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Tell Me Again What You Think of Me: Depression and Reassurance-Seeking in Couples

Man comforting his sad mourning friendApproximately 18.1 million Americans adults suffer from depression each year.[1] They experience symptoms such as irritability, fatigue, persistent feelings of sadness, disinterest in once-pleasurable activities, difficulty concentrating, sleep disturbances, and even thoughts of death.  In addition to these symptoms, depression also negatively affects communication in close interpersonal relationships, such as with friends, partners, and family members.

For example, depressed individuals are more likely to engage in reassurance-seeking behavior: asking for affirmation that he or she is lovable, worthy, and valued.[2]  Although most people ask for reassurance occasionally, individuals with depression tend to seek reassurance persistently and repeatedly, even after their partners have already offered it.[3] Some experts even suggest that excessive requests for interpersonal approval may be both a cause and a consequence of depression,[4] due in part to depressed individuals’ tendency to doubt or dismiss positive feedback from others.

A group of researchers at The Family Institute at Northwestern University, led by Dr. Lynne Knobloch-Fedders, studied the links between reassuring-seeking behavior and depression among couples.  In collaboration with colleagues at the University of Illinois and Michigan State University, the researchers investigated the communication behavior of 69 couples seeking treatment for relationship problems and depression.  Results of the study, which was funded by the Randy Gerson Memorial Research Award from the American Psychological Foundation, indicated that depressive symptoms were a primary predictor of reassurance-seeking behavior in couples.[5]  The researchers’ next step is to begin testing interventions designed to help reduce excessive reassurance-seeking, and increase positive communication and validation, among couples seeking treatment for depression.

Lynne Knobloch-Fedders, PhD,  is a licensed clinical psychologist at The Family Institute at Northwestern University, with expertise in couples therapy, premarital counseling, depression and anxiety disorders, infertility and adoption. Additionally, she maintains a clinical research program, with a primary focus on the associations between couples’ interpersonal behavior, relationship distress, and individual psychopathology. 

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester.  The Institute also conducts research which is incorporated into both our Clinical Service and Education Programs. Learn more about our Depression Treatment Program. Visit our website to learn more about our services.


[1] Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.

[2] Joiner, T. E., Jr., Metalsky, G. I., Katz, J., & Beach, S. R. H. (1999). Depression and excessive reassurance-seeking. Psychological Inquiry, 10, 269-278.

[3] Pettit, J. W., & Joiner, T. E., Jr. (2006). Chronic depression. Washington, D.C.: American Psychological Association.

[4] Haeffel, G. J., Voelz, Z. R., & Joiner, T. E., Jr. (2007). Vulnerability to depressive symptoms: Clarifying the role of excessive reassurance seeking and perceived social support in an interpersonal model of depression. Cognition and Emotion, 21, 681-688.

[5] Knobloch, L.K., Knobloch-Fedders, L.M., & Durbin, C.E. (2011).  Depressive symptoms and relational uncertainty as predictors of reassurance-seeking and negative feedback-seeking in conversation.  Communication Monographs, 78, 437-462.

Stop the Fighting! 3 Red Flags to Save Your Marriage: Part III

Couple Having ArgumentIn the final installment of “Stop the Fighting,” Staff Clinician Alexandra H. Solomon, PhD, discusses a third “red flag” fight that couples have — feeling as if they have dramatically different points of view.

Red Flag #3: “We don’t live in the same reality.”

When a couple recounts a fight in a therapy session, the therapist sometimes wonders whether the partners were even in the same room when the fight happened because their stories are so different. This can be a reflection of a deeper problem which is a lack of willingness or ability to work collaboratively to create a story of the relationship that honors multiple realities and differences in perspective. If this continues, it can feel demoralizing and lonely. When there is untreated addiction, untreated mental health problems like anxiety or depression, or relational abuse of any kind (emotional, physical, and/or sexual), spouses are particularly at risk of feeling like they live in two different realities.


  • Commit to living and loving with humility. Your reality is ALWAYS shaped by your perspective and is ALWAYS limited.
  • Lean in to your spouse’s view of the problem and actively look for pieces of his/her story that you can buy into and empathize with. In other words, work with your spouse to create a shared couple story of the problem.
  • Try to look at the fight from the perspective of a neutral third party. This is why couples therapy can be so helpful. The couples therapist has the advantage of being able to look at the dance between partners rather than being stuck in one partner’s story or the other and he or she can help the spouses begin to hold this “third story” view as well.

Each of these “red flag” fights — “You don’t have my back”; “I don’t believe in us”; and “We don’t live in the same reality” — can be worked out. If you see these red flags in your relationship, be sure to talk to your partner and work on the tips. Do not be afraid to reach out to a couples therapist to work through a bump in your relationship road.


Dr. Alexandra H. Solomon is a licensed clinical psychologist at The Family Institute at Northwestern University and an assistant clinical professor in the Department of Psychology at Northwestern University. Read more about Dr. Solomon on our website.

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester. We have a team of clinicians dedicated to helping couples strengthen their relationship. To learn more about our therapy and mental health services, please visit our website.

Make Your Relationship Affair-Proof

Attractive woman chatting animatedly on her mobileCan you affair-proof your relationship? Infidelity can be tough to talk about, but being honest about the temptations that we all face once we have committed to an intimate relationship can be a powerful form of prevention.

Family Institute Staff Therapist Alexandra H. Solomon, PhD, offers four ways couples can proactively stack the deck in their favor.

