We all do it.
We have bad days.
Terrible traffic. A horrendous workload. Difficult faculty. Insurance disasters. An argument with staff. A patient you just couldn’t save.
As physicians, we often come home running empty on food, hydration, and patience, and full of frustrations, complaints, stress, anger, helplessness, and utter exhaustion. It’s the norm. And when we come home, we unload it on the person we love most, our best friend, our partner, our spouse because they are the only person in the world we are quite certain won’t judge us for the ungrateful rant we are about to erupt into.
“You will not believe what I had to deal with today…”
I call this spouse-dumping, because it represents a routine where we dump our negative energy onto our spouses.
Spouse dumping is a form of therapy, a time to verbally process difficult experiences you had to grit your teeth for in the name of unwavering professionalism, and a time to gain some validation for the spectrum of feelings you had swallow as you ran around trying to learn, treat, and please others in an environment where you struggle to feel adequate. Spouse dumping is a way to express the anger you felt at the condescension of a faculty member, or the shame you felt when you performed a procedure wrong that resulted in a bad outcome for a patient. It’s a time to let out the pent-up screams that you would love to hear reverberate down the hallways of a hospital, but that simply stay muffled in your chest as you try to process your exhaustion from today and wrap your head around with how much more work there is going to be tomorrow.
Spouse dumping is a natural phenomenon. I do it. You do it. We all do it.
The problem is, our spouses are humans too. If you’re in medicine, they don’t see you all day…and, when you come home, they get a taste of the worst of you.
Not because you’re a bad person.
But, because you’re struggling to find meaning in the path you’ve chosen. Trying to make sense of the love/hate relationship you have with medicine and trying to channel the negative energy somewhere where you won’t get fired for it. Hell, some nights you’re just trying to find some stable mental ground to stand on for a minute without the pager going off.
Spouse dumping is okay intermittently, but when we rely on it as a daily form of release, we don’t realize that we are sabotaging the relationships that mean the most to us. Because, although your partner may empathize with your struggle and serve as your therapist, that’s not their job. They might have signed up for “in sickness and health,” “for better or worse,” and, “on call and post-call,” but interacting with the bitter, resentful version of you probably is not what they deserve at the end of every day.
Though our partners love us, the emotional burden of our experiences is just as heavy on their shoulders as it is on ours, and it’s not sustainable for us to transfer it to them long-term. This especially goes for dual medical professional households, where both members can be in danger of adding to a cup that is already overflowing, and adding fuel to a fire that is already raging. So what are healthy alternatives to spouse dumping?
THE 10-MINUTE DUMP
The 10-minute dump is exactly what it sounds like. It’s limiting your existential crises to a sustainable time frame for your partner’s mental health. It’s choosing a time every day to let out all the crazy, to yell, rant, cuss, huff and puff (whatever floats your boat) and come to terms with the mental and emotional traumas you’ve endured that day. The catch is, when your time is up, you snap out of it, change the subject, and you and your partner both try to focus on other (more positive) things. Release and relax. It’s that simple.
FRIENDS WITH BENEFITS
If ten minutes is not enough for you to unload the emotional cargo you’re carrying, look to your best friends to talk about what’s been going on at the hospital. Create some structured time and a recurring date every month to unload about your stressors and get some much needed sympathy, empathy, and perspective from them. The key is to meet regularly (virtually or in person), so you can look forward to a time to talk about what’s bothering you. Not knowing when or where you can find a release can add to the anxiety and stress you’re already carrying.
If you feel like what you’ve got on your plate at a particular time is way too much for one person or a small group of friends, talk to different family members about different issues and spread out the angst. If your mom is particularly empathetic, your brother is great at pumping you up, and your Grandpa is a great listener, talk to each person about a different issue and let them each support you in their own way. Take advantage of all the platforms out there that make it easy to connect with each other; whether it’s a phone call on the way home from work, FaceTime, Zoom, or Marco Polo. Take some time to tap into different facets of your support system to diffuse your mental bomb. It makes it manageable for everyone, and it will allow you to preserve your relationships for a long time.
A WELLNESS DATE
A great way to de-stress is by tying together a wellness activity with a mini-therapy session. This might be getting your hair or nails done and talking to your stylist or manicurist about what you’re going through at the same time. Meeting up for a quick game of basketball, golf, or yoga might be another way to meet friends and mix verbally letting off steam while physically engaging in an activity that helps you relax.
