The document discusses psychopathology related to marriage and marital relationships. It addresses several topics: (1) Problems that can occur before marriage like marriage phobia, spinsterhood phobia, problematic love relationships, and hesitancy in choosing a partner. (2) Issues during the engagement period like managing contact with one's partner and establishing boundaries. (3) Challenges during the marriage process such as navigating relationships with the partner's family, financial planning, and tensions between one's own family and partner. The document provides an overview of mental health issues that can arise at different stages of marriage and the marital relationship.

1. Psychopathology of Marriage &
Marital Relationship
‫االضطرابات‬‫النفسية‬‫في‬‫الزوجية‬ ‫العالقات‬
ISMAIL SADEK
Lecturer of psychiatry
Faculty of medicine

2. • Satisfying marriages are valued by nearly
all adults in the United States.
• Indeed, marital satisfaction is one of the
largest correlates of life satisfaction.
• Moreover, distressing romantic
relationships are associated with poor
physical health and diminished well-being

3. The principal goal is to attain a more
comprehensive and refined understanding of the
role that marriage plays in mental health.
• (a) clarifying whether marital discord is a global risk
factor for the broad class of internalizing disorders,
• (b) examining the relative contributions of marital
dissatisfaction and specific relationship processes
during the transition into marriage to the
subsequent development of internalizing symptoms,
and
• (c) implementing a series of methodological
refinements

4. ‫ع‬ ‫النفسية‬ ‫باألمراض‬ ‫التشخيص‬ ‫يعتمد‬ ‫هل‬‫لى‬
‫وجو‬ ‫على‬ ‫يعتمد‬ ‫أم‬ ‫؟‬ ‫العالمية‬ ‫التصنيفات‬‫د‬
‫المرضى؟‬ ‫لدى‬ ‫المعاناة‬ ‫و‬ ‫النفسية‬ ‫األعراض‬

5. ‫عل‬ ‫يقوم‬ ‫النفسية‬ ‫باألمراض‬ ‫التشخيص‬ ‫هل‬‫ى‬
‫وجود‬ ‫يكفى‬ ‫أم‬ ‫بالجسم‬ ‫بيولوجى‬ ‫خلل‬ ‫وجود‬
‫الزواج؟‬ ‫مثل‬ ‫إجتماعية‬ ‫و‬ ‫نفسية‬ ‫أسباب‬

6. What is marriage?
•It is a social
behavior but
A touch of
sexual
behavior and
emotions are
components
of marriage
•‫لكنه‬ ‫و‬ ‫إجتماعى‬ ‫سلوك‬ ‫الزواج‬
‫الوظائف‬ ‫بعض‬ ‫على‬ ‫يحتوى‬
‫الس‬ ‫مثل‬ ‫األخرى‬ ‫الفسيولوجيا‬‫لوك‬
‫المشاعر‬ ‫و‬ ‫الجنسى‬

7. ‫الزواج‬ ‫دوافع‬
•‫ليه؟؟؟‬ ‫بنتزوج‬ ‫احنا‬

8. Marriage as an instinct
‫للزواج‬ ‫كدافع‬ ‫الغريزة‬
•marriage inevitably
involves the sexual,
impulse common to
all animals (biological
in origin), driven and
sustained by instincts
no different than
found in other
animals.
•‫و‬ ‫الزواج‬ ‫فى‬ ‫جنسى‬ ‫دافع‬ ‫هناك‬
‫كل‬ ‫فى‬ ‫بيولوجى‬ ‫دافع‬ ‫هو‬
‫الحية‬ ‫الكائنات‬

9. ‫للزواج‬ ‫أخرى‬ ‫دوافع‬
•Marriage as Means
of Production
•Marriage as an
Ethical Bond
•Marriage as an
economic bond
•Marriage a social
bond
•Marriage as a
religious bond
•‫لإلنجاب‬ ‫وسيلة‬ ‫الزواج‬
•‫أخالقية‬ ‫رابطة‬ ‫الزواج‬
•‫إقتصادية‬ ‫رابطة‬ ‫الزواج‬
•‫رابط‬ ‫الزواج‬‫إجتماعى‬
•‫رابطة‬ ‫و‬ ‫دينى‬ ‫مطلب‬ ‫الزواج‬
‫دينية‬

