SOCIAL WELLBEING & POST-DIVORCE ADJUSTMENT

Highlights

• Marital status is a predictor of emotional and physical health, with divorced persons at greater risk for depression, anxiety, and poor physical health status.

• Divorce adjustment may hinge on the clients' social health or wellbeing and, in particular, the presence of perceived social support.

• Social support is defined as the physical and emotional resources an individual perceives as available and reliable and is thought to buffer the physiological stress response and lessen the stressor’s negative effect on the individual's mental and physical well-being.

• Research repeatedly demonstrates that social support is a major resource for overcoming the upheaval and loss of divorce to a healthy post-divorce adjustment.

• When relationships are too heavily burdened, are entrenched in conflict, or have unhealthy emotional and social characteristics such as poor boundaries, manipulation, substance abuse, and the alike, they become a wellbeing liability.

• A critical first step in therapy is assessing the quantity, quality and accessibility of the social networks of your clients.

• The therapeutic alliance, generally regarded as one of the most important determinants of therapy outcome, is dependent on the ability to develop collaborative and supportive relationships.

• Social support is equally important to the professional wellbeing of the helper and has important treatment implications.

• Prioritizing social wellbeing when rebuilding and renewing inner and external resources is necessary for creating a future of belonging, of intimacy, and of connectedness.

Two recently divorced clients, Carol and Jane, seek your assistance for post-divorce adjustment. Both are well educated, employed, physically healthy women in their mid-thirties, with no custody issues and no history of personal or family mental illness. Treatment goals and techniques aimed at processing and resolving issues associated with multiple losses, increasing effective stress management skills, and rebuilding meaning, identity, and self-esteem are outlined and implemented. Carol is quick to collaborate with you on goals and objectives. She utilizes her internal and external resources, including the therapeutic alliance, engages in CBT exercises and assignments, and positive change occurs gradually over 3 months. Jane, on the other hand, though regular in her attendance, proceeds slowly in therapy, struggling to modulate stress at home and work, and frequent reports of anxiety, sleeplessness, and feelings of guilt or shame despite targeted CBT. What may best explain this difference in symptom course and therapeutic response?

LOSS AND REORGANIZATION:

A large body of literature documents an association between marital status and psychological health, with the married consistently found to enjoy better health compared to their unmarried counterparts. Divorce, just like widowhood, is a difficult transition with important negative implications for psychological health.

Often preceding divorce is the loss of basic social support, which for married individuals is the spouse. This entails a loss of many benefits associated with marriage such as emotional support, companionship, and physical intimacy. With divorce, there is a loss of identification as a “married couple” and “family”, as well as a change in contact with the in-laws and siblings of the former spouse, his or her relatives, friends, or acquaintances. Economic losses and sometimes the loss of an established residence and daily contact with children ensue.

The post-divorce process is a time of renewing and revising social identities. In the cases of Carol and Jane, the difference in divorce adjustment may hinge on the clients' social health or wellbeing and, in particular, the presence of perceived social support. Granted, reaction to divorce depends on numerous factors and individual reactions that cannot be easily foreseen. And yet, it's long been known that patient factors make a strong contribution to psychotherapy outcome.

Those that have an easier path to rebuilding an identity, a rich and diverse social network, and a life rooted in supportive relationships may, like Carol, have greater resilience in weathering the adjustment to divorce. Whereas those individuals, like Jane, who have very limited social support, restricted social networks, and/or difficulty establishing relationships are apt to struggle with more severe symptoms of dysphoria, anxiety, and compromised daily functioning.

DEFINING SOCIAL SUPPORT:

Research of the past couple of decades unequivocally illustrates that having a strong network of support or strong community bonds fosters both emotional and physical health and is an important component of adult life. A social network refers to linkages between people and organizations and is conceptualized through structural and functional components. Structural components include network size and frequency of contact between members, both of which are important during times of challenge as larger networks and more frequent contact may provide for greater access to support and resources. Functional components (see Figure 1) describe the relationship characteristics of a social network and, collectively, are referred to as “social support.” Social support is defined as the physical and emotional resources an individual perceives as available and reliable and is thought to buffer the physiological stress response and lessen the stressor’s negative effect on the individual's mental and physical well-being.

“It is an absolute human certainty that no one can know his own beauty or perceive a sense of his own worth until it has been reflected back to him in the mirror of another loving, caring human being.” John Joseph Powel

SOCIAL SUPPORT AND WELLBEING:

Our social relationships are one of the most robust behavioral predictors of our longevity. Social support is so critical to our well-being that without it we risk premature mortality. Restricted social networks predict mortality twice that of those who enjoy greater social integration. Risk for chronic and disabling conditions is higher in individuals with low or poor social support and, for those with existing chronic disease, the lack of social support is associated with poorer health outcomes. On the flip side, chronic conditions such as type 2 diabetes have a less deleterious course and lower A1C levels for individuals with strong social support systems versus those without.

