states of mind about the other and obscure negative aspects of the beloved. We are neurochemically primed through these transmitters to also experience a sense of oneness based on exaggeration of similarities and minimization of difference. These effects facilitate a sense of symbiosis, which eventually wanes after about 8 to 12 months when the tidal wave of neurochemicals subsides. At this point, we begin to realize our differences with our beloved, which can then bring on more conflict for some couples. Fisher’s conclusion based on fMRI studies was that adult romantic passionate love is a primary motivation system in the brain and stems from the changes in neurotransmitters summarized in this blog post.

Fisher’s research studies explain why in the early stages of a relationship, particularly during the adult romantic passionate love phase, many partners will describe having had “tons of great sex” and then later wonder “where did it go?!” For those of you who wondered, this chemically heightened period that revs your sexual motor only lasts for about one year. After this period, sex within the context of an attachment bond becomes motivated by different goals. See my other blogs on attachment and sex, including Part 2 of this blog series, to see what happens to couple sexuality once couples move from romantic passionate love to a more stable long-term bond.

Clinicians at CFIR work to support clients to develop passionate relationships and secure attachment bonds. We recognize that novelty and a connection are important contributors to a lifetime of passion. We also support our clients to recognize that falling in love might be a different experience from the process of establishing a secure attachment bond with a partner. Once the adult romantic passionate love phase ends, usually within one year, the dust settles and our self and relationship experience can shift. Learn how to recognize the telltale signs of whether you have found Mr./Ms. Right in a future blog post titled “Is This Mr./Ms. Right or Wrong?: Consider This Dating and Relationship Screener Before You Say ‘I Do’”, so that when the adult romantic passionate love phase settles, you will be ready for a lifetime of love.

Dr. Dino Zuccarini, C.Psych. is CEO and co-founder of the CFIR. He has published book chapters and peer-reviewed journal articles on the subject of attachment, attachment injuries in couples, and attachment and sexuality. He has taught courses at the University of Ottawa in Interpersonal Relationships, Family Psychology, and Human Sexual Behaviour. He has a thriving clinical practice in which he treats individuals suffering from complex attachment-related trauma, difficult family of origin issues that have affected self and relationship development, depression and anxiety, personality disorders, sex and sexuality-related issues, and couple relationships. At CFIR, he also supports the professional development of counsellors, psychotherapists, and supervised practice psychologists by providing clinical supervision.

Can You Fall Out of Love?

My colleague and friend, Genevieve Boudreault, and I were interviewed for a university podcast. At one point, the show host asked us, “Can you fall out of love?

Gen and I are therapists who specialize in working with both couples and individuals who come to us facing loneliness, heartbreak, and uncertainty whether they can make their relationship last.

Gen remarked: “No, I don’t think that you can fall out of love…” She seemed so confident in her answer. It made me pause.

Can you fall out of love?

I pondered this question for a while, thinking about the clients who come to me for help – many who have scars based on past relationships, showing that the effects of loving another are far-reaching.

Love changes your body chemistry. It can change the way you see the world and, conversely, when love ends, the world can feel like it is falling apart. The wounds of lost love can feel devastating. Therefore, when I was asked, “Can you fall out of love?” I responded that despite whether you can or can’t ‘fall out’ of love, there are some essential ways to keep yourself together if a relationship ends:

  • Talk to someone. Often when we are hurt, it can be a tendency to keep out feelings bottled up, to slink further into ourselves. Opening up about our heartache can lessen its effects.
  • Realize that love can come from more than a romantic partner. Friends, family, and colleagues can give fulfillment and a sense of security.
  • Take time to write out a letter to yourself about why things ended. This exercise has been incredibly useful for my clients who have had recent heartbreaks. Writing a loving letter can help keep perspective when we start to miss this person and wonder why it is over.
  • Talk to a therapist. While friends can offer love and comfort, therapists are skilled at seeing patterns of relating and can help guide you to feeling worth within yourself, so when you love again, you can feel stronger.

Psychologists and clinicians at CFIR help individuals and couples discover how to identify and express their selves in their relationships with others. We also support individuals and partners on how to exit from challenging relationship patterns and become more accessible and responsive to one another. Healthy relationship functioning is essential in maintaining a good sense of ourselves.

