Evo Terra (Host): Making a marriage work takes work. So how do you build a healthy marriage before and after you say, I do? That's what we'll learn from Drs. Frank and Jennifer Clark, a husband and wife team of a Psychiatrist and a Psychiatry Nurse Practitioner with PRISMA Health. This is Flourish from PRISMA Health. I'm Evo Terra.

Dr. Clark and Dr. Clark. it's a pleasure to have you here with me today.

Jennifer Clark, DNP, PMHNP-BC: It's a pleasure to be here.

Frank Clark, MD, DFAPA: Thanks, Evo. We look forward to the conversation.

Host: Jennifer, I want to start with you. What makes a relationship healthy versus unhealthy?

Jennifer Clark, DNP, PMHNP-BC: That's a good question, and I think each relationship may have, every relationship may have healthy and unhealthy characteristics, but overall, a healthy relationship, it doesn't equal perfect. We have to remember that. It's important to remember that all relationships have some good, some bad. It's not always smooth sailing.

I think that's a common misconception. But a healthy relationship is built upon foundations of friendship, mutual respect, kindness, common bonds and open communication. And not to say that in a healthy relationship, we can definitely have irritability with our partners. I'm sure my husband would attest to it.

I might occasionally get irritable. We get irritable about silly things sometimes, but we're human. The important thing is in a healthy relationship, partners strive to communicate. They try not to let things fester. Whereas an unhealthy relationship, we might be looking at one of those when more of those negatives come out than positives.

And that could be even cases of physical abuse, emotional abuse, sexual abuse. There could be, usually there's a power imbalance in unhealthy relationships, where one partner may exert control over the other. There could be infidelity or trust issues that are prevalent in the relationship. Those are some examples of unhealthy characteristics.

Host: All good info. Frank, I know, obviously, compatibility is a part of all of this, but how does one know if they're truly compatible with the person they're going to choose to be their life mate?

Frank Clark, MD, DFAPA: That's a very good question. I think the first thing that is important when we're looking at compatibility is to know thyself. So, my wife and I, we both do our own therapy, and we've done our own therapy for many years, and I think there has to be self-reflection. You can't be in a healthy relationship unless you know who you are. 

Now, we all bring baggage to a marriage, but I think it is important to one, name your values, and then two, do those values align with the person that you could be potentially spending the rest of your life with? Number two, I think it's also important to embrace authenticity. We don't want to change our partners, we want to lean into our partners, and hopefully they will reciprocate that and lean into us.

And then lastly, as my wife so eloquently stated, is that we have to have trust. So, can you be yourself with the person that is potentially going to be your mate?

Host: Those all sound like great tips to me and understanding, but I'm trying to think back 30x years ago when I first got married, I don't know that I knew, I guess I knew at the time when it was right for me to ask my wife to marry her, or did she ask me? I've forgotten now. It doesn't really matter, but the question is, how does one know when the right time is there for them to get married? Jennifer, why don't you take that one?

Jennifer Clark, DNP, PMHNP-BC: I think that's a really trick question because there really isn't a good answer to that per se, and it varies for different people, but I think in general, we can look at if you have some of those healthy components that we talked about before, trust, communication, that's a good foundation. That might be a start.

Sometimes it's timing for some people. Some people may look at it logically and feel like they want to make sure they're in a stable financial situation or they're out of certain stressors like school. But also it's just, it's just, looking at the right time, not right time, but the right reasons for that.

Are they entering that relationship or thinking about marriage for the right reasons and coming from the right place? Sometimes there could be societal pressures. I mean, I remember being back in my early thirties before I got married and kind of thinking, okay, like I had set myself in my mind, I thought I would be married by 30, but I wasn't. And so I think sometimes there can be pressures from parents or, even you see other friends getting married. So some people may make those decisions, rush into them a little bit, from outside pressure. So it's, I think it's really important to reflect and make sure that you're doing it for the right reason.

And also that you're communicating with your partner. Have you been through challenges with your partner to be able to really know who they are? What do your friends and family think about that partner? Just some other tips.

Host: You brought up pressure, and yeah, marriage is pressure, but I know that wedding planning is one of the most stressful things. We didn't do it, but I understand a lot of people do. So, Frank, can you help me with ways that couples can stay connected and maybe resolve conflicts between each other while they're doing the most stressful thing of their life thus far, planning a wedding?

Frank Clark, MD, DFAPA: Sure. I think it is important to communicate how you're feeling to your partner. Wedding planning can be a joyous occasion, but the pendulum can also swing the other way where there can be times of stress. I know for Jennifer and I, we were very cognizant and mindful of what each person desired as we were planning the wedding.