Fig 1. Components of social networks and the types of social support offered

As is true for physical wellness, social support and emotional wellbeing have a direct and positive relationship and this suggests that social support resources are a first priority when exploring treatment needs and goals with clients such as Carol and Jane. Social support provides critical resources that, when under challenging or stressful situations, may reduce a person's risk for developing depression and anxiety disorders, a significant post-divorce risk. A plethora of studies have also demonstrated social support’s capacity to lessen the impact stressors have on those individuals with existing mental illnesses by reducing episodes of acute symptom relapse and deterioration. Figure 1 illustrates the many faces of our social networks and the types of social support that they can provide. It is thought that social support protects and buffers the effects of stress by its ability to foster self-esteem and inhibit feeling helpless in coping with stress. A 2017 meta-analysis revealed that people with more positive social relations and greater perceived social support tend to possess better communication and problem-solving skills, and benefit from boosts in self competence which directs them away from depression and other mental problems.

"Our social relationships are one of the most robust behavioral predictors of our longevity.”

SOCIAL WELLBEING AND THE TREATMENT PROCESS:

Pretreatment client characteristics can either facilitate achievement of recovery and lasting benefits or can constitute a risk for different kinds of treatment failure. The difference in divorce adjustment between the two hypothetical clients is likely connected to the characteristics and health of their relational worlds, with the perception of social support being one such characteristic. Research repeatedly demonstrates that social support is a major resource for overcoming the upheaval and loss of divorce to a healthy post-divorce adjustment. But, whether your role is that of psychologist, social worker, or coach you already knew that. Your experience has likely taught you that clients entering therapy with strong social support systems, without heavily entrenched malignant relationship conflict, capable of developing and maintaining quality relationships, on average, benefit most readily and substantially from the helping process. Knowing that the client's social network and relationship dynamics are complex and fluid, trust in your clinical skills is enhanced with thorough assessment.

While sufficient social support from a variety of sources is critical to successful post-divorce adjustment, an equally important aspect to social relationships for all of us, regardless of marital status, is the severity and frequency of relationship distress that can be experienced within or across social relationships. Even the best of friendships or colleague relationships require work and are not immune to misunderstandings, conflicts in values, disappointments, and changes in desired closeness to name a few. However, when relationships are too heavily burdened, are entrenched in conflict, or have unhealthy emotional and social characteristics such as poor boundaries, manipulation, substance abuse, and the alike, they become a wellbeing liability.

For individuals looking to bolster their resources and resiliency after divorce, assessing the extent to which they are embroiled in new or ongoing relationship conflict is a necessary and revealing process. Thinking back on your hypothetical clients, Carol and Jane, a critical first step in therapy is assessing the quantity, quality and accessibility of the social networks of your clients. Utilizing an instrument such as the Self-Centric Relational System (SCRS) provides you with a comprehensive and powerful view of the client's relational networks at the outset of the helping process and is invaluable when following changes in those networks throughout the course of your work together.

SOCIAL WELLBEING AND THE HELPER:

The therapeutic alliance, or working relationship between the client and therapist, generally regarded as one of the most important determinants of therapy outcome, is dependent on this ability to develop collaborative and supportive relationships. And that relationship, research demonstrates, is a function of both the therapist's and the client's relational resources and attachment styles. For example, therapists with secure attachment styles have been reported to form stronger alliances with their clients, versus therapists with insecure attachment styles who are generally perceived by clients as lacking in empathy and caring less. Securely attached clients demonstrate better therapeutic outcomes in comparison to their insecure cohorts, and are observed as more self-disclosing with positive perceptions of the therapeutic relationship. Greater challenges confront the therapist with insecurely attached clients who struggle to establish strong relationships and are less able to readily invest in the therapeutic relationship with trust and confidence. The crucial role of the therapist working with insecurely attached clients is patience. And more patience.

Social support is equally important to the professional wellbeing of the helper and has important treatment implications. Therapists and coaches are better able to prevent work burnout and reduced performance when they, too, have access to perceived social support. Skovholt and Trotter-Mathison, in their book "The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals," argue that to be effective, practitioners must develop a professional alliance or working relationship with clients that maintains appropriate boundaries and levels of emotional or psychological involvement. And while most helpers readily acknowledge such, it is the therapeutic and ethical necessity of doing so consistently and without reciprocity that can become a burden on one's mental and emotional energy that, if not replenished, renders the practitioner vulnerable to burnout and professional impairment. In a 2019 review article, psychologists Posluns and Gall from Saint Paul University in Canada, highlight previous research that consistently demonstrates that support from supervisors and informal peer support protects work engagement during times of high stress. In their review, social support was the most significant predictor of compassion satisfaction among trauma therapists.

CONCLUSION:

Human beings are social creatures that, once upon a time, developed relationships and groups of belonging for survival. In contemporary society, survival is often a state of mind, an awareness of the relationships that sustain us and those that undermine our wellness; it is the belief in one’s ability to be of service and a belief in one’s worth in seeking support from others.

A large body of literature documents an association between marital status and psychological health, with the married consistently found to enjoy better health compared to their unmarried counterparts. Divorce, just like widowhood, is a difficult transition with important negative implications for psychological health. Whether through informal relationships or through the therapist or coach relationship, prioritizing social wellbeing when rebuilding and renewing inner and external resources is necessary for creating a future of belonging, of intimacy, and of connectedness.

The current 2023 life expectancy in the United is 79.11 years. And for most of those years, it is our relationships and felt belonging that will give shape to our physical and emotional wellbeing. Positive adjustment to many struggles and losses affords a lifetime of relatedness that will bring us from infancy to old age, having found meaning, purpose, and satisfaction.

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