Psychotherapy for medical residents, fellows, and physicians
Seen as the pillars of communities, physicians may find that they have no one they can turn to when times get rough for them. Covid-19 has exacerbated such challenges for the medical community. Dr. Sandhya specializes in discreet, focused, high-calibre care with concrete self-care strategies for providers. The sessions will be tailored around your goals and are meant to be of a short-term duration (although you can add to the length if you wish) to factor in physicians' busy lives and at different stages of their career.
Even for it's most successful student, medical school is not without it's stresses. Today's medical students, residents and fellows face a slew of stresses that can be all-consuming. In order to survive, and thrive in medical school, they face prolonged challenges. For doctors-in-training today, such challenges can range from: managing the stress of matching with a good medical program or speciality; traveling to hospital sites in different cities for interviews; adjusting in different cities during internship, residency or fellowships; lack of sleep with 24-hour and 36-hours rotating shifts; following an arduous clinical day, writing patient notes in a consistent and detailed manner; passing the many STEP exams; providing patient medical synopsis to one's attending and team regularly; being on call and supervising residents'; and, managing one's patients' emotional health and one's own while routinely being exposed to the traumatic events. The list of stressors for physicians is unique, long, and can be self-isolating.
Additionally, many physicians can discover that when their training ends, the intensity of their professional lives does not end. Despite performing hundreds of operations, some may struggle with anxiety after a medical procedure gone awry, or others may face a hard time negotiating the gendered or political worlds of hospitals or academic departments or difficult personalities. Female physicians may find additional challenges in managing how factors such as gender, minority status, skin color, and so forth may determine others' perceptions of their clinical expertise, before it is too late and a toxic "whisper campaign" against them may occur. Therapy at critical junctures of one's career to navigate difficult personalities or politics by acquiring new skill-sets can often prevent sometimes, years of self-recrimination and dejection.
Times are changing today and it is especially stressful to be a physician. There is little time left for self-care, one's own relationships, healthy eating, and/ or boosting one's own mental health. During these strenuous periods, neglect of one's care can result in alienation from friends and family, burnout that is insidious, chronic and damaging to one's morale and impede personal growth. Loneliness, dark thoughts, and rumination can be a sign of depression, and can affect sleep, energy levels, motivation, productivity, and life's goals; negative spirals of feelings, being trapped in rabbit holes of negative thinking, and feeling like the "shoe will drop any time" can prevent a healthy work-life balance or personal growth.
Even when medical professionals can recognize their signs of depression, it is often too late for them to do anything about it. Also, while physical burnout is serious but it does not begin to capture the silent spiral downhill in a doctor's life. Experts estimate about 300 to 400 physicians in the U.S. take their lives every year.
There are many reasons why doctors who invest time and care in the health of others, push their own medical health under the rug:
Stigma in the medical culture and the fear doctors have that being in therapy will negatively affect their ability to practice
Lack of wellness and support groups at their work place
Lack of time and sleep to focus on self-care
Discounting their mental health until it becomes a huge issue
Isolation from families, loved ones, and the presence of an active support network
It is okay to seek therapy for yourself or your family member. It is important to know that there are other medical professionals like you who have been in similar situation and whom, therapy has assisted in sharpening goals, developing supportive networks and achieving fulfilling relationships. You may read some of their stories below.
Dr. Sandhya is familiar with the pressures medical professionals undergo and the continuous care they need to re-focus their ambitions and hopes, as well as to halt the train of unproductive rumination. She has provided short-term and long-term coaching for students, medical residents and physicians all over the US, and in particular, at The University of Chicago, Feinberg School of Medicine - Northwestern University, The University of Chicago Medical Center, Depaul University, Stanford University School of Medicine, Rush Medical School, Loyola University, Columbia College, and the University of Illinois. She can also work with your irregular rotation schedule to provide you with a consistent schedule that allows for a meaningful and purposeful exploration of yourself.
