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Letting go of grudges and bitterness has proven to help a persons state of mind by
▫️ Improving mental and heart health
▫️Stronger immune system
▫️Less anxiety, stress, and hostility
▫️Lower blood pressure
▫️Healthier relationships

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Forgiveness: Letting go of grudges and bitterness

When someone you care about hurts you, you can hold on to anger and resentment - or embrace forgiveness and move forward.
By Mayo Clinic Staff
Who hasn't been hurt by the actions or words of another? Perhaps a parent constantly criticized you growing up, a colleague sabotaged a project or your partner had an affair. Or maybe you've had a traumatic experience, such as being physically or emotionally abused by someone close to you. These wounds can leave lasting feelings of resentment, bitterness and anger - sometimes even hatred.

But if you hold on to that pain, you might be the one who pays most dearly. By embracing forgiveness, you also can embrace peace and hope. Consider how forgiveness can lead you down the path of physical, emotional and spiritual well-being.

What is forgiveness?

Forgiveness means different things to different people. But in general, it involves an intentional decision to let go of resentment and anger.

The act that hurt or offended you might always be with you. But working on forgiveness can lessen that act's grip on you. It can help free you from the control of the person who harmed you. Sometimes, forgiveness might even lead to feelings of understanding, empathy and compassion for the one who hurt you.

Forgiveness doesn't mean forgetting or excusing the harm done to you. It also doesn't necessarily mean making up with the person who caused the harm. Forgiveness brings a kind of peace that allows you to focus on yourself and helps you go on with life.

What are the benefits of forgiving someone?

Letting go of grudges and bitterness can make way for improved health and peace of mind. Forgiveness can lead to:

Healthier relationships.

Improved mental health.

Less anxiety, stress and hostility.

Fewer symptoms of depression.

Lower blood pressure.

A stronger immune system.

Improved heart health.

Improved self-esteem.

Why is it so easy to hold a grudge?

Being hurt by someone, particularly someone you love and trust, can cause anger, sadness and confusion. If you dwell on hurtful events or situations, grudges filled with resentment and hostility can take root. If you allow negative feelings to crowd out positive feelings, you might find yourself swallowed up by bitterness or a sense of injustice.

Some people are naturally more forgiving than others. But even if you tend to hold a grudge, almost anyone can learn to be more forgiving.

What are the effects of holding a grudge?

If you struggle with finding forgiveness, you might:

Bring anger and bitterness into new relationships and experiences.

Become so wrapped up in the wrong that you can't enjoy the present.

Become depressed, irritable or anxious.

Feel at odds with your spiritual beliefs.

Lose valuable and enriching connections with others.

How do I move toward a state of forgiveness?

Forgiveness is a commitment to change. It takes practice. To move toward forgiveness, you might:

Recognize the value of forgiveness and how it can improve your life.

Identify what needs healing and who you want to forgive.

Join a support group or see a counselor.

Acknowledge your emotions about the harm done to you, recognize how those emotions affect your behavior, and work to release them.

Choose to forgive the person who's offended you.

Release the control and power that the offending person and situation have had in your life.

What happens if I can't forgive someone?

Forgiveness can be hard, especially if the person who hurt you doesn't admit wrongdoing. If you find yourself stuck:

Practice empathy. Try seeing the situation from the other person's point of view.

Ask yourself about the circumstances that may have led the other person to behave in such a way. Perhaps you would have reacted similarly if you faced the same situation.

Reflect on times when others have forgiven you.

Write in a journal, pray or use guided meditation. Or talk with a person you've found to be wise and compassionate, such as a spiritual leader, a mental health provider, or an impartial loved one or friend.

Be aware that forgiveness is a process. Even small hurts may need to be revisited and forgiven again and again.

Does forgiveness guarantee reconciliation?

If the hurtful event involved someone whose relationship you value, forgiveness may lead to reconciliation. But that isn't always the case.

Reconciliation might be impossible if the offender has died or is unwilling to communicate with you. In other cases, reconciliation might not be appropriate. Still, forgiveness is possible - even if reconciliation isn't.

What if the person I'm forgiving doesn't change?

Getting another person to change isn't the point of forgiveness. It's about focusing on what you can control in the here and now. Think of forgiveness more about how it can change your life by bringing you peace, happiness, and emotional and spiritual healing. Forgiveness can take away the power the other person continues to have in your life.

What if I'm the one who needs forgiveness?

The first step is to honestly assess and acknowledge the wrongs you've done and how they have affected others. Avoid judging yourself too harshly.

If you're truly sorry for something you've said or done and want forgiveness, consider reaching out to those you've harmed. Speak of your sincere sorrow or regret. Ask for forgiveness without making excuses.

You can't force someone to forgive you. Others need to move to forgiveness in their own time. Remember, forgiveness is a process. Whatever happens, commit to treating others with compassion, empathy and respect.

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Show references

1. Rakel D, ed. Forgiveness. In: Integrative Medicine. 4th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Nov. 2, 2022.

2. Forgiveness can improve mental and physical health. American Psychological Association. https://www.apa.org/monitor/2017/01/ce-corner.aspx. Accessed Nov. 2, 2022.

3. Silva RS, et al. Forgiveness facilitation in palliative care: A scoping review. JBI Evidence Synthesis. 2020; doi:10.11124/JBISRIR-D-19-00286.

4. Martinez-Diaz P, et al. Victim's perspective of forgiveness seeking behaviors after transgressions. Frontiers in Psychology. 2021; doi:10.3389/fpsyg.2021.656689.

See more In-depth

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When someone you care about hurts you, you can hold on to anger and resentment - or embrace forgiveness and move forward. By Mayo Clinic Staff Who hasn't been hurt by the actions or words of another? Perhaps a parent constantly criticized you growing up, a colleague sabotaged a project or your partner had an affair.

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When talking about death you start to mentally prepare yourself for future obsticles.
▫️Improves mental stability
▫️Decreases stress and anxiety
▫️Identifies the idea of after death problems
▫️Connects you and the person with there feelings

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Talking about death is hard. The loss of a loved one can be one of the most overwhelmingly painful experiences of life.

A large part of this pain, quite naturally, is caused by the absence of one who was cherished. However, part of the pain of grief consists of the loneliness and fear that also often accompany death.

Frequently, those who grieve find that the people around them do not want to talk about, or that people's empathy and support begin to fade after a few months.

At the same time, the mourner often feels a need to share their continued sadness, or to talk about the person who is now gone.

The result is often a loss of social networks and a sense of isolation as people withdraw (or appear to withdraw) from the mourner.

Why do we have such a difficult time talking about death and what can we do about it?

Avoiding Conversations About Death

Avoiding conversations about death and dying has a psychological basis.

And what psychologists and other experts point out is that, while not talking about death is natural, it is those very conversations that can hold the key to healing from grief.

People naturally avoid talking about death because the subject reminds them of their own mortality.

Discussing the passing of another, therefore, can make death feel uncomfortably close, and can make people feel helpless to contribute to the mourner's healing.

Death is an uncomfortable topic for many people because it reminds them that they too will die someday, perhaps sooner than they wish.

Psychologists use the term "terror management theory" to refer to the fear that people experience when thinking about their own death, and the actions they take to avoid the subject.

Terror management theory says that people naturally engage in behaviour that minimizes the need to reflect on the terror-inducing fact that they will die.

