The Role of Psychological Distress in Relational Health Instability among Romantic Couples: A Qualitative Inquiry

Michelle A. Calda-Tolibas

College of Nursing, Visayas State University, Baybay City, 6521 Leyte, Philippines

Corresponding Author’s Email: michelle.tolibas@vsu.edu.ph

ABSTRACT

Background: Relationship instability, which creates an additional burden to the couples, has contributed to relationship disconnection. Factors like stress play a vital role in the flux of relationship status and in understanding the stability of intimate relationships and quality in romantic relationships. Yet, a dearth on psychological distress noted on non-marital relationship disconnection, since the most documented research has centered on the context of marital bond disconnection. Thus, it prompted the researcher to conduct a qualitative inquiry on the role of psychological distress among women with experiences on mutual bond disconnection.

Methods: Constructivist grounded theory and feminist theory designs were utilized to describe the role of psychological distress in relational health instability from the lens of women who participated in this study. This study employed theoretical and purposive sampling methods to explore research interest in relationship loss. Guided by a semi-structured questionnaire, the researcher explored women’s experiences of mutual bond disconnection. However, this paper focused on the thoughts, views, and feelings among women about relational health instability among couples.

Results: Thematic analysis generated the participants’ psychological stressors such as disrespect, disinclination, and monetary issues that caused their relational health instability and further led to mutual bond disconnection. Moreover, it provided an in-depth understanding of the factors causing romantic relational health instability such as: (i) humiliation, and (ii) financial matters.

Conclusion: The findings provided an increased in-depth understanding of the psychological factors that lead to unhealthy relationships among romantic couples, which further cause a mutual bond's disconnection.

Keywords: Psychological Distress; Relational Health Instability; Mutual Bond Disconnection; Women; Romantic Couples

INTRODUCTION

Generally, minor conflicts within romantic relationships are typical. However, these are situational problems causing conflicts among couples. Marital strain, a complexity that includes friction and disharmony, is common (Tracy & Utz, 2020). However, these common feelings of complexity can create more conflicts with people's intolerance of dealing with relational issues in some instances. This low tolerance can lead to a significant struggle, causing them to experience more challenges in solving a normal marital conflict (Navidian et al., 2014). Hence, the psychological distress resulting from poor adjustment. Karney & Bradbury (2005) assume that these poor skills in adaptation and problem-solving following major life events can deteriorate the quality of the marital relationship. Once the couples find difficulty in dealing with marital conflicts, they will experience more marital strain, leading to relationship instability.

Relationship instability, which creates an additional burden to the couple, has contributed to relationship disconnection. Factors like stress play a vital role in the flux of relationship status and in understanding the stability of intimate relationships and the quality of romantic relationships (Randall & Bodenmann, 2009). Concentrating on stress is judicious. However, relatively few studies focused on the context of the role of psychological distress on relational health instability and mutual bond disconnection. Hence, the importance of identifying the causes of stress that impact relationship instability and mutual bond disconnection calls for attention.

Causes and Effects of Relational Health Instability

Relational health is defined as the interaction between individuals to build up reciprocated growth, leading to the empowerment of every person (Liang & West, 2011), as sincere connections between people can nurture relationships. Having a supportive relationship is a determinant of life satisfaction and self-fulfillment and achieving optimal health as a whole (Pinker, 2014, as cited in McGill, 2016). Nonetheless, some researchers have demonstrated that mutual bond disconnection is a causative factor in the instability of a healthy romantic relationship. In the study of Canham et al. (2014), the identified premarital factors that influence relationship instability are faulty decision making, personal baggage before the marital bond, and the unpleasant atmosphere of the paternal house. In comparison, the most common identified stressors in marital relationships causing divorce are the accumulation of stress every day (Randall & Bodenmann, 2009). These marital stressors include differences in opinions, values, needs, desires, and habits that cause marital discord (Randall & Bodenmann, 2009; Farshad et al., 2011; Tolorunleke, 2014).

METHODOLOGY

This study is a part of a more extensive study using qualitative design to analyze twenty Filipino women's experiences of mutual bond disconnection. Nevertheless, this paper focuses on the role of psychological stress in the relational instability of the thirteen women who were in intimate relationship before the romantic relationship disconnection.

