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Couples & Family Counselling - Family counselling

Families with one or more members being involved in medicine face the same type of problems that other, non-medical families face. However, with one or both parents being medical students or medical professionals, their families also face problems specific to their choice of career. The long hours and high demands of a career in medicine can have a particular impact on your family.

Unsure how satisfied you are in your relationships? Try the Burns Relationship Satisfaction Scale. Note that this inventory can be used to evaluate your relationship with your partner, child, other family members, friends, colleagues and patients. If you score a 25 or less, we encourage you to book an appointment with one of counsellors who will be able to review the scale with you and help you discover the reason(s) for your relationship dissatisfaction.

Examples of family problems

Examples of some of the problems medical families face include, but are not limited to:

• Mental health disorders (as described by the DSM-IV-TR) • Physical disabilities • Learning difficulties

• Yelling, threatening, putting down, humiliating, coercing... • Withholding basic needs, using intimidation tactics... • Hitting, pushing, shoving, sexual abuse...

• Guilt, shame, anger, resentment, projected anger towards children... • Custody battles and long, drawn-out settlements • Children who feel responsible for their parents separation

• Genograms: inherited traits • Family of origin problems • Step-parents, step-siblings, adoptive parents, adopted children

• Cultural • Religious • Generational differences in values

• Prejudice and discrimination against parents, against children • Acceptance by family, friends, co-workers, the community • Legal and social recognition as equal parents with equal rights

Communication breakdown

All families have their share of communication problems and medical families are no different. A major barrier to communication can be if symptoms of exhaustion are being experienced by one or both parents. When you’re asleep on your feet and feeling overworked, you are not likely to be able to put much effort into communicating effectively with your partner and children, if at all. As a medical student, you may also find that you sometimes have difficulties communicating with your parents. If you have non-medical parents you may have difficulty getting them to understand the stress and high demands of your education and career choice. If you have medical parents, you may have difficulty getting them to accept your choice of specialization or any interests you have in medicine that may differ from theirs. Oftentimes, we don’t even know why communication between us and another family member has broken down. We simply know that something is not working. Regardless of the reason for its breakdown, communication (along with trust and respect) is a key element in a healthy, happy family, because in order to resolve any conflict, reservations or concerns you have with or about each other, you must first learn and be able to communicate effectively with one another.

For more information on how to improve your communication skills, check out the Communication webpage. You can also book an appointment with one of our counsellors if you would like some one-on-one guidance.

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Children with special needs

Being the parent of a child with special needs can be challenging and a very demanding job in itself. Add to that the demands and time constraints of medical school, and those challenges can seem difficult to conquer. If you are struggling to cope with having to care for a child with a mental health disorder (as described by the DMS-IV-TR) or a physical disability, please book an appointment. Our counsellors will be able to help you overcome any stress and anxiety you may feeling, and they will be able to help you discover the joys of being a parent. You can also check out our Accommodations page for information.

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Abuse: physical and/or emotional

First, please note that anyone can be abused, male or female, young or old, disabled or not. Abuse can take on many forms, such as physical, sexual, emotional and economical. It is important to recognize the signs and cycles of abuse and in order to prevent abuse from occurring and/or break its cycle. Often times, victims and perpetrators of abuse fall into a cycle or pattern without realizing it. The first time an incident of abuse occurs, both the parents and child are generally shocked and surprised. Afterwards, apologies and vows to never repeat the act again may be made and accepted. Forgiveness may occur and all parties may move on. The child however, may be more deeply affected by that one event and may experience more difficulty accepting the apology offered to them. In some situations, the cycle can be prevented from forming if the victim and abuser are separated in some way or if the promises are kept and the problems the abuse stemmed from are worked on. It is possible, however, for a cycle or pattern of abuse to form.

In a family, anyone can be the victim of abuse. Possible scenarios include: spousal abuse between parents, child abuse by one or both parents, elderly abuse by children and/or grandchildren. Abuse can have long-lasting, devastating effects on a person, especially a child. If you or a loved one is a victim of abuse, if you are concerned that you or a loved one may engage in abusive behaviour, or if you have been abusive towards a loved one, please visit the emergency section of the website to speak with a professional immediately. It is important to break the cycle before it has a chance to be set.

For more information on abuse cycles and types, please click here.

For more information and resources, including contact information for shelters and hospitals, check out:

• The Children's Aid Society of Ottawa
• Women's Resource Centre – Student Federation of the University of Ottawa
• Kids Help Phone website

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Separation & divorce

When a relationship has suffered to the point of breaking, separation and possible divorce may follow. Unfortunately, the high demands and long hours of a medical student and physician can be a contributing factor, though not always. Separation and divorce can be particularly difficult when children are involved. It is important to remember that your decision to end your marriage, whether mutual not, will affect not only yourself and your spouse, but your children as well. To help children and their parents through the transition of separation and divorce, it is often advisable to seek out the help of a counsellor.

