How's Your Marriage, Doctor?

Many medical couples strugglewith communication. Fortunately,physicians and their spousescan improve things at home by puttingsome oomph into their communication.Before we discuss how to do this, let'sreview our subject matter.

Communication 101

Communication is complex. How wecommunicate depends on our geneticmakeup, what we learned growing upfrom our first role models (ie, our parentsand stepparents), and what we picked upfrom friends, colleagues, life experiences,and previous relationships. We are humanvariants in medicine. Couples must striveto improve the integrity of communicationin their marriage, which takes commitment,resolve, and guts.

We communicate at both a consciousand unconscious level. Conscious communicationhas two forms: expressed (ie,what we discuss openly with our spouses)and unexpressed (ie, what we censor, pushaway, or sanitize). Often, our spouse willperceive that we are inwardly upset aboutsomething, though we don't express it.

Bottom line:

Unconscious communication is revealedin our dreams and fantasies. It's what wesay and do when we are uninhibitedbecause of alcohol. Be opento self-examination so that you are able tocommunicate more directly and authenticallywith your spouse.

Open Channels

Now that we've covered the basics, let'sdiscuss your options. Following are suggestionsto improve communication betweenyou and your physician-spouse:

• Experiment with venues where youcommunicate in a more open and relaxedmanner. For example, maybe you and yourspouse communicate best in the kitchen,while you're out for a walk together in theevening, or sitting opposite each other inthe den. The majority of couples I see tellme that their best talks occur outside thehome—away from distractions, interruptions,and unfinished tasks.
• Visit your local bookstore or libraryand pick up one of the many manuals onhow to improve communication in yourmarriage. If you have a computer, you canalso search for manuals on line. Try some ofthe exercises together for a month or two.
• Consider a marital enrichment weekend.Faith communities, private corporations,and community colleges offer thesetypes of retreats where many couplesimprove their communications. By participatingin a weekend retreat, both spousesare acknowledging that they care enoughabout their marriage to try to learn newways of renewing their relationship.
• Go for marital therapy if you feelyour personal efforts aren't working. Ithelps tremendously to have the expertiseof a professional who can diagnose theproblems, explain the "whys," appreciateboth your positions, relieve anxiety andsagging spirits, and offer guidance andhope. You won't regret it.
• Safeguard time for communication inyour busy life. Many spouses of physicianscomplain that medicine has a much higherpriority than they do. You must watch yourdefensiveness and work with your spouseto correct this. There may be a disconnectbetween your internal experience and yourexternal actions. In other words, you mighthonestly feel that your spouse and childrenare more important than your work, butyour long days and evenings at your practicebelie this fact.

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.