So for me, she knows I love to dance. So the only request that I had, I wanted a DJ. And two, that's not the only request, I'm sorry, but we decided to take dance lessons together, and I wanted us to do a performance at the reception. So, she will tell you that she is quite shy, and has always been shy, so she did lean in to me, we met in the middle on that, and, she was a good sport about that, and that's one of the things I appreciate about her. She's really into creativity, and she loves to decorate, like if you came to our home, every season, she has decorations, and so I know that about her, that is something that she enjoys, and so, one of the things that fills her love bank, she wanted, you know, certain flowers, a certain color for her bridesmaids.

I wanted a certain look for my groomsmen. So we just had an open and honest conversation and anything that we disagreed on, we had to choose our battles. Okay, how important is this to us versus, X, Y, and Z, but I think it turned out well, Jennifer. You're still with me, so.

Jennifer Clark, DNP, PMHNP-BC: Yeah and also remembering it's a wedding. The marriage is the most important thing. It's one day really trying not to sweat the small stuff.

Host: Very, very good advice with that one. So, Jennifer, I wonder, do you think that couples counseling should be considered before someone gets married?

Jennifer Clark, DNP, PMHNP-BC: I think it certainly can, and there's different types. I mean, there's like the premarital counseling that can be done in a session or two by like a minister, sometimes that's maybe required if someone wants to marry in a church or maybe they even get a discount on their marriage license or something like that if you do premarital counseling. So some people do that, but actually like maybe even going to see a counselor and doing some session or work before then, I think is a great idea. And we did the traditional premarital counseling, but we didn't do like actual couples counseling I think that's great, as Frank mentioned, we do our own counseling.

It's just helpful for us as mental health professionals to just have our time, our outlet. And I think therapy is something that gets a little bit of a stigma, whereas we can easily tell people I'm going to go to the gym and work out, you know, it's common conception that we're going to work out, we're going to exercise our physical bodies, we tell people that.

But there's more of a shame or stigma around therapy sometimes, and therapy is just mental exercise. Frank and I are both of the personal belief that everyone should see a therapist. So yes, with couples counseling, it can help people resolve conflicts, learn about themselves, and learn about each other as a couple, and Frank mentioned something earlier in the podcast that we bring our baggage into relationships.

So for example, if you come from parents that are divorced, in a childhood of divorce, you may have some preconceived notions about marriage or how you communicate that may be different than somebody who's had parents that have been married for years. Or if you've been in a toxic relationship before, you may have anxiety bringing it, bringing that into the relationship and into your present relationship. So that can all be worked out in couples counseling.

Host: I'm going to stay with you for a minute longer, Jennifer, and ask about some common relationships, conflicts. You brought up conflicts. What's common? What comes up after marriage? I'm specifically looking for tips that, for newlyweds, to help them start that marriage off on a good start.

Jennifer Clark, DNP, PMHNP-BC: Sure and I think that when you're dating, there are things that don't pop up until you're married. So there may be differences that you even know about before marriage, like do you spend money differently than your partner? It may not matter when you're dating, but when you're merging finances, that may be a big deal.

Or how you're going to raise kids. Do you have religious or political differences that maybe weren't so big when you were dating, but then when you're living in the same household, or things change over time; that could be a big contention point. I know for us, a big challenge was becoming parents. You know, it's different and you know your time is different when you're a parent. Sometimes, the communication can change a little bit and you have to be more intentional about it. I think I expected, Frank to read my mind on things I needed when I was a new mom and taking care of a baby and I had to learn I had to tell him explicitly what I need.

So we got through that challenge, but that's a big time, that first year of parenthood. I work with pregnant and postpartum moms a lot in mental health and that first year it can be really hard, especially on newlyweds or parents. And then some tips, I think some good tips are, never growing complacent, don't just take your partner for granted. Plan date nights. Have times where you can communicate, you know, set aside time with each other. Don't let things fester. Don't go to bed angry. We've always, that's something we've always talked about and thought was very important. So yeah, those are some, some tips.

Host: That's, great. Frank, I'm going to kind of do the opposite with you here. I'm looking for some common events or experiences that you see in your practice that have damaged the strength of a marriage. And then, if that's the case, what do couples do to strengthen their relationship again?

Frank Clark, MD, DFAPA: So, I would take it, the example of kind of looking at it as I think a lot of couples sometimes don't get to the root of why there is a conflict. So, one of the things that I see at the root of conflict or marital discord is the lack of communication. Oftentimes, and Jennifer and I are guilty of this, this is charged, we can make assumptions. If we make assumptions, we are often wrong. So we have to remember that we are coming in with our own vulnerability factors, you know, Jennifer talked about you know, not everybody comes from a intact home. 

I know for myself, I did not come from an intact home. I came from a home that pretty much I was raised by a single mother and my father was partially absent, partially present. Versus, Jennifer came from a home where she had a two parent household. We've had to learn over the almost 10 years that we've been married, we are still learning about one another.

