Physician Relationship Mistakes and How to Avoid Them with Mika Ross

In this episode Therapist, Relationship Coach and Speaker Mika Ross talks about common relationship mistakes that physicians make.

-Mika Ross, M.Ed., LPC, NCC

Mika has worked with many physician clients and understands their unique situations in relationships. Jill and Mika take us through some examples of scenarios couples commonly find themselves in and Mika gives us some time tested and data backed ways to work through the scenarios as well as preventative measures we can take. In this episode you’ll gain tools to thrive in your relationship and some interesting data about what leads to relationship destruction. 

Mika is a licensed Therapist, Relationship Coach, Speaker, and Mama of 3 who has dragged couples into better relationships through her private practice, live workshops, and comprehensive and online programs for couples for 14 years. She has a not-so-secret mission to help moms get to a point where they don’t have to say, “WHY do I have to tell you what to do, WHY CAN’T YOU JUST KNOW??!” in their relationships, so they can lead more fulfilled lives.

Find out more about Mika Ross at https://www.mikaross.com and https://www.instagram.com/mikaross.therapist/

Find full transcripts of DocWorking: The Whole Physician Podcast episodes on the DocWorking Blog 

Podcast produced by: Amanda Taran

Please enjoy the full transcript below

Mika: I want you to address things when you’re at a 2/10, and not an 8, 9 or 10/10 on the anger, frustration, irritation scale.

[DocWorking theme]

Jill: Hi, everyone. We’re so glad you’re here on DocWorking: The Whole Physician Podcast. I’m Jill Farmer, one of the lead coaches at DocWorking. I want you to remember that this broadcast is brought to you by DocWorking Thrive, our subscription coaching service just for physicians. Check it out today at docworking.com. Well, it’s February so we’re going to talk about relationships and I have to tell you, I know physicians that are working really hard and often I hear from my physician coaching clients that a challenge in their life is making their relationships outside of work, and those at work as well, work the best that they can be.

Today, I’m really excited to be joined by Therapist & Relationship Coach extraordinaire, Mika Ross. She has a thriving practice and she is a brilliant communicator. I’ve learned a lot from her through the years and I’ve sent physician clients to her who have really, really appreciated her wisdom, and therapy, and coaching. So, I’m really excited that she’s here to join us today. Thanks for being here, Mika.

Mika: Thank you so much for having me.

Jill: Let’s talk today about mistakes. I know that certainly physicians in relationships, whether they’re two physician families or one physician and somebody, who does something else in the relationship, don’t have a corner on the market of making mistakes, but it is, I think, really enlightening to understand some of the pitfalls that as couples that we can fall into, that can really create situations for ourselves that we don’t want to be in. So, let’s talk about what would you say is one of the most common mistakes that you see folks making in relationships that they could do something about?

Mika: Yeah. I think I have one that’s pretty general, that I would say is across the board. I think that in working with the number of physicians that I have; I think that they have some unique challenges. I think across the board, one of the mistakes that I see people making that they don’t really know that they’re making is that, from my perspective, relationships break very slowly over a long period of time and I think a lot of people don’t really give that enough credit. Communications that don’t go well, maybe go from anger, frustration, and irritation, but don’t get all the way to that resolution. People don’t leave feeling better, more seen, more heard, more understood. They might start piling up some resentment, the more of those conversations that they have that don’t get all the way to a resolution. So, that resentment, that relationship demise builds really slowly over a very long period of time, maybe not specifically physicians, but I feel busy people.

When we get really busy in the beginning of our relationship, before we had lots on our plates, perhaps we had a lot of time to really hash things out and get to the bottom of stuff if you really wanted to. I want my couples to get through conversations that are tough in 10 minutes or less. I think that physicians, a lot of their residencies, I think coincide with the times that they have little kids in the home, which is already a tough time in relationships. So, there’s just this double whammy, where relationships can unfortunately just get off track.