For Physician Wellness and Psychotherapy, CARE offers services for medical students, physicians and their families around the following concerns:
Anxiety, rumination, and worries about the future
Burnout and recovery
Trauma and bereavement
Managing challenging personalities
Managing challenging interpersonal communication
VIGNETTES (*names/identifying details have been changed)
Lauren: Enhancing Self-Worth
"The year I crashed with depression was the darkest year. I was operating as a subhuman. My memory went to shit. I became a different person. I was trying so hard to distract myself from getting tangled in ruminative thoughts that would spiral me into despair. I would sit with a book and could not turn the page as my mind would wander off. I couldn't talk to my family. My parents would say something to me that would hurt me to push or provoke me out of the depression. Dad was clueless. When I told him I was depressed, he said, 'You're fine.' I would ask mom to tell me one thing that was good about me that could cheer me up sometimes, and she would say, 'You're a good student.' She was not trying to be cruel but she couldn't understand. Medical school was rough with a general understanding that if you had depression you either dropped out or took a year off. It was a very, very awful time."
— Lauren, 25-year old, Caucasian Medical Student
Stacy: Physician Burnout and Battling for Personal Wellness
"I'm suffering from an extreme case of burnout. I'm very anxious about my future and am constantly tired," shares Stacy, an Associate Professor and an Emergency Medicine physician. Stacy graduated from Northwestern, obtained a residency at Stanford and got her fellowship at UCLA and "after that, I hoped that things would settle down but I constantly feel squeezed between demands at work and home. Finding herself depleted and "feeling like I didn't care about work" and "writing incomplete patient stories," "not getting my notes completed in a timely manner" and "making only superficial contact with her patients," caused her to seek psychotherapy.
— 35-year old Stacy, Emergency Medicine Physician
Iman: Building Reliable Communication in Relationships
"We are a Muslim couple that has been married for five years with one child. Our relationship has been plagued from misunderstanding and miscommunications right from its start. At first we thought it was our strong personalities and different expectations and that our relationship was just a work in progress, that things would ease themselves out eventually... Over these years, we have tried to connect but end up being fixated on what he or I did wrong in the past, how it happened and why it happened without not only resolving the issue at hand but also dredging up old issues... We have also tried pushing things under the rug but that has not worked...Our last argument dragged our families into it that resulted in a family sit-down where everyone got involved with emotions that ran high...as for the issue, not a dent was made on it."
— Iman, 38-year old, Muslim, Cardiologist
Patricia: Raising my kids with unconditional love
"I have unrealistic expectations of myself. I want to be a better surgeon, a better mom, a better wife, a better daughter... In that I'm constantly second guessing myself and driving myself... 'Did I miss something? Did I forget something? Is my home clean enough? Did I do enough..?' So much is always spinning in my head. I spend 90% of my time reducing others anxieties - telling my children it's going to be ok, telling my patients they'll be okay, telling other people, it's okay... somehow when I say those things to myself, they just don't stick.'
I want to raise my children with the unconditional love that I did not get growing up. There were always conditions attached to everything I received otherwise I would be disowned. I'm afraid that I do not want to be passing onto my kids whatever I didn't get in my childhood."
— Patricia, 40 year old, Ob/Gyn Physician
"My name is Adam. I am a human being, a husband, a father, a pediatric palliative care physician, and associate residency director. I have a history of depression and suicidal ideation and am a recovering alcoholic. Several years ago, I found myself sitting in a state park 45 minutes from my home, on a beautiful fall night under a canopy of ash trees with a plan to never come home. For several months, I had been feeling abused, overworked, neglected, and underappreciated. I felt I had lost my identity. I had slipped into a deep depression and relied on going home at night and having a handful of drinks just to fall asleep."
(Excerpt from: Hill, A. B (2017). Breaking the stigma - A physician's perspective on self-care and recovery. The New England Journal of Medicine, 376, 12)