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Impact of COVID-19 on Relationships: What isn’t Being Talked About

For Mental Health Month

As individuals, couples, families, and roommates continue to shelter at home for what is quickly becoming a sustained duration, it has never been more important to look at the impact of this pandemic era on intimate relationships. Many have joked about the increased opportunity for sexual activity and the likelihood of a baby boom next year. The sale of sex toys is booming and as reported by Rolling Stone, some are specifically developed to be effective for couples separated by distance. They even have a unique name – teledildonics.

Heartening as it is to know that many people are making the most of this extra time, we need to acknowledge that not all couples and families have relationships that are psychologically intact and lots of folks lack the adequate space to achieve the privacy people want and need. Close proximity has increased tensions, leading to greater substance abuse and intimate partner violence/abuse. Early in April, the New York Times reported an increase in domestic violence in China and throughout Europe (NYT, April 6). At the same time, the United Nations Secretary General António Guterres tweeted for governments to put women’s safety first. However, it appears that no government, including the US government, was prepared for this aspect of the pandemic. As police and other first responders may be overwhelmed by the exigencies of the pandemic, it is difficult to assess the capacity to respond to domestic violence calls. We also do not know how many women will avoid going to an emergency room for fear of being infected by COVID-19.

Treating intimate partner violence requires a thoughtful, trauma-informed approach. Addressing and changing violent behavior is a long process and often a hard road for both the patient and the therapist. One critical factor is the violent partner’s ability to learn to observe their emotional reactions and regulate emotional reactivity before it escalates out of control. Developing space between feeling and action so that a cognitive appraisal can take place is one of the most challenging and critical goals for a person whose habit is to act impulsively. Domestic violence rehabilitation relies on an individual’s capacity to develop insight into the origins of his or her violent behavior. This history may include their own trauma and an understanding that violent and abusive behavior is damaging and unacceptable. Change also depends on the capacity to value a relationship with one’s partner more than the discharge of emotions. When substance abuse is involved, the challenges are compounded.  From a treatment perspective during this time of on-line mental health intervention, it is also challenging to deliver this kind of intensive work because nuances of interactions, body language, and non-verbal cues can be difficult to discern online.

For decades, efforts to find an effective treatment for domestic abuse have floundered. Treatments have ranged from reducing testosterone in violent men to more therapeutic approaches such as enhancing violent men's self-esteem in order to increase frustration tolerance or cognitive-behavioral therapy. Recently a Norwegian study compared two approaches to reducing intimate partner violence. Men (144) were randomized into two arms, one offered cognitive-behavioral therapy while the other offered a mindfulness-based stress reduction therapy. Both arms included individual as well as group sessions. Six months after the beginning of the study, both interventions resulted in a significant reduction of physical violence, sexual violence, and injury.  Psychological violence was reduced only slightly in both groups. Changes were retained at 12-month follow-up. While it is encouraging to see that these approaches reduced physical violence, it is imperative to recognize that psychological violence is still abuse. It is clear that individuals who engage in violent behavior need sustained support for their gains and treatment for the areas of harm reduction that they have not yet achieved.

During the Mental Health Month, we recognize that emotional and sexual intimacy can help individuals and couples cope with the stress and anxieties currently brought on during the COVID-19 pandemic. Job loss, financial insecurity, social distancing, loneliness, and overcrowding with no clear end in sight are genuinely challenging for everyone. But as sexual health and mental health providers, we must also be alert to the harms that these circumstances can confer and be ready to address them or refer our patients to resources that will provide expert assistance. The National Domestic Violence Hotline (https://www.thehotline.org/help/) provides support for both abuse survivors and abusive partners. It has services for the deaf and access to legal advice.

Daniela Wittmann, PhD, MSW & Sharon Bober, PhD