Psychiatry and Personal Relationships

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rpkall

rpkall

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Hi all;

I'm currently applying to medical schools this application cycle, and very interested in finding more information on the home-life of the typical private practice psychiatrist; I have heard through friends and physicians I have worked with in the past that psychiatry is an extremely stressful and emotionally challenging field, and that rarely do personal relationships seem to work out over the long term (i.e., the divorce rate may be higher than other fields, etc).

Not that this would necessarily halt my desire to pursue the field if I find out, on rotations, that it's my life's ambition, but I am extremely curious whether the ability/skill to analyze and classify the psyches of patients makes for an interminably annoying spouse (perhaps for whom it is difficult to perpetuate a balanced, psychologically equivalent relationship with a significant other).

Obviously, the success of personal relationships have more to do with the individual, but does anyone have any thoughts on how the training, roles, or responsibilities of a psychiatrist might actually affect interpersonal relationships?

I'd appreciate the input. Thanks, all.

Best wishes, happy holidays, and happy new year, etc, etc. 😉
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I had no clue that the divorce rate for psychiatrists are so high, compared to other specialties! Out of curiosity I googled the subject and I came up with several studies, some dating in the 90's

http://www.hopkinsmedicine.org/press/1997/MARCH/199703.HTM

http://www.pitt.edu/utimes/issues/29/050197/27.html

and some more recent ones replicating the same findings

http://www.aafp.org/afp/20020901/resident.html

etc.

Indeed, it seems that the divorce rate for psychiatrists is 50 % (which then brings it in tune to the general population) compared to other lower percentages for other specialties. This may show that while psychiatry ranks there with the general population, other specialties may have some "protective" factors about them (rather than "psychiatry" being "detrimental" to marriage.) I wonder what those protective factors might be (for the other specialties).

I also wonder re. whether the percentages may also be correlated with the gender percentages (male vs. female) within each specialty.

See page 14 of http://www.aapss.org/uploads/quick_read_synopsis.pdf
re. women physicians are more likely to get divorced than male physicians, etc.

N.B. I don't have a specific conclusion or "agenda" to push. I just noticed this stuff myself just now after the original post made me curious about these issues.
 
Re. the stresses of the profession itself "impinge-ing" on one's view of and quality of relationships...IMHO, the most stressful aspect of being a psychiatrist is probably having to witness so much human (psychological) suffering and misery day-in-day-out...at least this is what is most stressful about it for me, personally. I don't think it made me more "mysanthropic" or "cynical"...to the contrary...it made me appreciate even more humanistic values, including the value of human relationships. But this is a personal perspective.
 
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I have no hard facts to support this post but a couple of thoughts occur to me:
1) Psychiatry is reasonably lifestyle friendly, which can only benefit relationships
2) Doing what you love and being happy in it is important for your overall happiness and therefore probably contributes to conjugal happiness.

I don't think any job is automatically a kiss of death for a relationship but some are easier than otehrs, I just don't know where psychaitry fits on that scale.
 
DrIng said:
I have no hard facts to support this post but a couple of thoughts occur to me:
1) Psychiatry is reasonably lifestyle friendly, which can only benefit relationships
2) Doing what you love and being happy in it is important for your overall happiness and therefore probably contributes to conjugal happiness.

I don't think any job is automatically a kiss of death for a relationship but some are easier than otehrs, I just don't know where psychaitry fits on that scale.
Click to expand...

As With Boromir in Lorien, there are those who find peril in psychiatry, and those who bring their own peril with them...

I was concerned about this too, but if you are a healthy person with a history of healthy relationships, psychiatry will be great for you. (If not, then any specialty will be tough on your relationships.)
 
I am definitely concerned about this issue as well, as one of my major considerations with choosing specialty is finding one that will allow me to have a happy home life.
Perhaps the difference with psych isn't really about the work creating unhappiness. Perhaps one factor is that a psychiatrist is more willing to leave a relationship that isn't working than the general public is, due to the insights their training gives them into relationships?
For that reason, I would be curious in a comparison of the divorce rate of psychiatrists with other non-physician mental health workers...or some way of rating the happiness of those psychs who DO stay married compared to married couples in other fields.
 
