How's Your Marriage, Doctor?

When I lecture to physiciansand their spouses about marriage,I like to talk about thewarning signs of a marriage in trouble.

Watch for the following danger signsin your own marriage:

• A sense of something not beingquite right at home
• Feeling tense or anxious, havingtrouble sleeping, or losing your appetite
• Irritability with family, friends, orfellow coworkers
• Angry outbursts or generally feelingunhappy
• Vague physical symptoms, including:headaches, upset stomach, chestpain, dizziness, backache, etc
• Avoiding love making or makinglove in a halfhearted way
• Drinking more than usual, usingrecreational drugs, or taking tranquilizersand painkillers
• Persistent thoughts of separatingand planning what life would be like inyour own place
• Feeling fine yourself, but yourspouse is miserable

Sudden Change

The last is the single warning sign thatbrought Dr. Dal to see me. He thoughtthings were great in his marriage until 1day when his wife asked him for adivorce. He was stunned, saying, "Ithought she had been drinking or it washer steroids talking to me." (She was ona brief course of Prednisone for her asthma.)He continued, "However, I have toadmit that as she tallied up all of thethings that weren't happening in ourmarriage, I did see her point—but togive up and just end things is not right—I can't get her to change her mind."

Dr. Dal's story is a sad one. He emigratedfrom a third world country withhis family as a child. His parents boughta restaurant in which everyone toiled. Heworked his way through college andwith bursaries, scholarships, and loansgot through medical school. After hisresidency in family medicine, he tookover a solo practice in a neighborhood ofracial and ethnic minorities. His workethic prevailed. Approaching the age of40, kind of lonely and unmarried, he metsomeone through an Internet dating service.She was 12 years younger. Theywere married within 2 months of meetingeach other and started a family rightaway. They have 3 children, ages 8, 6,and 4. He is proud of being married andbeing a father. He showed me a photographof his family taken last Christmas.The photo showed a beautiful family,but I noticed that no one was smiling.

Hidden Troubles

I asked Dr. Dal what his wife's complaintswere. He said: "She says that Iwork too hard, that I'm no fun, that Iworry about money too much, that I'mold and I'm making her old, that shewants to be free to meet younger men,that she made a mistake marrying me,that she wants to date a man who is culturallymore like her, and that she doesnot like my family—they are too seriousand she can't relate to them."

Dr. Dal's efforts to get his wife to comein to meet with me have fallen on deafears. I called her myself and invited her into tell her side of the story. Although verycordial to me over the phone, she refusedto see me, and she is not open to maritaltherapy with anyone. To quote her, "I gotmarried too young. I just want out."

I will do my best to help Dr. Dal navigatethe long journey of separation anddivorce that lies ahead.

Michael F. Myers, MD, 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.