The well-being of physicians is the product of at least two distinct domains of life: the professional and the personal. Most recent study of physician well-being and its counterpart, burnout, tends to focus on the professional side. But the personal domain often plays at least as large a role in overall well-being, and for many physicians, the single most significant aspect of personal life is their most important long-term relationship, often marriage. A flourishing relationship offers companionship and promotes both physical and emotional well-being, while a failing one can take an equally substantial toll. Those seeking to enhance physician well-being need to understand the features of thriving relationships. Two important sources of insight on such relationships are empirical research and imaginative literature.
Empirical Research
Empirical research offers one approach to understanding why some relationships thrive while others do not. For example, in 1999 a researcher at Washington University, John Gottman, published The Seven Principles for Making Marriage Work . His seven principles are: enhancing love maps, nurturing fondness and admiration, turning toward each other instead of away, allowing partners to exert influence, solving solvable problems, overcoming gridlock, and creating shared meaning ( ). Other researchers have developed different frameworks for understanding long-term relationships, one of which emphasizes the importance of mutual support ( ). The fact that such theories tend to overlap substantially makes Gottman’s model a reasonable one to focus on.
By “love map” Gottman refers to partners’ understandings of each other, which could include their biography, their hopes and fears, and their general outlook on life. When partners better understand one another’s love maps, he argues, they are better positioned to communicate and connect with each other. For example, if one partner wants to express appreciation for what the other has done, situating it in the context of the other’s love map will enhance the degree to which they both understand and benefit from it. Conversely, failing to understand a partner’s inner life and experience of the world will make effective communication less likely.
Partners who nurture fondness and admiration take time to reflect on each other’s noble qualities, in effect reminding themselves of the roots of their love. One such approach is to ponder a particular quality, such as honesty or compassion, that makes the partner admirable. Another is to reflect on past incidents or shared experiences that serve as reminders of the partner’s best qualities. To do the opposite—to focus on qualities or past experiences that lead to resentment against a partner—is to sow the seeds of discord. Implicit in both approaches is the idea that what partners habitually attend to will, over time, powerfully shape their level of fulfillment in their relationship.
Turning toward the partner means seeking out opportunities for companionship and connection. One recent study showed that physicians’ marital satisfaction is associated with the number of waking minutes they spend with their partners ( ). When partners fail to spend quality time with each other, think about each other little when apart, or fail to share the events and experiences that make up their lives, the probability increases that they will grow apart. Simply put, it is important that each partner develop the habit of shifting attention when the other makes a bid for it. Such bids may take very different forms, from sharing a hurtful incident to recounting a humorous story, but in each case, the key is to engage rather than to disengage. Underlying this advice is the notion that neglect can prove no less harmful than outright hostility.
Allowing partners to exert influence means that neither partner conceptualizes the relationship as made up of two parties, a sculptor and clay. Where one partner assumes the role of shaper, expecting to do all the shaping while undergoing none of it, the long-term prospects for the relationship are poor. More recent work also supports this notion that a need to be in control can wreak havoc on a relationship ( ). It is far more realistic and fruitful for both partners to expect to be shaped by each other, and that such influence will, at least in large part, help them to become better people. Implicit here is the notion that neither partner enters into the relationship as the fully developed person they are meant to be, and the relationship itself plays an important role in completing this growth and maturation.
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Literature
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Conclusion
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References
1. Gottman JM, Silver N: The seven principles for making marriage work.1st ed.1999.Crown PublishersNew York, NY
2. Perlman RL, Ross PT, Lypson ML: Understanding the medical marriage: physicians and their partners share strategies for success. Acad Med 2015; 90: pp. 63-68.
3. Shanafelt TD, Boone SL, Dyrbye LN, et. al.: The medical marriage: a national survey of the spouses/partners of US physicians. Mayo Clin Proc 2013; 88: pp. 216-225.
4. Meyers MF: Medical marriages and other intimate relationships. MJA 2004; 181: pp. 392-394.