How's Your Marriage, Doctor?

This month I want to return to thetheme of love and the medicalmarriage. More specifically, let'sfocus on when love for one's spouse isdying and love for someone else is sprouting.Although this can happen in the marriagesof both male and female physicians,I will discuss only men in their middleyears here because this is the group that Isee most commonly.

Messy Situation

Dr. Hall, a 55-year-old family physician,started his first visit with these words: "Ihope I'm not wasting your time. My life is amess. I've been married for 32 years to avery decent woman, a good mother, and akind soul. Only problem is that I'm not inlove with her anymore. I love her, I careabout her, and I respect her values, but Ifeel nothing exciting. No spark. No desire.We haven't had sex in I don't know howlong. No interest to do anything with her.

"Last year I met someone else at work,a nurse. I'm the classic cheating husband.Last month my guilt got to me and Idecided to stop seeing her. That lastedless than a week. Not only am I right backat it, but also it's more intense than ever.Two weeks ago, I told my wife about her.I was shocked that she wasn't surprised,she had suspected it for months, and shewas so calm. I moved into a hotel lastweekend and I'm getting my own apartmentat the beginning of the month. Sowhy am I here? I need help. I've neverdone this before, and you psychiatristssee this stuff all the time."

Dr. Hall was right—his life was a mess(to use his non-clinical word). He hadquite a few symptoms of depression andanxiety. He was drinking too much andusing pharmaceutical samples. Everyonewas mad at him—his wife, his 2 growndaughters, his 2 practice partners (whowere very judgmental, despite both havingbeen divorced themselves), theirmutual friends (who shunned him andsupported his wife), and his parents (whoadored his wife and saw him as embarrassingthe entire extended familyuntainted by divorce). Even his girlfriendwas mad at him for taking his own placeand not moving in with her.

Confidence Building

I tried my best to help by listening andvalidating his lost marital love. He beratedhimself for not trying hard enough tomake his marriage work. I reminded himthat he and his wife had been in maritaltherapy with 2 different excellent therapistsover the past 5 years. Despite severalvisits, reading, communication exercises athome, "romantic getaways," and a maritalenrichment weekend, he felt no affectionfor his wife. I took over his self-prescribedantidepressant, which was helpinghim, and ordered some sleeping medicationto replace the Scotch he was ingestingto help him sleep.

I suggested that he speak with his pastor.This was helpful and relieved him ofsome of his guilt. I also met with his wifeon 2 occasions to help her through hergrief and I had a visit with his 2 daughters.They were actually quite reasonable andmature young women. They loved theirdad a lot but were very clear that theywere not interested in meeting his newpartner, not then, and "maybe never."

My therapy with Dr. Hall is ongoing.The major thrust is letting time take itscourse. It is essential that he continue tolive on his own to mourn his marriageand to regain some independence andself-reliance. He's trying his best to makehis girlfriend understand that this ishealthy, and if their relationship survives,in her best interest.

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 theProblems and Their Solutions (Plenum PubCorp; 1994) and How's Your Marriage?: A Bookfor Men and Women (American PsychiatricPress; 1998). He is the past president of theCanadian Psychiatric Association, and welcomesquestions or comments at myers@telus.net.