It's not what you say -- it's how you say it

A new study suggests that where heart health is concerned, how a couple fights may be more important than what they fight about.

Published October 2, 2007 6:23PM (EDT)

Here's another interesting one from the New York Times: an update on how different argument styles affect men and women's health. According to the Times, it doesn't really matter what you fight about; it's how you fight that counts.

A study of nearly 4,000 men and women from Framingham, Mass., revealed that 32 percent of men and 23 percent of women reported that they "typically bottled up their feelings during a marital spat." It's interesting in itself that men tend to hold back their emotions more often than women do. But far more fascinating is the effect this habit can have on health. Keeping things bottled up didn't appear to have any effect on men's health, according to a report referred to by the Times that was published in Psychosomatic Medicine. But for women, staying tight-lipped was associated with a fourfold increase in risk of death by heart attack during the study's 10-year period, regardless of whether the women reported being in a happy or an unhappy marriage.

As Gary Taubes pointed out in his recent piece about scientific studies in the New York Times Magazine, it's hard to determine cause and effect in studies like this -- there may well have been other risk factors at play. And then there are always studies that suggest the opposite -- e.g., the one we reported on back in January that suggested that women who outwardly expressed their anger put themselves at higher risk of heart attack.

From my own nonscientific standpoint, I'd guess that ideally we should work toward some sort of balance: Don't hold stuff in, but try not to explode. (If you think about it, those two actions are often linked -- if you bottle things up, they'll come out with more force.) And also, be sensitive about how you express yourself. One of the most interesting points made by the article and study is that for both men and women, the style of the fighting meant more than the content of the words spoken -- in fact, one researcher even claims this is as important a risk factor as whether a person smokes or has high cholesterol. In the 150 couples studied, men responded the most negatively, heart-health-wise, to discussions that were battles for control. Women's heart health, on the other hand, was most affected by the tone of the comments made during the fight. The researchers classified comments as being either "warm" or "hostile" (e.g., "Did you pass elementary school math?" versus "Bless you, you are not so good with the checkbook, but you're good at other things," during a fight about money), and as might be expected, the hostile ones had a much worse effect on heart health than the warm ones.

It's always hard to know what to take away from studies like this other than interesting fodder for water cooler talk. But the bottom line seems pretty obvious: Treat each other with warmth and respect, even when you're fighting, and your heart -- not to mention your relationship -- will be healthier as a result.

By Catherine Price

Catherine Price is an award-winning journalist and author of Vitamania: How Vitamins Revolutionized the Way We Think About Food. Her written and multimedia work has appeared in publications including The Best American Science Writing, The New York Times, Popular Science, O: The Oprah Magazine, the Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Mother Jones, PARADE, Health Magazine, and Outside. Price lives in Philadelphia.

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