By Professor Alan Hayes FAPS, Ruth Weston PSM and Dr Lixia Qu
Australian Institute of Family Studies

The personal is constituted by the relation of persons.
(Macmurray, 1961)

Mental health problems represent an increasing contribution to the global burden of disease (World Health Organization, 2009, 2010). Relationships and family factors may underpin and/or exacerbate these. In turn, mental health challenges have profound impacts on couple and family relationships. Intimate couple relationships are prime sources both of protection and risk. The pressures on couple and family relationships reflect forces from within and beyond the family unit. Distal and proximal factors lead to life events that bring into stark relief human vulnerability and resilience. For example, many of the pressures increasingly flow from the rapid pace of social change - along with unpredictable events such as disasters and economic downturns - on a national scale, and conflicts, accidents, illnesses and loss on the personal side. This article seeks to explore some of the pressures on couples and families and sketches the implications for psychologists faced with addressing the growing prevalence of mental health problems and behavioural disorders.

A land of “droughts and flooding rains”

The widespread floods that marked the start of 2011 across five states of Australia broke the drought in a catastrophic way. Like the Victorian bushfires, the floods illustrate how events beyond the family can have profound impacts on persons and their relationships. On the one hand, the courage and compassionate responses of individuals, families and communities within and beyond Australia highlight the best of humanity. On the other, these immediate responses tend to be short-lived, and some of the multi-faceted problems faced by victims can remain with them across a lifetime. Furthermore, the more widespread the problems are, the greater is the likelihood that support is eroded, given that many others are also engulfed by the same tragic circumstances, and other events progressively overtake those not as directly involved (Kaniasty & Norris, 1995).

It is all too easy to lose sight of the fact that such disasters do not displace the more commonplace pressures that Australian families face. Many couples face ongoing, everyday problems that place their relationships under pressure. Demographic, social and economic factors form the backdrop to many of the daily dramas that play out in households across the nation. Psychologists are well placed to see the ways in which events that impact on families, and the human relationships at their heart, leave indelible impressions if left unaddressed. The prime role of therapeutic and behavioural supports can too often be overlooked. After all, familiarity can breed acceptance, apathy, or at worse, contempt for the commonplace but personally significant problems that beset many relationships. The very word ‘familiarity' highlights the fact that so much that is familiar, for good and ill, is learned in the family (Skynner & Cleese, 1993).

Population age structure

The inexorable elongation of human life spans has exerted one of the most dramatic influences on family lives and relationships. ‘'Til death us do part' has a very different meaning in the 21st century than at any other time in human history. The personal and relational implications of the changing age structure of modern societies are profound.

As is the case for all developed countries, Australia's population is ageing, with the key drivers being low fertility rates and increased life expectancy. One important question is whether or not there will remain a sufficient labour force to support the elderly, taking into account the fact that the proportional representation of the other main dependent group, those too young to work, is shrinking. As a result, today's taxpayers are likely to inherit a heavier tax burden. The issue is becoming increasingly critical, given that the first of the baby boomers - those born between 1946 and 1966 - are turning 65 years old this year.

One key response of governments, including the Australian Government, is to increase labour force participation rates through various policies, including the removal of barriers to participation of older people (Commonwealth of Australia, 2010). We are seeing a reversal of the trend for men to retire ‘early' and a continuing increase in the proportion of middle-aged and older women remaining in paid work (Qu, 2008). This means that the proportion of grandparents who can care for grandchildren during work hours will decrease, placing added pressures on parents in paid work who also have dependent children. As such, families will lose a valuable source of support, as will the wider community. While the new paid parental leave scheme will help families with infants, care needs to extend over childhood and into adolescence. Leaving children and young people to ‘fend for themselves' while both parents are in paid work has its risks.

The ageing of the population also means that the demand for services will change, given the different needs of the burgeoning elderly population and those of younger generations. For example, there will be a growing demand for geriatric psychologists to address the problems of dementia and other mental health concerns that attend increasing frailty. Psychologists may also be increasingly called upon to assist families to manage the emotional effects of the pressures that caring for elderly relatives places upon them.

Partnership formation

The prolonged pursuit of education along with developments in contraception have contributed to a progressive delay in marriage and childbearing, and to increased diversity in life course trajectories. In the 1950s and 1960s, women were typically dependent first on their fathers and later on their husbands. They tended to leave home to marry, with children being an inevitable outcome for most. Those who ‘failed' to achieve these milestones were pitied and for the most part, loss of a husband meant poverty, with divorce itself attracting considerable social censure. Women's options for alternative lifestyles were severely constrained.

