Limerence And Love

Once upon a time when I was a humble resident at the outpatient clinic of the University of Kansas School of Medicine, Wichita, Kansas, I shared a patient with a psychologist in private practice.  He was Jewish, of eastern seaboard origin and training.  He asked me for a date, and we dated a few times.  Dr. C. was really smart, and was a top-notch therapist who knew plenty more than a lot of the university types. After four dates, he did not even try to kiss me — not even a chaste peck on the neck — nothing, really. I liked him.  He was a puddingy guy, in both body and disposition — no athlete, not a heartthrob, and I certainly could not motivate myself to kiss him first.  But I really did like him. I asked him, as gently as I could, if he wanted to continue to hang out, because it was plain to me that this was not going anywhere.

“We got no limerence,” he told me. He was a little disappointed that I did not know the meaning of the word.  I shrugged my shoulders; this was psychology, not psychiatry, and I knew plenty of stuff, but not this. He told me that when he looked at me, he saw the tiny piece of food stuck between my teeth.  Besides, I was a “larger” woman and he preferred shorter. He was really saying I was too heavy, which I would have been for lots of folks at that time. I thanked him for his candor. I saw him next at a local film series with his date, a very thin woman with crooked teeth, who did not seem to have any food stuck between them. He was right.  We had no limerence. As far as I was concerned he didn’t find me in any way “sexy” and didn’t want to try and that was just fine, really.  It was all cordial and we continued to share patients. Curiously enough, I was friendly with his family. The idea of a psychiatrist and psychologist being married and practicing together was financially seductive to his family.  It was easy to stay with them when I was invited East to present a paper at a conference. I told his sister-in-law, after a warm greeting, that love was not going to happen and certainly not marriage but I needed friends and I was only a resident so not very rich could I stay with them anyway?   She laughed and then so did I. All of this has been good. I now have love and limerance and a thousand other delicious things with my beloved husband. Still, I checked up on Dr. C’s use of the term “limerance,” and it was accurate.

The psychologist Dorothy Tennov earned her immortality by coming up with this term in her 1979 book, ” Love and Limerence: the Experience of Being in Love.”

Her description certainly explains why it is generally pretty much impossible to work with a member of a psychiatric clinical staff who is “in love.” (They don’t usually recognize it as limerance, even if they know the concept.) Come on, you work with them, too, or at least know them, or at least laugh when they are ridiculed on television sitcoms. To her credit, Tennov characterized the “thoughts, feelings, and behaviors” of the state as “obsessive-compulsive,” which they certainly are. Oh, the longing for “reciprocation.” Oh the “emotional dependence.”

This is the acute stuff about which songs are written.  If it lasted much longer, people probably would have trouble dealing with its intensity.  It allegedly becomes something more mature and stable as one progresses in love. There is no doubt that it is a neurochemical and physiological phenomenon. As for continuing to do psychiatric clinical work during the phenomenon, some folks do better than others. I am reasonably certain that nobody in my (university resident) clinic noticed any kind of a dip in my work.  Believe me, my supervisor would have told me if there had been any problems. I verified my beloved had two physical signs of limerence that I could verify, so that I could make sure that he was not faking. (Oh, I really was a woman of little faith, trusting in science more than love.) Both signs were nonspecific. The first was a rapid pulse.  This one was not hard to check out; I mean, there would have been something going wrong if there had not been at least some wrist-and-arm touching going on. I had to estimate here.  I mean, I did not exactly want him to see me consulting the second hand on my watch. (I did take care to avoid taking his pulse in other, possibly more controversial places.) The second sign I went for wads dilation of his pupils.  This was easy enough to observe when I moved in for the kiss. My heart nearly leapt out of my body when I saw how dilated his pupils were. As far as I know this is impossible to fake. I do suppose other things could have caused it. The ambient light was not dim enough to explain it. I had recently read that pupils could sometimes get dilated with, for example, intense concentration on mental mathematics.  By this time, I knew the gentleman well enough to believe that was not a particularly likely possibility. Monitoring the sympathetic nervous system given the current sophistication of neurotransmitter measurement may seem a bit simplistic, but it still works. I strongly believe this is the sort of educational information, if any, that needs to be included in any set of core educational standards.  I mean, this is something humans need to know about to govern their own lives.  Aside from a couple of specialized journals, the only place I know where non-professionals can learn this kind of crucial information is from me.

Once there was a time that I turned to the Skeptical Inquirer magazine for fearless objectivity.  At least this online article seems a tad more flippant than I recall. I am really glad that this author came to the conclusion that, with current technology, it is not possible to read limerence, let alone true love, from a brain scan. Right now, even the diagnosis of hard-core psychiatric pathology uses biological, psychological, and social parameters.

