Sara Szal MD
Women are expected to build secure attachment in their primary relationship with almost no instruction about how to pull it off. It’s part of the invisible emotional labor we are supposed to carry, and the emotional intelligence we are supposed to express.
I never got a manual at the altar. Did you? When my marriage began to falter, we went to couples therapy… on and off for 10 years.
I followed every directive and piece of advice to the letter. I tried Harville Hendrix Imago therapy about how your partner reveals your unfinished work, John Gottman’s love maps and appreciations, John Welwood’s focus on what blocks love, Sue Johnson’s work on what attachment fears drive conflict, and Stan Tatkin’s psychobiology model on how the nervous system creates relationship stability.
We saw many of these famous therapists personally.
I did all the homework between sessions. Mirror, validate, and empathize before responding! Five positive interactions for every negative one! Practice radical presence, stay on the razor’s edge insert of fixing it! Hold paradox! Create the couple bubble!
I ran every exercise exactly as prescribed, including one called the BOAT: Bid, Ownership of what I did wrong (two rounds), Appreciation, Touch. Sitting next to each other on a sofa, structured turns, someone always grading the tone. I believed, the way a physician believes in a well-designed protocol, that the right inputs would produce the right outcome.
We divorced anyway.
In my medical training, I was taught that a relationship’s communication problems were a soft skill, something to refer out to couples therapy, not something with a distinct physiology. It was separate from the health of a person, which was my zone of competence. A patients describes relational conflict, send them to a therapist who is good with couples, end of conversation.
What I know now, three decades and two divorces later, is that safety between two people is not a skill you practice on a sofa in a therapy office. It is a nervous system state, and it does not arrive because someone finally graded your tone correctly. It is a nervous system state that can be learned and embodied.
That knowledge did not arrive overnight, and neither did Brad. We met 31 years ago, as interns together at the University of California, San Francisco. He was training in internal medicine. I was training in obstetrics and gynecology. Life took us in different directions for a long time, but we kept in touch. We found our way back to each other three years ago.
Now as life partners, BradJacobsMD and I do something different.
We call it the Vibe Check. Once a week, more if either of our nervous systems is lit up. We do it hiking or watching the sunset or while making dinner. Moving, side by side, moving large muscle groups, and definitely not seated on a table, staring at each other’s face like two people who forgot they liked each other.
I paid thousands of dollars to learn what a sunset now teaches us for free.
I believe the geometry matters as much as the words. Sustained eye contact during a hard conversation reads to a stressed nervous system as confrontation rather than intimacy or safety. Moving side by side lowers the vigilance enough for two people to actually hear each other instead of defending territory.
Four questions carry the whole practice.
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How are you feeling in our relationship?
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Are your needs being met?
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What do you need from me this week?
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How can I be your ally?
There’s no scorecards or tone checks, just two nervous systems checking in instead of keeping score.
Co-regulation is a hormonal event for me: cortisol drops, oxytocin rises, and vasopressin, which reinforces pair bonding in every species we have studied it in, gets laid down again, one hike and one vibe check at a time.
You are not just talking about your week, you are dosing each other.
I’m a highly sensitive person, though I did not use that language or know about it when I was learning to be a wife the first time. For years I read every situation before I read my own body, as I’ve described here.
The Vibe Check is the first communication practice I’ve ever done that does not require me to manage anyone’s emotional temperature except my own. It is unmasking with a witness, and it only works because nobody is grading me.
Of course, the Vibe Check will not resuscitate a relationship with no safety in it yet. Structured therapy helped many women build that safety in the first place, and if you are earlier in the process than we are, a therapist’s office may be exactly where you need to sit for a while longer.
Vibe Check is maintenance for two nervous systems that already trust each other enough to answer honestly. It is not resurrection or a miracle, but wow, it fills me with delight, awe, and wonder.
If you spent years managing everyone’s emotional temperature just to keep the room calm, you already know what a formal sit-down costs you.
Try the four questions this week, on a walk, with no scorecard. Notice what your body does when nobody is being graded.
xo, Dr. Sara
Welcome to The Female Edge. A quick note on how this post was written: every idea here is mine, drawn from my own research, my clinical practice for 30 years, and my six published books. I use AI tools trained on my own writing to help me edit and publish more efficiently, the same way I’d use any other tool in my practice. The framework, conceptional model, critical thinking, clinical recommendations, personal experience, and the care behind it all are entirely my own.
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