Research Design

This research utilized constructivist grounded theory design to capture their narratives on views, thoughts, feelings, and their experiences on the relationship disconnection. Another school of thought that the study was grounded from is the feminist theory to describe the causes of psychological distress in the instability of mutual bond from the lens of women who valued and understood the experiences as the critical connection between knowledge and reality (Ramazanoglu & Holland, 2002).

Sampling Technique

This study utilized the purposive sampling technique, which is based on a researcher's personal choice of informants and on the researcher's knowledge of their capacity to describe first-hand information of their own experience through personal narratives and story-telling. The purposive sampling technique, also called judgement sampling, was based on the qualities of the participants' processes. It was a non-random method that did not need fundamental theories or a set number of participants (Etikan et al., 2016). It also utilized the snowball sampling method. This type of sampling technique allows the researcher to use referrals from an early participant who knew the person (Polit & Beck, 2012).

The participants were selected based on their first-hand experiences with the loss of mutual bonds from an intimate relationship. Adaptation following spousal loss suggested that it took up to 8 years to return to the pre-loss level while bereavement may vary from one year up to ten years, or perhaps will never occur (Infurna et al., 2017; Raphael, 2005). Hence, this study chose participants who had experienced the loss of a mutual bond within the last fifteen years.

Before recruitment, these considered participants were chosen based on predetermined inclusion and exclusion criteria to be regarded as informants, as shown on the table 1.

Table 1: Inclusion and Exclusion Criteria

Setting and Samples

The chosen participants who experienced symbolic loss from 20 women interviewed were in two categories. Those who disconnected from their partners as the: 1) initiator, and 2) victim.

Data Collection Method

Recruitment. After obtaining clearance from the Institutional Review Board, the participants were recruited through a social media flier on the researcher’s Facebook to gather a public pool of volunteer participants with the desired context of being studied (Forgasz et al., 2018). The eligible

participants underwent a screening procedure using the inclusion and exclusion criteria such as being biologically female, Filipino, 20–60 years old with experience of the symbolic loss of more than three months but less than fifteen years. Initially, this study utilized a judgement sampling technique, so it does not need fundamental theories or a set number of participants (Etikan et al., 2016). To allow an increased sample size, it also utilized snowball sampling, or the use of referrals from an early participant who knew other people (Polit & Beck, 2012) eligible for the study.

Interview. Before an interview was conducted, a pilot study was carried out on women with similar sample experiences. It provided the opportunity to gain insights into the causes of complexities related to relational issues and helped to revise the methods for a more extensive investigation (Watson, 2016). Adherent to theoretical sensitivity, this study started the data collection in February 2019 utilising a semi-structured interview guide. The individual interview method with pre-determined open-ended questions was conducted to maintain anonymity and confidentiality as the detailed conversation was elicited on the topic (Charmaz, 2006). The conduct of interviews collected a thick and extensive data corpus, which lasted from thirty to ninety minutes. The semi- structured questionnaire is composed of demographic and topic guide questions, which served as a beginning topical outline for the initial interview. Face-to-face interviews were conducted with all Filipino participants in the Philippines and abroad by the principal investigator as another research instrument (Streubert & Carpenter, 2011). To generate primary data, the interviews were recorded to capture the key informants' exact words during the interview. At the same time, to get the explanations given by the participants, field notes and memos were also employed.

Data Analysis

The data were analyzed inductively by the principal investigator using the 6-phase guide of Braun and Clarke’s (2006) thematic analysis to investigate women's experiences of romantic relationship instability and disconnection. The six thematic analysis processes begin with the familiarization of the data where the empirical data was transcribed, followed by reading and re-reading of the transcription. In the second phase, the data corpus was broken down into discrete parts, and the significant statements were extracted, and in vivo codes were developed. The third phase was done by grouping the codes that fits together to generate a broader theme. While in the fourth phase, the themes were reviewed according to their relatedness to have an organized, interesting, and significant concept captured from the data or research question (Streubert & Carpenter, 2011). The fifth phase was defining the theme, and finally, the last phase was writing the report.

