February 20, 2000 Copyright 2000 The New York Times Company When It Pays to Argue With a Spouse By ERIC NAGOURNEY There are those who may think it is something out of an Edward Albee play, or maybe "The Newlywed Game" meets Jerry Springer. But for the couple tired of flowers, chocolates and renting Nora Ephron films, it could just be another way to celebrate their love. Researchers at Ohio State University are placing volunteer married couples in a hospital room for two 24-hour sessions, inflicting small wounds and then encouraging the couple to chat about anything from in-laws to their sex lives. Then they take regular samples of blood, saliva and sometimes fluid from the wounds. Though it seems like "get the guests" -- the venomous game in Albee's "Whose Afraid of Virginia Woolf?" -- taken to new extremes, serious science is going on. The exercise is one of a series of studies at the university that are taking a look at how emotions affect healing, for better or worse. And the results may help change how surgery patients are treated, among other things.    The experiment and related research are taken so seriously that the National Institutes of Health recently gave grants totaling $18 million to studies at Ohio State's Institute for Behavioral Medicine Research. The couple behind the studies, Dr. Janice Kiecolt-Glaser, a psychiatrist, and her husband, Dr. Ronald Glaser, an immunologist, are in the growing field of psychoneuroimmunology, which explores mind-body issues as they relate to health. Already they have found strong evidence that stress can not only make it harder to recover from illness, but also make a person more susceptible to it. But the thing about the Glasers' experiment that seems to interest people the most is not the science, but simply how the volunteers feel. And they seem especially interested in those little wounds given at the outset of each session, which include blisters administered on the forearm with a small suction device called a chamber. "It sounds terrible, I know, when you hear about it," said Dr. Kiecolt-Glaser, who said she and her husband had both been "chambered" several times. "But it's not. It's like someone gently pinching your arm." The arguing is not that bad, either, she said, adding that the goal was not to provoke 24 hours of disharmony. The couples, who are paid $1,800 and must consider themselves happily married, are asked to discuss a contentious issue (identified in earlier discussions) for only a half hour during the second session. During the first session, they are asked to talk about more neutral aspects of their relationship, like how they met (although this, too, can lead to conflict). Over the next 24 hours, researchers draw fluids to check for levels of hormones like cortisol, which indicates stress, as well as healing agents like leukocytes. Later, they correlate their findings with a videotape taken of the entire session to see when the stress points were. In the past, the researchers have studied wound healing in other people considered to be under stress, among them medical students and people who care for Alzheimer's patients, and found that their healing mechanisms were impaired. But in those cases, they had to settle for people who reported being under stress. Bound by ethics, the researchers could not design experiments in which human subjects, unlike animal studies, were placed under deliberate psychological pressure. Then some years ago, the Ohio scientists, drawn by the stress that naturally occurs in relationships and the ability to measure it physically in a lab setting, thought of using married couples. "We wanted to take a real-life situation that was filled with a lot of emotion and a lot of history," said Dr. William B. Malarkey, an internist who is involved in the studies. At first, the married couples were not given wounds, but simply studied to see how their immune and other biological systems were affected as they argued. The latest experiment is the first in which the volunteers are given either blisters or small wounds called punch-biopsies. The researchers hope to study about 100 couples, which could take several years. Glaser said the findings could help convince hospitals that reducing stress can improve patient care and even shorten their stays, which would lower costs. Although much has already been written about the dangers of stress, he said he wanted to establish clearly the connection between it and wound healing. "The medical community is a very conservative community," he said, "and it takes a while to convince people."

Return