by DrTony


August 25, 2014 in Featured by DrTony

How do medical marriages fair?  What are the advantages and disadvantages of being married to a physician?  The University of Michigan Medical School (Understanding the Medical Marriage, Academic Medicine, 2014) interviewed 25 physicians and their spouses to discover ways for them to succeed. The researchers concluded that mutual support, recognizing the importance of each family member’s role, sharing values, and acknowledging the benefits of being in a medical marriage all had a positive impact.  They also concluded that extended family support and shared responsibility can make a big difference.  Physicians and their spouses face similar challenges in their relationships as the general population, yet other stressors are unique to the field of medicine.  The importance of work-life balance is especially important to achieve fulfillment on both areas.

Over the last decade multiple and significant changes have occurred in the practice of medicine.  These changes include an increase in corporate medicine, healthcare reform with new governmental regulations/policies, and the mandate for electronic medical records, just to name a few.  All physicians are experiencing more stress and pressure to meet certain criteria, increase productivity, learn new systems for record keeping, follow specific standards of care, and maintain patient satisfaction.  In my practice, 25% of my patient population are physicians, not surprising since the demands of the profession can be taxing on their personal lives.  Most physicians are used to being in charge and solving problems even when their spouse prefers that they listen and validate their feelings instead of offering a solution.  They may also become accustomed to others following their instructions and recognizing their knowledge and authority whereas at home the goal is to have shared responsibility and decision-making. Physicians are often reinforced for being unemotional, analytical, and logical in the workplace, but these traits don’t always work at home. They may de-value the role of their partner and not acknowledge their spouse’s contribution to the marriage.  Some physicians don’t transition well from work to home either by maintaining their work role or by carrying their stress/worry about their patients home with them.  In many cases frequent on-call coverage keeps them on-edge and tense which can be projected onto those close to them.

Physician marriages can work when couples communicate their expectations of roles, responsibilities, and decisions.  Being a good physician and caring spouse requires a special effort to set boundaries, take care of self and family, and successfully detach from work when heading home.  Lastly, remember that work shouldn’t be your only identity and valuing relationships can provide more satisfaction and fulfillment in the long run.  Celebrate your success in your career, but don’t lose sight of the  relationships that will enrich your life.

by DrTony


August 18, 2014 in Featured by DrTony

The recent death of Robin Williams devastated millions who appreciated his unbelievable talent and incredible gifts.  His restless energy and countless characters amazed all of us.  However, we never fully understood his internal struggles with depression and addictions nor could we fully understand the depth of his pain.  He was always performing and probably felt more comfortable being someone else rather than himself.  Chances are, his humor and acting were an outlet and coping mechanism to cope with his emotional pain.  He’s not alone in looking for whatever works to deal with mental illness as so many others seek relief.

Many people who struggle with emotional pain or trauma rely on constructive and/or destructive ways to survive.  The obvious unhealthy ways include addictions and destructive choices, but sometimes even constructive behaviors like work, humor, exercise, or hobbies at extreme levels can be harmful.  Using these mechanisms to avoid, escape, distract, and numb emotional pain doesn’t work.  Individuals can be very creative in their attempts to run and hide from their pain.  Others maintain a cloaked facade and even people close to them have little awareness of their internal turmoil.  Even today people perceive mental illness as a weakness and associate it with a negative stigma.

The loss of Robin Williams may serve as a reminder to all of us that mental illness does not discriminate, regardless of success, intellect, financial resources, or even having the admiration, respect, and love of millions.  The suffering and pain persist in spite of it all.  Hopefully this loss will motivate others experiencing emotional pain to seek treatment and acknowledge the need for help.  Time alone does not heal all wounds.  Healing starts when we acknowledge and confront our pain, but often we need professional support.  You can run, but you can’t hide from emotional pain, it will catch you.  Take action and get the help you need today!

by DrTony


August 11, 2014 in Featured by DrTony

Can you spot a narcissist?  What do you look for? A study published in PLOS One, 2014, found that identifying a narcissist only requires one simple question.  Researchers found that they could reliably identify narcissistic people by simply asking if they see themselves as a narcissist.  Ironically narcissists are almost proud of this trait and don’t perceive it as a negative quality.  The co-author of the study, Brad Bushman stated that narcissism is problematic for both individuals and society since narcissists are less likely to improve themselves or help others.  Narcissists also have low empathy which is important for close, intimate relationships.