The passing of someone, and the intense grief experienced by that person's loved ones, can make death feel very close. In order to distance themselves from death, (as part of their terror management efforts) people tend to avoid the mourners.

In addition, even empathy can result in avoidance of death discussions, according to psychologists. Feeling another's pain can cause discomfort and distress for sympathetic listeners.

When people find themselves unable to take that grief away, therefore, they naturally withdraw in an attempt to remove themselves from the source of their discomfort.

Despite people's natural inclination to avoid discussing death, it is those very conversations that can help mourners to heal. Open and honest discussions about death can help mourners to identify and deal with the strong emotions that accompany grief.

Benefits of Talking About Death

Despite people's desire to avoid talking about death, experts have long recommended that people discuss their grief.

For example, grief expert William Worden's second task of mourning involves talking about the pain of grief in order to bring those feelings to the surface, where they can be dealt with.

Annie Broadbent, while not a psychologist, wrote a book We Really Need to Talk about Grief to highlight the importance of discussing death even when doing so is not comfortable.

According to psychologists, talking about grief has a number of benefits. Perhaps chief among them is the fact that doing so can help mourners to confront and deal with their feelings.

For example, talking with a good friend about your grief may bring feelings of anger to the surface that you may not have consciously realized were there.

Or going over memories of a loved one with another friend or family member might help you to feel a sense of peace.

Perhaps just as importantly, talking about grief allows the mourner to establish an important connection that prevents isolation, fear, and illness caused by suppressed emotions.

One of the reasons that professionals such as counselors, grief experts, and psychologists encourage the open and honest discussion of grief is because suppressing grief, and all the emotions that come with it, can be physically, mentally, and emotionally damaging.

Isolation, fear, and illness are all natural outgrowths of suppressed grief, making it more difficult to heal:

Isolation: the sense of feeling alone and perhaps rejected, can be a natural outgrowth of suppressed grief.When someone feels unable to talk about their sadness, or when they feel as if the people around them are rejecting them because of their grief, they can begin to feel alone.This feeling is often compounded by the fact that they are already experiencing lonesomeness due to the loss of a cherished loved one.

Fear: can also be a reaction to suppressed grief. As mentioned above, death can create feelings of fear and unease in others.When someone you love dearly has died, these feelings can be exacerbated, and with no place to discuss them, they can grow.In addition, fear of other things, such as being alone, feeling sad forever, or having to learn new things (such as doing things a deceased spouse used to do) can all be compounded when this fear is not discussed.

Illness: the emotions that come with bottling up emotions can also take a physical toll, according to experts.For example, one ten-year study found found that women who did not talk about their emotions during an argument were four times more likely to die.More concretely, emotional suppression, including the suppression of grief, has been linked to higher levels of stress, higher levels of mental illness, lower immune system functioning, and greater incidences of illnesses such as heart disease.

Talking About Death With Supportive People

Clearly, talking about death, as well as taking concrete actions to memorialize the deceased, can help grieving individuals to feel as if they can move on from the death.

The benefits of discussing grief are pretty clear.

But what is the bereaved to do if they feel that their friends and family are unwilling to continue discussing the loss?

First, establishing a network of several people who are willing to talk about the loss can help spread the burden of grief so that it does not fall on a single friend or family member.

Second, it may be necessary to find a support network outside one's friends and family.

For example, a counselor or a grief support group can offer a more intensive and helpful kind of support for people who are struggling with their grief journey.

In addition, professionals such as counselors can often provide practical and useful suggestions for healing.

Third, you may wish to consider taking concrete actions to memorialize the deceased.

Experts have long recognized the psychological benefit of mourning customs such as funerals in helping people to heal from their grief.

Taking steps such as holding a scattering ceremony for the deceased's ashes, writing a poem about their lives, planting a tree in their honor, or having their ashes turned into a cremation diamond, can bring a sense of closure and peace.

Regardless of how you choose to deal with your grief, the key is to acknowledge your feelings and deal with them, rather than stuffing them away inside.

By openly and honestly talking about death and handling your emotions, you will be able to more quickly heal from your grief, and find meaningful ways to honor the one you loved so much.

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Why Talking About Death is a Necessary Part of Grieving

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Talking about death is hard. The loss of a loved one can be one of the most overwhelmingly painful experiences of life. A large part of this pain, quite naturally, is caused by the absence of one who was cherished. However, part of the pain of grief consists of the loneliness and fear that also often accompany death.

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It has been proven that men and women should not be alone.  They were made to compliment eachother and develop society.
▫️Its safer because it lowers domestic violence
▫️Marriage is good for mental health, in aspects of becoming less anxious and improves depression
▫️40% of people are more happy being married then single

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When Americans debate the value of marriage, most attention focuses on the potential harm to children of divorce or illegitimacy, and for good reason. Mountains of research tell us that children reared outside of intact marriages are much more likely than other kids to slip into poverty, become victims of child abuse, fail at school and drop out, use illegal drugs, launch into premature sexual activity, become unwed teen mothers, divorce, commit suicide and experience other signs of mental illness, become physically ill, and commit crimes and go to jail. On average, children reared outside of marriage are less successful in their careers, even after controlling not only for income but also for parental conflict.

Yes, marriage protects children. And yes, marriage therefore protects taxpayers and society from a broad and deep set of costs, personal and communal. But there is another case for marriage, equally significant, that you probably haven't heard. Marriage is a powerful creator and sustainer of human and social capital for adults as well as children, about as important as education when it comes to promoting the health, wealth, and well-being of adults and communities. For most Americans, this is news. When it comes to adults, the case for lifelong marriage has been framed in exclusively moral, spiritual, and emotional terms: one side argues for personal liberation from marriage, the other urges parents to sacrifice for God's and/or the kids' sake.

These are important considerations to be sure. Parents surely should be willing to make appropriate sacrifices for their kids' sake. But framing the marriage debate solely in those terms obscures as much as it reveals. It misses the profound benefits that lasting marriage confers on adults. And it overestimates considerably the likelihood that divorce will, in fact, lead to greater happiness for the individual.

Recently, I had the opportunity to review the scientific evidence on the consequences of marriage for adults with University of Chicago scholar Linda J. Waite for our new book, The Case for Marriage. What I found surprised me. Quietly, with little fanfare, a broad and deep body of scientific literature has been accumulating that affirms what Genesis teaches: it is not good for man to be alone-no, nor woman neither. In virtually every way that social scientists can measure, married people do much better than the unmarried or divorced: they live longer, healthier, happier, sexier, and more affluent lives.

How big a difference does marriage make? If David Letterman were to compile a Top Ten list for marriage, it might look something like this:

TOP TEN REASONS WHY MARRIAGE IS GOOD FOR YOU:

10. IT'S SAFER. Marriage lowers the risk that both men and women will become victims of violence, including domestic violence. A 1994 Justice Department report, based on the National Crime Victimization Survey, found that single and divorced women were four to five times more likely to be victims of violence in any given year than wives; bachelors were four times more likely to be violent-crime victims than husbands. Two-thirds of acts of violence against women committed by intimate partners were not committed by husbands but by boyfriends (whether live-in or not) or former husbands or boyfriends. As one scholar sums up the relevant research: "Regardless of methodology, the studies yielded similar results: cohabitors engage in more violence than spouses." Linda Waite conducted an analysis of the National Survey of Families and Households for our new book. She found that, even after controlling for education, race, age, and gender, people who live together are still three times more likely to say their arguments got physical (such as kicking, hitting, or shoving) in the past year than married couples.