I too have some of these concerns about psychiatry. My wife wonders if I would be able to leave "work at work" and disconnect with some of the depressing things seen throughout the work day. I would think that other fields have their share of depressing work (telling a mother af 5 young kids that she has 3 months to live etc). I find psychiatry to be a really intersting field, but it seems that so many people out there (family, fellow students, doctors in other fields) have such negative views about the field. Is it easy to leave "work at work" for a psychiatrist? 😕
 
There's a lot of sad stories throughout medicine. I mean even derm has SJ syndrome. One think I really like about psychiatry is that the treatments work well. Often you will see improvement in patients. There's a lot of areas of medicine where this is not always the case.

I think we'll learn more about the biological basis of psychiatric diseases over the next two decades. It's going to continue to be a rewarding area of medicine. Then again, I like the work. Others might hate it. You have to do what you enjoy. This will lead to you being happier professionally, and that will indirectly translate into a happier personal life. If your gut is telling you that you might not be able to deal with the type of problems that these patients have, then you should not ignore it.

That said, I think it's important to keep in mind that your "emotional muscles" are strengthened in medical school and residency. I'm sure if a person thought about being a surgical attending it might seem scary or overwhelming. But overtime as that person is trained it becomes more routine. The same holds true for psychiatry or any specialty for that matter.

OPD, the Boromir quote is a great metaphor.
 
PsychMD said:
I had no clue that the divorce rate for psychiatrists are so high, compared to other specialties! Out of curiosity I googled the subject and I came up with several studies, some dating in the 90's

http://www.hopkinsmedicine.org/press/1997/MARCH/199703.HTM

http://www.pitt.edu/utimes/issues/29/050197/27.html

and some more recent ones replicating the same findings

http://www.aafp.org/afp/20020901/resident.html

etc.

Indeed, it seems that the divorce rate for psychiatrists is 50 % (which then brings it in tune to the general population) compared to other lower percentages for other specialties. This may show that while psychiatry ranks there with the general population, other specialties may have some "protective" factors about them (rather than "psychiatry" being "detrimental" to marriage.) I wonder what those protective factors might be (for the other specialties).

I also wonder re. whether the percentages may also be correlated with the gender percentages (male vs. female) within each specialty.

See page 14 of http://www.aapss.org/uploads/quick_read_synopsis.pdf
re. women physicians are more likely to get divorced than male physicians, etc.

N.B. I don't have a specific conclusion or "agenda" to push. I just noticed this stuff myself just now after the original post made me curious about these issues.
Click to expand...

Great info. Thank for compiling it. Another thing to consider is that there are no studies assessing the quality of marriage for those who remain married. One of the studies above mention that and I think it's true. Married does not always = happy. The most important factor to being happily married is the two people involved. Do they share similar values and goals? Are they willing to make sacrifices for each other? How well do they communicate.

I think the AAFP article's comparison to the military makes sense. Maybe it would be possible to include family into hospital life more as the article suggests. The military seems to do a great job of this.
 
RaistlinMajere said:
...

OPD, the Boromir quote is a great metaphor.
Click to expand...

Holy Thread Resurrection, Batman!

I have noticed a tendency to "Med Student Syndrome by Proxy".

You know how in med school you diagnose yourself with everything? "Gosh my eyes hurt and my mouth is dry this morning--OMG--I'VE GOT SJOGREN'S SYNDROME!!! (Never mind--there was that tequila last night...:o) " That's Med Student Syndrome.
After I did peds, every time my kids had a fever and were cranky I KNEW it was bacterial meningitis. That's the "by Proxy" part.

Now I'm in psych, and all the oppositional teenaged and toddler behavior I have to deal with at home becomes "OMG--(s)he's going to end up just like THAT patient!"

It can be hard dealing with whiny demanding people all day and coming home to more of the same. (At home though, at least I can sip my single malt scotch while I contemplate the "treatment plans". 😀)
 
Anasazi23 said:
Awesome!

