Comparing the effects of a mindfulness versus relaxation intervention on romantic relationship wellbeing: No significant differences

Comparing the effects of a mindfulness versus relaxation intervention on romantic relationship wellbeing. Johan C. Karremans, Gesa Kappen, Melanie Schellekens & Dominik Schoebi. Scientific Reports volume 10, Article number: 21696 (2020). Dec 10 2020. https://www.nature.com/articles/s41598-020-78919-6

Abstract: There is increasing scientific interest in the potential association between mindfulness and romantic relationship wellbeing. To date, however, experimental studies using active control groups and testing dyadic effects (i.e. examining both actor and partner effects) are lacking. In the current study, romantically involved individuals engaged for 2 weeks daily in either guided mindfulness exercises, or guided relaxation exercises. Participants, and their partners, completed measures of relationship wellbeing at pre- and post-intervention, and at 1-month follow up. The mindfulness intervention significantly promoted relationship wellbeing, for both participants (i.e. actor effects) and their partners (i.e. partner effects). However, these findings did not significantly differ from changes in relationship wellbeing in the relaxation condition. Theoretical implications of these findings for understanding the association between mindfulness and romantic relationship wellbeing are discussed. Moreover, the findings are discussed in light of recent debates about the relative lack of proper control groups in mindfulness research.

General discussion

Does mindfulness promote the wellbeing of romantic relationships? The possible causal effect of mindfulness training on romantic relationships has received very little empirical attention so far. After 2 weeks of daily guided mindfulness practice, participants in the mindfulness intervention group reported significantly higher levels of relationship satisfaction, lower relationship distress, felt more connected to the partner, and were more accepting towards the partner (but not more excited about their relationship). These effects were maintained 1 month after the intervention. Their partners, who did not engage in mindfulness practice, also reported higher relationship satisfaction, less distress, and felt more accepted by their partners (but not more connected; and they reported actually less relationship excitement, a finding we further discuss below). In general, these findings may be considered as promising for the effectiveness of mindfulness intervention in promoting relationship wellbeing. A similar pattern of findings, however, was found in the active control condition. Participants who received a daily guided relaxation intervention for 2 weeks showed similar relationship benefits (in fact, they showed significantly more positive change in partner acceptance, and positive change in relationship excitement), as did their partners. Thus, while the current findings suggest that the daily practice of mindfulness generally can lead to various beneficial relationship outcomes, relaxation practice on a daily basis yielded comparable outcomes.

What is an adequate interpretation for these findings? First, these results might simply mean that any intervention, similar in structure, would positively affect self-reports of relationship wellbeing (sometimes referred to as a trial effect58). For example, the intervention may have prompted participants to reflect on their relationship, which could have promoted positive feelings and thoughts about the relationship (although in theory it might also do the opposite, of course). Also, engaging in an intervention could have led participants to report desired rather than actual outcomes. The fact that intervention participants showed similar changes in both conditions, across most relationship outcome measures, and that their partners showed similar changes (except regarding relationship excitement), makes this a possible interpretation of the current findings.

An alternative interpretation might be that the relationship benefits may be genuine, both in the mindfulness as well as relaxation intervention. In the introduction, we discussed several theoretical reasons why mindfulness may promote relationship wellbeing (for more details10), and the results in the mindfulness group may reflect such theorized effects. Similarly, the results obtained in the relaxation group may reflect true relationship benefits of daily relaxation exercises. For example, daily relaxation might reduce overall psychological and physiological stress levels, which in turn might positively affect how people behave and respond to their partners18,59. Accordingly, both mindfulness and relaxation intervention may have promoted relationship wellbeing, but possibly through different mechanisms. The obtained effects in both groups, however, also may have been caused by a similar ‘relaxation mechanism.’ While mindfulness is theoretically distinguishable from relaxation, in reality it is possible that the mindfulness exercises in our study increased feelings of relaxation to a similar extent as the relaxation exercises. As noted previously60, the historical development of (mindfulness) meditation and relaxation techniques as therapeutic strategies in the past century show substantial overlap, and indeed one of the challenges of studying the effects of mindfulness is to distinguish them from ‘mere’ relaxation effects61.