10. Why important?
• The issue of the
breakdown of the
marriage bond has
become a routine
object of social and
moral concern,
political and public
debate.
•‫الزواج‬ ‫باثولوجيا‬ ‫عن‬ ‫الحديث‬
‫نس‬ ‫إرتفاع‬ ‫إلى‬ ‫أهميته‬ ‫يرجع‬‫ب‬
‫فى‬ ‫الزوجية‬ ‫الحياة‬ ‫إنهيار‬
‫األخيرة‬ ‫السنوات‬

11. Why important?
• This is striking, given
that in most non-
western cultures still,
marriage has been
insisted upon as the
required
precondition for the
mating of men and
women as the act
that initiates and
sustains the family
•‫الشرقي‬ ‫الثقافات‬ ‫فى‬ ‫الزواج‬‫هو‬ ‫ة‬
‫األ‬ ‫لتكوين‬ ‫الوحيدة‬ ‫الوسيلة‬‫سر‬
‫الجنسية‬ ‫الحياة‬ ‫وممارسة‬
‫واإلنجاب‬.

12. Changes of the concept &
collapse of 'traditional family
values'
• The rate of divorce
soars beyond one out
of every two.
• The incidence of
single parenthood,
has increased by
scary level.
•‫إلى‬ ‫تصل‬ ‫الطالق‬ ‫نسب‬50%
‫البالد‬ ‫بعض‬ ‫فى‬
•‫فى‬ ‫المعيلة‬ ‫المرأة‬ ‫نسبة‬
‫بش‬ ‫تزداد‬ ‫العربية‬ ‫المجتمعات‬‫كل‬
‫كبير‬

13. Changes of the concept &
collapse of 'traditional family
values'
• non-marital sexual
activity, far from
socially destructive or
morally improper has
come to be regarded
as itself an
expression of
freedom.
•‫إنهي‬ ‫من‬ ‫الغربى‬ ‫العالم‬ ‫يعانى‬‫ار‬
‫بسبب‬ ‫أخالقى‬ ‫و‬ ‫إجتماعى‬
‫عن‬ ً‫ا‬‫بعيد‬ ‫الجنسية‬ ‫الحرية‬
‫التقليدى‬ ‫الزواج‬

14. Western countries
• It has become common
for couples not to
bother with marriage at
all, to marry only after
years of living together
on other terms, to set
preconditions under
which the marriage is to
be tolerated, to agree
that the marriage
remain 'open'(loving
relationship).
•‫الرفق‬ ‫يتزوج‬ ‫ما‬ ‫عادة‬ ‫الغرب‬ ‫فى‬‫اء‬
ً‫ا‬‫سوي‬ ‫المعيشة‬ ‫من‬ ‫سنوات‬ ‫بعد‬‫و‬
‫اإلستمرارية‬ ‫تضمن‬ ‫بشروط‬

15. In Arab Culture
• Marriage is a wish,
drive, motive and
everything.
• However,
– it is a temporary
contract
– It is optional
•‫وكل‬ ‫وأمنية‬ ‫رغبة‬ ‫هو‬ ‫الزواج‬
‫الدوافع‬
•‫إختيارى‬ ‫و‬ ‫مؤقت‬ ‫عقد‬ ‫الزواج‬

16. Psychopathology
• Although marriage is
not found in ICD-10 or
DSM-V, A lot of cases
in private clinics are
related to this topic
• In most of cases , it is
an adjustment
disorder
• Some other
diagnoses may be
encountered
•‫يوج‬ ‫ال‬ ‫و‬ ً‫ا‬‫مرض‬ ‫ليس‬ ‫الزواج‬‫د‬
‫لألم‬ ‫العالمية‬ ‫بالتصنيفات‬‫راض‬
‫النفسية‬
•‫كبير‬ ‫نسبة‬ ‫ذلك‬ ‫من‬ ‫بالرغم‬ ‫و‬‫ة‬
‫تراجع‬ ‫التى‬ ‫الحاالت‬ ‫من‬
‫ت‬ ‫النفسيين‬ ‫األطباء‬ ‫عيادات‬‫عانى‬
‫الزواج‬ ‫من‬

17. Outlines
• Before marriage
• During marriage
process
• During marriage
• After marriage
•‫الزوا‬ ‫قبل‬ ‫النفسية‬ ‫المشاكل‬‫ج‬
•‫خطو‬ ‫أثناء‬ ‫النفسية‬ ‫المشاكل‬‫ات‬
‫الزواج‬
•‫الزو‬ ‫أثناء‬ ‫النفسية‬ ‫المشاكل‬‫اج‬
•‫الزواج‬ ‫بعد‬ ‫النفسية‬ ‫المشاكل‬