Can we make that a plaque and hang that on our wall or something? ...with a ring?
Click to expand...

As you wish. I usually find myself referring to it in the context of my teenager and his school life. 🙁

BTW--any other movie quotes you're tempted to use with patients?

I like this exchange myself:
Buttercup: You mock my pain.
Westley: Life is pain, Highness. Anyone who says differently is selling something.
 
Has anyone ever studied the outcomes of children raised by psychiatrists? I mean, everyone "knows" that the children of psychiatrists are completely crazy, but has anyone actually looked at it and compared it to other specialties? Compared to the surgeons and Ob/Gyns i've met so far, the laid-back psychiatry residents & attendings I've worked with seem likely to churn out way more normal children...
 
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I got one I got one..... I might have even used it once.

Darth Vader: "I find your lack of faith... disturbing."
 
Chrismander said:
Has anyone ever studied the outcomes of children raised by psychiatrists? I mean, everyone "knows" that the children of psychiatrists are completely crazy, but has anyone actually looked at it and compared it to other specialties? Compared to the surgeons and Ob/Gyns i've met so far, the laid-back psychiatry residents & attendings I've worked with seem likely to churn out way more normal children...
Click to expand...

I had to say this I suppose. Just as it would not be ethical/recommended for a surgeon to operate on his spouse or his child.... just as it would not be recommended for an internest to be the physician of his direct family.... then why would it be okay for a Psychiatrist to sit and analyze their family members. My two cents on the whole thing. Just leave work at work otherwise you will be burnt.
 
Faebinder said:
I had to say this I suppose. Just as it would not be ethical/recommended for a surgeon to operate on his spouse or his child.... just as it would not be recommended for an internest to be the physician of his direct family.... then why would it be okay for a Psychiatrist to sit and analyze their family members. My two cents on the whole thing. Just leave work at work otherwise you will be burnt.
Click to expand...

Just to clarify, my noting the "med student syndrome by proxy" issues above does not mean that I would provide professional mental health care to my family. Psychiatry is psychiatry and parenting is parenting. However, the nature of the the specialized knowledge that we have lends itself to us having a particularly different set of anxieties about our kids. :scared:
 
In my exasperated treatment of a borderline, I think I quoted Yoda to a patient once....

Something like "...do, or do not. There is no try."
 
Faebinder said:
I had to say this I suppose. Just as it would not be ethical/recommended for a surgeon to operate on his spouse or his child.... just as it would not be recommended for an internest to be the physician of his direct family.... then why would it be okay for a Psychiatrist to sit and analyze their family members. My two cents on the whole thing. Just leave work at work otherwise you will be burnt.
Click to expand...

Hey, I think I remember Scott Peck writing that he couldn't avoid (and we shouldn't) practicing psychotherapy on EVERYONE he saw everyday. The idea being that we should always be trying to facilitate the spiritual growth everyone around us.

I wonder if that's....healthy.
 
billypilgrim37 said:
Motivational Interviewing is the single best strategy for getting someone to come home with you from the bar.
Click to expand...

Really? All the hotties I meet seem to be stuck at Pre-Contemplation. Maybe some judicious psychopharm will "assist" their movement down the MI stages.

Just kidding! 😱
 
I never understood those stats.

As a psyche resident, I usually got a full night's sleep, had free weekends & when on call, was able to go home during the night.

My dad is a surgeon & is 70 & still pulls all nighter calls, still works like a resident (harder than me!). I've seen several surgeons who have no personal lives because of the demands of their jobs. Their wives (almost all are male) are either from the old country & see marriage as a life duty and stick by their man, or they are having plenty of side affairs, and often end up divorcing their husbands & taking half their money.

Of the females I knew who entered surgery, it was very difficult for them to have personal lives as well. The dynamics though different were still stressful. Residency is often done during the late 20s to early 30s, putting more stress on the biological clock.

I've seen similar in Ob-Gyn. IM was also bad though not as bad as surgery & Ob-Gyn.