Jill: Yeah, you said it. It’s the normal pressures of just being in a relationship with another human being, and coexisting, and often co-parenting. And then, you add just an incredibly intensely busy schedule and a lot of pressure in the field. You add some dynamics to the relationships which I think are complicated. I have heard you talk about the tendency that we as humans have to love to point out to others, often others that we’re in relationship with, things that they could do better. [laughs] I think of it as just some good ideas or advice, but obviously our partners and spouses often hear that as criticism. So, I want you to talk a little bit about how criticism can be destructive in a relationship. I know a lot of my physicians are very logical people, and so, they’ll come to me and say, “Well, my spouse gets so upset when I point out XYZ,” and I can tell they’re not hearing what they’re pointing out as criticism, but certainly the spouse is hearing it as that. So, I want to hear some of your wisdom on that.

Mika: Yeah. People will say a lot to me. Well, shouldn’t she be able to take constructive criticism? I don’t disagree with that. It’s just that Dr. John Gottman, the leading researcher in relationships in our country has identified four variables that he looks for to predict divorce with up to a 93% success rate, which is super alarming. Those four things that he looks for in interactions with couples are criticism, defensiveness, those go hand in hand in my brain, you perceive criticism, we get defensive, criticism-defensiveness stonewalling, which we won’t go into right now, and contempt over long periods of time resentment builds, you start having contempt for your partner.

Criticism is like you said focusing on what the other person isn’t doing quite right or what they’re not quite doing enough of. For me, every criticism can be turned into a complaint, which is self-focused and not other focused. Criticisms are relationally damaging, complaints can increase emotional intimacy. An example might be like, oh, gosh, I had a criticism that I had to turn into a complaint just recently with my husband. I think it was something to do with getting the house all situated in the morning after the kids leave for school. Instead of saying, like, “You never put the dishes away.” I said, “I need every morning for the dishes to be your job. Would that be possible?”

Would that be possible is, we’re inviting somebody to collaborate with us, instead of coming from a superior place of like, “I’m the manager, I’m right, you’re wrong. I’m smart, you’re stupid. I’m sane, you’re crazy.” Affective neuroscience agrees with this, but what we don’t want to do is we don’t want to elicit that fight or flight response in our partner because that’s going to get us defensiveness and it’s going to get us even further away from that resolution or solution, and what you’re really wanting and needing.

Jill: That’s the thing I’ll hear from a lot of folks is like, “Well, what I’m saying is true. I have facts.”

Mika: Totally.

Jill: “I have the information and I’m saying a factually based statement about whatever it is they’re doing and how it needs to be better or it could be done better.” But what they don’t understand is, I think what you’ve just said so beautifully is that, when it is a criticism, the other person is just having their normal neurological response to that, which is defensiveness, which then creates a situation where you don’t move forward in your communication, you’re stuck. Am I saying that right?

Mika: Yeah, you are saying that right. There is a Marianne Williamson quote, where she says that, “Relationships are the laboratories of the spirit. They are hospitals of the soul.” It’s where we go so that our deep wounds can be healed and I think that that’s definitely the case. But if I’m carrying around a lot of unresolved issues for myself, I might be more apt to get defensive quickly, then if I didn’t. So, there’s that perceived criticism, defensiveness, and you’ve got to focus on your part. If I’m getting met with defensiveness, I know that the person that I’m talking to has perceived criticism, whether I meant it or not. Then I go into investigative mode and try to figure out “what did they hear?” How did you hear me say that you didn’t do something right or you didn’t do something enough? Do you think I’m saying you’re stupid? Then, once we identify that and really validate that defensiveness and what that person heard, then we can clear it up or persuade them into, “No, here’s what I actually meant. I get how it sounded that way, but here’s what I was really saying.”