Jess A.L. Erb, D.Psychotherapy, R.P. (Qualifying) is a Registered Psychotherapist (Qualifying) who believes that the best therapy happens when a deep trust can form between counsellor and client. She works with adults and adolescents in an array of issues such as depression/suicidal ideation, anxiety/panic disorders, grief and loneliness, as well as all forms of abuse – emotional, physical, sexual, self-harm, and eating disorders. Before working as an associate at CFIR, she trained as a doctor in psychotherapy at the University of Edinburgh, UK.

Emotional Dialogues in Couples: 9 Steps to Greater Emotional Communication and Connection!

Learning how to experience and express our emotions and needs to a partner can be very difficult, particularly if in our own family of origin, our inner feelings and needs were not addressed. Working through feelings and emotions requires adequate time and space to complete these types of interactions.  Couples often struggle and elevate distress when trying to engage in discussions of feelings and needs while multi-tasking (e.g., cooking, driving, shopping, taking care of the children). 

Discovering how to efficiently and effectively process your partner’s and your emotional experience is essential, so each of you feels understood and seen by the other. Picking the right time to have these dialogues is crucial, taking turns so that each partner feels sufficiently validated in their experience and their needs resolved is also important. Emotional accessibility and responsiveness to our partner’s emotional experiences and needs help our partners distress to lower and deepens the connection between partners. To be accessibility means to be able to be present and engaged sufficiently with your partner’s emotional experience. Responsiveness involves interest and engagement in identifying and resolving the underlying needs associated with emotions. These types of interactions are the essence of secure attachment.

The clinicians at CFIR support couple clients to develop emotional attunement through nine different steps. Learning how to complete these types of emotional interactions can lower distress and stress levels when partners have a guide to help them to process their emotions and needs. Come learn how to emotionally communicate and connect using steps developed by clinicians at CFIR’s offices.

Attachment Injuries in Couples: Healing After Betrayals

by: Dr. Dino Zuccarini, C.Psych.

An attachment injury occurs when a partner is betrayed or abandoned, and trust is violated at a moment of critical need for support and care. The injury can be traumatic as the injured partner is left with a sense of helplessness, isolation, and intense fear about the other’s availability (Johnson et al. 2001; Zuccarini et al. 2013). These traumatic incidents occur when a partner’s belief and faith in the reliability and dependability of the partner is shattered. Examples of these types of injuries include marital affairs, emotional affairs, money mismanagement, violation of boundaries, abandonment at times of need during pregnancy, alignment with parents over partner, child-rearing conflicts, and lack of support during illness, among others. These traumatic incidences become a barometer of the offending partner’s trustworthiness, dependability, and reliability. The attachment bond between partners becomes frayed as a result of these injuries.

In these instances, clinicians at CFIR will address the lingering hurt and anger and heal the frayed bond. The emotional processing of these events is essential to the healing process.  Attachment bonds are emotional bonds.  The emotional accessibility and responsiveness to the injured partner’s experience facilitates recovery and healing.

Relationship Therapy for LGBTQ+

by: Dr. Dino Zuccarini, C.Psych.

Living and loving in the social margins of a heteronormative world can create complexity in the relationships of individuals from the LGBTQ+ community.  In our early years, recognition of being different than members of your family of origin and peers can create significant attachment and self fears. We all need a sense of acceptance, emotional validation, approval, and admiration if we are to develop a strong sense of self and connection to others. Individuals from LGBTQ+, in many instances, may face abandonment, rejection, punishment, and abuse just for being different. These types of traumatic experiences create fears and distrust in others, mainly when early attachment figures are the individuals who are the source of rejection, punishment, and abandonment. Rejection also fills individuals with a deep sense of shame that comes with deep feelings of unlovability, insignificance, and worthlessness.  

The internalization of these experiences can create difficulties when fears, shame, and past hurts limit the capacity to trust and connect others. The clinicians at CFIR work to build more secure, resilient identities and strengthen interpersonal relationships in the LGBTQ+.  They support you to unpack the emotional residue of early distress in attachment and/or with pears and the impact of this residue on your attachments.

Attachment Style and Couple Sexual Issues

According to attachment theory, as a result of early year interactions with caregivers, we either become securely attached or insecurely attached—either anxiously or avoidantly attached.  Attachment style then influences sexuality in complex ways. Anxiously attached partners in the bedroom might be seeking out sex for reassurance of self or attachment fears.  For example, they may feel less positive about themselves (e.g., undesirable or unattractive), and/or have worries about the availability, accessibility, and responsiveness of their partner.  Strong sexual desire is fuelled by the need for self and attachment reassurance. Avoidantly attached partners are not motivated sexually in the same way.  These partners are more likely to focus on the pleasure-oriented aspects of sex only and have difficulties with feelings of closeness.  Some avoidantly attached partners will have sex for duty’s sake. Arousal and desire problems arise when anxiously or avoidantly attached partners are unable to fulfill these goals.  

