Marianne Legato on Sex Differences

I doubt anyone will call her anti-feminist, but it's hard to say how people will react when "science" contradicts their pet ideology. There would be much agreement between her and (Dr.) Laura Schlessinger, so perhaps it would enough to dismiss her by saying "You agree with Dr. Laura!"

Dr. Legato is the author of Why Men Never Remember and Women Never Forget.

Original page for the interview

Why Men Never Remember and Women Never Forget

WebMD Live Events Transcript
Event Date: Wednesday, August 31, 2005


Why won't he ask for directions? Why does she always want to talk about the relationship? Why is it so hard for men and women to understand each other and what can we do about it? Marianne J. Legato, MD, author of Why Men Never Remember and Women Never Forget, says that our fundamental differences lie in the chemical and structural makeup of our brains. She joined us on Aug. 31, 2005, to share tips and strategies for learning to think like the opposite sex in order to get past our differences.

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live. Our guest today is Marianne J. Legato, MD, author of Why Men Never Remember and Women Never Forget. She's here to help us understand how to think like the opposite sex and get past our differences.

Welcome, Dr. Legato. Could you please tell us about "gender-specific" medicine and your work in this area?

LEGATO:
I became interested in the differences between men and women as a result of my research on women and heart disease. It became apparent there were significant differences between the sexes and in the techniques we should use to diagnose, prevent and treat coronary artery disease.

I began to wonder as a result of that research whether there were other, just as important, differences between men and women in other systems of the body, and found to my great interest and delight that in all of our body systems, there are significant differences between us. I am now convinced a patient's sex should be a very important feature in how we prevent, diagnose, and treat all illness.

MODERATOR:
How does our physiology affect our brain function?
"There are differences in men's and women's ability to interpret facial expression."

LEGATO:
The anatomic, functional, even molecular characteristics of our brains differ between men and women. As a result, the way our intellectual functions operate are quite different as a result. Men's brains are larger than those of women, for example, but women have more intricate and extensive connections between their brain cells in, for example, parts of the brain devoted to speech.

MODERATOR:
How do these physical differences affect how we respond?

LEGATO:
There are differences in our ability to interpret facial expression and tones of speech. Women are more able to process facial expression and the tone of what is said to them than are men.

And because of the impact of estrogen on memory, another important difference is that women will remember details of unpleasant experiences much more than men. As a result, a woman carries a much more detailed memory of an unpleasant event than a man.

Even at rest, there is baseline activity in the primitive parts of the brain in the limbic system which is different in men and women. For example, at rest men are better able to perceive movement, even from the periphery of their vision than are women.

How can I soften bad memories?

MEMBER QUESTION:
How can I at least soften bad memories? I would find it easier to forgive if I could forget, or at least forget some of the details.

LEGATO:
I think it is very important to dispose of a disagreement with another person as quickly as we can. A bad or painful memory is best addressed by trying to negotiate some kind of understanding with the person with whom we had an unpleasant agreement.

If that's not possible, try to relegate that memory to a storage bin so it doesn't preoccupy you. If you find that in spite of your best efforts bad memories plague you, seek the help of a professional, because there is a tendency in some people to become obsessed with bad or sad memories. Psychiatric help or psychological counseling can be very helpful.

MODERATOR:
Let's go back to the differences between the genders. Can you give an example of a situation and how a man might perceive it, then how a woman may perceive the same event?

LEGATO:
If a woman has a problem, her tendency is to reach out to others and discuss possible reasons for the problem and solutions for it. So calling a mother or a friend to "talk through" the issue is characteristic of women.

Men, on the other hand, regard problems as something they need to solve. They do not like prolonged discussion; they will not have a tendency in general to discuss possible solutions. They will, by themselves, decide to ignore the problem or to solve it in as simple a way as possible.

"One of the almost inevitable traps into which women fall is to bring up past quarrels."