9. IT CAN SAVE YOUR LIFE. Married people live longer and healthier lives. The power of marriage is particularly evident in late middle age. When Linda Waite and a colleague, for example, analyzed mortality differentials in a very large, nationally representative sample, they found an astonishingly large "marriage gap" in longevity: nine out of ten married guys who are alive at 48 will make it to age 65, compared with just six in ten comparable single guys (controlling for race, education, and income). For women, the protective benefits of marriage are also powerful, though not quite as large. Nine out of ten wives alive at age 48 will live to be senior citizens, compared with just eight out of ten divorced and single women.

In fact, according to statisticians Bernard Cohen and I-Sing Lee, who compiled a catalog of relative mortality risks, "being unmarried is one of the greatest risks that people voluntarily subject themselves to." Having heart disease, for example, reduces a man's life expectancy by just under six years, while being unmarried chops almost ten years off a man's life. This is not just a selection effect: even controlling for initial health status, sick people who are married live longer than their unmarried counterparts. Having a spouse, for example, lowers a cancer patient's risk of dying from the disease as much as being in an age category ten years younger. A recent study of outcomes for surgical patients found that just being married lowered a patient's risk of dying in the hospital. For perhaps more obvious reasons, the risk a hospital patient will be discharged to a nursing home was two and a half times greater if the patient was unmarried. Scientists who have studied immune functioning in the laboratory find that happily married couples have better-functioning immune systems. Divorced people, even years after the divorce, show much lower levels of immune function.

8. IT CAN SAVE YOUR KID'S LIFE. Children lead healthier, longer lives if parents get and stay married. Adults who fret about second-hand smoke and drunk driving would do well to focus at least some of their attention on this point. In one long-term study that followed a sample of highly advantaged children (middle-class whites with IQs of at least 135) up through their seventies, a parent's divorce knocked four years off the adult child's life expectancy. Forty-year-olds from divorced homes were three times more likely to die from all causes than 40-year-olds whose parents stayed married.

7. YOU WILL EARN MORE MONEY. Men today tend to think of marriage as a consumption item-a financial burden. But a broad and deep body of scientific literature suggests that for men especially, marriage is a productive institution-as important as education in boosting a man's earnings. In fact, getting a wife may increase an American male's salary by about as much as a college education. Married men make, by some estimates, as much as 40 percent more money than comparable single guys, even after controlling for education and job history. The longer a man stays married, the higher the marriage premium he receives. Wives' earnings also benefit from marriage, but they decline when motherhood enters the picture. Childless white wives get a marriage wage premium of 4 percent, and black wives earn 10 percent more than comparable single women.

6. DID I MENTION YOU'LL GET MUCH RICHER? Married people not only make more money, they manage money better and build more wealth together than either would alone. At identical income levels, for example, married people are less likely to report "economic hardship" or trouble paying basic bills. The longer you stay married, the more assets you build; by contrast, length of cohabitation has no relationship to wealth accumulation. On the verge of retirement, the average married couple has accumulated assets worth about $410,000, compared with $167,000 for the never-married and $154,000 for the divorced. Couples who stayed married in one study saw their assets increase twice as fast as those who had remained divorced over a five-year period.

5. YOU'LL TAME HIS CHEATIN' HEART (HERS, TOO). Marriage increases sexual fidelity. Cohabiting men are four times more likely to cheat than husbands, and cohabiting women are eight times more likely to cheat than wives. Marriage is also the only realistic promise of permanence in a romantic relationship. Just one out of ten cohabiting couples are still cohabiting after five years. By contrast, 80 percent of couples marrying for the first time are still married five years later, and close to 60 percent (if current divorce rates continue) will marry for life. One British study found that biological parents who marry are three times more likely still to be together two years later than biological two-parent families who cohabit, even after controlling for maternal age, education, economic hardship, previous relationship failure, depression, and relationship quality. Marriage may be riskier than it once was, but when it comes to making love last, there is still no better bet.

4. YOU WON'T GO BONKERS. Marriage is good for your mental health. Married men and women are less depressed, less anxious, and less psychologically distressed than single, divorced, or widowed Americans. By contrast, getting divorced lowers both men's and women's mental health, increasing depression and hostility, and lowering one's self-esteem and sense of personal mastery and purpose in life.

And this is not just a statistical illusion: careful researchers who have tracked individuals as they move toward marriage find that it is not just that happy, healthy people marry; instead, getting married gives individuals a powerful mental health boost. Nadine Marks and James Lambert looked at changes in the psychological health of a large sample of Americans in the late eighties and early nineties. They measured psychological well-being at the outset and then watched what happened to individuals over the next years as they married, remained single, or divorced. When people married, their mental health improved-consistently and substantially. When people divorced, they suffered substantial deterioration in mental and emotional well-being, including increases in depression and declines in reported happiness. Those who divorced over this period also reported a lower sense of personal mastery, less positive relations with others, less sense of purpose in life, and lower levels of self-acceptance than their married peers did.

Married men are only half as likely as bachelors and one-third as likely as divorced guys to take their own lives. Wives are also much less likely to commit suicide than single, divorced, or widowed women. Married people are much less likely to have problems with alcohol abuse or illegal drugs. In a recent national survey, one out of four single men ages 19 to 26 say their drinking causes them problems at work or problems with aggression, compared with just one out of seven married guys this age.

3. IT WILL MAKE YOU HAPPY. For most people, the joys of the single life and of divorce are overrated. Overall, 40 percent of married people, compared with about a quarter of singles or cohabitors, say they are "very happy" with life in general. Married people are also only about half as likely as singles or cohabitors to say they are unhappy with their lives.

How happy are the divorced? If people divorce in order to be happy, as we are often told, the majority should demand their money back. Just 18 percent of divorced adults say they are "very happy," and divorced adults are twice as likely as married folk to say they are "not too happy" with life in general. Only a minority of divorcing adults go on to make marriages that are happier than the one they left. "Divorce or be miserable," certain cultural voices tell us, but, truth be told, "Divorce and be miserable" is at least as likely an outcome.

This is not just an American phenomenon. One recent study by Steven Stack and J. Ross Eshleman of 17 developed nations found that "married persons have a significantly higher level of happiness than persons who are not married," even after controlling for gender, age, education, children, church attendance, financial satisfaction, and self-reported health. Further, "the strength of the association between being married and being happy is remarkably consistent across nations." Marriage boosted financial satisfaction and health. But being married conferred a happiness advantage over and above its power to improve the pocketbook and the health chart. Cohabitation, by contrast, did not increase financial satisfaction or perceived health, and the boost to happiness from having a live-in lover was only about a quarter of that of being married. Another large study, of 100,000 Norwegians, found that, with both men and women, "the married have the highest level of subjective well-being, followed by the widowed." Even long-divorced people who cohabited were not any happier than singles.

2. YOUR KIDS WILL LOVE YOU MORE. Divorce weakens the bonds between parents and children over the long run. Adult children of divorce describe relationships with both their mother and their father less positively, on average, and they are about 40 percent less likely than adults from intact marriages to say they see either parent at least several times a week.

