Psychotherapy and Marital Therapy for Physicians

While many physicians are happy in their personal and professional lives, it is also true that physicians "routinely claim to be working too many hours, at too chaotic a pace, under too much time pressure." And while physicians have a broad range of personality characteristics, they do tend to have some traits in common: "Doctors tend to be perfectionists and hard workers, to a fault. They often demand a lot of themselves. They can have difficulty relaxing or allocating time for themselves, and they tend to have an exaggerated sense of responsibility to patients." (Roger Collier, citing Dr. Tait Shanafelt, director of the Mayo Clinic Department of Medicine Program on Physician Well-Being in Rochester, Minnesota, CMAJ December 11, 2012 vol. 184 no. 18. First published October 29, 2012, doi: 10.1503/cmaj.109-4329, 

Collier cites Shanafelt further: “'Part of what makes us good at what we do also puts us at risk,'" and continues: "The combined effect of the external and internal stressors affecting physicians is a high rate of burnout. In fact, nearly half of doctors will at some point in their careers experience this condition, which...(has) three classic signs: emotional exhaustion, a reduced sense of accomplishment and 'depersonalization' (an excessively detached response to duties and a cynical attitude)."

 Physicians also are thought to experience depression and substance abuse problems at a rate equal to if not higher than that of the general population, and commit suicide at higher rates (this is even more true of female physicians) (Berge,, Mayo Clin Proc. 2009 July; 84(7): 625–631, ).

I spent 17 years working with physicians: as the Behavioral Science faculty member of the Mercy Health System Family Medicine Residency Program in Janesville, WI. There, I taught young family physicians about psychological, behavioral, interpersonal, and emotional aspects of primary care medicine, and also counseled and supported them regarding their own wellbeing and managing the stresses of practicing medicine.

From my experience, I know that physicians spend a lot of time taking care of and trying to "fix" problems in others. In fact, in my work with medical residents (the term for physicians in training after medical school), I coined the term "fix-it-itis" for their inclination to feel responsible for fixing whatever problems patients shared with them.  This inclination becomes problematic because, though it may be possible to "fix" problems like bacterial infections, it is not a realistic expectation when it comes to others' emotional, interpersonal, and psychosocial problems. 

Perhaps as a result of their professional role as "fixer" and healer, physicians often seem much less comfortable acknowledging difficulties, stress, or distress in their own lives, especially if and when they can't identify solutions - "fixes" - on their own. As a result, they may be reluctant to acknowledge the need for personal assistance or to seek psychotherapy. Also, the practice of medicine places a premium on speed, efficiency, analytic thinking, and practicality, which may seem somewhat contrary to the perceived "touchy-feely" world of psychotherapy. This discrepancy may further discourage them from approaching that world.

Some physicians have made their way to my office individually. Others have come in with spouses - typically wives - when the stresses of medicine, together with other personality characteristics and dynamics, have caused problems in their marital relationships. I have been in a good position to make a connection with them: understanding the professional stresses they face and the related difficulties of letting their guard down, acknowledging their feelings and needs, and allowing themselves to need and to get help.

If you are a physician who is feeling stressed or unhappy, I invite you to contact me by filling out and submitting the secure form below, or leaving a confidential voicemail at 608-271-8799. I have a private office and a private waiting room, maximizing anonymity; both look out onto a pleasant courtyard. (During the pandemic, meetings are online.)

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