The physician’s dilemma: The importance and challenge of emotional connection

As a couple’s counselor, I have found that relationship challenges can often be attributed to negative patterns of interaction that limit our ability to feel connected to one another. These patterns are often the result of experiences in early years, difficulty with vulnerability, unresolved issues in the current relationship, lack of understanding of our attachment styles, and difficulty regulating emotions in times of conflict. Neither physicians nor their relationships are spared these challenges. 

I have worked over the years with doctors and their significant others, as well as with groups of doctors aiming to prevent professional burnout. During this time, I have identified one difficulty that stands out: medical practitioners can struggle to connect with their partners on an emotional level. Because the medical field encourages the separation of self from emotions when dealing with patients, health care professionals may find it difficult to access their emotions when off duty. Western society reinforces this practice by warning us against connecting too much with our own or others’ emotions. Yet, emotions have been described as the lifeblood of relationships and the messenger of love. (For more information on that idea, read General Theory of Love by Thomas Lewis).

We can all strengthen our patterns of interaction by first creating greater connection with our own emotions, and then connecting with our partners and their emotions. In doing so, we can become more proficient at speaking the language of attachment that strengthens bonds and helps create more successful and lasting romantic relationships. Strong, romantic partnerships can become a source of great comfort and strength, both in times of peace and of stress.

For physicians, the demands of work, times constraints, and emotional exhaustion can all play into increasing the possibility of conflict at home. Most conflicts are rooted in several important questions: “Are you there for me? Do you have my back? Do I matter to you? Do you get who and how I am? Is it safe to emotionally connect with you?” When these questions are addressed successfully by both partners, emotional attachment is strengthened. 

In working with couples, I do not focus first on helping couples fix specific problems, such as those related to house cleaning, spending, or frequency of sex, since doing so can prevent partners from truly listening to each other. Instead, our first aim is to understand how the couple interacts. Such a focus can be particularly hard for physicians, who are accustomed to diagnosing and treating specific problems. In couple therapy, our first and overarching aim is to look at connection—what helps and what gets in the way.  

Couples with strong connections have frequent “ARE conversations.” In this acronym, each letter denotes qualities that partners can offer each other: A stands for accessible, R for responsive, and E for engaged. Successful partners can learn to relate to each other in ways that reflect mutual emotional accessibility, responsiveness, and engagement. Importantly, whereas ARE conversations connect, conflictual conversations disconnect. The goal for couples is to have as many of the first type and as few of the second type as possible.

Physicians and their partners deserve and can build safe, secure attachments and enduring romantic partnerships. 

If you are interested in further exploring these themes, these resources can help: 
•    Brene Brown’s TED talk on vulnerability
•    Attached by Amir Levine and Rachel Heller (re: attachment styles).
•    The ARE questionnaire (to help assess the state of a current relationship)

—David Darwin, MEd, RCC

Read the related June 2023 editorial, "Bizarre Love Triangle."

This post has been peer reviewed by the BCMJ Editorial Board.

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Becky Mills says: reply

I’m dating a surgeon who I’d like to understand and have ARE conversations.

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