The clinicians at CFIR support couple partners to discover the multiple ways in which securely attached partners experience and explore sexuality. The couple and sex therapy clinicians at CFIR use a wide variety of strategies to support couple partners to build more confidence in their sexuality, greater eroticism, and desire.

Forgiveness and Reconciliation for Couples Post Affairs

Forgiveness and reconciliation after an extramarital affair is a complex process. Forgiveness occurs when there is an experiential shift in the injured partner toward the betraying partner— a movement toward softer feelings. This experiential shift requires an unpacking of different types of emotional reactions associated with these types of relationship traumas. The shattering of one’s sense of self, the other, and one’s sense of future identity in the aftermath of an affair can create instability and insecurity in one’s self and the relationship. These types of injuries result in complex emotional reactions that require resolution. Reconciliation, the next step in recovery, occurs when steps are taken to rebuild trust and restore the relationship after a forgiveness process. These steps are essential for the restoration of security.

The team of psychologists, psychotherapists, and counsellors at CFIR employ evidence-based interventions to support relationship partners beleaguered by emotional injuries in the aftermath of an affair. Steps to forgiveness and reconciliation and the interventions required for successful resolution of an extramarital affair have been delineated in research conducted by Dr. Zuccarini, C.Psych., co-founder of the Centre for Interpersonal Relationships. (Zuccarini et al., 2013). Clinicians at CFIR are prepared to support you in promoting healing in your relationship.

7 Signs Your Relationship May Need Help

by: Joshua Peters, M.A., R.P.

Relationships have never been easy and now it seems we’re in a space and time where technology and the way we connect are continuously growing and changing. The intimacy we have with someone can mean so much, yet it seems we consistently struggle to maintain the bond. How can we know if we are “getting it right” in our partnerships?

In speaking about the complexity of our relationships, famed relationship expert, Esther Perel notes that “companionship, family, children, economic support, a best friend, a passionate lover, a trusted confidante, an intellectual equal […] we are asking from one person what an entire village once provided.” In this paradigm, it can be hard to understand when our partners and our relationships maybe failing us. 

Here are some signs that indicate your relationship may need some work:

1. Lack of Communication 

In a world bursting with ways to communicate, it may be surprising to learn that ineffective communication remains a common issue in relationships. It’s impossible for your partner to know all your needs, feelings, and thoughts without talking about them. Communication is essential in overcoming relationship wounds, and very few relationships can survive without it.

2. Arguing with No Repair

Though constant arguing can sometimes be indicative of relationship distress – unrepaired conflict may be the real culprit. Arguments, when done sympathetically, are an essential part of relationship satisfaction. Repairing from a dispute allows partners to accept each ones’ differences and re-establish their love for one another. 

3. Loss of Curiosity

We are continually growing and changing as individuals and it crucial we remember to remain curious about our partners as they grow. The experience of curiosity and surprise is one of the essential processes in maintaining long-term desire. Partners in healthy relationships are happy to explore their partner’s unique perspective of the world.

4. Mind Reading

This familiar refrain, “Look, I know you’re angry…” exposes a common misstep in many relationships. Often experienced in conjunction with a loss of curiosity, partners start assuming they are always in each other’s “bad books” even before a problem is revealed. Stay tentative about your perceived experience of your partner, especially in times of distress. You might be surprised by the difference between how they feel and how you thought the feel!

5. Loss of Priority

It can be hard to find a balance between work, children, friends, and family in today’s busy world. How you prioritize your relationship may look different to you, so it’s crucial that you discuss this with your partner. Failure to explore this in a discussion could leave your partner feeling unloved and unimportant. 

6. No Hurt – Only Anger

When we’re most distressed it may feel instinctive to get angry. Though anger is an important emotion in that it tells us something isn’t working, it isn’t usually helpful in resolving conflict. Instead, opting to express our more vulnerable and hurt emotions allows our partner to understand and ultimately care for us when necessary. 

7. Blaming your partner

It takes two to tango! Though one partner may sometimes be experiencing more distress, it’s beneficial to recognize that your relationship is co-created by both of you. Take note of how you may be contributing to the dynamic between you and your partner.