Since this period, first unions have increasingly begun with cohabitation rather than marriage. Cohabitation is not only the typical pathway to marriage, but is an increasingly common context for childbearing, with marriage occurring later or not at all. The proportion of partnered people who are cohabiting rather than married has increased across all age groups, and marriage rates, along with overall partnership rates, have fallen across all ages over the last few decades.¹

Unlike marriage, the meaning of cohabitation is uncertain. Couples may decide to cohabit early in their relationship when first ‘going steady', or they may embark on cohabitation as a trial marriage, as a replacement for marriage, or they may see marriage as something to enter should they decide to have children. Still others may construe cohabitation as a ‘no strings attached' arrangement. Partners may disagree on how their cohabitation should be interpreted and the meaning of the relationship for each may either merge or diverge. The various interpretations of the relationship can generate a great deal of pressure on these couples.

The increased life course options that young adults have today have created a different set of pressures. The emergence of choice about pathways that were once considered inevitable, such as marriage and having children, opens the way for difficulties in making personal decisions that may close off options and generate disagreements between partners on relationship priorities. Such disagreements are particularly problematic given that their likely timing is now occurring later in the life course. That is, with advancing age, the female partner's more restrictive ‘biological clock' places her in a very vulnerable position should she want children and should her partner remain undecided on this issue. In other words, keeping some options open inevitably leads to the closure of others. Opportunities that are lost may turn out to be those most treasured. Along with relationship breakdown, dashed hopes and unmet expectations are fertile fields for the emergence of mental health problems, such as anxiety and depression.

Community attitudes can be a further source of pressure that complicates relationship choices. Some relationships confront the challenges of community ambivalence and antipathy. Cross-racial, age-disparate and same-sex relationships are still likely to be subject to negative stereotyping and stigmatisation. Same-sex couples, for example, may be forced to conceal their relationship from their families, friends and colleagues to avoid potential rejection and discrimination. Concerns about acceptance can have a negative impact on relationship quality, parenting decisions and mental health.

The timing of childbearing, family size and approaches to parenting

In the 1950s and 1960s, many women became mothers in their early 20s. By contrast, women today tend to begin childbearing in their late 20s and early 30s.² Large families are disappearing, while two-child families have become the norm. Smaller family sizes and increased wealth, coupled with concerns about job security, may lead parents to invest heavily, in terms of time, energy and money, in providing experiences that will enhance their children's life chances.

Technological change, including the advent of the mobile phone and social media, has contributed directly to changes in parenting, as well as in the peer relationships of children. Some parents attempt to continually monitor their children, over-schedule them and protect them from problems both great and small. This is not without cost. Various terms have been created to describe such parents such as ‘helicopter parents', who hover over their children, and ‘lawnmower parents', who smooth the terrain by mowing life's bumps. Attempts to enhance the life chances of their children may be counter-productive, however, in that they restrict children's opportunities to develop the skills required for adult autonomy. Along with increased expectations for the few children most couples now have, over-protection may be contributing to the rising prevalence of anxiety disorders among children and adolescents. Psychologists again have a vital role to play in addressing the consequent mental health needs of less than positive parenting practices.

The economy and labour market, financial pressures and responses

Our living standard has never been as high as it is today. The gross household disposable income per person in Australia increased by 72 per cent between 1998 and 2009 (from $21,300 to $36,600) (Australian Bureau of Statistics [ABS], 2010). On average, household consumption expenditure grew two per cent annually between 1960-61 and 2005-06 (ABS, 2007).

However, this overall picture masks the diversity of financial circumstances that families face. Some families are particularly disadvantaged financially, for example, families headed by single mothers. The direct and indirect negative impact of low income and its correlates - including parenting practices, neighbourhood disadvantage and social exclusion - on the physical, cognitive and socio-emotional development of children has become clearly apparent as data from Growing Up in Australia: the Longitudinal Study of Australian Children (LSAC) accumulate (Gray & Smart, 2008).