Methodological Rigors

The iterative process of data collection and analysis of this investigation was performed simultaneously to ensure credibility or internal validity. Also, validation of critical points was performed at the end of the individual interview. In addition, the results were given back to the authors of the narratives. The investigation was consistent with the sampling method and reviewed the interviews to adhere to the reliability of the qualitative method. It ensured data collection from different grounds in the context of the destabilisation of the couples' relational health. This process provided a theoretically diverse sample to encourage broader applicability.

Also, the use of audiotapes was to ensure consistency in the techniques of interviewing to support dependability. This investigation kept memos and a detailed record of the research methods provided by detailed documentation to identify potential biases and coding decisions to ensure confirmability or objectivity.

Furthermore, this method yielded a thick description of data in discussing findings and themes, thus giving the reader a chance to compare with other settings.

Ethical Considerations

The necessary permission was obtained from the Institutional Review Board with protocol code 2018-01-PhDNS dated November 15, 2018.

The data collection started in February 2019 after approval of ethical clearance from the SPUP- IRB through face-to-face interviews, video calls, and chatting privately on Facebook Messenger. On the day of the personal interview, participants signed informed consent and completed the demographic profile section of the questionnaire. While the other participants sent a yes-approval in a private message to give consent to the interview. Information about the purpose of the interview was reiterated, and they were reminded, too, about the recording of the interview. For rich data collection, this study utilized a semi-structured individual interview method with a pre- determined open-ended question designed to maintain anonymity and confidentiality as the detailed conversation was elicited on the topic (Charmaz, 2006). Hence, an unstructured interactive interview about the participant's experiences with the loss of mutual bond from an intimate relationship was used. However, it posed particular risks in terms of psychological-related issues due to flashbacks of painful memories during the actual interview. Although no clinics were provided, the interview was conducted with consideration and compassion. Hence, the following were emphasized before the informed consent was signed: 1) the details of the study with emphasis on the freedom of withdrawing from the study anytime if not willing to continue to participate in this study; 2) to stop the storytelling when she displayed symptoms of bad memories until she regained composure; 3) the choice of whether to continue or to stop the narration for a moment and re-schedule it at a later date.

Considering the ethical implications, all the data was stored, such as the transcribed data, and maintained on media storage. The hard copies were kept in a locker while the soft copies were saved on the computer. The stored files saved on the computer have been locked with a password and can be accessed only by the researcher. Moreover, any information that would identify the participants was separated from the audiotapes or records of interviews. The data gathered was kept in a safe and secure file. In the case of publications, the participants' identifying information will be kept confidential and anonymous. The transcripts of audio recordings were stored without the participants' identities. After completion of the study, all the information recorded, including hard copies, will be deleted and destroyed. The audiotape, as well as the materials that would identify the status of the participants, will be destroyed after the results are available and approved by the dissertation committee. The deletion will be done at least three years after the final results of the publication.

RESULTS

This investigation unfolded the life stories of the thirteen chosen Filipino women who experienced building romantic relationships, relational health instability, and relationship disconnection. Table 2 shows the demographic profiles of the participants.

Table 2: Demographic Profiles of the Participants

The findings revealed the life stories among women of the experiences from stable to unstable relationships before the mutual bond disconnection. The following are the descriptive categories surfaced from their narratives.

Disrespect

Respect is a vital component in building a strong bond between romantic couples. Once it vanished, relational conflicts set in. Being disrespected can humiliate a person and can create a detachment between couples. Because of the repetitive actions of physical abuse and lack of support from her in-laws, SL4 thought of being disrespected. She said:

Because of the physical pain and unsafe situation, it seemed to me that he did not respect me at all[…] He asked for something, even his cliques were around, like "Get that one, hurry!” He gave me the feeling that he had no respect for me at all as his wife.

SL7, the youngest of all participants, told her stories during the destabilization time of her relationship with her common-law husband. She emphasized disrespect within the relationship when she explained that:

We quarreled a lot[…] as in every single day. So, we became cold to each other. Because we were still young and had an immature relationship, we lacked respect […]. Since then, respect started to disappear from each other.

These narratives suggest that a lack of respect can destabilize relational health.

Disinclination

Disinclination is a scornful remark or treatment of someone else, which can insult a romantic partner. It could wear away the mental and emotional well-being of a person, resulting in feelings of low self-esteem. SL3 narratives show that he would not like to be with her and her child at a significant moment that a couple should share. She described that:

During Valentine's day, he told me that he could not be with us because he would be with someone else[…] with his friends. Yes, I did not mind because I was overwhelmed when my baby came and all. I said to myself: "We will be able to fix this not-so-cleared relationship in the future."

