It's always seemed to me that one of the main sources of tension in John and Elly's marriage is their differing backgrounds. As I had mentioned before, John is a man from a small town while Elly comes from a big city. This tells me that their understated physical and emotional bonds, while real on some level they don't feel like sharing with others, have to overcome the obstacle of very different expectations of the world. It seems to me that John might be seen in his home town as a local boy who made good. This need to not disappoint or betray the trust of the folks back home by being anything less than an exponent of their values is something that would never occur to someone who grew up with the expectation of anonymity. She'd have a hard time trying to figure out that he needs to stand out in the crowd; he's just another dentist, after all. Why should she care if a bunch of people she doesn't know think highly of him. The point of life is to impress the people they know, not to be a beacon for people she doesn't.