1. YOU'LL HAVE BETTER SEX, MORE OFTEN. Despite the lurid Sex in the City marketing that promises singles erotic joys untold, both husbands and wives are more likely to report that they have an extremely satisfying sex life than are singles or cohabitors. (Divorced women were the least likely to have a sex life they found extremely satisfying emotionally.) For one thing, married people are more likely to have a sex life. Single men are 20 times more likely, and single women ten times more likely, not to have had sex even once in the past year than the married. (Almost a quarter of single guys and 30 percent of single women lead sexless lives.)

Married people are also the most likely to report a highly satisfying sex life. Wives, for example, are almost twice as likely as divorced and never-married women to have a sex life that a) exists and b) is extremely satisfying emotionally. Contrary to popular lore, for men, having a wife beats shacking up by a wide margin: 50 percent of husbands say sex with their partner is extremely satisfying physically, compared with 39 percent of cohabiting men.

How can a piece of paper work such miracles? For surprisingly, the piece of paper, and not just the personal relationship, matters a great deal. People who live together, for the most part, don't reap the same kinds of benefits that men and women who marry do. Something about marriage as a social institution-a shared aspiration and a public, legal vow-gives wedlock the power to change individuals' lives.

By increasing confidence that this partnership will last, marriage allows men and women to specialize-to take on those parts of life's tasks, from developing an interesting social life to getting money out of insurance companies, that one person does better or enjoys more than the other. Though this specialization is often along traditional gender lines, it doesn't have to be. Even childless married couples benefit from splitting up the work. Married households have twice the talent, twice the time, and twice the labor pool of singles. Over time, as spouses specialize, each actually produces more in both market and non-market goods than singles who have to shoulder all of life's tasks on their own.

But because marriage is a partnership in the whole of life, backed up by family, community, and religious values, marriage can do what economic partnerships don't: give a greater sense of meaning and purpose to life (a reason to exercise or cut back on booze, work harder, and to keep plugging even in the middle of those times when the marriage may not feel gratifying at all). Married people are both responsible for and responsible to another human being, and both halves of that dynamic lead the married to live more responsible, fruitful, and satisfying lives. Marriage is a transformative act, changing the way two people look at each other, at the future, and at their roles in society. And it changes the way significant others-from family to congregation to insurance companies and the IRS-look at and treat that same couple. Sexual fidelity, an economic union, a parenting alliance, the promise of care that transcends day-to-day emotions: all these are what give a few words mumbled before a clergyman or judge the power to change lives.

What proportion of unhappily married couples who stick it out stay miserable? The latest data show that within five years, just 12 percent of very unhappily married couples who stick it out are still unhappy; 70 percent of the unhappiest couples now describe their marriage as "very" or "quite" happy.

Just as good marriages go bad, bad marriages go good. And they have a better chance of doing so in a society that recognizes the value of marriage than one that sings the statistically dubious joys of divorce.

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When Americans debate the value of marriage, most attention focuses on the potential harm to children of divorce or illegitimacy, and for good reason.

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Family relations effect the well being of all future life choices.
▫️Provides social support for advice or providing care
▫️Lessens the struggle of making life choices
▫️Encourages positive thoughts

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Abstract

Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships-marital, intergenerational, and sibling ties-that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses.

Keywords: Caregiver stress, Gender issues, Intergenerational, Social support, Well-being

Translational Significance

It is important for future research and health promotion policies to take into account complexities in family relationships, paying attention to family context, diversity of family structures, relationship quality, and intersections of social statuses in an aging society to provide resources to families to reduce caregiving burdens and benefit health and well-being.

For better and for worse, family relationships play a central role in shaping an individual's well-being across the life course ( Merz, Consedine, Schulze, & Schuengel, 2009). An aging population and concomitant age-related disease underlies an emergent need to better understand factors that contribute to health and well-being among the increasing numbers of older adults in the United States. Family relationships may become even more important to well-being as individuals age, needs for caregiving increase, and social ties in other domains such as the workplace become less central in their lives ( Milkie, Bierman, & Schieman, 2008). In this review, we consider key family relationships in adulthood-marital, parent-child, grandparent, and sibling relationships-and their impact on well-being across the adult life course.

We begin with an overview of theoretical explanations that point to the primary pathways and mechanisms through which family relationships influence well-being, and then we describe how each type of family relationship is associated with well-being, and how these patterns unfold over the adult life course. In this article, we use a broad definition of well-being, including multiple dimensions such as general happiness, life satisfaction, and good mental and physical health, to reflect the breadth of this concept's use in the literature. We explore important directions for future research, emphasizing the need for research that takes into account the complexity of relationships, diverse family structures, and intersections of structural locations.

Pathways Linking Family Relationships to Well-Being

A life course perspective draws attention to the importance of linked lives, or interdependence within relationships, across the life course ( Elder, Johnson, & Crosnoe, 2003). Family members are linked in important ways through each stage of life, and these relationships are an important source of social connection and social influence for individuals throughout their lives ( Umberson, Crosnoe, & Reczek, 2010). Substantial evidence consistently shows that social relationships can profoundly influence well-being across the life course ( Umberson & Montez, 2010). Family connections can provide a greater sense of meaning and purpose as well as social and tangible resources that benefit well-being ( Hartwell & Benson, 2007; Kawachi & Berkman, 2001).

The quality of family relationships, including social support (e.g., providing love, advice, and care) and strain (e.g., arguments, being critical, making too many demands), can influence well-being through psychosocial, behavioral, and physiological pathways. Stressors and social support are core components of stress process theory ( Pearlin, 1999), which argues that stress can undermine mental health while social support may serve as a protective resource. Prior studies clearly show that stress undermines health and well-being ( Thoits, 2010), and strains in relationships with family members are an especially salient type of stress. Social support may provide a resource for coping that dulls the detrimental impact of stressors on well-being ( Thoits, 2010), and support may also promote well-being through increased self-esteem, which involves more positive views of oneself ( Fukukawa et al., 2000). Those receiving support from their family members may feel a greater sense of self-worth, and this enhanced self-esteem may be a psychological resource, encouraging optimism, positive affect, and better mental health ( Symister & Friend, 2003). Family members may also regulate each other's behaviors (i.e., social control) and provide information and encouragement to behave in healthier ways and to more effectively utilize health care services ( Cohen, 2004; Reczek, Thomeer, Lodge, Umberson, & Underhill, 2014), but stress in relationships may also lead to health-compromising behaviors as coping mechanisms to deal with stress ( Ng & Jeffery, 2003). The stress of relationship strain can result in physiological processes that impair immune function, affect the cardiovascular system, and increase risk for depression ( Graham, Christian, & Kiecolt-Glaser, 2006; Kiecolt-Glaser & Newton, 2001), whereas positive relationships are associated with lower allostatic load (i.e., "wear and tear" on the body accumulating from stress) ( Seeman, Singer, Ryff, Love, & Levy-Storms, 2002). Clearly, the quality of family relationships can have considerable consequences for well-being.