Couples experiencing any of these relationship difficulties at heightened levels may feel like they are insurmountable problems. However, exploring these issues can provide a needed check-in for your relationship. Moreover, what you discover can inspire you and your partner to reimage what your relationship could become. Couples therapy offers an excellent opportunity to explore these struggles and move towards growth. The skilled clinicians at CFIR can help you and your partner better understands your current distress and support you to build a more resilient and healthy relationship.

A Look at Hypersexuality: Treatment and Assessment

by: Dr. Ainslie Heasman, C.Psych.

The classified advertising site, Backpages.com, was recently shut down by the United States government, thereby making it inaccessible in Canada as well.  The website, which hosted everything from child care to real estate ads, was recently suspended by U.S. law enforcement due to activity stemming from the “adult” sections on the site.

Many essential political and societal discussions have transpired following the decision to close the site, including debates about whether the intention to prevent sex trafficking will benefit from this action.  

Amid these discussions, some of my clients who use the internet to access sex services, and who identify as having problems regulating their sexual behaviour feel a sense of relief.  Some are experiencing an unexpected external control over their response, albeit temporary, now that Backpages.com is no longer accessible.

What is hypersexuality?

Problematic sexual behavior is referred to using a variety of labels – from sex addiction to compulsive or impulsive sexual behaviour to hypersexuality.  Societally, this is commonly labeled as sex addiction, but there remains little scientific evidence to support sex as an addiction.  There is also some suggestion that perceived addiction to pornography can contribute more to psychological distress than pornography use itself (Grubbs, Volk, Exline, & Pargament, 2013).  

Many of my clients seek out therapy for problems managing their sexual behaviours, sexual interests or both. Regardless of the label, many men (and it is mostly men that seek treatment for this in my practice) are struggling with a variety of sexual behaviours, from anonymous sexual encounters to frequent masturbation and pornography use.  Some men also experience distress related to the content of their sexual thoughts, or pornography use (versus the frequency of their sexual behavior).  In other words, they experience a sexual interest that is atypical or less common; the inclination could turn illegal if acted upon and/or it contributes to significant moral distress.  

Assessment 

Research has been conducted to identify the characteristics of individuals who seek out help for hypersexuality, along with related treatment targets (Cantor et al., 2013; Sutton, Stratton, Pytyck, Kolla, & Cantor, 2014). The paths leading people to engage in hypersexual behaviour are varied and beyond the scope of this current blog, but there are more common ones I see in my clients.  Clients often use sexual behaviour as a way of procrastinating, avoiding, and escaping stressors.  Many of my clients struggle with identifying, labeling, and expressing their emotional experiences (preferring instead to ignore and suppress). This is even more common with emotions experienced as being more challenging to manage (i.e., frustration, anxiety, anger, disappointment), and they seek out a distraction, and a way of temporary escape, through sexual behaviour.  

Other clients have varied sexual interests that are explored through pornography or sexual activity with another, that they may not feel comfortable talking about or exploring in their partnered relationship.  At times there is a mismatch in sexual drive or interests in a relationship, but what is often apparent is a lack of healthy communication between partners about their needs and experiences in their sexual relationship. 

What is essential when seeking support is finding a mental health clinician who will engage in a detailed assessment to understand the nature of the problem and the contributing factors.  It is also essential to determine if there are other mental health concerns (i.e., depression, anxiety, bipolar disorder to name a few) that are influencing the behaviour and also require intervention.  There is no ‘one size fits all’ approach to treating individuals who struggle with sexual behaviour. As a result, an assessment helps to determine the most relevant treatment targets to assist those seeking help to achieve their goals. 

Treatment 

A therapist assists clients in understanding the origins and development of their behaviour.  Clients are offered support through their journey to develop and refine skills to live a life that is more in line with their values.  This path is often challenging and filled with a range of emotions, and mistakes and a return to old patterns may occur.  With the guidance of a therapist, these challenges can be navigated and explored in a safe and supportive environment. The client can take steps they feel are necessary to define and live a more fulfilling and value driven life.

Often when a man is in a partnered relationship, couples therapy is recommended, mainly when the sexual behaviour of concern involved infidelity.  In these situations, the sexual behaviour that occurred happened in the context, and with all the relevant dynamics, of a relationship.  If the couple desires to remain together, at the very least, the rebuilding of trust occurs again in the context of the couple.  With that in mind, many men still seek out therapy on their own, either at the insistence of their partner or without their partners’ knowledge that there is a problem.  

If you can identify with these struggles, there is help and support.  Individual and couples therapy is available at the Centre for Interpersonal Relationships (CFIR).

