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The Four Attitudes of Resilient Medical Families

Wayne M. Sotile, PhD

Disclosures

May 21, 2021

Over the past four decades, my group and I have coached and counseled over 30,000 health professionals, including more than 13,000 physicians and/or their life mates, and I have consulted with hundreds of medical organizations concerned about their workplace relationships. The focus of my work has been to discover the keys to resilience for medical professionals, their families, and their organizations: what differentiates those who emerge from hard times better and stronger from those who do not. Four attitudes are key.

Meaning

Meaning is the antidote to distress. Meaning brings energy, and energy fuels coping, connection, and — sometimes — joy. But familiarity tends to blur our vision for the meaning of the activities that fill our days and the specialness of the people we love and work with.

Wonderment

Enter the second resilience attitude: wonderment, that capacity for seeing the familiar in unfamiliar ways. When the world hit the pause button in early 2020, most of us entered a state of wonderment. Since March 2020, I have conducted virtual programs for physicians and medical families in 65 countries. I noticed that, worldwide, at the start of the pandemic, people experienced renewed appreciation of many aspects of their work, lifestyle, and family that now were threatened. Thanks to wonderment, many medical families reported renewed intimacy and appreciation of each other. They noted things they had been lulled into taking for granted; voiced shared concerns for each other and about their own and their children's futures; and, often rather guiltily, shared a "honeymoon" period of pause from their typically frenetic lifestyles.

But no honeymoon is made to last. Many medical families then drifted into conflict, and some into chaos. Besides the obvious stresses that came with the pandemic, medical families are being strained as the "unrelenting mistress that is medicine" once again calls physicians away. More physicians work 60+ hours each week than any profession we have studied; approximately 20% work 80+ hours each week. Most medical families grow accustomed to the unique work-family imbalances that come with a life in medicine...often while their neighbors assume that they are living the cushy life of a "rich doctor's family."

Marriage therapists have long noted that one key to family happiness is within-couple role agreement. More important than how much or what you do is being honored by your mate for what you do. The dialogue of a thriving couple goes like this: "Thank you for what you do. It allows me to do what I do."

Here's where wonderment in the wake of the pandemic has created the best of times for some and the worst of times for other medical families. The good news comes when families view each other as heroes. When writing about medical families in the late 1990s, my wife and I coined the notion that "heroes are people who create safe spaces for other people." Medical families who are thriving today recognize each other's heroism, whether that involves saving lives in the hospital or clinic or keeping the home fires burning. In thriving medical families, wonderment is renewing appreciation of each other's roles.

For others, wonderment has exposed or magnified the fact that life in medicine puts medical families at risk. Most physicians work daily in settings that expose them to risks that might contaminate their families upon their return home. The pandemic supercharged awareness of these physical risks, and the pause in their typically frenetic lifestyles heightened awareness of how much of their lifestyle is absorbed by the physician's extraordinary work hours. The medical families who are in most chaos today are those who do not have "within-couple role agreement" about the physician's work. When a spouse or family takes the position of "Why would you put our family at risk by returning to that office, hospital, and lifestyle?" the couple flounders in a swamp of moral and practical dilemmas.

Incorporation

The third resilient attitude can help here: incorporation. People who flounder in the wake of any setback or coping challenge tend to think in terms of disruption and discontinuity, as in, "My life/career was going reasonably well; then THIS happened and now my life/career sucks." They then tend to withdraw from meaningful engagement in the many aspects of their life that remain unaffected by the major setback. In so doing, they flounder.

Resilient people, on the other hand, incorporate the new challenge into the flow of their unfolding journey, as in, "My life/career is about a lot of stuff. Now it is about this, too. So I'll learn to live with ___ (fill in the blank)."

Realistic Optimism

The final resilient attitude helps: realistic optimism. Here, I am not referring to a glass-half-full, rose-colored-glasses perspective. Those folks tend to ignore the challenges they face, assume a passive "I'm so lucky or blessed, no need to do anything about this" attitude, and they fail.

Realistic optimism entails acknowledging the challenges you're facing but maintaining an attitude of hope — that oil that fuels the engine of resilience, the sense that "we have the will and the way to incorporate into the flow of our life whatever we have to do to cope with our challenges and move forward." This realistic optimism helps families to, at minimum, manage to have functional partnerships and their fair share of harmonious days, even when the honeymoon wears off.

In future blogs I will address a wide range of topics regarding physician relationships, at home and at work. In the meantime, I am interested in your observations and experiences. Input from medical professionals at all stages of career and family life, in all forms of committed personal relationships, and in one- and two-income relationships would help significantly to broaden and deepen our learnings about medical family life. Input from you regarding the interpersonal challenges and solutions you face and observe in the medical workplace will be equally welcomed. When it comes to relationships, each of us has a deep and rich reservoir of wisdom born of experience. Please share yours in the comments.

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About Dr Wayne Sotile
For more than 30 years, clinical psychologist Wayne M. Sotile, PhD, has studied resilience and work-life issues for high-performing health professionals. He has authored 10 books, including The Thriving Physician (2018) and Thriving in Healthcare (2019), both with Gary Simonds, MD. Wayne founded the Center for Physician Resilience, in Davidson, North Carolina. A sought-after keynote speaker, Wayne has delivered more than 6000 invited addresses to corporate and medical audiences interested in resilience and optimal performance. For more information, visit his website.

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