How's Your Marriage, Doctor?

Dear John

I recently received an unexpectedphone call from a former colleague.“Greetings Dr. Myers, thisis Dr. Beck calling. I'd like to see you. Icame home from work the other nightand found a letter. I'm prettyupset.” I responded to Dr. Beck'snews with an unconscious, gut reaction,“Ouch, I'm sorry to hear that.Sure, let me get my appointment book.How about tomorrow at 6 PM?”

Dr. Beck was a young nephrologist.I remembered him from his medicalstudent days, when he spent his psychiatryclerkship with me at the teachinghospital where I work. I alsoremembered his wife, Dr. Ames, whodid her clerkship here too. She hadgone on to become a family physician.They were a striking couple; they wereboth very good looking, smart, well-liked,and musically talented. And theyran marathons together. I wonderedwhy Dr. Ames had moved out likethat—gone with just a goodbye note.

Background Check

When I met with Dr. Beck he wasmore than upset. In fact, he was awreck and absolutely devastated thathis wife was gone. He told me thatthey had visited with a marital therapistabout 2 weeks before his wife'sdeparture. Dr. Ames did not see anymerit in returning to the psychologistbecause they were both too busy to go.“That's a crock,” Dr. Beck responded.He told me that he thought the therapyfrightened his wife.

Dr. Beck thought this fear was rootedin her adolescence. “She was forcedto see a psychiatrist when she was akid. She had a long bout of anorexiaand bulimia,” he said. Her parentswere very unhappily married. Hermother attempted suicide a number oftimes and was eventually diagnosedwith bipolar illness. They went on todivorce when Dr. Ames was away atcollege. During her first year of medicalschool, Dr. Ames' mother killedherself. It was shortly after this painfulloss that she met Dr. Beck.

“My background is no bed of roseseither, Dr. Myers,” Dr. Beck said. “I'mthe child of 2 alcoholics—both doctors.My mother got help though.She's been dry and with AlcoholicsAnonymous for 5 years. My dad stilldrinks, but he drinks less. He loves hisdenial and is very self-righteous. Myfolks have a lousy marriage. My brotherhad problems with cocaine. He'sbeen to residential care twice. Can yousee why, with my wife's backgroundand mine, it's so important to me tomake my marriage work?”

Dr. Beck told me more about hisrelationship. They both worked hardand played hard. They had lots offriends, kept active, and enjoyed participatingin community events. Becauseof their own difficult upbringings,they had decided not to have children.However, except for everydaymatters, they didn't talk easily together.Despite this, it was only in the pastyear that Dr. Beck sensed that his wifewas pulling away.

Problematic Conditions

According to Dr. Beck, his wife hadmade a number of independent friends(all single or divorced) whom she preferredto see on her own. She was lesscommunicative and more private athome. “She was kind of touchy when Iprobed,” Dr. Beck said. Their sexualrelationship had become nonexistentover the past few months. “Of course,I suspected an affair,” he said. AfterDr. Ames denied the charge, Dr. Becklet it drop.

I met with Dr. Beck for over a year.He needed to talk about being abandonedand the frustration of not beinggiven a chance to fight for his marriage.He gained important insight intohis loneliness and other wounds. Heexplored how he became a professionalcaretaker and a familial caretaker tohis wife initially. Our work togetherended when he began group therapywith other physicians seeking tounderstand themselves better.

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.