I do not find psychiatry more stressful than other fields. If anything our hours are much easier. Only way I can see someone finding this very stressful is if they don't like the job & didn't go into this field because they enjoyed it. (I'm biased I guess, I love psychiatry & knew I wanted to do this before medschool).
 
I am almost done with one year of surgery now.. and going to Psychiatry. I compare what is expected of me here and what is expected of me in Psychiatry.... I just shake my head and say, "What was I thinking?"

Sometimes you don't really know how good something is till you try the other things.
 
Anasazi23 said:
In my exasperated treatment of a borderline, I think I quoted Yoda to a patient once....

Something like "...do, or do not. There is no try."
Click to expand...

You must be a trip to work with. :laugh: I once referenced a scene from a chick flick, as I wanted to challenge her rigid beliefs of what men 'know', and my patient looked at me dumb-founded. Part of me wanted to explain HOW I knew that (Ultimatum via my then g/f because she REALLY wanted to see it), as I felt like she wanted to ask for my Man Card, but then it'd be about me and not her.

If only I busted out a SW reference instead. 😀
 
I think it's curious that the divorce rate of psychiatry is similar to the divorce rate of the general population, as someone above noted.

Maybe it's because you actually have more time to spend around each other in a real relationship (ie more time to get annoyed with each other!) whereas the career-obsessed surgeon or the jack-of-too-many-trades internist-entrepreneur-community volunteer never really arrives at that dilemma.

Maybe psychiatrists....as weird as they are known to be...are actually more normal than the other specialists!

-J

PS: This post is to be read with a sense of humor. Certainly...with regards to personal life... there are completely balanced surgeons and internists, and floridly psychotic and hopeless psychiatrists.
 
This is an interesting thread. I'd seen that paper too, and had considered asking what people here thought about it, but I was afraid it would come off as trollish.

I think that it's a bit disingenuous to compare the 50% figures for psychiatrists and the general population. The figure for the general population is a bit lower, if I remember correctly, and more importantly includes people who are not comparable to physicians. Getting married when older and being educated are both protective factors against divorce.

I'm still curious to know if the higher rate for psychiatrists is a fluke or really is related to the field. Perhaps as RaistlinMajere noted it has something to do with willingness to stay in an unhappy marriage?
 
OldPsychDoc said:
Holy Thread Resurrection, Batman!

I have noticed a tendency to "Med Student Syndrome by Proxy".

You know how in med school you diagnose yourself with everything? "Gosh my eyes hurt and my mouth is dry this morning--OMG--I'VE GOT SJOGREN'S SYNDROME!!! (Never mind--there was that tequila last night...:o) " That's Med Student Syndrome.
After I did peds, every time my kids had a fever and were cranky I KNEW it was bacterial meningitis. That's the "by Proxy" part.

Now I'm in psych, and all the oppositional teenaged and toddler behavior I have to deal with at home becomes "OMG--(s)he's going to end up just like THAT patient!"

It can be hard dealing with whiny demanding people all day and coming home to more of the same. (At home though, at least I can sip my single malt scotch while I contemplate the "treatment plans". 😀)
Click to expand...

No Robin, 3 years is nothing for a thread resurrection. I didn't even have to use my Batpowers.
 
Chrismander said:
Has anyone ever studied the outcomes of children raised by psychiatrists? I mean, everyone "knows" that the children of psychiatrists are completely crazy, but has anyone actually looked at it and compared it to other specialties? Compared to the surgeons and Ob/Gyns i've met so far, the laid-back psychiatry residents & attendings I've worked with seem likely to churn out way more normal children...
Click to expand...

I did not 'know' this for sure. This is the craziest thing I have heard about Psychiatry. Who comes up with such ideas ? Tom Cruise-probably not.
 
Nice to see that someone resurrected my 2004 post. Kudos.

P.S. I'm a 3rd year now and currently trying to decide btwn psych and radiology (not just following the money--used to be a nuclear tech and have a bit of actual interest). 😉

If anyone had a similar dilemma, feel free to PM me...
 
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