Marital Relationships

A life course perspective has posited marital relationships as one of the most important relationships that define life context and in turn affect individuals' well-being throughout adulthood ( Umberson & Montez, 2010). Being married, especially happily married, is associated with better mental and physical health ( Carr & Springer, 2010; Umberson, Williams, & Thomeer, 2013), and the strength of the marital effect on health is comparable to that of other traditional risk factors such as smoking and obesity ( Sbarra, 2009). Although some studies emphasize the possibility of selection effects, suggesting that individuals in better health are more likely to be married ( Lipowicz, 2014), most researchers emphasize two theoretical models to explain why marital relationships shape well-being: the marital resource model and the stress model ( Waite & Gallager, 2000; Williams & Umberson, 2004). The marital resource model suggests that marriage promotes well-being through increased access to economic, social, and health-promoting resources ( Rendall, Weden, Favreault, & Waldron, 2011; Umberson et al., 2013). The stress model suggests that negative aspects of marital relationships such as marital strain and marital dissolutions create stress and undermine well-being ( Williams & Umberson, 2004), whereas positive aspects of marital relationships may prompt social support, enhance self-esteem, and promote healthier behaviors in general and in coping with stress ( Reczek, Thomeer, et al., 2014; Symister & Friend, 2003; Waite & Gallager, 2000). Marital relationships also tend to become more salient with advancing age, as other social relationships such as those with family members, friends, and neighbors are often lost due to geographic relocation and death in the later part of the life course ( Liu & Waite, 2014).

Married people, on average, enjoy better mental health, physical health, and longer life expectancy than divorced/separated, widowed, and never-married people ( Hughes & Waite, 2009; Simon, 2002), although the health gap between the married and never married has decreased in the past few decades ( Liu & Umberson, 2008). Moreover, marital links to well-being depend on the quality of the relationship; those in distressed marriages are more likely to report depressive symptoms and poorer health than those in happy marriages ( Donoho, Crimmins, & Seeman, 2013; Liu & Waite, 2014; Umberson, Williams, Powers, Liu, & Needham, 2006), whereas a happy marriage may buffer the effects of stress via greater access to emotional support ( Williams, 2003). A number of studies suggest that the negative aspects of close relationships have a stronger impact on well-being than the positive aspects of relationships (e.g., Rook, 2014), and past research shows that the impact of marital strain on health increases with advancing age ( Liu & Waite, 2014; Umberson et al., 2006).

Prior studies suggest that marital transitions, either into or out of marriage, shape life context and affect well-being ( Williams & Umberson, 2004). National longitudinal studies provide evidence that past experiences of divorce and widowhood are associated with increased risk of heart disease in later life especially among women, irrespective of current marital status ( Zhang & Hayward, 2006), and longer duration of divorce or widowhood is associated with a greater number of chronic conditions and mobility limitations ( Hughes & Waite, 2009; Lorenz, Wickrama, Conger, & Elder, 2006) but only short-term declines in mental health ( Lee & Demaris, 2007). On the other hand, entry into marriages, especially first marriages, improves psychological well-being and decreases depression ( Frech & Williams, 2007; Musick & Bumpass, 2012), although the benefits of remarriage may not be as large as those that accompany a first marriage ( Hughes & Waite, 2009). Taken together, these studies show the importance of understanding the lifelong cumulative impact of marital status and marital transitions.

Gender Differences

Gender is a central focus of research on marital relationships and well-being and an important determinant of life course experiences ( Bernard, 1972; Liu & Waite, 2014; Zhang & Hayward, 2006). A long-observed pattern is that men receive more physical health benefits from marriage than women, and women are more psychologically and physiologically vulnerable to marital stress than men ( Kiecolt-Glaser & Newton, 2001; Revenson et al., 2016; Simon, 2002; Williams, 2004). Women tend to receive more financial benefits from their typically higher-earning male spouse than do men, but men generally receive more health promotion benefits such as emotional support and regulation of health behaviors from marriage than do women ( Liu & Umberson, 2008; Liu & Waite, 2014). This is because within a traditional marriage, women tend to take more responsibility for maintaining social connections to family and friends, and are more likely to provide emotional support to their husband, whereas men are more likely to receive emotional support and enjoy the benefit of expanded social networks-all factors that may promote husbands' health and well-being ( Revenson et al., 2016).

However, there is mixed evidence regarding whether men's or women's well-being is more affected by marriage. On the one hand, a number of studies have documented that marital status differences in both mental and physical health are greater for men than women ( Liu & Umberson, 2008; Sbarra, 2009). For example, Williams and Umberson (2004) found that men's health improves more than women's from entering marriage. On the other hand, a number of studies reveal stronger effects of marital strain on women's health than men's including more depressive symptoms, increases in cardiovascular health risk, and changes in hormones ( Kiecolt-Glaser & Newton, 2001; Liu & Waite, 2014; Liu, Waite, & Shen, 2016). Yet, other studies found no gender differences in marriage and health links (e.g., Umberson et al., 2006). The mixed evidence regarding gender differences in the impact of marital relationships on well-being may be attributed to different study samples (e.g., with different age groups) and variations in measurements and methodologies. More research based on representative longitudinal samples is clearly warranted to contribute to this line of investigation.

Race-Ethnicity and SES Heterogeneity

Family scholars argue that marriage has different meanings and dynamics across socioeconomic status (SES) and racial-ethnic groups due to varying social, economic, historical, and cultural contexts. Therefore, marriage may be associated with well-being in different ways across these groups. For example, women who are black or lower SES may be less likely than their white, higher SES counterparts to increase their financial capital from relationship unions because eligible men in their social networks are more socioeconomically challenged ( Edin & Kefalas, 2005). Some studies also find that marital quality is lower among low SES and black couples than white couples with higher SES ( Broman, 2005). This may occur because the former groups face more stress in their daily lives throughout the life course and these higher levels of stress undermine marital quality ( Umberson, Williams, Thomas, Liu, & Thomeer, 2014). Other studies, however, suggest stronger effects of marriage on the well-being of black adults than white adults. For example, black older adults seem to benefit more from marriage than older whites in terms of chronic conditions and disability ( Pienta, Hayward, & Jenkins, 2000).

Directions for Future Research

The rapid aging of the U.S. population along with significant changes in marriage and families indicate that a growing number of older adults enter late life with both complex marital histories and great heterogeneity in their relationships. While most research to date focuses on different-sex marriages, a growing body of research has started to examine whether the marital advantage in health and well-being is extended to same-sex couples, which represents a growing segment of relationship types among older couples ( Denney, Gorman, & Barrera, 2013; Goldsen et al., 2017; Liu, Reczek, & Brown, 2013; Reczek, Liu, & Spiker, 2014). Evidence shows that same-sex cohabiting couples report worse health than different-sex married couples ( Denney et al., 2013; Liu et al., 2013), but same-sex married couples are often not significantly different from or are even better off than different-sex married couples in other outcomes such as alcohol use ( Reczek, Liu, et al., 2014) and care from their partner during periods of illness ( Umberson, Thomeer, Reczek, & Donnelly, 2016). These results suggest that marriage may promote the well-being of same-sex couples, perhaps even more so than for different-sex couples ( Umberson et al., 2016). Including same-sex couples in future work on marriage and well-being will garner unique insights into gender differences in marital dynamics that have long been taken for granted based on studies of different-sex couples ( Umberson, Thomeer, Kroeger, Lodge, & Xu, 2015). Moreover, future work on same-sex and different-sex couples should take into account the intersection of other statuses such as race-ethnicity and SES to better understand the impact of marital relationships on well-being.

Another avenue for future research involves investigating complexities of marital strain effects on well-being. Some recent studies among older adults suggest that relationship strain may actually benefit certain dimensions of well-being. These studies suggest that strain with a spouse may be protective for certain health outcomes including cognitive decline ( Xu, Thomas, & Umberson, 2016) and diabetes control ( Liu et al., 2016), while support may not be, especially for men ( Carr, Cornman, & Freedman, 2016). Explanations for these unexpected findings among older adults are not fully understood. Family and health scholars suggest that spouses may prod their significant others to engage in more health-promoting behaviors ( Umberson, Crosnoe, et al., 2010). These attempts may be a source of friction, creating strain in the relationship; however, this dynamic may still contribute to better health outcomes for older adults. Future research should explore the processes by which strain may have a positive influence on health and well-being, perhaps differently by gender.