AN ACTUAL THERAPIST
If your stressors have reached the level of chronic depression and anxiety (and let’s be honest, no shame, this is a lot of us!), look to a therapist for help. A psychiatrist, psychologist, psychology nurse practitioner, or couples counselor are great options to provide regular relief for the ongoing mental and emotional traumas we can experience as medical professionals. The amazing thing is that many of these services are now available online. So you can have a session on the move on your phone or your laptop. Yes, some of these options may be pricey, but nothing is worth more than your mental health and being the best version of you for yourself, your family, and all the people that love you.
Medicine is a blessing and burden no single person care bear alone. There are good days and bad days in the thick of it (especially residency), but just like a bad Yelp review, the effect of a bad day sticks around much longer than a good one. There is absolutely nothing wrong with acknowledging a bad day or talking to your spouse/partner about it, but having these coping mechanisms as a back up will help both of you diffuse the negativity and resentment and traverse these mentally and emotionally taxing years together. I promise you’ll emerge stronger than ever at the end of it.
Mariam Molani, DO, MBA is a 4th year Pathology resident at UT-Southwestern in Dallas, Texas. She is a writer, entrepreneur, and advocate for women in medicine. She is the founder of LibraMed, LLC, a website focused on helping doctors find success through all avenues of medicine by incorporating balance and wellness into their careers.
Thank you for highlighting this topic. I did not realize how much I do it and that it is a real thing. I have been blessed to have a patient and understanding spouse who lets me just ramble and ramble after bad days. It looks like we inadvertently turn our spouses into psychiatrists and it is not fair on their part to be dumped on. This was a very revealing article. I will try my best to adopt some of the measures here. With telehealth more available I will be taking advantage.
Thank you for the suggestion.
Thank you so very much for this article. For the past thirty years I thought it was “just me”. Maybe I was not tough enough to take it in medicine. Depression and anxiety ran rampant. What I identified most with was gritting teeth, and stifling screams to be professional. I will share this with my husband, and also my son, both of whom had to endure my rants once I was home from the hospital. I did take and semi enjoy at telemedicine career, it comes with its own set of frustrations. Thanks again.
I am married to someone who also has a high powered career in a different field. We both have stressful days full of logistical and emotional challenges. My spouse is always happy to hear about my day and I hear about his. We are there for each other and we are a team. We talk about approaches to solving problems and making our work lives better. We say things like “It sounds like you’ve had a worse day than me, so do you want to take a break while I watch the kids”. If there is negativity for too long, we say “I’ve heard you saying a lot of negative things recently. Did something happen?” and then try together to fix it. I would hate being in a marriage where I felt like I couldn’t tell my husband how I was feeling and expect to respond empathetically and supportively. Honestly this article raised a lot of red flags for me. And if you find nothing good to say about your job, you should get a new one. Being in medicine is hard but there are great moments too.
you are a role model.
Totally agree with you. I find this article quite offensive, actually. Growing up, I watched a healthy relationship modeled by my parents. They appropriately leaned on one another during difficult times. My husband and I are emotionally available to one another, during good times and in more challenging times. In sickness and in health means just that! I could not imagine being married to a person who could not listen to all of my thoughts/concerns nor could I imagine being the spouse that could not do the same.
Thank you for opening my eye to what I do unconsciously more often than not. I will take advantage of your suggestions to distribute the pain in order to spare my spouse.
Hey I would “dump” on my spouse but I have not seen him since we both graduated medical school 30 + years ago. We both work long hours, we never see each other. The end. Medicine as a career is bad for relationships. So I do not dump. He dumps during the only time we speak, which is when he is driving. It helps keep him awake. Vacations? Weekends? Oh hell no.
That is so very sad to me. We all can choose happiness and get control of what makes you whole….
Thanks for a realistic and fantastic article.
I always found it helpful to go out back and scream for a little while before going in the house. Just (um, mostly) kidding.
Thank you so much of this. It could not have come at a better time. I was just approached by my partner Friday night telling me that he cannot take and absorb my 45-60 minutes of negative energy and ranting every night. That was a really hard conversation to work through. I have been in therapy trying to work through my own struggles in this career – to hear him also be dragged down for it and have such a detrimental impact on our relationship was really difficult to process. I appreciate knowing and hearing that others go through similar experiences. Thank you for sharing.