Many highly successful and powerful people, including many US presidents, possess a higher level of narcissism.  And in fact, there are some positive aspects to this personality type.  For example, narcissists can be persuasive, self-motivating, risk takers, and fearless.  The term “adaptive narcissism” has been coined to describe positive aspects of narcissism. We admire a confidant, driven, persevering, and problem-solving leader who thrives in crises. The key is balancing these traits and not assuming that they will work well in all situations.  While passion for our job is usually rewarded, intensity at home can be annoying.  Unfortunately, most people don’t separate the persona they have at work to the one they bring home which creates conflict in a marriage.

The topic of narcissism is becoming more popular since these characteristics appear to be on the rise.  Technology and social media has proven to be fertile ground for budding narcissists.  People are consumed with themselves.  In the September issue of Men’s Health magazine an article on narcissism includes a test to determine if you are narcissistic.  I was grateful that the magazine contacted me for the article and included some of my quotes (check out my Facebook page or website). As the article states, channelling these traits in a constructive and helpful way can prove to be effective and powerful.  Recognizing who we are and sharpening our beneficial characteristics while dumping the negative ones will prove to be helpful.

by DrTony


August 4, 2014 in Featured by DrTony

How do you manage stress?  What lifestyle best describes you?  A study, soon to be published in Molecular Psychiatry, from UC San Francisco looked at the impact lifestyle can have on the effects of stress.  The researchers concluded that healthy living can buffer against stress-related cell aging.  More specifically, they found that individuals who exercised, slept well and maintained a healthy diet were able to lower the effects of stress on our bodies.  They also found that stress accelerates immune cell aging and the lifestyle we lead can directly impact this process.  Of course, we’ve all seen people age dramatically in a short period of time especially when they’re under tremendous stress.  Look at our current and past presidents for a clear example of stress on aging.

Some of us can be couch potatoes, emotional eaters, and/or poor sleepers.  Which of these most affect you?  It may be all three, especially when you’re under stress.  The bad news is that stress is unavoidable and affects everyone.  The good news is that you can do something about the impact stress has on your life.  Join a gym, enlist an exercise buddy, put exercise on your daily schedule and make it happen.  A recent study found that running consistently can add as much as three years to your life.  Get moving!

We’re surrounded by food and need it to sustain our health.  Our problem often is the quality and quantity of food we consume.  Eating can be a social activity, but overeating may have more to do with seeking comfort from stress.  Confronting and resolving emotion either in conversation or through writing can reduce our need for excessive amounts of comfort foods.  We also may associate eating with certain activities like watching TV and numb our emotions with food through entertainment.  Limit the food you have readily available in your home and find distracting activities when temptation arises.  Sometimes flossing and brushing my teeth immediately after dinner can be a deterrent to eating more later that night.

Lastly sleeping without worrying, planning, and/or dwelling on something can sometimes be a challenge.  Try keeping a journal and dumping your worries on paper.  Engaging in an activity that relaxes you and helps to shut down your brain can also prove helpful.  Create a positive and soothing routine that helps your body slow down before sleep.  Avoid stimulating activities including the computer, rigorous exercise, disturbing or action packed movies, and news programming shortly before sleep.  Be healthy and live longer!


by DrTony


July 28, 2014 in Featured by DrTony

Can you think of any personality traits that are good in one setting and bad in another?  Our personality can directly affect our personal and work relationships in a big way. Take a few minutes to think about your own personality traits.  Are you intense, sensitive, critical, passive, controlling, and/or outgoing?  Sometimes our traits serve us well at work, but create conflict at home. As I mentioned in last week’s blog some of us have very little awareness of our actions and their impact on others.  In some cases, we are rewarded for our traits at work and criticized for the same characteristics at home.  Many highly successful people are praised at work for their drive, intensity, perfectionism, and risk taking nature, yet condemned for these traits in their personal relationships.  The other common problem is that these characteristics are often manifested at extreme levels.

A recent article written by Trish Regan for USA Today discussed this very issue.  She mentioned CEO Dov Charney of American Appparel and his reportedly inappropriate behavior that eventually was reprimanded.  The writer concludes that “the very personality traits that enable entrepreneurs to thrive early on – self-confidence, charisma and a willingness to be controversial – often prove to be their undoing.”  I couldn’t agree more with this analysis and personally witness in my practice the results of destruction to relationships.  Often the increased power and control associated with success combined with a sense of entitlement and arrogance proves to be a volatile formula for failed relationships.