Intergenerational Relationships

Children and parents tend to remain closely connected to each other across the life course, and it is well-established that the quality of intergenerational relationships is central to the well-being of both generations ( Merz, Schuengel, & Schulze, 2009; Polenick, DePasquale, Eggebeen, Zarit, & Fingerman, 2016). Recent research also points to the importance of relationships with grandchildren for aging adults ( Mahne & Huxhold, 2015). We focus here on the well-being of parents, adult children, and grandparents. Parents, grandparents, and children often provide care for each other at different points in the life course, which can contribute to social support, stress, and social control mechanisms that influence the health and well-being of each in important ways over the life course ( Nomaguchi & Milkie, 2003; Pinquart & Soerensen, 2007; Reczek, Thomeer, et al., 2014).

Parents

Family scholarship highlights the complexities of parent-child relationships, finding that parenthood generates both rewards and stressors, with important implications for well-being ( Nomaguchi & Milkie, 2003; Umberson, Pudrovska, & Reczek, 2010). Parenthood increases time constraints, producing stress and diminishing well-being, especially when children are younger ( Nomaguchi, Milkie, & Bianchi, 2005), but parenthood can also increase social integration, leading to greater emotional support and a sense of belonging and meaning ( Berkman, Glass, Brissette, & Seeman, 2000), with positive consequences for well-being. Studies show that adult children play a pivotal role in the social networks of their parents across the life course ( Umberson, Pudrovska, et al., 2010), and the effects of parenthood on health and well-being become increasingly important at older ages as adult children provide one of the major sources of care for aging adults ( Seltzer & Bianchi, 2013). Norms of filial obligation of adult children to care for parents may be a form of social capital to be accessed by parents when their needs arise ( Silverstein, Gans, & Yang, 2006).

Although the general pattern is that receiving support from adult children is beneficial for parents' well-being ( Merz, Schulze, & Schuengel, 2010), there is also evidence showing that receiving social support from adult children is related to lower well-being among older adults, suggesting that challenges to an identity of independence and usefulness may offset some of the benefits of receiving support ( Merz et al., 2010; Thomas, 2010). Contrary to popular thought, older parents are also very likely to provide instrumental/financial support to their adult children, typically contributing more than they receive ( Grundy, 2005), and providing emotional support to their adult children is related to higher well-being for older adults ( Thomas, 2010). In addition, consistent with the tenets of stress process theory, most evidence points to poor quality relationships with adult children as detrimental to parents' well-being ( Koropeckyj-Cox, 2002; Polenick et al., 2016); however, a recent study found that strain with adult children is related to better cognitive health among older parents, especially fathers ( Thomas & Umberson, 2017).

Adult Children

As children and parents age, the nature of the parent-child relationship often changes such that adult children may take on a caregiving role for their older parents ( Pinquart & Soerensen, 2007). Adult children often experience competing pressures of employment, taking care of their own children, and providing care for older parents ( Evans et al., 2016). Support and strain from intergenerational ties during this stressful time of balancing family roles and work obligations may be particularly important for the mental health of adults in midlife ( Thomas, 2016). Most evidence suggests that caregiving for parents is related to lower well-being for adult children, including more negative affect and greater stress response in terms of overall output of daily cortisol ( Bangerter et al., 2017); however, some studies suggest that caregiving may be beneficial or neutral for well-being ( Merz et al., 2010). Family scholars suggest that this discrepancy may be due to varying types of caregiving and relationship quality. For example, providing emotional support to parents can increase well-being, but providing instrumental support does not unless the caregiver is emotionally engaged ( Morelli, Lee, Arnn, & Zaki, 2015). Moreover, the quality of the adult child-parent relationship may matter more for the well-being of adult children than does the caregiving they provide ( Merz, Schuengel, et al., 2009).

Although caregiving is a critical issue, adult children generally experience many years with parents in good health ( Settersten, 2007), and relationship quality and support exchanges have important implications for well-being beyond caregiving roles. The preponderance of research suggests that most adults feel emotionally close to their parents, and emotional support such as encouragement, companionship, and serving as a confidant is commonly exchanged in both directions ( Swartz, 2009). Intergenerational support exchanges often flow across generations or towards adult children rather than towards parents. For example, adult children are more likely to receive financial support from parents than vice versa until parents are very old ( Grundy, 2005). Intergenerational support exchanges are integral to the lives of both parents and adult children, both in times of need and in daily life.

Grandparents

Over 65 million Americans are grandparents ( Ellis & Simmons, 2014), 10% of children lived with at least one grandparent in 2012 ( Dunifon, Ziol-Guest, & Kopko, 2014), and a growing number of American families rely on grandparents as a source of support ( Settersten, 2007), suggesting the importance of studying grandparenting. Grandparents' relationships with their grandchildren are generally related to higher well-being for both grandparents and grandchildren, with some important exceptions such as when they involve more extensive childcare responsibilities ( Kim, Kang, & Johnson-Motoyama, 2017; Lee, Clarkson-Hendrix, & Lee, 2016). Most grandparents engage in activities with their grandchildren that they find meaningful, feel close to their grandchildren, consider the grandparent role important ( Swartz, 2009), and experience lower well-being if they lose contact with their grandchildren ( Drew & Silverstein, 2007). However, a growing proportion of children live in households maintained by grandparents ( Settersten, 2007), and grandparents who care for their grandchildren without the support of the children's parents usually experience greater stress ( Lee et al., 2016) and more depressive symptoms ( Blustein, Chan, & Guanais, 2004), sometimes juggling grandparenting responsibilities with their own employment ( Harrington Meyer, 2014). Using professional help and community services reduced the detrimental effects of grandparent caregiving on well-being ( Gerard, Landry-Meyer, & Roe, 2006), suggesting that future policy could help mitigate the stress of grandparent parenting and enhance the rewarding aspects of grandparenting instead.

Gender Differences

Substantial evidence suggests that the experience of intergenerational relationships varies for men and women. Women tend to be more involved with and affected by intergenerational relationships, with adult children feeling closer to mothers than fathers ( Swartz, 2009). Moreover, relationship quality with children is more strongly associated with mothers' well-being than with fathers' well-being ( Milkie et al., 2008). Motherhood may be particularly salient to women ( McQuillan, Greil, Shreffler, & Tichenor, 2008), and women carry a disproportionate share of the burden of parenting, including greater caregiving for young children and aging parents as well as time deficits from these obligations that lead to lower well-being ( Nomaguchi et al., 2005; Pinquart & Sorensen, 2006). Mothers often report greater parental pressures than fathers, such as more obligation to be there for their children ( Reczek, Thomeer, et al., 2014; Stone, 2007), and to actively work on family relationships ( Erickson, 2005). Mothers are also more likely to blame themselves for poor parent-child relationship quality ( Elliott, Powell, & Brenton, 2015), contributing to greater distress for women. It is important to take into account the different pressures and meanings surrounding intergenerational relationships for men and for women in future research.