18. ‫الزواج‬ ‫قبل‬ ‫ما‬ ‫مشاكل‬
‫الزواج‬ ‫فوبيا‬
‫العنوسة‬ ‫فوبيا‬
‫العاطفية‬ ‫العالقات‬
‫اإلختيار‬ ‫فى‬ ‫التردد‬
‫للزواج‬ ‫مرضية‬ ‫دوافع‬

19. MarriagePhobia
1-‫الزواج‬ ‫فوبيا‬
Before marriage
‫الزواج‬ ‫قبل‬

20. Before marriage
‫الزواج‬ ‫قبل‬
•Spinsterhood
phobia: Excessive
preoccupations and
anxiety
•2-‫العنوسة‬ ‫فوبيا‬:
–‫الزواج‬ ‫فى‬ ‫متواصل‬ ‫تفكير‬
–‫توتر‬ ‫و‬ ‫قلق‬
–‫تسرع‬ ‫و‬ ‫إستعجال‬

21. 3-‫العاطفية‬ ‫العالقات‬
•Love from one side
•Loving relationship
•Broken loving
relationship
•Love and others
•Love is never enough
•‫واحد‬ ‫جانب‬ ‫من‬ ‫الحب‬
•‫مشاكله‬ ‫و‬ ‫العاطفية‬ ‫العالقات‬‫ا‬
•‫العاطفية‬ ‫العالقة‬ ‫إنهيار‬
•‫أخرى‬ ‫اشياء‬ ‫و‬ ‫الحب‬:
‫يكفى‬ ‫ال‬ ‫وحده‬ ‫الحب‬

22. Broken love
Young men are playing

23. Before marriage
•Hesitancy:
–How to assess the
partner?
–When to accept and
when to refuse?
hesitancy
•4-‫التردد‬:
–‫البنت‬ ‫و‬ ‫األسرة‬ ‫تقيم‬ ‫كيف‬
‫الخطيب؟‬
–‫م‬ ‫و‬ ‫تقبل‬ ‫متى‬ ‫و‬ ‫التردد‬ ‫مشكلة‬‫تى‬
‫ترفض؟‬

24. Pathological Motivation to marriage
‫للزواج‬ ‫مرضية‬ ‫دوافع‬
•‫التسلط‬
•‫الغيرة‬

25. ‫الزواج‬ ‫خطوات‬ ‫أثناء‬ ‫النفسية‬ ‫المشاكل‬

26. Contact during engagement
‫الخطبة‬ ‫فترة‬ ‫أثناء‬ ‫العالقات‬
• Contact with partner (
social, emotional,
physical etc)
• Limits and red lines
•‫الخطيب‬ ‫مع‬ ‫التواصل‬:
–‫إجتماعية‬
–‫عاطفية‬
–‫جسدية‬
•‫الحمراء‬ ‫الخطوط‬ ‫و‬ ‫الحدود‬

27. During marriage process
• Relationship with
family of the partner
• Financial
management of the
process
• Debate: My family
very my partner
• Time table and
progress
•‫الخطيب‬ ‫أسرة‬ ‫مع‬ ‫العالقات‬
•‫الزواج‬ ‫قبل‬ ‫المالية‬ ‫اإلدارة‬
•‫الشهير‬ ‫الصراع‬:‫أم‬ ‫أسرتى‬
‫خطيبى‬
•‫إلجراءات‬ ‫الزمنى‬ ‫الجدول‬
‫الزواج‬

28. During marriage
‫الزواج‬ ‫أثناء‬

29. ‫الزواج‬ ‫مراحل‬
.1‫المؤدب‬ ‫التفاعل‬
.2‫العاصف‬ ‫التفاعل‬
.3‫المتعاون‬ ‫التفاعل‬

30. ‫الزواج‬ ‫مراحل‬

31. After marriage
•Building up a
relationship
–Emotional
–Social
–Sexual
–Economical
–Authority and power
distance
•‫العالقات‬ ‫بناء‬ ‫فى‬ ‫مشاكل‬
–‫العاطفية‬
–‫اإلجتماعية‬
–‫الجنسية‬
–‫اإلقتصادية‬
–‫السلطة‬