This is one of the most important reasons for the discontent of men and women with the quarrels they have. A man tries to move on as quickly as possible and either solve or close the issue and forget it. A woman's tendency is to remember the issue and think about it and discuss it until she is satisfied she has reached a solution.

One of the almost inevitable traps into which women fall as a result is to bring up past quarrels or issues that have still not been settled. This simply overburdens the listening male and is really counterproductive.

MEMBER QUESTION:
That's what my husband does; he "closes" the issue even though it isn't resolved! Drives me crazy! Just saying it is over doesn't make it over!

LEGATO:
We have to be realistic in our discussions with our significant others. Women are much more interested in the details of a personal relationship than are men. Men are only interested in the simplest aspects of the relationship.

Men don't tend to be as verbal as women at all. They move along after a problem or quarrel much more quickly than we do, and don't have the inner need for resolving an issue completely that women have. Do not take this personally. It does not mean your spouse does not care about you.

If you have an issue with your husband that is troublesome, and his response is not satisfying, try reading the chapter in my book called Legato's Laws for Improving Communication.

If, after you have pared down and refined your arguments to short, clear sentences, and suggested appropriate solutions to the problem, your husband still does not respond, I would suggest couples counseling. Often a third party can help resolve a situation and relieve a sense of being accused or being punished that many husbands have as a result of arguments raised by their wives.

How can I help my husband improve his memory?

MEMBER QUESTION:
How can I help my husband improve his memory? He has a hard time even remembering his own children's ages.

LEGATO:
I think we should realize that in general, women over the course of evolution have been selected out for their interest in and ability to sustain family relationships. Women are able to hold and process in their minds several events at once. Men have much less facility for doing that.

It is helpful if your husband cannot remember the ages of his children not to accuse him of not caring about his children, but if the occasion arises, remind him of their ages, such as at birthdays.

It is important for men and women to realize that because of differences in our brains and in the way society trains us, men and women communicate differently and emphasize the importance of things differently. Once we accept that, we no longer feel personally hurt because of what we interpret as a lack of interest from our spouse. If I had one message to give men and women, it would be that.

MEMBER QUESTION:
How do our hormones affect how our brains work? Do men go through hormonal changes that affect their brains too?

LEGATO:
Men and women both undergo hormonal changes as they grow older. For women, the change is more dramatic and compressed in time; for men, the change is more gradual and steady.

There is no question that good estrogen levels help memory and keep our brain cells in optimal operating shape. During the time estrogen production begins to falter, as they do in perimenopause, women experience difficulty in thinking clearly; they become depressed in some cases, and memory is impaired.

Sometimes estrogen therapy in the perimenopause is very helpful. Other women don't even notice menopause and seem to sail through it with no problem, but they are a minority. Eventually, particularly if we continue to exercise our brains and memories, and don't become too depressed or isolated, the changes in our thinking stabilize.

For premenopausal women, monthly cycling may have a real effect on intellectual function, and some of my female patients refuse to do complex intellectual tasks just before they are due to menstruate or the first day of their period They feel they are better able to process and remember information later in their cycles, when estrogen levels are higher.

"Repeating questions is not necessarily an indication that a man is not listening."

MEMBER QUESTION:
My husband tells me the same things over and over saying he doesn't remember all the times he asked me before. What is his problem? He drives me crazy!

LEGATO:
I think it may actually be a function of aging. A short, simple discussion with your husband and his doctor might be helpful.

There is a process called psychomotor testing, in which a qualified person tests a person for early dementia or Alzheimer's disease. There are mediations and techniques to slow down the process, if it is diagnosed, and so I would suggest if faulty memory becomes so severe it's irritating, a physician should be consulted.

MEMBER QUESTION:
My husband has done this for years. It's not dementia -- he just keeps asking until he gets the answer he wants.

LEGATO:
I think a simple, short conversation with your husband should go something like this: "I will answer a question once. If you repeat it I will answer it twice. I will not answer it a third time, no matter how many times you ask me. End of conversation."