Race-Ethnicity and SES Heterogeneity

Family scholars have noted important variations in family dynamics and constraints by race-ethnicity and socioeconomic status. Lower SES can produce and exacerbate family strains ( Conger, Conger, & Martin, 2010). Socioeconomically disadvantaged adult children may need more assistance from parents and grandparents who in turn have fewer resources to provide ( Seltzer & Bianchi, 2013). Higher SES and white families tend to provide more financial and emotional support, whereas lower SES, black, and Latino families are more likely to coreside and provide practical help, and these differences in support exchanges contribute to the intergenerational transmission of inequality through families ( Swartz, 2009). Moreover, scholars have found that a happiness penalty exists such that parents of young children have lower levels of well-being than nonparents; however, policies such as childcare subsidies and paid time off that help parents negotiate work and family responsibilities explain this disparity ( Glass, Simon, & Andersson, 2016). Fewer resources can also place strain on grandparent-grandchild relationships. For example, well-being derived from these relationships may be unequally distributed across grandparents' education level such that those with less education bear the brunt of more stressful grandparenting experiences and lower well-being ( Mahne & Huxhold, 2015). Both the burden of parenting grandchildren and its effects on depressive symptoms disproportionately fall upon single grandmothers of color ( Blustein et al., 2004). These studies demonstrate the importance of understanding structural constraints that produce greater stress for less advantaged groups and their impact on family relationships and well-being.

Directions for Future Research

Research on intergenerational relationships suggests the importance of understanding greater complexity in these relationships in future work. For example, future research should pay greater attention to diverse family structures and perspectives of multiple family members. There is an increasing trend of individuals delaying childbearing or choosing not to bear children ( Umberson, Pudrovska, et al., 2010). How might this influence marital quality and general well-being over the life course and across different social groups? Greater attention to the quality and context of intergenerational relationships from each family member's perspective over time may prove fruitful by gaining both parents' and each child's perceptions. This work has already yielded important insights, such as the ways in which intergenerational ambivalence (simultaneous positive and negative feelings about intergenerational relationships) from the perspectives of parents and adult children may be detrimental to well-being for both parties ( Fingerman, Pitzer, Lefkowitz, Birditt, & Mroczek, 2008; Gilligan, Suitor, Feld, & Pillemer, 2015). Future work understanding the perspectives of each family member could also provide leverage in understanding the mixed findings regarding whether living in blended families with stepchildren influences well-being ( Gennetian, 2005; Harcourt, Adler-Baeder, Erath, & Pettit, 2013) and the long-term implications of these family structures when older adults need care ( Seltzer & Bianchi, 2013). Longitudinal data linking generations, paying greater attention to the context of these relationships, and collected from multiple family members can help untangle the ways in which family members influence each other across the life course and how multiple family members' well-being may be intertwined in important ways.

Future studies should also consider the impact of intersecting structural locations that place unique constraints on family relationships, producing greater stress at some intersections while providing greater resources at other intersections. For example, same-sex couples are less likely to have children ( Carpenter & Gates, 2008) and are more likely to provide parental caregiving regardless of gender ( Reczek & Umberson, 2016), suggesting important implications for stress and burden in intergenerational caregiving for this group. Much of the work on gender, sexuality, race, and socioeconomic status differences in intergenerational relationships and well-being examine one or two of these statuses, but there may be unique effects at the intersection of these and other statuses such as disability, age, and nativity. Moreover, these effects may vary at different stages of the life course.

Sibling Relationships

Sibling relationships are understudied, and the research on adult siblings is more limited than for other family relationships. Yet, sibling relationships are often the longest lasting family relationship in an individual's life due to concurrent life spans, and indeed, around 75% of 70-year olds have a living sibling ( Settersten, 2007). Some suggest that sibling relationships play a more meaningful role in well-being than is often recognized ( Cicirelli, 2004). The available evidence suggests that high quality relationships characterized by closeness with siblings are related to higher levels of well-being ( Bedford & Avioli, 2001), whereas sibling relationships characterized by conflict and lack of closeness have been linked to lower well-being in terms of major depression and greater drug use in adulthood ( Waldinger, Vaillant, & Orav, 2007). Parental favoritism and disfavoritism of children affects the closeness of siblings ( Gilligan, Suitor, & Nam, 2015) and depression ( Jensen, Whiteman, Fingerman, & Birditt, 2013). Similar to other family relationships, sibling relationships can be characterized by both positive and negative aspects that may affect elements of the stress process, providing both resources and stressors that influence well-being.

Siblings play important roles in support exchanges and caregiving, especially if their sibling experiences physical impairment and other close ties, such as a spouse or adult children, are not available ( Degeneffe & Burcham, 2008; Namkung, Greenberg, & Mailick, 2017). Although sibling caregivers report lower well-being than noncaregivers, sibling caregivers experience this lower well-being to a lesser extent than spousal caregivers ( Namkung et al., 2017). Most people believe that their siblings would be available to help them in a crisis ( Connidis, 1994; Van Volkom, 2006), and in general support exchanges, receiving emotional support from a sibling is related to higher levels of well-being among older adults ( Thomas, 2010). Relationship quality affects the experience of caregiving, with higher quality sibling relationships linked to greater provision of care ( Eriksen & Gerstel, 2002) and a lower likelihood of emotional strain from caregiving ( Mui & Morrow-Howell, 1993; Quinn, Clare, & Woods, 2009). Taken together, these studies suggest the importance of sibling relationships for well-being across the adult life course.

Gender Differences

The gender of the sibling dyad may play a role in the relationship's effect on well-being, with relationships with sisters perceived as higher quality and linked to higher well-being ( Van Volkom, 2006), though some argue that brothers do not show their affection in the same way but nevertheless have similar sentiments towards their siblings ( Bedford & Avioli, 2001). General social support exchanges with siblings may be influenced by gender and larger family context; sisters exchanged more support with their siblings when they had higher quality relationships with their parents, but brothers exhibited a more compensatory role, exchanging more emotional support with siblings when they had lower quality relationships with their parents ( Voorpostel & Blieszner, 2008). Caregiving for aging parents is also distributed differently by gender, falling disproportionately on female siblings ( Pinquart & Sorensen, 2006), and sons provide less care to their parents if they have a sister ( Grigoryeva, 2017). However, men in same-sex marriages were more likely than men in different-sex marriages to provide caregiving to parents and parents-in-law ( Reczek & Umberson, 2016), which may ease the stress and burden on their female siblings.

Race-Ethnicity and SES Heterogeneity

Although there is less research in this area, family scholars have noted variations in sibling relationships and their effects by race-ethnicity and socioeconomic status. Lower socioeconomic status has been associated with reports of feeling less attached to siblings and this influences several outcomes such as obesity, depression, and substance use ( Van Gundy et al., 2015). Fewer socioeconomic resources can also limit the amount of care siblings provide ( Eriksen & Gerstel, 2002). These studies suggest sibling relationship quality as an axis of further disadvantage for already disadvantaged individuals. Sibling relationships may influence caregiving experiences by race as well, with black caregivers more likely to have siblings who also provide care to their parents than white caregivers ( White-Means & Rubin, 2008) and sibling caregiving leading to lower well-being among white caregivers than minority caregivers ( Namkung et al., 2017).