32. ‫العاطفية‬ ‫العالقة‬ ‫مشاكل‬
•‫دون‬ ‫لطرف‬ ‫الشديدة‬ ‫الرومانسية‬ ‫بسبب‬ ‫مشاكل‬ ‫تحدث‬ ‫قد‬
‫اآلخر‬
•‫ا‬ ‫ميل‬ ‫و‬ ‫للعاطفة‬ ‫النساء‬ ‫ميل‬ ‫بسبب‬ ‫المشاكل‬ ‫تحدث‬ ‫قد‬‫لرجال‬
‫اآلخر‬ ‫لطبيعة‬ ‫منهما‬ ً‫ال‬‫ك‬ ‫فهم‬ ‫عدم‬ ‫و‬ ‫للمنطق‬
•‫المرضية‬ ‫الغيرة‬

33. ‫اإلجتماعية‬ ‫العالقة‬ ‫مشاكل‬
•‫هم‬ ‫أو‬ ‫أنا‬ ‫إما‬(‫أسرته‬)
•‫الحماة‬ ‫مع‬ ‫العالقة‬
•‫األوالد‬ ‫تأثير‬

34. ‫الجنسية‬ ‫العالقة‬ ‫مشاكل‬
•‫الطرفين‬ ‫لدى‬ ‫جنسية‬ ‫ثقافة‬ ‫وجود‬ ‫عدم‬
•‫للزواج‬ ‫األولى‬ ‫الفترة‬ ‫فى‬ ‫العالقة‬ ‫إنضباط‬ ‫عدم‬
•‫اآلخر‬ ‫الطرف‬ ‫على‬ ‫طرف‬ ‫رغبة‬ ‫زيادة‬
•‫غيره‬ ‫أو‬ ‫األوالد‬ ‫أو‬ ‫بالعمل‬ ‫الطرفين‬ ‫احد‬ ‫إنشغال‬
•‫المختلفة‬ ‫الجنسية‬ ‫الثقافة‬
•‫الحرام‬ ‫و‬ ‫بالحالل‬ ‫الجهل‬
•‫الحديثة‬ ‫التكنولوجيا‬ ‫تاثير‬
•‫الطرفين‬ ‫لدى‬ ‫الشكلية‬ ‫التغيرات‬ ‫تأثير‬

35. ‫الطرفين‬ ‫لدى‬ ‫الشكلية‬ ‫التغيرات‬

36. ‫اإلقتصادية‬ ‫العالقة‬ ‫مشاكل‬
•‫الشديد‬ ‫اإلسراف‬
•‫الشديد‬ ‫البخل‬
•ً‫ا‬‫إيجاب‬ ‫و‬ ً‫ا‬‫سلب‬ ‫العالقات‬ ‫باقى‬ ‫على‬ ‫العالقة‬ ‫هذه‬ ‫تؤثر‬

37. ‫الزوجين‬ ‫بين‬ ‫السلطة‬ ‫مشاكل‬
•‫السلطوى‬ ‫الزوج‬
•‫العنيد‬ ‫الزوج‬
•‫الطرفين‬ ‫احد‬ ‫لدى‬ ‫خفى‬ ‫هدف‬ ‫وجود‬
•‫التفاوض‬ ‫مهارات‬ ‫غياب‬
•‫الطرفين‬ ‫بين‬ ‫المهام‬ ‫و‬ ‫العمل‬ ‫تقسيم‬

38. Rigidity

39. Hidden agenda

40. Negotiation skills

41. Marriage is a heavy duty

42. ‫الطرفين‬ ‫بين‬ ‫المهام‬ ‫و‬ ‫العمل‬ ‫تقسيم‬

43. Home authority

44. ‫الزواج‬ ‫إنتهاء‬ ‫بعد‬ ‫مشاكل‬

45. Death of spouse
‫الزوجة‬ ‫أو‬ ‫الزوج‬ ‫وفاة‬
•‫يعد‬ ‫بالزواج‬ ‫مقترنه‬ ‫نفسية‬ ‫مشاكل‬ ‫من‬ ‫سبق‬ ‫ما‬ ‫بالرغم‬‫وفاة‬
‫يلقى‬ ‫و‬ ‫اإلنسان‬ ‫على‬ ‫الضغوط‬ ‫أقسى‬ ‫من‬ ‫الزوجة‬ ‫أو‬ ‫الزوج‬
‫المتب‬ ‫على‬ ‫اإلجتماعية‬ ‫و‬ ‫النفسية‬ ‫المشاكل‬ ‫من‬ ‫بالعديد‬‫منهما‬ ‫قى‬
–‫عاطفية‬ ‫مشاكل‬
–‫إجتماعية‬ ‫مشاكل‬
–‫إقتصادية‬ ‫مشاكل‬
–‫جنسية‬ ‫مشاكل‬

