How's Your Marriage, Doctor?

The chief complaint of many medicalcouples is, "We're not communicating."I like to equate thismarital symptom with a fever. When apatient has a fever, my goal is to find thecause and institute treatment.

Communication troubles are not uncommonin physician marriages. Wecommunicate with our patients, colleagues,staff, and friends very differentlythan with our spouses. There is tremendousmystery in marriage, and in no otherrelationship are we so vulnerable. Thishelps explain our headaches andheartaches when things aren't going sowell at home. If you are a physician in acommitted relationship who wondersabout communication, here are someimportant questions to ask yourself:

• Do you feel bored or lonely, especiallywhen the two of you are alone?When you consider the current state ofyour relationship, do you find yourselfworrying about the future?
• Does your spouse complain thatyou don't share enough of yourself? Howdoes this criticism make you feel? Doyour reasons (eg, "I'm tired," "I don'thave anything new to tell," or "I wasborn this way") seem unsatisfactory?
• Are you arguing without resolvingthe issues? Do you argue about the samematters? Do you find that "agreeing todisagree" really isn't working? Do yourarguments leave you feeling exhausted,frustrated, or demoralized?
• Are your arguments increasing infrequency? Do you disagree about trivialmatters? Are your arguments increasingin intensity? Are they escalating to fights?
• Instead of arguing, are you withdrawinginto yourself or using passive-aggressivemaneuvers (eg, forgetting requests,coming home late, or respondingwith sarcasm)? Is your spouse doing this?
• Do you make a beeline for theliquor cabinet after work instead of talkingabout your day, or give an abbreviatedversion once the alcohol takes effect?
• Is it possible that your medicalwork has become preferable to conversationswith your spouse? Do you find practicingmedicine more fun, rewarding, andego-boosting than spending time alonewith your spouse? If so, are you overworkingto run away from home?
• How is your sex life? Do you findthat your sexual relationship doesn'tseem very intimate? Do you have sex butdon't make love? Have you or yourspouse grown disinterested in that dimensionof your relationship?

If you answered yes to any of thesequestions, don't despair. You can domore to improve things at home thanyou realize. In my next column, I willdiscuss how to put some "oomph" inyour communication.

Michael F. Myers, a clinicalprofessor in the Department ofPsychiatry at the University ofBritish Columbia in Vancouver,Canada, is the author of Doctors'Marriages: A Look at the Problemsand Their Solutions (Plenum Pub Corp;1994) and How's Your Marriage?: A Book forMen and Women (American Psychiatric Press;1998). He is the past president of the CanadianPsychiatric Association and welcomes questionsor comments at myers@telus.net.