We all know that junk food and a sedentary lifestyle increase the risk for heart disease, but a third factor, stress, can also be quite destructive to the heart.
Effective emotional regulation buffers the effects of stress on the heart, but because humans are a social species, our ability to emotionally regulate depends heavily on our relationships. Healthy relationships that protect our hearts have one key ingredient: co-regulation.
What is co-regulation?
Co-regulation refers to each partner in a couple responding to the other’s emotional dysregulation in a way that calms their partner down.1 Co-regulation requires three skill sets: 1) the ability to identify when your partner is emotionally dysregulated, 2) the ability to tell your partner when you are dysregulated, and 3) the ability to react to your partner in a way that is calming. For example, when one partner comes home stressed from work, a co-regulating partner recognizes that the other is dysregulated (“I see you had a bad day”) and helps to calm their partner down (hug, offer to listen).
If partners are simultaneously dysregulated, they take turns stepping into the role of co-regulator in a way that feels balanced to both over time. Co-regulation buffers both partners from the negative impacts of stress on their health by helping to defuse that tension.1 With consistent co-regulation, over time, even just your partner’s presence can produce a calming effect.
Is it natural for humans to co-regulate?
Absolutely. Humans have evolved to be a social species, meaning our survival depends on communication, cooperation, and connection with others; this brings us mating opportunities, helps us meet our basic needs, and protects us from threats.2 Studies show that coregulation produces oxytocin,3-4 a bonding hormone that reduces stress,5 which means our bodies have a built-in mechanism that reinforces co-regulation.
Why is co-regulation good for your heart?
To answer this question, we first need to understand why stress is bad for the heart. During stress, the body releases cortisol, a hormone that raises blood pressure and constricts blood vessels. Chronically high cortisol increases the risk of hypertension, atherosclerosis, and abdominal obesity.
Stress also causes the body to release cytokines, which promote inflammation and plaque buildup in the blood vessels.7-8 Altogether, stress is an enormous strain on our cardiovascular system. While it is impossible to avoid stress, our ability to quickly return our bodies to a calm state reduces the toll stress takes on our hearts.
Where does co-regulation come in? First, myriad studies have demonstrated an association between relationship satisfaction and heart health.9-10 The pathway by which this occurs is via the impact of our partner on our physiology. When romantic partners interact with each other, their nervous systems become linked as if by an invisible string.11 If you are under stress, your partner will feel stress, and how you respond to your partner’s stress heavily influences their stress levels, which in turn will influence your stress levels.12 This means you have much to personally gain from attempting to calm your partner down. When each partner helps regulate the other’s stress, the outcome is emotional and relational equilibrium.
Additional evidence for the role of co-regulation in heart health comes from a study that found that romantic partners whose blood pressure declined during their interactions had reduced risk for heart disease 6 years later.13 This suggests that in-the-moment cardiovascular reactions during couple interactions can have long-term effects on heart health.
Another reason coregulating partners improve each other’s heart health is that co-regulation defuses conflict. Studies show that low-conflict romantic relationships have a protective effect on heart disease risk for both partners.14
How do you co-regulate?
The first step in co-regulation is to ask your partner what they need in their moments of dysregulation. This question alone will mean relationship points, but be sure to take notes on their answer! Generally, here are a few ways to co-regulate that will reduce stress and cardiovascular reactivity in most people:
- Physical touch (e.g., holding hands, a hug)
- Eye contact
- Reflective listening is a form of listening that summarizes and empathizes with what was heard
- Deep breathing together
- Rituals of connection, such as a reassuring phrase (“I got you, OK?”)
- Offering help with a task
- Stress check-ins (“Where are you right now on a scale from 0-10?”)
What gets in the way of co-regulation?
1. Poor emotional regulation: The biggest challenge to co-regulation is regulating your own emotions enough to have the bandwidth to do it. This can be especially challenging during conflict. Emotional regulation can be thought of like oxygen masks on an airplane—you have to put yours on before you can help another person, but you want to avoid taking so long that you don’t get around to your partner. When helping your partner feels like a big lift, remember that co-regulation is itself a form of emotional regulation, meaning that helping to calm your partner down will calm you down.
2. Emotional isolation: This is when one partner isolates under stress and prefers their partner to do the same. Research shows that closing the door to co-regulation may not be a healthy choice. One study showed that partners who are ambivalent or who receive ambivalence during their interactions had greater coronary artery calcification, a serious risk factor for heart disease.15
3. Resource depletion: Even the best co-regulators can falter when their emotional resources are depleted due to things like sleep deprivation, illness, caregiving, competing demands, and or sensory overload. Keep these things in check with good self-care habits to help you maintain bandwidth for your partner.
What if co-regulation dysregulates me?
If the idea of co-regulating with another person raises your blood pressure, you may be in a state of chronic dysregulation; it may hamper your ability to be present for someone else. Working with a therapist to identify the root cause will improve your quality of life and the quality of your relationships.
The next time your partner seems stressed out, give co-regulation a try by holding their hand, looking into their eyes, and asking them, “What do you need from me in this moment?”