Jill: I think it brings up another challenge for a lot of physicians that we’ve talked about in some of the other coaching conversations with other physician coaches including Dr. Victoria Silas, who is a physician and a coach, and that is that physicians don’t tend to love vulnerability. In a situation where I’m talking to my partner and I want their behavior to change I don’t like what’s happening, a lot of times, I might say and I do this, too. I’m not a physician, but I do this all the time to my husband. I’d rather tell him what he should do differently than to really talk about what I need. So, can you talk a little about that vulnerability and why it’s important for us to be willing to ask for what we need, what’s hurting us, what we don’t like about the situation in a constructive way.

Mika: Yeah, so, criticism, or what I’m not doing right, or what I’m not doing enough of it’s very hard to hear. It’s very easy to say, though. Rolls off the tongue, hard to hear, easy to say. What I want, what I need, what hurts, what I’m afraid of are harder to say, because it requires a little side dish of vulnerability, but so much easier to hear. So much easier to hear. You’re going to be less likely to elicit defensiveness in the listener, which will keep you on track towards resolution and not veering off into defensiveness, the blame attack cycle, but I get how it feels counterintuitive, it feels worse. [laughs] But I think that once you start getting results with this, you start to trust it more, it starts to become more of a habit.

Listen, I grew up in a family, both of my parents have been married three times. I did not come out of childhood and into early adulthood with the skills necessary to get through tough conversations at all. I think the gift that I had in that was that I was very clear about it. I had no question that I needed to figure all this out for myself selfishly. So, yeah, that vulnerability, not just for physicians, I mean, maybe for physicians especially now that I think about it, but I think for a lot of us, it’s tough.

Jill: Yeah, it is. A physician client said that’s a muscle I know I need to exercise, but I’m not super wacky [laughter] about doing that workout and I totally understand that. This system hasn’t made it super safe in the structure to always be vulnerable. So, we’ve talked about mistakes that get made by couples. One is ignoring things until, over the course of time, slowly, it can really create a chasm that can be tough to bridge. We’ve talked about communication, particularly, criticism and how easy it is to give out, how hard it is to take, and then how we can reframe that. What are some other mistakes that you see couples making that they’re just often not aware of what they are making? If they were aware, could they change it?

Mika: I think that a lot of people have a hard time knowing what’s worth addressing and bringing up, and what’s not worth it. I tell people, I want you to address things when you’re at a 2/10, and not an 8, 9, or 10/10 on the anger, frustration, irritation scale. But I think that so many of us have been taught not to take up space or not to make people uncomfortable. We haven’t been given the skills to know how to talk about our wants and needs without making somebody wrong and bad. We don’t want to upset or hurt somebody, and so, we hold it in, hold it in, hold it in, hold it in, and then blow. That’s a huge one that I see people making quite a bit for lots of reasons.

Jill: What might that look like in an actual scenario as it comes up? So, somebody is irritated by something that their partner is doing, say, they’re unhappy that their partner is not picking up the clothes from the bathroom floor. I’m just going to make something up. Not saying that’s ever happened in my [laughs] relationship or not, it has and so that little thing that doesn’t seem such a big thing, but if I don’t address it or communicate about it, then suddenly when I’m in another part of the house and there’s a dishcloth on the floor in the kitchen, then I get really angry, and all of a sudden, we’re having a fight over a dish cloth on the floor in the kitchen, which in the big picture of things really isn’t anything that I objectively would want to have a conflict over? Is that the kind of thing you’re talking about or is it usually bigger than that?

Mika: No, I think it’s a lot of the little stuff. Oftentimes, when people come in and talk to me, the things that they’re brain-dumping that are tough in their relationships. Almost every first-time couple will say, “This seems really small.” I know this seems silly to talk about and I’m like, “No, no, no, no.” When I tend to find those little examples, whether it’s the laundry on the floor, we tend to attach meaning to those, and for me, that meaning tends to have a theme. Whether my husband’s late or he’s left something on the floor, I might put that all in the category of, I’m not important, I don’t matter. Now, that’s another interesting thing that I want people talking about, and being aware of, and conscious of how we’re perceiving things and what’s the meaning that I’m attaching, and is that what this is really meaning, and how do I check that out and talk to my partner about this? Before it grows, it’s like a slow growing cancer in my relationship.