The ways to prevent this scenario from unfolding come from maintaining humility, accountability, and respectability.  Leading a balanced life, giving back to others, and focusing on gratitude can keep us centered on others not just ourselves.  Also nurturing faith and accepting that there is a power greater than you will help you stay grounded.  Recognize your strengths in your personality, but don’t allow them to be become weaknesses.  Living a good lifestyle is not necessarily living a good life.


by DrTony


July 21, 2014 in Featured by DrTony

Do you know people who are either too pushy or are pushovers and have no awareness of their behaviors?  Many of us have limited insight into our communication style, personality, and flaws.  A recent study from Columbia Business School by Ames and Wazlawek found that people seen as under-assertive or over-assertive think that they are appropriately assertive.  This study, to be published in Personality and Social Psychology Bulletin, also found that those who were communicating with correct assertiveness mistakenly thought they were perceived as pushing too hard.  The study paired up developing professionals for mock negotiations over certain issues.  The researchers concluded that many people are clueless as to how they come across to their counterparts and colleagues.

So why are people oblivious to their behaviors and others’ perceptions?  In some cases people don’t pay attention to subtle or not so subtle cues from others.  We can be so self-absorbed that we miss the nonverbal expressions or direct feedback from others.  Maybe we don’t want to know what others think or we’d rather ignore others’ reactions so that we don’t have to change.  Living in today’s technological world, those who may have had less face to face contact have developed limited social skills.  Based on my experience many people would rather keep their head in the sand than acknowledge their  inadequacies.  Communication skills are no different.  The obvious problem with unawareness is that we can alienate others, tolerate more than we should, and/or avoid necessary change and growth.

How do we raise our awareness?  For starters, we need to find a trustworthy and reliable person who can be honest and direct with us.  We also need to accept feedback without being defensive and justifying our actions.  Asking for constructive criticism can be difficult, but this may help alleviate future pain and rejection.  Sometimes those closest to you may not be the best resource but instead try relying on someone who can be objective and unbiased.  Ask direct questions about the way you come across and the impact that you might have on others.  Be receptive to the feedback and use it to make changes in yourself.  Communication is a valuable skill and honing this capability will result in positive consequences.  We are all clueless and confused at times, recognize it and do something about it.

by DrTony


July 14, 2014 in Featured by DrTony

Last week I discussed the achiever-connector marriage, but what about two achievers who are in a relationship?  As I’ve mentioned, we’re all different, which is good and bad, but our personality types do impact our marriages.  You might feel you are both an achiever and a connector, but chances are you’re more of one than the other.  If you’ve accomplished the 50/50 split of these two types than you’ve successfully reached a balance that most have not.  So what does marriage look like for two achievers?  Remember achievers tend to be driven, competitive, and goal-directed which has its advantages and disadvantages, but when you both have that same focus sparks can fly and conflicts erupt.

Dual Achiever relationships may never enter the therapy office since they feel like they have it covered and tend to handle problems independently.  Relying on others or even their partner for help may be difficult.  Unfortunately, many high achievers outsource responsibilities that have great value and meaning including child-rearing.  They approach the marriage like a business relationship rather than an intimate connection.  Of course not all achievers take it to this extreme.  So what can be done to make these marriages work?

Achievers do well with schedules and objectives, so pre-planning dates together works.  Also, agree upon rules about disconnecting from technology and focusing on conversation unrelated to work.  Achievers need to cooperate and recognize that you’re on the same team which involves mutual respect and shared responsibilities.  Recognize the strengths in each of you and learn to delegate based on those assets.  Since achievers are task-driven, introduce more enjoyment into your marriage by each person creating a fun list and selecting one activity to do each week.  Try initiating spontaneous affection and connect through intimate conversations.  The checklist of tasks never ends so decide to limit your time “doing” and spend more time “being.”  Watch a thunderstorm or sunset, play cards, have a glass of wine, walk the neighborhood, go for a night swim; these are just a few examples of connecting activities.  Use our advanced technology to connect with your spouse when face to face interaction is not an option.  Most importantly, value relationships over material success.  Research has found that materialism doesn’t produce happiness, but rather is a stronger predictor of unhappiness.

by DrTony


July 7, 2014 in Featured by DrTony

We are all so different.  We each have different personalities, expectations, and needs, yet we find ourselves in relationship with someone who has a divergent focus.  Why are we drawn to someone different from ourselves?  I believe we are attracted to aspects of our personality that we don’t possess.  In essence, we’re looking to fill our gaps/weak points through our partner and complement our position by finding someone who can assume roles we’re not good at.  For example, if one person in the relationship lacks social skills, then the other person may take responsibility for developing and maintaining the couple’s friendships.  This is not necessarily a bad thing-we can’t be good at everything-but when there is a clear imbalance and total reliance on the other person, problems can arise.