And so if a couple tends to personalize things, that's going to create resentment. And I think we have to always be mindful of again, try not to make assumptions. If you are having any concerns about the marriage, Dr. Gottman, Julie and John Gottman, from the Gottman Institute, they've done a plethora of research as it relates to how to remain in a healthy relationship, how to work through conflict.

And one of the things that they talk about is the importance of using I feel statements. So it could be related to financial things that are coming up in the marriage. It can be related to intimacy. But if we use terms like, you always do this. You always do that. I hate this. I, you, you know, no one always does anything.

If we can come to approach our partners with a nonjudgmental attitude and realize that this is a respectful relationship; I think that can kind of curtail a lot of the things that can damage a relationship. But I find in my practice that a lot of patients just don't talk to their partners.

One, they may not know how to talk to their partners or when they do try to talk to their partner, they feel like there is a sense of criticism that they are receiving and defensiveness. And defensiveness is one of the things that Gottman talks about in his Four Horsemen apocalypse of the predictors of divorce, one of those being criticism, the other being defensiveness, also contempt, and stonewalling.

And Jennifer and I see that a lot in our practice with a lot of our patients that are experiencing marital discord.

Host: Yeah, some of those might ring a bell, maybe, perhaps, haha. So any tips, Frank, when maybe one or, or perhaps both of a married couple, feel like the spark or the magic has gone from the relationship, how do you rekindle that?

Frank Clark, MD, DFAPA: Sure. And I think Jennifer would agree with this. You know, when we first started dating 10 years ago, I think there's different levels of love. You know, you kind of have that puppy dog love where you're just like infatuated ao to speak with the person and you just want to be with them every single moment.

And I mean, I still feel that way about my wife, but I think we could also be honest and say that you might not love your partner the same way every day. And we've experienced that in our marriage, but it has to be intentionality. For us, a lot of our marriage is centered by our faith.

We are both Christian and we put God at the center of our relationship. And I know that for some people, they're more spiritual or they may not have any type of faith belief and that's okay, you know, whatever helps them grow. But I know for us, when we're able to keep God at the center of our relationship, that allows us to flourish.

But with that being said, we realized that we have to prioritize one another. Jennifer will tell you, I'm very intentional. If we haven't had a date night a while, I'll say, Hey babe, I call her Boo Bear. That's my nickname for her. But, you know, I may say, Hey Boo Bear, we need, we haven't, you know, I feel, you know, I'm missing the frequency of our date nights have been, you know, smaller or lower than they have been and my request is that we find a way to increase the frequency of our date nights. So I've made my request. I have not criticized, so she's less likely to be defensive. I have not held her in contempt, and there's no stonewalling, Now, do I practice that every day? No, I'm guilty as charged. I'm a human being. So we're perfectly imperfect. But that intentionality and making our requests known can be helpful. And it doesn't always have to be spending money at a nice restaurant or actually even going for a walk. You know, we love to play games with one another. 

Jennifer is again, that's one of her love languages. She's very good about acts of service and quality time. So I recognize that and just watching a movie, she's a movie junkie. So anything that, you know, one of our date nights is, we may just watch a movie, but that builds connection. 

So, when people say the spark might be missing, my response is why is the spark missing? And I think, again, we have to go back to those roots. If we want the flower, if we think about our marriage as a flower, we have to water the flower, right?

During all seasons, spring, summer, fall, and winter, especially in the winter, right? When we just want to cuddle up and insulate and not really do anything, we have to keep that flower blooming. 

Host: All good information. I'm very glad we're recording this because I'm curiously making notes. But Frank, I want to stick with you for a second since you and I share a common upbringing and the fact that our, our parents were divorced and the same thing for my wife, her parents were divorced several times.

So, when it comes to this topic of a broken marriage, can it be healed? I mean, if a marriage is failing, is it going to fail? That's it? Or is there something we can do to rebuild that?

Frank Clark, MD, DFAPA: I appreciate that question, Evo. I would say that I'm an optimist, but I'm also a realist at the same time. I believe, going back to, it takes two to tango. Relationships must be reciprocated. If there is a lack of reciprocity, can the marriage be healed? I don't think it can be. Now, with couples counseling, if both parties are willing and motivated and devoted it to one another. Again, it goes back to vows. And again, we'll speak from a faith standpoint. I took a vow to for richer or for poorer, for better or for worse, in sickness and health. And sometimes I have to revisit those vows that I made to my better half.

We've gone through some trials and tribulations in our marriage. I'll give you a quick example, that could have broken our marriage. It didn't. But I think that's because we have those roots and those roots are strong. So, Jennifer had a horrible pregnancy where she experienced intractable nausea and vomiting.

She had a condition called hyperemesis, which resulted in several hospitalizations throughout the pregnancy. She was a trooper. She was still going to work. God bless her. I don't know how she did it. Well, actually, I do know how she did it. She's just that type of person. She's just strong and I'm grateful for her for many reasons.