And then stick to your guns. Do not repeat the answer more than twice. If this causes your husband significant distress, offer to take him to a physician or a neurologist to see why his memory isn't working appropriately.

By the way, repeated questions are not necessarily an indication that a man is not listening. Sometimes intense anxiety or worry can prompt a person -- male or female -- to ask the same questions again and again as a way of seeking reassurance.

For example, if a child who has used drugs is becoming secretive and depressed again, a concerned parent might ask the other repeatedly, when did he come in last night? Such a question in such a setting might not indicate a flawed memory, but more anxiety about the child.

If your husband's repeated questions seem to be prompted in situations or about things that make him anxious, it might be helpful to sit down with him and point out that he asks the same questions repeatedly on these topics, and try to find out if, in fact, he is upset or worried about the issue.

If he asks the same questions because he is not paying attention, that's a different issue. Men do not parallel process several things at the same time with the efficiency women do. If your husband asks you a question that is not connected to what he is doing, he may well not even hear the answer.

Direct his attention to you -- make sure he is looking you in the eye -- and answer the question. That may help. Try talking less. Try not drowning your spouse in a torrent of words. Make your communication clear and brief. If your husband wants more conversation, that is encouraging. It may be that you talk so much and so often he simply tunes out. Keep it to the essentials and see if that helps.

Why does a man repeat himself during an argument?

MEMBER QUESTION:
Would that speak to why a man repeats himself so many times during an argument?

LEGATO:
I think that if your husband or partner repeats himself most frequently during an argument, it is a sign of emotional distress and tension. Try to phrase your reply to something that does not further upset or stress him.

For example, a simple situation in which he has refused to take out the garbage. Instead of saying, "You never help me with the housework, and you haven't taken the garbage out in a month, in spite of all my requests." Try instead, "I really would like your help. Can you take this garbage out for me? I would very much appreciate it." And see what happens.

MODERATOR:
But doesn't that presume a societal role that we as women are responsible for the home and he is just being asked to assist rather than be a full partner?

LEGATO:
No, I think to make a request for help simply does not define a role. For example, another request might be, "I know it's Super Bowl Sunday and you want to watch the game. I have to leave tonight to give an important presentation. Can you look at my slides with me after the game because your opinion is so useful for me"?

The idea is not to threaten your significant other with tone or words. The idea is to solicit help when you want it. I might add that men's ability to decode our facial expressions is not as developed as ours. They cannot decode sadness on the face of women, for example, with great accuracy. It is important not to depend on sulking or angry glares, but use clear, brief sentences to communicate. Ask for the answer you want. Don't count on his interpreting from expressions what you need.

MODERATOR:
How do all of these differences affect how we parent?

LEGATO:
Parenting is an extremely demanding activity. In the first place, there are real differences in the rate of development of boys and girls. Young girls at puberty are much more mature in their judgment and decision making than are boys of the same age, who are inclined to be much more impulsive and not as mature in judgment until later in adolescence.

"We do get past our differences and become couples."

So how to help your children develop responsibility and do what is healthy and safe for them may require a quite different effort, depending on whether your child is male or female.

There is a special chapter in my book on parenting. It is called Peek-A-Who, the Changing Face of Parenthood. In that chapter, I discuss the fact that men and women parent differently. Fathers talk less to children and roughhouse more with them and tend to give their children more independence than their mothers.

One interesting study shows that when their mothers come near them, babies relax their pulse and breathing rate slows. In contrast, when their dads appear they begin breathing more quickly, their shoulders tense and their eyes open wide, as if they are expecting something quite exciting to happen.

MODERATOR:
Obviously, we do get past our differences and become couples. How do we manage to do that given how different we are?

LEGATO:
Men and women have rather well-defined roles to play in any partnership. In the first place, we are neurologically structured with abilities to do some tasks better than the opposite sex. That's not to say we can't learn to perform tasks equally well, but our basic equipment suits us to do some things better than others.