The last two weeks I described the attributes of “achievers” and “connectors” in relationships. These different attributes may cause misunderstanding in the relationship and over time may cause resentment. Both parties may feel that they are carrying the ball by themselves with certain activities.  All marriages have differences which can lead to frustration and anger; the problems arise when the partners either ignore the conflicts or attack each other.  Conflict that is not resolved or managed will result in deepening resentment and hurt which is often followed by detachment.  The good news is that achievers and connectors can be successful in their relationships.

The first step is awareness,that is, recognition by both partners that a problem exists.  Next comes an understanding of each others’ differences and a willingness to address the issues.  Gaining an appreciation and respect for your differences can help with the process of change.  Next comes working through the steps of conflict resolution:  identification, expression, validation, brainstorming, negotiation, compromise, and implementation.  Individually working on taking responsibility for your own shortcomings instead of relying exclusively on your partner can prove beneficial.  Lastly, recognize that both achievers and connectors typically have good intentions for their relationship but are unaware of how to achieve them together.  Practice over this next week engaging in a behavior that your spouse normally tackles and if your spouse also does this exercise reinforce them for stepping out of the box to do things differently.  The achiever might consider initiating a date, while the connector may limit their social media time as an example.  Find ways to be connected that suits both parties.

by DrTony


June 30, 2014 in Featured by DrTony

Last week I shared what behaviors define an achiever, now what about the behaviors of a connector?  While achievers value success, connectors value relationships.  Of course, we might have a good balance of both qualities, but typically a person is geared more towards one or the other.  Connectors focus on people building, desire belonging, and like helping others.  They aren’t as competitive and don’t get stressed out by things like achievers do.  Connectors also have a greater ease in expressing themselves  and invest time and energy into developing and maintaining deep, intimate relationships.  They receive great comfort and joy from people rather than things.

The value of being a connector is obvious, but there is a downside when someone’s behavior is too skewed towards this approach.   The negative aspects of connectors occur when they try too hard to please others, overextend themselves, can’t say no, and fixate on what others think about them.  They place others above themselves, lose their own identity,  and have difficulties setting boundaries.  Their expectations of others may be unrealistic and they become disappointed, frustrated, and resentful of people, yet fear they’ll lose the connection if they speak up.

Connectors can work towards balance by working on expressing their needs assertively, become  better boundary setters, and by accepting that they can’t make everyone happy.  Also shifting their focus from finding purpose in others to other sources of meaning and fulfillment can make a big difference.  Building self-worth that is not exclusively tied to other people and can be achieved independently of others can be another valuable mechanism to become less dependent on others for happiness.

Both the achiever behaviors and connector behaviors have great value when approached in moderation. Next week I will discuss when an achiever is married to a connector, which is the most common scenario that I see in my practice.  I will also discuss the less common dynamics of two achievers or two connectors being married.

by DrTony


June 23, 2014 in Featured by DrTony

You know you are married to an achiever when they map out the Disney Theme park attraction schedule before leaving to maximize every minute of the experience.  Achievers tend to be leaders who are hardworking, confident, competitive, goal-oriented, driven, and who persevere through challenges.  These characteristics can be rewarded in the workplace and create positive opportunities for career success.  Achievers take the initiative and are driven to overcome obstacles that would hinder many. They also tackle problems head-on, operate independently, and are analytical in their approach.  Many great leaders, entrepreneurs, and professionals possess most of these attributes which enable them to be successful in their careers.  Unfortunately many high achievers are not good at balancing their careers with their family/married life.  The characteristics that contribute to their success are not always conducive to good relationships.

Many high achieving types never leave work because they bring work home with them or can’t shut their minds off.  They may have difficulties following others’ lead and/or delegating.  Achievers tend to be hard on themselves and others with the expectation of perfection.  Their focus is on success building instead of people building.  They tend to be insensitive to others’ emotions and deny their own.  Cooperation, compromise, and empathy are not common characteristics of the high achievers.  Many achievers like to be in control of their own destiny and may react poorly when others are attempting to share in control.

The good news is that achievers can learn to balance their lives and adopt a new mindset.  Gaining an awareness of the characteristics that don’t bode well for their marriage and making a concerted effort to tone down some of these traits will make a difference.  Acknowledging the value of relationships and learning to recognize and express emotion can also create a greater connection.  Transitioning from work mode to home mode while adopting a noticeable difference in attitude, behavior, and demeanor will benefit the entire family.  Being a high achiever myself I recognize the sense of fulfillment from hard work, but I also appreciate the need for a balanced life and healthy relationships.  Balance breeds success.