Directions for Future Research

Research on within-family differences has made great strides in our understanding of family relationships and remains a fruitful area of growth for future research (e.g., Suitor et al., 2017). Data gathered on multiple members within the same family can help researchers better investigate how families influence well-being in complex ways, including reciprocal influences between siblings. Siblings may have different perceptions of their relationships with each other, and this may vary by gender and other social statuses. This type of data might be especially useful in understanding family effects in diverse family structures, such as differences in treatment and outcomes of biological versus stepchildren, how characteristics of their relationships such as age differences may play a role, and the implications for caregiving for aging parents and for each other. Moreover, it is important to use longitudinal data to understand the consequences of these within-family differences over time as the life course unfolds. In addition, a greater focus on heterogeneity in sibling relationships and their consequences at the intersection of gender, race-ethnicity, SES, and other social statuses merit further investigation.

Conclusion

Relationships with family members are significant for well-being across the life course ( Merz, Consedine, et al., 2009; Umberson, Pudrovska, et al., 2010). As individuals age, family relationships often become more complex, with sometimes complicated marital histories, varying relationships with children, competing time pressures, and obligations for care. At the same time, family relationships become more important for well-being as individuals age and social networks diminish even as family caregiving needs increase. Stress process theory suggests that the positive and negative aspects of relationships can have a large impact on the well-being of individuals. Family relationships provide resources that can help an individual cope with stress, engage in healthier behaviors, and enhance self-esteem, leading to higher well-being. However, poor relationship quality, intense caregiving for family members, and marital dissolution are all stressors that can take a toll on an individual's well-being. Moreover, family relationships also change over the life course, with the potential to share different levels of emotional support and closeness, to take care of us when needed, to add varying levels of stress to our lives, and to need caregiving at different points in the life course. The potential risks and rewards of these relationships have a cumulative impact on health and well-being over the life course. Additionally, structural constraints and disadvantage place greater pressures on some families than others based on structural location such as gender, race, and SES, producing further disadvantage and intergenerational transmission of inequality.

Future research should take into account greater complexity in family relationships, diverse family structures, and intersections of social statuses. The rapid aging of the U.S. population along with significant changes in marriage and families suggest more complex marital and family histories as adults enter late life, which will have a large impact on family dynamics and caregiving. Growing segments of family relationships among older adults include same-sex couples, those without children, and those experiencing marital transitions leading to diverse family structures, which all merit greater attention in future research. Moreover, there is some evidence that strain in relationships can be beneficial for certain health outcomes, and the processes by which this occurs merit further investigation. A greater use of longitudinal data that link generations and obtain information from multiple family members will help researchers better understand the ways in which these complex family relationships unfold across the life course and shape well-being. We also highlighted gender, race-ethnicity, and socioeconomic status differences in each of these family relationships and their impact on well-being; however, many studies only consider one status at a time. Future research should consider the impact of intersecting structural locations that place unique constraints on family relationships, producing greater stress or providing greater resources at the intersections of different statuses.

The changing landscape of families combined with population aging present unique challenges and pressures for families and health care systems. With more experiences of age-related disease in a growing population of older adults as well as more complex family histories as these adults enter late life, such as a growing proportion of diverse family structures without children or with stepchildren, caregiving obligations and availability may be less clear. It is important to address ways to ease caregiving or shift the burden away from families through a variety of policies, such as greater resources for in-home aid, creation of older adult residential communities that facilitate social interactions and social support structures, and patient advocates to help older adults navigate health care systems. Adults in midlife may experience competing family pressures from their young children and aging parents, and policies such as childcare subsidies and paid leave to care for family members could reduce burden during this often stressful time ( Glass et al., 2016). Professional help and community services can also reduce the burden for grandparents involved in childcare, enabling grandparents to focus on the more positive aspects of grandparent-grandchild relationships. It is important for future research and health promotion policies to take into account the contexts and complexities of family relationships as part of a multipronged approach to benefit health and well-being, especially as a growing proportion of older adults reach late life.

Funding

This work was supported in part by grant, 5 R24 HD042849, Population Research Center, awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Conflict of Interest

None reported.

References

Bernard J. (1972). The future of marriage. New Haven, CT: Yale University Press. [Google Scholar]

Edin K., & Kefalas M (2005). Promises I can keep: Why poor women put motherhood before marriage. Berkeley, CA: University of California Press. [Google Scholar]

Ellis R. R., & Simmons T (2014). Coresident grandparents and their grandchildren: 2012. Washington, DC: U.S. Census Bureau. [Google Scholar]

Harrington Meyer M. (2014). Grandmothers at work - juggling families and jobs. New York, NY: NYU Press. doi:10.18574/nyu/9780814729236.001.0001 [[PubMed] Google Scholar]

Stone P. (2007). Opting out? Why women really quit careers and head home. Berkeley, CA: University of California Press. [Google Scholar]

Waite L. J., & Gallager M (2000). The case for marriage: Why married people are happier, healthier, and better off financially. New York: Doubleday. [Google Scholar]

Articles from Innovation in Aging are provided here courtesy of Oxford University Press

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Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships-marital, intergenerational, and sibling ties-that have an important influence on well-being. We ...

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Morrie believes the basic affections you get from life come from a family.  Such as support, love, and care.

“If you dont have the support and love and caring and concern that you get from a family, you don’t have much at all”(Albom 91).

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Morrie believes that love is the biggest part in a marriage and so many people dont understand that.  Marriage has so many benefits in a persons life.

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Morrie uses his emotions to influence his thoughts on death and how it influences the way people live

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Morrie started to mature and started to understand the idea of forgiveness by realizing:

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1. Morrie says that the basic backbone for a family is love and  he says that you have to love eachother or parish.

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1. There is no point in keeping vengeance or stubborness.

Morrie says, “These things -he sighed- these things I so regret in my life”(Albom 164).

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1. Morrie says that marriage gives someone through all the hard times.

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1. Being prepared for death gives you a better outlook on the world, over the idea of forgetting or pushing aside death.

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2.

“Once you learn how to die, you learn how to live”(Albom 82).

Morrie believed this was one of the biggest life lessons to learn in order to be one with your emotions.

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2. Marriage teaches you to compramise and respect other people.

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2. Along with love though you have to care because caring gives you hope when you have none and knowing someone always has you back.

What I call your ‘spiritual security’- knowing that your family will be there watching over you”(Albom92).

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3. Morrie believes that marriage is a huge part of life.  This is clear when Morrie says.

“Personally, he sighed, his eyes still closed, I think marriage is a very important thing to do, and you’re missing a hell of a lot if you don’t try it”(Albom 149).

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2. Pride and Vanity are things humans do, but as Morrie expressed they are things people shouldn’t do.

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The idea behind family for Morrie was the idea that a family shouldn’t be forced because social norms or pressure from your marriage. He believed a family was made from the idea of unconditional love and support that is created between the special bond you make.

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3. Morrie believed that everyday is a repeat, until you face death and that changes it.  It changes because, the idea of death makes you want to live life in the moment. The moment you let go is the moment you becoming free of stress and anxiety.

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3. To release stress and anxiety you have to forgive yourself, in order to move forward in life.

“For all the things we didn’t do.  All the things we should have done, you can’t get stuck on the regrets of what should have happened” (Albom 166).

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Morrie’s Gravestone turned out the way he wanted it.

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Morrie’s Gravestone turned out the way he wanted it.

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How Morrie explained what love should be 

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How Morrie explained what love should be 

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Morrie doing what he loved the most (Dancing)

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Morrie doing what he loved the most (Dancing)