As psychologists will well be aware, the experience of financial pressure is not entirely based on objective circumstances. Perceptions can have pervasive influences. Changing norms can generate a sense of financial pressure and can also encourage parents to take decisions and actions that increase time pressures, work-family balance issues, and their associated guilt. For example, some of ‘yesterday's luxuries' have become ‘today's necessities' for many current or prospective parents (e.g., one bedroom for each child) - and some of today's ‘necessities' had not even been invented ‘yesterday' (e.g., advancing generations of mobile phones) (Weston et al., 2004). The more affluent parents become, the more likely are they to revise their material ambitions upwards, the achievement of which can create quite severe financial pressures on relationships. For example, the basic need for shelter can be translated into an imperative to own a ‘McMansion'. Psychologists may have an increasing role in assisting parents and children to appreciate the difference between ‘needs' and ‘wants', to explore appropriate priorities in life and to see the impacts of these symptoms of ‘affluenza' on mental health and wellbeing.

Regardless of whether they are based on objective factors or changing social norms, economic pressures and opportunities tend to be important drivers of family trends. Low-skilled yet relatively high paid jobs for early school leavers have virtually disappeared, having been replaced by jobs entailing fixed-term contracts and part-time or causal hours, thereby providing limited economic security for many people. McDonald (2001) argues that this era of job insecurity has been accompanied by a strong economic cycle of ‘booms and busts' and fluctuating house prices, which have not only led young adults to invest in their education and career development, but have also encouraged couples to maintain dual incomes. The global financial crisis highlights the growing uncertainties that frame the economic context for families, bringing relationships under pressure and contributing to a changed context for family formation and other transitions.

Parents’ changing roles

Over the last few decades, the extent to which women participate in the labour market has reached an unprecedented level. In couple families with children, there has been a significant departure from the male-breadwinner and female home-maker model that characterised much of the 20th century.³

Unsurprisingly, meeting the competing demands from both work and family has its downside. Analyses of LSAC data (2004) show that many employed mothers and fathers with pre-school children reluctantly miss out on family activities because of their work commitments. In addition, around one-quarter indicated that their work made family life less enjoyable and more pressured. Further, the great majority of mothers who were working full-time reported that they often or always felt rushed or pressed for time (Baxter, et al., 2007). While families have always developed strategies to deal with the competing challenges they face, some may falter under this continued work-family strain. The spillover from work to family and from family to work can seriously erode individuals' capacities to cope, and result in relationship difficulties and impaired work performance that can either create or exacerbate mental health problems. Again, industrial and organisational psychologists, as well as family-focused practitioners, have a clear role here.

Relationship breakdown

As noted above, cohabitation has become increasingly prevalent. The proportion of children born outside marriage has increased dramatically, largely as a result of increasing cohabitation rates (Qu & Weston, 2008). However, cohabitation tends to be a fragile arrangement; most such arrangements end in either separation or marriage within the first five years of their commencement (Weston, Qu & de Vaus, 2008).

Although separation rates for marriages are lower than those for cohabitation, marital separation became considerably more common after the introduction of the Family Law Act 1975. Divorces became easier and faster to achieve. Relationship breakdown, separation and divorce create new sets of pressures. These include increased financial pressures (especially for women), distress associated with negotiating property settlements and care-time arrangements, the need to manage dashed hopes, grief and loss, the impact of the separation on the children, other parent, extended family and friends, and the possible need to relocate. Relocation itself is a major life strain that places considerable pressure on families, and especially on children.

Several authors have suggested that women's changing priorities have contributed to the fragility of relationships - changes that have their basis in an interaction of many factors, including weakening of the stigma attached to sole parenting, improved welfare payments, ability to maintain some level of financial independence, child support payments and so on. According to this argument, increasing importance is now placed on the quality of the relationship (see Qu & Soriano 2004). Maintenance of the couple relationship rests with its continuation to meet the emotional needs of the partners.

Many relationships, however, face other serious challenges. The ‘toxic trio' of family violence, mental health problems and substance misuse (and other addictions, such as gambling) place enormous pressures on relationships, often resulting in separation and divorce (e.g., see Kaspiew et al., 2009). These issues have profound effects on relationship quality, parenting behaviours and the psychological wellbeing of family members. They are by no means restricted to couples that separate. Similar issues have an impact on those who remain in dysfunctional relationships. Arguably, the latter group can be at greater risk than those who manage to leave the relationship. Again, psychologists have a clear role in addressing the complex problems confronting such couples, whether intact or separated. In considering the area of child protection, for example, Bromfield et al. (2010) conclude:

Families with multiple and complex problems are no longer a marginal group in service delivery. In fact, they have become the primary client group of modern child protection services. The challenge for child protection services is to respond holistically to address inter-related problems in order to better support families to make and sustain changes to better meet the needs of children. (p.1)

While these authors focus largely on child protection, the complexity they highlight regarding parenting and children's experiences and developmental outcomes has clear implications for practitioners, including those working in the areas of clinical, relationship and family psychology. Assisting clients to overcome or manage their psychological problems is a key element in helping them to move on.