46. Divorce
‫الطالق‬
–‫عاطفية‬ ‫مشاكل‬
–‫إجتماعية‬ ‫مشاكل‬
–‫إقتصادية‬ ‫مشاكل‬
–‫جنسية‬ ‫مشاكل‬
–‫األوالد‬ ‫مشاكل‬

47. Divorce and children

48. Explanations for relation between
marriage and psychopathology
A. Selection Hypothesis
Less healthy cannot sustain marriage; healthier can
Schizophrenics and alcoholics high rates of never
getting married

49. B. Causation Hypothesis
Marriage is said to be either the cause of or protects
against psychopathology
Benefits for married, but... Not true for women?
Suspect gender role specificity rather than biological
factors
Effects of major change in marital status (e.g.,
divorce)

50. C. Treatment Utilization Hypothesis
Factors associated with differential utilization
Data are confounded by differential utilization of
mental health services; for example, after death of
a spouse we might find more women on average
seeking some treatment

51. Theoretical Perspectives Linking Personal
Attributes to Intimate Relationships
Theoretical approaches to relationships have been
broadly distinguished as either:
• Intrapersonal approaches consider how individual
differences in either personality or psychopathology
are associated with relationship functioning.
• Interpersonal approaches focus on how behavioral
interactions between partners are associated with
relationship quality and stability.

52. Marriage as a Risk Factor for
Internalizing Disorders
• Based on Lawrence and colleagues’ work and existing research
demonstrating links between marital processes and psychopathology,
four relationship processes were identified as particularly relevant to
the present study:
1. Conflict/problem-solving interactions: frequency and length
of arguments; behaviors engaged in during conflicts;
presence, level and severity of aggression or withdrawal
during arguments; emotions and behaviors during
arguments; recovery strategies after arguments

53. Marriage as a Risk Factor for
Internalizing Disorders
2.Support transactions: quality of support when
one partner is feeling down or has a problem;
match between desired and received levels of
support; whether support is offered in a positive
or negative manner; mutuality of support
provided and received across both partners

54. Marriage as a Risk Factor for
Internalizing Disorders
3. Emotionally intimate transactions: mutual sense of
closeness, warmth, interdependence and affection; comfort
being emotionally vulnerable; comfort being oneself with
partner; quality of self-disclosures; friendship;
demonstrations of love and affection (verbal and physical
expressions)
4. Balance of power and control in the relationship:
couple's ability to negotiate control across a variety of areas
(e.g., scheduling one's own day, finances); treatment of
each other as competent, independent adults; a/symmetry
in decision-making and power

55. Conclusion
• Counseling before ,
during and after
marriage is a priority
in psychological and
social services
•‫أثنا‬ ‫و‬ ‫قبل‬ ‫النفسى‬ ‫اإلرشاد‬‫و‬ ‫ء‬
‫و‬ ‫ضرورة‬ ‫اصبح‬ ‫الزواج‬ ‫بعد‬
‫النف‬ ‫الصحية‬ ‫للخدمات‬ ‫أولوية‬‫سية‬
‫اإلجتماعية‬ ‫و‬

56. •‫بالزواج‬ ‫الخاصة‬ ‫المرضية‬ ‫المشاكل‬ ‫بعض‬ ‫إضافة‬ ‫يجب‬
‫النفسية‬ ‫لألمراض‬ ‫العالمية‬ ‫بالتصنيفات‬‫الزواج‬ ‫إضافة‬ ‫أو‬
‫النفسية‬ ‫األمراض‬ ‫من‬ ‫العديد‬ ‫لحدوث‬ ‫قوى‬ ‫كمثير‬
•‫ال‬ ‫للتقسيمات‬ ‫المضافة‬ ‫النفسية‬ ‫األمراض‬ ‫من‬ ‫الكثير‬‫بها‬ ‫يوجد‬
‫بيولوجى‬ ‫خلل‬
•‫يكو‬ ‫أن‬ ‫يجب‬ ‫العالج‬ ‫و‬ ‫التشخيص‬ ‫فى‬ ‫األساسى‬ ‫المرجع‬‫ن‬
‫البا‬ ‫علم‬ ‫دراسة‬ ‫يجب‬ ‫بالتالى‬ ‫و‬ ‫النفسية‬ ‫المعاناة‬ ‫وجود‬‫ثولوجيا‬
‫النفسية‬