Simultaneously, my mother, who, I'm from Chicago, her health started to decline and we found out that she was showing the early signs of dementia. So we had to do an immediate intervention and fly her down to South Carolina permanently. So that she was not going to return because she was not caring for herself.

And we're thankful for her friend who called me one day when I was at work to tell me that she was worried about her. So I'm the only child for my mom and so I'm now the caregiver for my mom and I'm also the soon to be father of a child, our daughter, who we love to pieces. But also, I'm also kind of the caregiver I'm trying to help Jennifer. And then I'm also going through burnout at work. COVID did not help things. There was a lot of things going on at that time. So, needless to say, I wasn't my best self. And so, if I'm not my best self, how can I pour into my better half?

How can I pour into my mother? That was a time, we joke about it now, we've had a good conversations about this post pregnancy, and my mother is, thankfully doing well. She's now in a memory care facility where she has around the clock care, and we're thankful for that. But, if we hadn't talked about those issues, and we hadn't been there for one another, I could see how that pendulum could swing to, well, maybe, maybe it's time for us to call it quits. But one thing I always have known about my wife is that she has my back. To the day I die, she has my back and she knows that I have hers. There's nothing that will ever separate us from I mean, only death, would separate us. And again, I just use that example because I want our listeners to understand that when you are devoted and when you are intentional, for us, if we think about those vows, we're going to make this work. And it was a struggle. She went through postpartum anxiety.

That was difficult for me. I probably had some paternal postpartum depression at the time. That was difficult for me. But we have to acknowledge these things and we have to talk about them.

Host: Yeah. exactly. A great story. I'm glad you shared it with us. Jennifer, to wrap things up, are there any specific ways a married couple can communicate or can help make that marriage more likely to last?

Jennifer Clark, DNP, PMHNP-BC: Yes, definitely. There is a type of communication called assertive communication, and what that is, is just having open, honest, direct conversations with your partner, which can be hard sometimes. As Frank mentioned before, the I feel statements are very helpful, not using, like, you always do this, making generalizations or you statements can feel accusatory.

I think one of the biggest things with communication that I've noticed that patients have talked about or even just noticing in, in general with any relationship. You know, we're so technology driven. And so often people are on their phones. You might go to restaurants and see couples on their phones and not talking to each other.

And I guess that we may have business to do on our phones, but trying to be intentional about putting away technology. Frank and I are guilty of sometimes, you know, scrolling on, social media or news or something when we, you know, we probably could be talking to each other. We try to set some boundaries there, maybe putting away phones, things like that. So that's kind of eliminating distractions, setting certain times for communication. Another thing is that making sure that you're actively listening. Frank knows that morning time is probably not the best time to have a huge conversation with me because I am trying to get daughter ready, out the door to see patients, getting ready, and I'm, I'm busy and I may not be focusing on all the elements.

So making sure that your partner, it's a good time to actively listen. Making an effort. That's the biggest thing.

Host: Yeah, making an effort certainly goes a long way. You two have clearly been a couple that seems work well together for time to have careers and have a baby and all the things going on. Is there a trick that you're using or do you have some sort of special communication skills that you should bless all of us with?

Jennifer Clark, DNP, PMHNP-BC: Well, we are definitely human and we are, we're not marriage therapists at all. I should have clarified in the beginning. We're not counselors in that. We just try and make efforts. One thing we have also kind of held high is looking at, I'm sure most people have heard about the five love languages.

Frank, you may have to help me remember about these, but basically receiving gifts, quality time, physical touch, words of affirmation. I think I'm missing one.

Frank Clark, MD, DFAPA: Words of affirmation, physical touch, quality time, acts of service, giving gifts.

Jennifer Clark, DNP, PMHNP-BC: Yes, there we go. It's important to, you can take the test really easily, but it's, I think it's important to realize what your love language is and what your partner's is. Because sometimes we think that we're meeting their needs when we might not be. You know, if someone is a quality time person and we're not spending that much, that may make a difference.

And I'm really acts of service. That's mine. I like to do things for other people. Frank can wash a lunchbox for me and I'm like, oh my goodness, that's so, that's wonderful, because I, you know, I'm busy and it was something that he did nicely for me, that was a surprise. But I also recognize that physical touch is his love language.

And so sometimes I'm rushing around, I need to be more intentional about giving a hug in the morning or something like that. So I think, our love languages can also change over time. So kind of being intentional, looking at, at how, our partner, would like to be shown love.

Host: This has been great information, thank you very much Frank Clark and Jennifer Clark for joining me on the program today. And for more information on health and wellness, please visit prismahealth.org. If you found this podcast episode helpful, please share it on your social channels and check out the full podcast library of topics of interest to you.

I'm Evo Terra, and this has been Flourish from PRISMA Health. Thanks for watching.