Thanks for this article! I did use to do this too much. No wonder my husband my husband got a negative impression of medicine! Now I do telemedicine so I don’t have much negativity to dump anymore 🙂
I would also add that seeing a therapist BEFORE you have anxiety/depression is a good idea too. We are exposed to so much secondary trauma in this field, even if we’re not doing ER, and most of the time we don’t get any time and space to process it.
I have been married for 40 years, a physician for 38 years. During most of those years I made it a habit of not talking about my day. Especially the antidotes about patients- citing to myself patient confidentiality. If I had a difficult patient or encounter I would speak to colleagues or medical partners for advice or to vent. I definitely agree with need to decompress after work. I use a 10 + minute time out, even when my kids were young, to take a shower- no interaction- just me time. During periods of overwhelming anxiety, depression I agree with professional help and occasional venting with your spouse and best friend. Today stressors surround pandemic, politics- to me ok to vent with spouse, just not details of patients
It has always been my belief that a lot of marriages end in divorce, because when you are miserable, it is easier to get rid of a spouse than getting rid of your profession which you have invested so much time. I am married 45 years to my husband, and don’t kid yourself, it has not always been easy, but I am the person that would get rid rid of her profession before her marriage.
How about go to the root of the problem and examine WHY are doctors so stressed out? Why has medicine become a joyless profession that we need to “dump” on our spouses? We can put as many patches as we want on how to deal with the unhappiness of being a doctor, but how about taking charge of our profession and making it a happy one again?Wouldn’t that be much more efficient way to deal with this problem, rather than constantly hunting for people to dump on?
I have been married for over 40 years and physician for 35 yrs. My professional life has been full of stress. Patients angry, relapsing, dying. I try my best to leave my worries behind when I am driving home, granted it is not easy but somehow I have been able to manage. I prefer to talk to my colleagues who understand my problems better than my spouse because they are also in the same boat as I am.
Believe me going to happy home also helps, so I try my best not to spill beans…
This is very real. Thank you for this. My husband is not in the medical field (a good thing!), so my dumping is limited. I talk to friends usually (my therapy sessions). So I’m lucky I have that.
As a psychiatrist and widow with a 20 something child, I find that a therapist is the best person to deal with the negative feelings from work and life. Having a therapist has helped me to sift through through life’s many stresses, and find solutions to problems that I might otherwise have overlooked. Perhaps it is a form of consultation, but I found that psychoanalysis and psychotherapy have helped me to navigate through even the most difficult times, with difficult and heart-breaking cases, and my own significant life stresses. I do think that speaking with a psychiatrist, a physician who has “been there,” has been key. I have found that my husband and friends have been helpful in problems solving, as many are in similar fields, but I do try to avoid throwing too much negative affect in their direction. It is unfortunate that psychotherapy maintains a stigma as something needed for when things are becoming emotionally overwhelming. If more people, especially physicians, were able to examine their emotional states, it is likely that medicine would become a more humane endeavor, both for doctors as well as for patients. Thank you for the thoughtful article.
You are aware that many states do not allow physicians to see therapists without risking their ability to practice medicine? In all the states I’ve been licensed in, that has been the case. I was advised when I started medical school to figure out the best way to do my own therapy because of this.
Very good and timely article. We all do that. What helps is trying to look at the situations from aside or above. To be the participant and a seer at the same time. To realize that emotions are just the part of the whole picture, not be swallowed by them. Journaling helps tremendously along with other activities. I arranged with my medical school classmate who lives in another country that we journal for each other about our days, stresses and concerns. When something happens , it’s a story. And you can rewrite the story the way you see it at different angles. Some stories which seem stressfull at the time they happen, could become material for stand up comedy, sometimes. When you lighten the load being dumped on your partners, it is easier on them. While you look at the story though the different angles of the prism, it can actually help changing things and patterns you are not happy with. “Dumping” can be productive then.
This is an important issue. Thanks. We do need to find a solution to this problem and the whole profession needs to realise this is a problem for the profession to be accepted as for the whole profession and to be solved without finger pointing at the person who is suffering.
thank you for addressing this issue, and the encouragement to seek help when needed. But suggesting therapy is “something you can do on the move, on your phone” severely trivializes it. It’s not a quick fix. Like any relationship, therapy takes an investment of yourself, and the recognition that the focus on yourself is needed and worthwhile.