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Relational Challenges


Physicians are always engaged in professional relationships with their patients, with other health care workers and with the administrative staff within their workplace. These relationships may be fraught with interpersonal conflict and with difficulties in the process of interpersonal communication, both of which may result in tension and stress being experienced within the health care setting. In what follows I will offer a few thoughts on the complexity of professional relationships and I will then address the interrelated issues of emotional self-awareness and professional communication.

The manner in which a physician relates to others within a professional work environment is influenced by relational patterns and role expectations that may be operating unconsciously in the mind of the physician. For example, a physician in a leadership position may be idealized by some physician colleagues who see him/her as ‘born to lead’ and yet other physicians may resentfully envy the same physician leader and find collaboration with him/her to be demeaning. Some physicians are always interested in the opinions of co-workers and are explicit about their intention to collaborate with them while other physicians expect that the people they work with will ‘do as they are told’. There are many variants on these relational dynamics and given the hierarchical structure typical of health care settings there is certainly a risk of conflicting role expectations and dysfunctional patterns of behavior and communication.

Developing a capacity for both emotional self-awareness and emotional self-regulation is a challenge every physician encounters in their professional work. However, a physician may unconsciously rigidly defend against awareness of their own emotions, or be unable to manage their emotions, and this will impact their communications and relationships with others in their professional work - and in their personal life.

One physician told me that she thought that her emotions were her ‘enemy’ and later added that she was thought by her colleagues to be ‘aloof’ and ‘cold’ and that that this left her feeling ‘isolated’. She was able to understand that her ‘emotionless style’ was derivative of her emotionally constrained childhood family experience and she was then able to gradually become more emotionally self-aware, to engage in better professional communications and to enjoy closer relationships with her colleagues.

Another physician described himself as being seen as ‘explosive’ and ‘dangerous to be around’. The challenge of managing his emotions had had serious consequences for him in his professional life - and in his personal life. He was able to understand that in being ‘explosive’ he was behaving in the manner of his ‘explosive and controlling’ father. Upon appreciating this previously unconscious identification he was gradually able to manage his emotions much more effectively and to put an end to his being ‘explosive’. This led to improved communications and to better relationships with his co-workers.

It might seem simplistic to say that emotional self-awareness and emotional self-regulation are essential for all physicians but many physicians struggle with these challenges.

A physician’s understanding of their own behavioral and communicative style is essential to their being flexible and effective in their work with other people.