1) Talk about sexual monogamy. For those who choose it, sexual monogamy is a high bar for a relationship, and we as a society are reluctant to talk openly and honestly about what is actually required for a couple to be happy and Couples who are able to talk with each other about their sexual needs and desires are the ones who are most satisfied with their sexual relationships. Talk openly together: Why you are choosing to be sexually monogamous? What does each of you need in order to feel good about your choice? What does the relationship needs in order to thrive? Making this explicit rather than assumed goes a long ways toward preventing infidelity.

2)  Surround yourself. Even if you feel content in your intimate relationship, chances are good that you will find yourself feeling attracted to other people. It’s all about what you do with those feelings. Your friends can affect how you feel in your intimate relationship, so surrounding yourself with friends who support your intimate relationship can help you keep choosing fidelity.

3) Stay engaged. Infidelity does not happen “out of the blue.” A common storyline is that one or both partners disengaged emotionally and/or physically from the relationship prior to the infidelity. Staying engaged with each other requires actively tending to the relationship: spending time together, being curious about each other’s worlds, connecting physically and sexually, and setting goals together. If you or your partner feel disengaged, working with a couples therapist can be a great way to reconnect and reduce the risk of betrayal.

4)  Don’t think you’re immune. I have heard over and over again in my therapy office some version of: “I never thought it could happen to us,” “I am not the kind of person who cheats, but here I am,” or “I have no clue how we got here.” Stay humble. Relationships are complex and mysterious journeys. Effort and care are required … always.


Dr. Alexandra H. Solomon is a licensed clinical psychologist at The Family Institute at Northwestern University and an assistant clinical professor in the Department of Psychology at Northwestern University. She’s writing a book about relationships that will be published by New Harbinger in February 2017.

The Family Institute offers affordable therapy and assessment services at our Evanston, downtown Chicago, Westchester and Northbrook locations. Visit our website to learn more.



Couple with communication issuesThe Family Institute’s July Couple Tip of the Month discusses the third ear we each have, which hears the mood and emotion of our spouse.

From this month’s tip:

We all have a Third Ear, but we don’t always use it. The Third Ear hears beyond the surface words to a spouse’s underlying mood or emotions. With our Third Ear we’re like an audience listening while staying in our seats, never climbing onto the stage to join the drama. While hearing something potentially button-pushing, the Third Ear’s signal reminds us to refrain from taking the bait … and to aim for Being Smart instead of Being Right (read Right Versus Smart).

Read the entire Tip of the Month and learn how to control emotional reactivity.

For additional Tips and to sign up for our Tip of the month, visit our Tips webpage.

The Family Institute offers affordable counseling for families, couples and individuals. Learn more about our services on our website.

To get support at The Family Institute, visit our Find a Therapist page.

Veterans & Relationships: How can we help?

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military_coupleVeterans have their own unique opportunities and challenges when it comes to mental health. A current study at The Family Institute looks at what couples face when they’re reunited after deployment.

From researcher Lynne Knobloch-Fedders, PhD:

“There is an urgent need for research to inform prevention and intervention services for couples during the transition from deployment to reintegration,” Dr. Knobloch-Fedders said. “Experts believe incorporating a service member back into domestic life can be more demanding for military families than deployment itself.”

Read more about this important study in a previous TFI Talks post.

How to Treat Your Marriage Like You Treat Your Health

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RelationshipWe go to the doctor when we have severe pains, fevers or other physical symptoms. We take vitamins, have routine checkups, exercise and adapt our diets to prevent physical illnesses. As we commemorate Mental Health Awareness Month at The Family Institute, we’re talking to our expert clinicians about the connections between physical and mental health, as well as what can be done to prevent more serious mental illnesses.

Today’s insights relate specifically to couples, and come from Jaime Henry-Juravic, LMFT, a staff therapist at The Family Institute’s couples services. We asked Jaime a couple of questions about how we can tend to our relationships the way we tend to our physical health.



What are some symptoms that might clue an individual or couple in that she should seek mental health treatment to help with marriage issues?

  • Feelings of disconnection from the other that are not remedied by spending quality time together or participating in activities that once cultivated a sense of connection
  • Persistent thoughts or impulses to engage in a physically or emotionally intimate relationship outside of the primary relationship
  • Increasing or repeated conflict that you have not been able to resolve on your own, despite repeated attempts.
  • Significant life transitions that are contributing to increased stress in the relationship. These can include the birth of a child, the transition of a child out of the house, a change in location, a career change, or an ongoing physical illness in one or both members of the couple.
  • Dissatisfaction with sexual intimacy or the presence of sexual dysfunction



What are some preventative measures an individual or couple can take to avoid larger conflict, mental health or marital problems?

  • Continue to prioritize each other and the relationship throughout the entirety of the relationship. Avoid the trap of “checking the relationship box”.
  • When spending quality time together, focus on quality. Experiment with keeping technology out of the equation during your time together. Phones and computers can often serve as a barrier to intimacy and quality time.
  • Have dinner (or another meal) together as often as possible. Be intentional about engaging in conversation with each other, rather than zoning out in front of the TV or your phone. *Note: Zoning out is sometimes necessary. Just be aware of how often that occurs when you are spending time with your partner.
  • Experience new things together
  • Incorporate playfulness into the relationship. This can be in a sexual or non sexual way
  • If you are parents, be intentional about maintaining the “couple sphere” of the relationship in addition to the “parent sphere”. Imagine these as separate spheres, with areas of overlap. Each sphere has unique responsibilities and needs in order for it to thrive.
  • If you are feeling disconnected or unfulfilled, say something. These feelings will not simply disappear if you ignore them. And if you are struggling with how to communicate these feelings effectively to your partner, or are feeling invalidated when you do communicate them, reach out to a professional (such as a couples therapist) for help. That’s what we’re here for!

The Family Institute offers affordable counseling throughout the Chicagoland area. To learn more about our therapy and mental health services, please visit our website.

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