It could be theorized that longer mindfulness training is required to promote relationship wellbeing above and beyond effects of relaxation. Participants practiced mindfulness for 2-weeks, engaging in a relatively short guided mindfulness meditation each day. While such relatively short mindfulness interventions have revealed significant effects on various outcome measures42,43,44 (but rarely have been compared with active control groups), effects of mindfulness practice may occur and generalize to real life outcomes only after more extensive training, when paying non-judgmental attention becomes a more or less automatic manner of relating to one’s experiences62,63. How people cope with and respond to their experiences is the result of a lifelong process, and therefore difficult to ‘re-program’64,65. Likewise, particularly in long-term romantic relationships, interaction patterns between partners and appraisals about the relationship tend to become habitual, and are therefore difficult to change in the short run66. Thus, what the ‘dosage’ of mindfulness practice should be to potentially promote relationship wellbeing, and how much for whom, requires more research.

The results regarding relationship excitement revealed a somewhat different pattern than the other relationship outcome measures. There was no significant change in relationship excitement in the mindfulness group among intervention participants. This finding seems inconsistent with previous findings by Carson and colleagues, who found increases in relationship excitement after a mindfulness intervention35. The present results may suggest that it was not mindfulness per se leading to such changes in their study, but the fact that both partners engaged in their intervention may have explained an increase in relationship excitement. Interestingly, in the current study the partners of the mindfulness intervention participants actually reported significant declines in relationship excitement. We have previously speculated that there may be theoretical reasons to predict such declines13. For example, mindfulness may be associated with reductions in impulsivity, a potentially important source of relationship excitement67. This finding awaits future research and replication.

The results of the current study speak to the broader issue of the need for proper active control conditions in mindfulness research. A substantial percentage of research on mindfulness is lacking active control conditions, using waiting list controls, or examining changes in a variable of interest from pre- and post-mindfulness intervention68,69. Such studies can be informative to see whether mindfulness intervention is associated with any changes on variables of interest, or for example to study moderators of any effects of mindfulness intervention (e.g. for whom it does and does not ‘work’). Although the inclusion of an active control condition made the current findings perhaps more ambiguous and difficult to interpret, it highlights the importance of studying whether changes associated with mindfulness intervention can be attributed uniquely to mindfulness. In many previous articles on mindfulness research, the conclusion that mindfulness positively affects a certain outcome of interest is often unwarranted when an active control group is lacking32,40. The current findings raised a number of issues (as discussed above) that may remain unaddressed when control conditions are lacking, underscoring the need for active control groups to get a more nuanced and more comprehensive understanding of mindfulness and its effects, both for the individual and the relationship.

Similarly, the current findings have implications for couple intervention research more broadly. In the past decades, researchers have examined effects of various prevention and intervention couple programs. Some programs have obtained significant relationship benefits in the short- and longer-term70,71, others obtained negative outcomes (e.g. increased awareness that one is lacking relationship skills72, but often waiting list control groups are used to compare intervention outcomes. Relatively few studies used comparisons with active control groups, and if they did, similar effects have been found between target and control intervention groups73. Thus, there is a need for proper control interventions in order to examine relationship interventions more rigorously.

Before closing, some limitations should be noted. First, all outcome measures were self-reports, and future studies should include more objective measures of relationship functioning and wellbeing, such as observational coding of partner interactions, and/or physiological assessments of (relationship) distress. Second, as noted already, the interventions were relatively short. For example, examining the effects of longer protocolized interventions65, such as the mindfulness-based stress-reduction program on relationship outcomes, while including an active control intervention, would be a logical and important next step. Similarly, examining associations between length and frequency of mindfulness practice and relationship outcomes would be a valuable and complementary approach. Finally, a potential limitation of the current study is that the intervention in the current research targeted one member of the couple. While it is a theoretically interesting question whether the cultivation of mindfulness in one individual transfers to the relationship partner, mindfulness intervention might be more effective when both partners engage in the intervention.

The present study was the first to examine the causal impact of mindfulness training on romantic relationship outcomes using an active control group and testing both actor and partner effects, thereby extending previous research that has linked romantic relationship wellbeing mainly to self-report measures of mindfulness. The current study does not give definitive answers to the question whether or not mindfulness can causally affect relationship wellbeing, but does provide a compelling example of why research on mindfulness interventions would benefit from a wider use of active control groups, hopefully offering a springboard for future research.