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How can doctors live in a fulfilling relationship?
An Interview from Dr. B. Maeulen with Doug and Naomi Moseley in North Carolina (abbreviated as BM, D and N in the text)

Doug & Naomi Moseley, based in Taos, New Mexico, are authors and psychotherapists who specialize in leading week long personal growth residential retreats for individuals and couples.

BM:In Germany many physician couples have little shared time and quality in their relationships. As you are trainers and professionals with a long experience in helping couples, I would like to hear your ideas on how to live a fulfilling relationship as a professional.

Moseley: (D) I think finding time and setting time boundaries is of utmost importance. Without these boundaries firmly set in place, many professionals have a strong tendency to invest their energy into their vocational lives, where they feel strong, and thus have less energy left to put into their interpersonal lives, where they often don’t feel as strong. It takes a lot of determined effort and personal awareness to counter this tendency.

(N) It’s also true that many professionals use their profession to protect themselves from being personally vulnerable. Rather than feel their fear of intimacy, they become busy in their work, secretly using their workload as an excuse to avoid reaching out for intimacy.

(D) If we want to look at physicians more particularly, it seems clear that physicians, almost by definition, carry a lot of power and authority. They are trained that way and in their careers, exerting that power appropriately and carrying the responsibility that goes with it, is one of the major components of being a successful practitioner. The problem is that successful intimate relating is a lot about sharing in powerlessness. Even the idea of powerlessness is often unpalatable to a person who is trained in power yet the quality of an intimate relationship can’t be very high if one partner always tries to live primarily in their power persona. It’s not that physicians consciously try to take power in their relationships, it’s more of a habitual attitude or expectation. The problem is that if you are in an intimate relationship you can’t just have power all the time and one of the questions is ‘how do professionals, who are trained in power, learn to turn off this almost automatic tendency when they are at home with their spouses’? And this is even a bigger problem if power partners are unaware of their own expectation of having power. We’ve written in detail about this kind of thing in our first book: “The Shadow Side Of Intimate Relationships.”

(N) In physicians’ professional lives they have to be somewhat detached from their emotions to be most effective. In their intimate lives they have to be more attached emotionally and this is often where things break down in their relationships. Very often physicians have been trained out of emotional attachment to some degree part of their initiation is to be detached. They have worked so very hard to get where they are and it is quite a step to un-train some of that.

(D) Another aspect of the issue that Naomi raises is that professionals put so much of their energy into developing their skill set, that they often neglect their emotional development. When emotional development is bypassed or postponed, underneath the surface presentation of self there is a core of emotional immaturity. We see it all the time underneath the polished intellect and outstanding capacity is often a very young person emotionally, because the emotional development has been neglected or avoided. Of course this emotional youngness is a not a pleasant thing to acknowledge it’s so much easier to give one’s attention to work. In fact if work was all we focused on, we could probably hide quite well from our emotional immaturity and fool ourselves into believing otherwise. But we can’t get away with it in our intimate relationships.

(BM) It is like the physician is split into two parts: one is the grown up part which takes care of the patient, and one is a very childish and needy part, and that comes out at home. So the spouses of doctors do not see the strong doctor, they see the exhausted and very needy physician.

(D) Exactly! In the beginning doctors’ spouses find themselves attracted to the powerful persona but when they get more deeply committed, they find out, that their ‘doctor’ is very young deep down. It can be a shock. And of course we not yet talking about the spouse’s emotional age because if there is one law in attraction it is that people are attracted to partners of the same emotional age.

(N) Sometimes you have two physicians as a couple, who are exactly the same way, covered over and infantile underneath; they both are defended against each other because deep down they each need their mommy and daddy so much, that they don’t want to talk about it with each other. And sadly nothing much real can happen in this situation until both partners have some willingness to locate and become aware of their own emotional youngness. Only then can they begin the process of growing up into authentic maturity.

BM One issue even mature physicians have to face is very long and tiresome working hours, that are not friendly to any relationship, even if the partners want to work on their issues.

Moseley: (N) Again, this goes back to boundaries. If you choose to work so many hours then underneath all the excuses, you are really saying that you really don’t want to be in a close relationship. You are saying that your power in work (and prestige and finances) is more important than love. You are saying you are stubbornly holding onto the child’s belief that you can have it all. The key aspect here is setting boundaries, so that your life has some balance.

BM How would you work with a Doctors couple to find a healthy balance between work and private time in the very competitive world of a modern medical medicine?