SL8 also explained and said:

"My husband told me to look for someone else whom I will be happy to be with. Of course, it was painful to hear when he told me: If you find someone else who will make you happy, then go with him."

Being dumped by someone whom you have invested a lot in is humiliating and depressing. Hence, it will result in losing self-respect and further emotional and psychological turmoil. A scornful remark is humiliating, which can cause disrespect to oneself or another person and further result in a loss of self-confidence, affecting the couples' romantic relationship. These accounts acknowledge that humiliation instigated coldness between the couples and destabilized their mutual bond.

Monetary Issues

One of the participants described factors was a conflict in the financial aspect while in a relationship with their partners. SL8 recalled:

We were okay when I was the only one earning in the family. He managed everything at home. I gave my income to him without a doubt. However, when he got his own money, that was the time when we started to fight. I have noticed that he was keeping his money and continued to spend mine.

Two of the participants also explained the reasons why they decided to stay with their parents. SL9 said: "Both of us were young and jobless. We were studying by the time I got pregnant, and we could not support the needs of our two babies, so I stayed with my mom." SL5 also explained that: "We were both unstable at the time, so I had to go to Manila for a job, but I failed and went back to my mother and decided to disconnect from him."

This finding suggests that socioeconomic status is vital in maintaining a healthy relationship. If the couples are experiencing financial instability, it will weaken the couple’s mutual bond.

DISCUSSION

This investigation facilitated an in-depth exploration of thoughts, experiences, and feelings among women who experienced instability in relational health and intimate relationship disconnection. It was found that the contributing factors to relational psychological distress are the following:

Humiliation Disinclination and disrespect are the two identified descriptive categories that surfaced from the narratives. These are humiliating to them. Humiliation is a disrespectful way of causing a loss of respect and making someone feel terrible about themselves. It can be found in the form of infidelity and other forms of disconnection (Basharpoor & Sheykholeslami, 2015; "Humiliation," n.d.). Several studies posited that contempt and stonewalling in the conversation, frequent arguments, criticism, the husband's anger, whining, and emotional pain are the recognized causative factors in destroying romantic and passionate love, which makes the fundamental trials of romantic relationships disconnections (Gottman & Levenson, 2000; Fannin, 2005; Sailor, 2013).

Financial Matters. The finding of this study also highlights that the availability or non-availability of resources can both affect the mutual bond of couples. Some participants claimed that financial difficulty created conflicts between them. This result supports the previous studies that found financial matters are a factor contributing to the instability of a relationship. For example, Stanley et al. (2004) and Tolorunleke (2014) claimed that the reported causes of common arguments between partners are the failure to provide for the family's financial needs. Maestripieri et al., (2013) also declared that socioeconomic status is the reason for the instability of some African couples' relational health. Similarly, Farshad et al., (2011) reported that financial issues contributed to marital dissatisfaction. Moreover, among the identified causes of relationship instability, an unsafe environment and financial problems have the most prominent role in destabilizing relational health (Sailor, 2013; Wadsworth, 2015).

CONCLUSION

This study concludes that qualitative inquiry is a valuable method to gain quality insight by increasing in-depth understanding of the psychological stressors that lead to unhealthy relationships among couples, which further causes relationship disconnection. It highlighted two psychological stressors that can cause instability in relational health, further leading to detachment between couples.

As an implication, this study can help develop a significant database in the nursing discipline that aims to help individuals deal with actual and potential health problems through knowledge-based practice. In this regard, this result can be utilised to generate and test nursing theories. Hence, advancing knowledge of the factors that cause relationship instability is vital.

This paper provided knowledge on the factors causing the romantic relationship instability which can be the basis for developing intervention programmes programmes to enhance the couples' mutual bond. Thus, addressing the likelihood of mutual bond disconnection.

Conflict of Interests

The authors declare that they have no conflict of interests.

ACKNOWLEDGMENT

The author would like to thank Dr. Cyrus P. Tuppal for the helpful comments during the conceptualization of this qualitative inquiry.

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