When a couple comes together, hopefully there are complementary talents they offer one another. I think the secret to a happy and long relationship is to depend on the other person's strengths and remember always that almost everyone has some good things to offer a partnership.

The marvelous thing about the brain is that it is not fixed but can develop new abilities as we call on it. So negotiation, compromise, and exploring in a sensitive and caring way the needs and thoughts of your partner is not only good for the partner, it will help you learn new strategies of teamwork and communication. One of the great benefits of living with other people is that we learn from one another.

Are women more prone to inherit mental health disorders?

MEMBER QUESTION:
Are women more prone to inherit mental health disorders?

LEGATO:
It is said that throughout the world, women are twice as likely to be depressed as men. Interestingly this is not true in India, where the rate of depression in men and women is equal.

I do feel that depending on others and on the richness of personal relationships, rather than on what one achieves alone, makes women, in general, more vulnerable than men to disappointment.

One of the most important things we can offer our daughters and sons when they complain of emotional pain or distress is to say to them, "What are you going to do about that?"

Instead of encouraging a girl to focus on the negative about a friendship, one might remind her that few relationships are perfect and certainly none is perfect for all occasions. Therefore, a whole palette of friends is important to cultivate. One to go shopping with; one to chat with; one to discuss problems with; another to laugh with. If one is out of sorts, don't take it personally, try to call on another friend.

Above all, try to construct solutions for your problems, rather than allowing yourself to sink into sadness and despair into how things are going. Men, by nature, are equipped to solve issues as quickly as possible, or if a problem is insolvable, to outrun it. I think this contributes to men's lesser vulnerability to depression.

MODERATOR:
How does our brain physiology affect how we respond to stress?

LEGATO:
Women's high estrogen levels have an impact on the adrenal gland and their stress hormones stay elevated in the bloodstream a full 24 hours after a challenging or upsetting experience. This is not true of men. This elevation in stress hormones explains the lingering effect of a quarrel or unpleasant experience in women.

Another interesting difference is women respond to elevated hormone levels like cortisol, which is released in response to a challenge with anxiety and depression. In contrast, men who have a jolt of stress hormones often feel an elevation in mood and they are invigorated after a quarrel or contest.

This simple difference in response to stress hormones may explain why, after a quarrel, a woman may be convinced her husband doesn't care. She sees his mood isn't sad, but may in fact be quite happy. In fact, it is a simple difference in response to stress hormones.

"Our differences decrease after 60 and as we age."

MEMBER QUESTION:
Do men really just not listen?

LEGATO:
There is some evidence to show that the accuracy with which men hear the spoken word tends to decrease, even as soon as the age of 35, and so they simply may not hear correctly all the time. Keep your communication short, clear, and concise.

MODERATOR:
As we age, do our differences decrease or do we simply learn to work past them?

LEGATO:
That is a wonderful question.

In the first place, I think our differences decrease after 60 and as we age. Testosterone levels fall and men's memories become as affected as women's; so does their sensitivity to pain and their feeling of being fragile and needing care.

Apart from the simple physiological differences, I believe we learn from one another, lose our fear of being abandoned by one another and come to terms with the gaps in our relationships, as well as its strengths. I have had many patients who say to me, my marriage is not perfect, but after 30 years, I know I don't want to be alone, that he has many wonderful features, and that I can't depend on him for some aspects of my life.

MODERATOR:
Dr. Legato, do you have any final comments for us?

LEGATO:
Respect and try to think positively about the other person. Don't take differences in the way they communicate or approach an issue as evidence they do not care about you.

Understand that there are real differences in the way our brains operate and in our response to the hormones that are such an important part of our maleness or femaleness. I hope my book will help outline the nature of some of those differences and detoxify some of the hurt that arguments and a lack of communication seem to cause between men and women.

We can learn important things and improve our ability to cope not only with each other, but with the world around us, by taking the best of what our spouses have to offer and learning from it. The brain is not fixed in stone but grows and responds to challenges all the days of our lives, which should make us tremendously optimistic.