If you are going through a separation/divorce, are thinking about it, or are worried your spouse is, please book an appointment with one of our counsellors today. Remember, we’re here to help you.

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Family dynamics

The family we grow up with can largely define who we are as adults. This family is known as our family of origin and is not defined by our biological connection to each family member, but rather by their influence on us throughout our childhood and adolescence. The dynamics of our family of origin can vary greatly from one person to the next, making each of our families unique. When our family dynamics are dysfunctional in any way, it may lead us to experience problems such as a stress, anxiety and/or depression, and we may carry these problems with us into adulthood, whether we are aware of it or not. Mental and physical illnesses, certain personality types, and other family members’ family of origin dynamics, have the potential to impact us both positively and negatively.

When going through any major life transitions and/or stressful events, unresolved issues or conflicts with or stemming from our family of origin may arise. When this happens, it is best to look to someone for aid, either a trusted friend, spouse or family member, or an experienced counsellor. If you are experiencing any problems that you believe may be related to your family of origin, we encourage you to book an appointment with one of our counsellors. One counsellor in particular, Jane Keeler is very familiar with family of origin problems and will be happy to offer you family of origin therapy to help you through this difficult time. For more information on family of origin therapy, please see below.

Family of origin therapy

The purpose of family of origin therapy to help you navigate through any problems you may be currently experiencing, such as stress and anxiety, which may be related to or have been influenced by the family you grew up with. Usually, the first step is to identify the root cause of the problem: that is to say issue of family dynamics you were influenced by that could be negatively impacting your well-being today. The counsellor will help you to identify patterns of behaviour within your family of origin, as well as track mental and physical illness and the relationships between each family member by possibly working with you to create a genogram. A genogram is an enhanced family tree that identifies patterns of behaviour and illness, as well as patterns of inheritance and relationships. For more information on genograms and how to create your own, check out the links below.

Once the issue has been identified, the healing process can begin. Oftentimes, the problem stems from unresolved conflicts between you and one of your family members. While in some cases it may not be possible for the conflict itself to be resolved, the counsellor will help you to move past it and to become at peace with it.

For more information on family of origin therapy and to see if it’s right for you, check out one of the following links:

• Article on Genograms
• Going Home Again: A family of origin approach to individual therapy
• Can the Past Define Our Future? – Family of Origin and Relationships

You are also welcome to book an appointment with one of counsellors. Don’t forget, we’re here to help you.

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Family values

Everyone has a certain set of values that determines how they live their lives and how they interact with others. This set of values can vary for every individual, thus it should come as no surprise that conflicts can arise when the values of one person do not match those of another. These can include differences in cultural and religious values between family members, between peers and colleagues, as well as between doctors and their patients. Conflicts can also arise between children and their parents (and/or grandparents) in terms of generational values. You may find that your values are not the same as those of your parents or your grandparents simply because of the differences between your generations.

Furthermore, as a medical student and professional, you may find that your professional values and family values do not always match. For example, you may be interested in starting a family but you are worried about the negative impact your professional demands could have on the amount of time you would be able to spend with your children. Women in the medical field may experience the added pressure of feeling as though they must choose between having a family and pursuing their career, either due to societal expectations, familial expectations, or due to their own set of family values in terms the role of a mother.

If you are concerned about the impact medical school is having on your family values, or if you are in conflict with another person due to a difference in family values, please book an appoint with one of our counsellors. Remember, we’re here to help you.

You can also check out the following links for more helpful information:

• Medicine & Motherhood: an article by a female doctor on her struggles to start a family and maintain her career
• Mommd: connecting women in medicine

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Same sex parents

All families in which one or both parents are involved in medicine face a particular set of problems such as: time conflicts, energy deficits, etc. Same sex parents also face their own set of problems, including prejudice and discrimination, bullying, legal and social recognition as parents, and acceptance by family, friends and colleagues. Thus, being same sex parents in medicine may prove to be quite stressful. As same sex parents in the medical field, you may face the added challenge of being accepted by your patients. In smaller, rural communities where you are more likely to be seen and recognized outside the office by a patient, acceptance of your family may become an issue of contention with some of your patients. Acceptance by your colleagues also plays a much larger role because in order for physicians to work effectively with each other, there can be no underlying tension between them and personal beliefs and prejudices must be left behind.

If you are experiencing any problems related to same sex parenting or if you feel that you are being discriminated against as a parent due to your sexual orientation, please book an appointment with one of our counsellors. Remember, we’re here to help you. And know that professionalism is expected of all students, faculty members and staff, and any discrimination will not be tolerated.

Resources

If you are experiencing any family related problems or have any concerns, whether they are listed in the above examples or not, please do not hesitate to book an appointment with one of our experienced counsellors. Remember, we’re here to help you.

English Resources

• Medicine & Motherhood – by Dr. Dawn Barker
• Should Women Be Doctors? – by Lisa Belkin
• Family Equality Council

French Resources

• Je suis pas docteur, je suis maman – Unknown Author

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