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Dr. Kenneth Appel,our guest speaker, is a clinical psychologist who works with individuals, couples and families on relationship issues. Our discussion centered around unhealthy relationships, creating healthy relationships, being in a relationship with someone who has a mental illness, and online relationships.

David moderator.

The people in blue are audience members.

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to I hope everyone's day has gone well.

Our conference tonight is on "Recognizing Unhealthy Relationships and Creating Healthy Ones". Our guest is Kenneth Appel, Ph.D. Dr. Appel is a clinical psychologist who has worked with individuals, couples and families for over 37 years. He is on the faculty of the University of California, where he teaches psychiatry residents, and also teaches in the Department of Psychiatry at California Pacific Medical Center. I also want to mention that Dr. Appel met his wife online and later tonight we'll talk to him about that and the subject of online relationships.

Good Evening Dr. Appel and welcome to We appreciate you being here tonight.

So we are all on the same page here, please give us your definition of a "healthy relationship" and an "unhealthy relationship".

Dr. Appel:: A healthy relationship is characterized by dynamic balance and intimacy. An unhealthy relationship is characterized by being severely out of balance, with intimacy diminishing on a rapid curve.

David: "Dynamic balance" means what?

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Dr. Appel: Well, consider a picture of the Tai Chi symbol, a circle containing black and white in the form of an OGEE curve. Compare it to the same circle with one half painted black and one half painted white, and you'll see the difference between a relationship with dynamic balance versus one which is static though balanced.

David: Is it hard to find and maintain a healthy relationship?

Dr. Appel: I think not. I think that the opportunity to find healthy relationships is directly correlated with self-knowledge and maturity.

David: A significant number of people seem to hook up with the "wrong person." Why is that? Is it something within ourselves?

Dr. Appel: I think that's a good way to put it, that it might be something within ourselves that's perhaps unconscious, that motivates us to seek out a compliment to something unhealthy in ourselves. So we can learn from relationships like this and learn more about ourselves perhaps than about the other.

David: I'm also thinking that sometimes we meet a person, develop a relationship with them, then after several years, it all seems to fall apart. It used to be that when a person considered marriage, that it would be forever. That's no longer true. Do you think that it's extremely difficult to have a satisfying long-term love relationship?

Dr. Appel:: The nature of marriage seems to be changing parallel to the extension of life span. That is, as we have many many more years to live, the notion of "till death do us part" is being defied by current sociological evidence about divorce. However, there are many relationships which follow a developmental course, that last indeed forever and remain in dynamic balance, share intimacy, and continue to grow.

David: What is the criteria one should use to decide this is an "unhealthy relationship?"

Dr. Appel: There will be gut feelings that will inform you that "something is wrong." These feelings should be trusted. As they are trusted, they will begin to clarify what is going wrong in the relationship. For instance, diminishing intimacy, lack of sex, which usually begins with the distaste for kissing, fewer common goals. But above all, what you will feel is a closing of the heart, and everything in the relationship is then open to criticism.

David: The reason I asked that question is because, as you know we are a mental health community here at I get letters all the time from visitors and one topic that comes up a lot is how difficult it is to maintain a relationship when either you, or your partner, have a psychiatric disorder. As you can imagine, there can be some very trying times. I would like you to address that subject and give us some insight into when, or if, the non-ill partner should say "I'm getting out."

Dr. Appel: Good question. In the presence of a severe psychiatric disorder, that is one that is clinically manifested, relationships are severely stressed, and it is natural for the non-ill partner to wish to be out of the relationship and at the same time not to abandon the partner who is in trouble. The more severe the illness, the greater the stress on the relationship. And here, I'm talking about uncontrolled bipolar disorder, untreated psychotic depression, severe obsessive compulsive disorder, agoraphobia, etc.