It was on a Sunday afternoon that the pain pushed its way to the surface of my awareness. Coming from a tooth on the upper right side, as far as I could tell. Just a passing sensitivity, I thought-hoped. The next morning it spoke louder, finally drowning out my stoic, "It's-not-bad-enough-to-call-the-dentist" voice. Two hours later I looked up from my prone position as the dentist made his pronouncement: "Yep, looks like the beginning of an abscess; gonna need a root canal, buddy." And that was that. Eighteen hours after I first noticed the pain I had a diagnosis and treatment plan. Contrast this with the fact that, on average, it takes six years from the time a marital problem develops until a couple seeks professional help!

If couples aren't seeking help in a timely manner, we might wonder what they are doing during those six years in relation to the problem. Many times they start out by trying to deal openly with the problem, but in a misguided way, i.e., by trying to change each other. When they exhaust themselves in this futile effort (although some make this a conflictually-habituated way of life) they then may begin to employ various mental gymnastics and behavioral maneuvers in an attempt to avoid dealing directly with the issue. With regard to the former, denial and rationalization are common defenses. For example, a couple may believe that the cause is external or situational, and that when this passes or changes, the relationship will right itself (rationalization). Or, they may tacitly agree to ignore the husband's gambling addiction (denial).

With respect to the behavioral side of the equation, let's look more closely at some of the strategies couples use to circumvent their problems.
*The "Identified Patient." The problem may be viewed as an individual dysfunction and the interactional aspect of it denied. One person of the couple accepts the label of the sick one, the identified patient. Thus here the husband's gambling addiction is recognized, but dealt with solely as an individual issue. But if the husband stops gambling, this may destabilize the marriage because the wife hasn't changed her codependent role.
*Triangulation. Couples may get the heat off themselves and their issues by focusing on a third entity-either as an enemy they're united against (we call this "scapegoating"), or as a project they can embrace together. Children, an addiction, an invasive parent, a tyrannical supervisor, church, a sport--all of these and many more (even the "good" ones), can serve this purpose of avoiding the real, more threatening issue. Triangulation can go on for years. But what happens when the kids leave home, the meddling parent dies, or the addiction is treated? As noted above, this may destabilize the situation causing a marital crisis.
*Sublimation. This is a defense mechanism by which one seeks fulfillment and satisfaction through an alternative source. Obvious candidates are work, hobbies, artistic expression, a social or religious cause, a spiritual discipline-any skill or activity which is intrinsically rewarding or garners praise, admiration and respect. This sounds a lot like triangulation. But here only one person is focused on the activity. Sublimation can work if both find an outlet that's sufficiently engaging. But the barrenness and disconnection in the relationship versus the intense involvement in their respective outside interests may be increasingly difficult to ignore as the years pass.
*Affairs. We might call this, "Sublimation with a human face." But while you might be able to rationalize away your spouse's workaholism (sublimation), it's nearly impossible when the object of their passion is a person of the opposite sex. Affairs obviously are the ultimate in triangulation. Of all the strategies of defense, affairs, when discovered, are the most likely to end the avoidance and bring things to a head. Affairs are perhaps the most direct way of dealing with the unmet needs that emotional and sexual distance in a marriage creates; they're also the most destructive to the marriage.

With all of these defenses we see an interesting thing: the consequence of avoiding the problematic issues is a loss of intimacy and of knowing each other as real people, warts and all. Couples end up throwing the baby out with the bathwater. And you also get a sense of how much energy it takes to avoid talking about the pink elephant in the room.

One way to make sure that you're not slipping into this avoidance pattern might be to schedule yearly check-ups and have your marital hygienist scrub off the plaque and tartar of resentment that's built up and x-ray for signs of root problems. Otherwise, over time, a marital abscess could turn into marital absence, and by the time you heed the six year itch it may be too late.