References

Cantor, J., Klein, C., Lykins, A., Rullo, J., Thaler, L., & Walling, B. (2013). A treatment-oriented typology of self-identified hypersexuality referrals. Archives of Sexual Behavior. 42. 10.1007/s10508-013-0085-1.

Grubbs, J., Volk, F., & Exline, J., & Pargament, K. (2013). Internet pornography use: Perceived addiction, psychological distress, and the validation of a brief measure. Journal of Sex & Marital Therapy. 41. 10.1080/0092623X.2013.842192.

Sutton, K., Stratton, N., Pytyck, J., Kolla, N., & Cantor, J. (2014). Patient characteristics by type of hypersexuality referral: A quantitative chart review of 115 consecutive male cases. Journal of Sex & Marital Therapy. 41. 10.1080/0092623X.2014.935539.

Can Social Media Impact Your Romantic Relationship? Here are Five Ways to Get Connected

A restaurant in the U.K. recently announced it will be banning the use of mobile devices in their establishment on February 14 in an effort “to refocus diners on the food and experience”. This move has generated a bit of online buzz and has turned attention to how preoccupied society is becoming with the world-wide-web and more specifically, social media. In the spirit of Valentine’s Day, we recently asked, Dr. Tracy Dalgliesh C. Psych. “Can social media outlets have an impact on our romantic relationships? What are some positive ways to use them (or not) on Valentine’s Day?“. 

Here’s her response: 

Social media becomes problematic when we use it to turn away from our partner, resulting in decreased connection and communication. Instead of working through an argument and engaging in a difficult conversation, you turn to scrolling through social media. This is an avoidance strategy, and we know from couples research that shutting down (i.e., stonewalling) is a type of communication that can result in long-term couple distress.2 (For more on the four communication styles that predict the dissolution of a relationship, see https://www.gottman.com/blog/the-four-horsemen-recognizing-criticism-contempt-defensiveness-and-stonewalling/. Recent research suggests that excessive use of devices leads to lower relationship satisfaction.1 This is even truer for partners with anxious attachment (i.e., they fear that they are unlovable or unworthy). Other examples may include messaging friends over talking to your partner, checking your phone in the middle of a conversation with your partner, or sharing fun and exciting information with others online and not your lover. 

Individuals fall into the trap of the comparing themselves and their relationships to what they see on social media. Profiles often portray the happiest moments – and these are often posed images. They do not display the challenges that couples all face. Frequently seeing these stylized and selected images can impact how you view your own relationship. Thoughts of “why aren’t we that happy?” or “we never do anything exciting” may arise and create negative feelings towards your relationship and partner. This negative filter may then lead to thoughts of “I could be happier with someone else,” further contributing to dissatisfaction. 

Social media can also impact one’s feelings of jealousy and insecurity. All of the platforms for social media offer easy ways to connect with others privately. This becomes a problem when it is done in secret, or when connecting with someone else feels good and you are putting more energy into that connection than with your partner. A negative feedback loop can also start, where jealousy leads to snooping, which further exacerbates feelings of jealousy. In some situations, social media can lead to infidelity. 

While social media can present with its challenges for couples, I do believe that it can be used in a healthy manner – where couples can build and enhance their connection. Here are some tips on how to use social media this Valentine’s Day to enhance your relationship:

  • Set limits on the time that you are on your devices. Agree to put the phones on silent in another room (e.g., from 7pm-9pm) on Valentine’s Day (and maybe every day!).
  • Send a message letting your partner know you are thinking of them or excited to see them at the end of the day. We long to know that we matter to the ones we love, so let your partner in on your feelings.
  • Send a good morning or good night love meme.
  • Share a memory or article with your partner that you found on your social media outlet and use it to get to know the other person’s opinions and desires.
  • If scrolling and connecting is part of your time together, take a break and talk about what you each found interesting. Ask open-ended questions, like “What did you find most surprising to read today?” or “What emotions did you feel while seeing X.”

1. James A. Roberts, J. A., & David, M. E. (2016). My life has become a major distraction from my cell phone: Partner phubbing and relationship satisfaction among romantic partners. Computers in Human Behavior, 54, 134-141. https://doi.org/10.1016/j.chb.2015.07.058.

2. Gottman, J. M., & Krokoff, L. J. (1989). Marital interaction and satisfaction: A longitudinal view. Journal of Consulting and Clinical Psychology, 57, 47-52.

Read more about our Relationship & Sex Therapy Service.