They are still necessary here. Any attempt to label a single neurotransmitter as the stuff of which “morality” or “love” or any concept now socially defined is what Molly Crockett, a neuroscientist I have come to love, calls “neuroflapdoodle.” among other things. Fast-forward to a very lovable staff member of a psychiatric clinic that dealt with me for a few months. She was — to her credit — one of those who could maintain her work standard while she was in her “special” state. She was in her later sixties, and was surprised to find herself “in love (limerence) with someone she had known years earlier.  This self-described “old hippie” actually showed me lovely photographic portraits of both herself and the object of her affection from the old days. They were dreamy, with longing gazes into the distance. “It feels like a dopamine bath,” she told me with dreamy eyes and a wide smile.  She had chosen to share with me this amazing confidence because she thought I was smart enough to know what was actually going on.

I told her, as gently as I could, that although dopamine was the major “pleasure” transmitter in the human brain, things going on were a bit more complicated. For one thing, dopamine plays roles in a lot of other functions.  Cognition and attention and memory come to mind, for these are things I deal with and venerate.

There has been a wild increase in the studies about neural mechanisms about romantic love and related processes in recent years.  So much so that the easiest way to put them together is by reviewing a good review.

(NOTE: This link will open or download a PDF file.  You must have the free Adobe Acrobat reader to access this) Most of the studies reviewed have results more referable to regions of the brain where neurotransmitters may predominate than to individual neurotansmitters.  This makes sense given that the system is so complex that despite the advances in technology, people are still playing around with really basic philosophical questions like whether a human brain can ever understand its own complexity in any meaningful way. Romantic love has been studied in both heterosexual and homosexual relationships, in all stages from limerence through long term relationships.

Structures involved include those already implicated in sex and feeding — that is, behaviors necessary for survival of the individual and ultimately in the survival of the entire species. This might have slightly greater clarity in studies of earlier stages of attraction.  In later attraction, the quality of the relationship seems to buffer partners against the emotions of threat or stress.  This is great news for the real romantics, who want love to last forever — it actually seems good for you, and able to help keep you healthy.

Neurotransmitters implicated in this romantic love thing are many, and include oxytocin, vasopressin, serotonin, and norepinephrine, as well as testosterone and estrogen.  The take home idea here is that estrogen alone cannot be the be-all and end-all for this phenomenon to happen in women, for the woman who worked at my clinic and said she was having a “dopamine bath” was enough post menopause that my guess is her estrogen levels were unlikely to have been terribly impressive.  I can, however, vouch for the fact that testosterone has been implicated in sexual attraction in both sexes. When I took care of male patients transgendering to female, I often told them not to worry too much about their persistent testosterone levels, as they often did, for I thought as a postmenopausal (and very loving) woman I probably had more testosterone than they did.

Although many authors, including these, seem to be imagining there is a way to tell from a brain scan whether or not somebody is in love, we simply are not there. Expense would not be a barrier if accuracy were present.  The person who made this reflection probably was not a clinical psychiatrist, for the cost in terms of people (women in particular) whose psychopathology has been fueled by the noton of romantic rejection is simply too overwhelming.

The bottom line is that loving is a neurophysiological process, with an undisputed role in evolutionary biology, and an important role in helping to preserve our species. The tough part is getting people to understand that this takes nothing away, and may actually add something to ideas like “chemistry” and “mystery” and even “magic.” This reminds me of a wonderful and highly technically sophisticated obstetrician-gynecologist I worked with in Amiens, France, many years ago.  She believed women’s bodies to be controlled by the yin/yang forces and the whole hormonal (estrogen/progesterone, mostly) system controlled women’s bodies, too. She saw neither competition nor contradiction in the two systems.  She was a woman of great calm and equanimity, and we admired her for it. I think it is important to keep all the Shakespearean love sonnets along with any neurochemical explanation of romantic love.  They do not contradict the neurophysiology — rather, they underline its power.

In parting – I would like to share my favorite sonnet from “The Bard.” I often quote this to my own true love, my husband of Limerence And Love:

SONNET CXVI

Let me not to the marriage of true minds
Admit impediments. Love is not love
Which alters when it alteration finds,
Or bends with the remover to remove:
O, no! it is an ever-fixed mark,
That looks on tempests and is never shaken;
It is the star to every wandering bark,
Whose worth’s unknown, although his height be taken.
Love’s not Time’s fool, though rosy lips and cheeks
Within his bending sickle’s compass come;
Love alters not with his brief hours and weeks,
But bears it out even to the edge of doom.
  If this be error and upon me proved,
  I never writ, nor no man ever loved.