Forging new lives

For those who have separated, ‘moving on' often involves re-partnering and step-parenting. While re-partnering of either parent can provide parents and children with many positive opportunities across a range of domains, it can also create complex relationship dynamics and be a trigger for conflict. In some cases, the demands for adjustment not only erode the wellbeing of all concerned, but also increase the risk of further relationship breakdown - and subsequent re-partnering. Overseas studies suggest that such circumstances create a great deal of complexity in children's lives and can seriously compromise their immediate and long-term adjustment and mental health (see Cherlin, 2008; Teachman, 2008). There is evidence that ‘serial partnerships' are increasing (Cherlin, 2008; Weston 2008), with obvious implications for psychologists. These include assisting parents to avoid ‘rushing into' a new relationship that carries similar fragilities to the one just left; helping those in step-families to adjust on many fronts; and facilitating non-resident parents to ‘cope' with the fact that their children now have another parent figure in their lives.

Conclusions

Pressures on families arise from many fronts and occur on a range of scales. They may reflect major external events, such as droughts, floods, or financial crises; less obvious but inexorable demographic and social changes; or more proximal, but no less important, issues that crop up in everyday life. Irrespective of their source and scale, they leave relationship residues.

Contemporary family life is more complex than in the past, reflecting the evolution and progress of societies. In advanced societies, meeting material needs is now easier than in earlier eras and each generation has become wealthier than the one that preceded it. While this may not always remain the case, it highlights the extent to which the problems confronting families extend to the relational and emotional, although money worries often lie at the heart of relationship difficulties and amplify psychological vulnerabilities.

Patterns of family transitions also point to an increasing role for psychologists in helping couples to cope with the pressures that change itself brings. Again, this highlights the need for more sophisticated supports for individuals and their relationships, including education, counselling and clinical interventions at multiple points in life. There is evidence that couples increasingly seek support from relationship services to help them resolve the difficulties they confront.4

Family law reform now frames the key issues as relational rather than merely legal. Given the ‘toxic trio' of violence, mental health and substance misuse that characterises many relationships that struggle or falter, therapeutic responses would seem to be more effective than either turning a blind eye or seeking an eye for an eye. Again, psychologists have a key contribution to make in breaking the cycle of relationship difficulties which, if unaddressed, will lead to further exacerbation of the patterns of mental health problems that now underpin the global burden of disease.

The principal author can be contacted via www.aifs.gov.au/institute/contact.php.


¹ For example, 60% of first unions for those born in the early 1970s or more recently began with cohabitation, compared with 56% of those born in1962-71, and 40% of those born in 1952-61. Of those who married in 2006, 76% indicated that they had cohabited before registering their marriage, compared with 65% in 1997. Of all women aged in their late 30s, 74% were partnered in 2006, compared with 77% in 1996, and 63% were in a registered marriage in 2006, down from 70% in 1996.

² For example, 67% of new mothers in 1963 were under 25 years old, compared with 27% of new mothers in 2007. By contrast, 58% of new mothers in 2007 were aged 25 to 34 years and 14% were at least 35 years.

³ For example, almost 50% of all couple families with children relied on a single breadwinner in 1983, whereas in 2009, 61% of couple parents had two jobs between them, with one full-time and one part-time being more common than two full-time jobs (applying to 36% and 25% respectively). In total, 30% of all couple parents had only one job between them.

4 In the General Population of Parents Survey 2009 undertaken by the Australian Institute of Family Studies, over one-quarter of parents who were living with a partner reported that they thought their relationship was in trouble at one stage and around half of these parents reported that they had turned to professionals for their relationship difficulties (Kaspiew et al., 2009). At least one in ten parents who had not experienced relationship difficulties with their current partner had sought professional help to support or strengthen their relationship

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InPsych February 2011