But one really good example that I have of this, when my kids were tiny, a few months old, three and five, I was teaching graduate school a couple nights a week, which meant that my husband had the hardest time of day with three children, that dinner-bath-bed period alone, those two days a week. A few weeks in, one of my friends, I found out was moving out of state and she wanted to go out to dinner with me on a weeknight before she left. I told him that and when I told him, “Amanda wants to go to dinner with me before she leaves.” He goes, “Ah, that’s fine.” I said, “I hear you say it’s fine. But it doesn’t really sound like it’s fine.” Because in my job I know, I don’t want those little heart sinking moments to go unaddressed. I want to find the win-win. I want to figure out a way that I can go to dinner with her and it feels good to him. He said, “No, it’s fine. She’s your best friend. Of course, you have to go to dinner with her.” All very accurate and correct.

He was saying the right thing, but I kept pressing. The more I pressed like, “What would make it feel better, what would make it feel better?” He got angry. He was like, “I don’t know. Just go. It’s fine. She’s your best friend. It’s fine.” He has a hard time knowing when it’s worth addressing and when it’s not. Something heart sinking like that, he’s apt to just take it. I looked at him and I said, “If you knew that on Friday, you were going out with his two buddies from work, Matt and Neal, would that make it feel better?” His whole body sunk onto the counter and went, “Oh, God, that does feel better.” I just want people to know that there’s always a win-win solution and those like heart sinking things. They might not be huge, but I think they’re messages about something you need and they’re not to be ignored. But it also doesn’t have to be about me being wrong and bad, and I shouldn’t want to go to dinner with Amanda.

I think that that’s our brain’s tendency to either see it as this or that. I feel I’m teaching people a third way. I don’t want you screaming and yelling about it, I don’t want you sweeping it under the rug. All the examples I ever saw in childhood by the way. I want you working relentlessly toward those win-wins.

Jill: Powerful. One of the things that also comes up sometimes with physician clients is that, there’s just a lot going on emotionally for them at work, and particularly, right now, I can’t say it enough, and I’ll repeat it every time I’m on the podcast if I need to, but physicians are working so incredibly hard and doing such important and meaningful work. Right now, unfortunately, many situations are not being appreciated or given what they’re due in this work. It’s a very tough time to be a physician and yet, they just keep showing up, and working harder and harder and harder. Given all of that, it’s just a lot for human beings to deal with, and then you bring that home into the relationship. So, I want to know if you have any ideas for our physicians that are under that amount of pressure at work. How to be able to get some care and to be able to come home and not have to just feel they’re carrying the weight of the world?

Mika: The stories that I hear about how understaffed and overworked many people who are working in hospitals are hard to hear. I think that we are all in a different context with this pandemic. I think that when our context changes, we have to redefine success. Your definition of success, I don’t want it to be the same as it was in mid-2019. I think that really needs to be examined and we really have to work to consciously redefine what success is right now. Just as a mother in the beginning of the pandemic, I had to throw my ideas of what it looks like to be a successful mom completely out the window. My husband and I were meeting every night about what’s working, and what’s not working, and what needs to shift and change, because nobody was an expert about how to have a successful household and family in a pandemic, while you’re trying to work and homeschool children.

I speak to corporations about this, too. I did a workshop for Monsanto, which is now there. They’ve had some huge transitions. I think that we’re doing new things, it’s so easy to feel like a failure because we haven’t yet changed our definition of success. How we’re taking it personally, I think is something really heavy that you can bring home. There’s actually a layer you have a lot of control over. I might not be able to help you fix your workload, I might not be able to help you decrease the amount of crappy things that are happening at work, but I can help you redefine your definition of success, so, you’re not carrying it in the same way that you may be used to.

Jill: Yeah, beautifully said. We talk about that a lot, because there’s so much control and extrinsic markers that are built into the medical education that sometimes people forget that really defining success is an inside job.

Mika: Yeah.

Jill: It’s a value’s driven job, they really have let other people’s ideas of what success is be imposed on them in a way that doesn’t match up with their values, life conditions, as you said, the context of what’s happening in this moment now. So, I do think that’s a benefit of this experience, it’s almost forced people to have to contextualize their definition of success in a way that will make us healthier in the long run and create some resilience, which is not necessarily fun as we first awaken to that understanding.

Mika: Yeah.

Jill: As we wrap up here, I want to talk about something that I have noticed with physician clients, different a little bit from some of my other executive coaching clients or others, and that is that I am not a relationship therapist or coach, and so sometimes when I can hear that there are some challenges there, I want to recommend folks to go get some relationship therapy, counseling, or coaching. Their first reaction is, “Oh, no, it’s not that bad.” My reflection always back on them and so, I say, “As a physician you want to wait till somebody is really, really sick before they call the doctor and get any ideas about potentially some ways to do this,” and they laugh. But I do think there sometimes is a little bit of a, “Oh, gosh, we have to be ready for divorce court before we consider bringing somebody else in to help support our relationship.” So, I just want to hear your thoughts on that.

Mika: Yeah, so I’ve been doing this for 15 years. I think especially 15 years ago, people saw marriage counseling as crisis counseling, and not preventative and/or maintenance counseling, or nipping things in the bud. I think that’s starting to shift and change maybe more so on the coast than in the Midwest, but I’m seeing the needle move a little bit. Yeah, I think you’re exactly right. We wouldn’t wait until our car is smoking on the side of the road to go get an oil change. You see that, I’m almost to that mile marker. I’m a little bit over, I need to go get this taken care of, and I wish more people saw counseling and therapy in that way, we’re so preventative with so many things, our car, our teeth. It’s just that your relationships are one of the biggest factors in your happiness.

Just according to a longitudinal study from Harvard, I’m not just making this stuff up. Yeah, there is a mindset around it that it needs to be like me or the divorce lawyer, not that I don’t also love working with those people. But it is so much easier, so much quicker, so much more efficient, so much more effective when we can really deal with things early on rather than patterns that have been there for years, and years, and years.

Jill: So many good ideas. I could talk to you all day long. You also, by the way, have an excellent online course on conflict that I think should be required watching for couples. I think it would really help a lot.

Mika: Great.

Jill: If somebody wants to find out more about you, maybe take your online course on conflict or see all the other ways that you offer support in the world, how can they find you?

Mika: I think the most fun place to find me is on Instagram right now. My handle is @mikaross.therapist. My website, mikaross.com. You can find all the online courses that I have to offer. Like you said, I have one on conflict. I’ve got a group for moms called wellMAMA, where we cover lots of things that the mama physicians totally need as well. Those are the places that are probably the best places to find me currently.

Jill: Mika Ross, thank you so much for joining us for this conversation. It was great to talk with you.

Mika: Yeah, thank you.

Jill: Mika, by the way is spelled M-I-K-A-R-O-S-S, if you want to find her on Instagram or on her webpage. I want to thank all of you for taking the time to listen in on this conversation. I hope you were inspired like I am to think more about how I can state my needs, and what I want as opposed to focus on my partner with criticism, and to think a little bit differently about the way that I’m communicating and showing up in that most important relationship in my life, which is my 30-year marriage now. So, I’m always happy to get advice and some really good ideas for continuing to support and sustain that.

I want to thank all of you for joining us on DocWorking: The Whole Physician Podcast. Don’t forget to go right now to docworking.com to find out all about Thrive. It has never been more important for physicians to get coaching support as well as peer support in the community, as well as learn about ways to decrease stress and to help yourself be more peacefully productive. We have all of that for you in Thrive. Go to docworking.com today to find out more about it. Until next time, I’m Jill Farmer.

Amanda: I’m Amanda Taran, producer of DocWorking: The Whole Physician Podcast. Thank you so much for listening. Please don’t forget to like and subscribe, and head over to docworking.com to see all we have to offer.