Moseley: (N) One of our messages is that you can’t have it all. If you are not willing to make a sacrifice, then you can’t find a balance. You can’t work 16 hours a day for years on end to become the top notch in your field AND expect a juicy relationship. To put it in down-to-earth terms, there has to be a willingness to sacrifice some money (although I must say that we see a lot of people who finally decide to set some human-friendly boundaries and ultimately find themselves making as much money working less because when they are so much less stressed and so much more present in their work, they give it a totally different input.)
And the spouse has to make a choice too. If the physician-partner is going to spend more time away from work the spouse has to spend less money. Often the spouse wants more time and attention and is angry for not getting it. But the spouse also wants the power and the prestige and the money, so something has to give. The hungry children have to wake up.

BM Are there any specifics to the Moseley Method of couples therapy?

Moseley: (D) One of the first things we focus on is what we call ‘feelings training’ or getting more into the emotional body. Naomi has a real gift for helping people do that. Naomi goes past talking therapy and helps her clients to get in direct touch with their emotions. She helps people to come down from their rational analytical selves into an experience of their emotions in their bodies. Feelings training, as we see it, has three major aspects:

1) you have to learn how to locate your feelings,
2) then it is important to learn how to express your feelings
cleanly and effectively,
3) and then partners have to learn how to receive feelings
from each other.
This third aspect is not explored enough in the therapeutic community and to us that’s sad because in an intimate relationship, when one partner has not learned how to receive the feelings of the other, it is impossible to sustain feelings exchanges. When it is impossible to continue a feelings exchange it is impossible to sustain passion in a relationship. And without this exchange of feelings the relationship runs dry.
The second thing we specialize in is helping people look at the underbelly of a relationship, the so-called shadow side. In order to grow, all partners in intimate relationships need to be able to look at their own difficult aspects, their own difficult contributions to the relationship. We all have these aspects and because they are not usually very ego-enhancing we sometimes have difficulty clearly seeing these aspects in ourselves. We would prefer not to look at them. So there are times when it is important to work with a trainer, who helps you to get to your own shadow material, and that is true for both partners.
In order to successfully work with shadow material in partners, a non-judgmental atmosphere has to be created. At the beginning of our groups everyone has at least a little fear about delving into these areas but within a matter of hours participants begin to find it liberating. People become clear that without bringing these aspects forward you can’t work with them. And when you can’t work with them, you can’t advance in any kind of real and lasting way.

BM: Have you witnessed that couples, who do work with you, gradually reach a more fulfilling relationship? Or: What positive experiences can you share from your work with couples, especially medical couples?

Moseley: (D) We see it in every group we lead. And the truth is that deep change takes a lot of work and sustained effort. A lot depends on how determined couples are to follow through with what we teach them. We love working with physicians because even though they tend to be highly skeptical at first, when they realize there is something of value in our training, they often take it on with gusto. The same intelligence and dedication that helped them become successful physicians gets applied to their emotional work. That’s rewarding for us as teachers. Getting them in the door is the biggest problem.
In terms of an example, I remember the first surgeon we worked with many years ago. He was very skilled in his field, had an obvious broad range of knowledge in many areas and was somewhat intimidating in demeanor. But his marriage was dry as a bone. He came into our office, essentially dragged in by his wife because she was getting ready to leave him. He fought with us for a session or two not yet fully aware that a strong intellect can also serve as a strong defense system, not yet fully aware how his defense kept him protected against his own fear of becoming more vulnerable, not yet aware that becoming more vulnerable was exactly what was required to bring more juice to his marriage.
When he got past his habitual defense and down into directly experiencing some of his feelings, he looked like a changed person. His wife opened up to him again. Gradually he significantly improved his relationship with his children, in part because he spent a lot of effort growing himself up emotionally. As he continued working with us, he admitted he had trouble with his staff so he brought Naomi into his office for an entire day to work on staff relations. When that worked so well for him, he brought her along on his rounds with patients so that he could learn how to be more emotionally present with them. His work became more feeding to him and that had spin-offs back to his marriage work and love go hand in hand. We’re still friends with him to this day.

BM: Not everyone can fly to a seminar in the US. What can physician couples do at home in Germany?

Moseley: (D) In our experience most physicians have pretty well developed intellectual insights into themselves and others and what they are lacking more is emotional training. It is very difficult to do good emotional work without a skilled helper. We recommend that people who have a desire to do some emotional work seek out a skilled experiential therapist. Although there are many skilled insight therapists, I think it is more difficult to find therapists who can help their clients move more into their emotional bodies in an experiential way (as opposed to only talking about it). One of the pitfalls to look out for in the experiential therapies is that some of them have seem to have difficulty knowing where to go, past the cathartic aspects. For example in some types of Esalen-style work there is focus on expression but not much emphasis on learning how to express cleanly within boundaries. And there is no emphasis on receiving expression so after an experience of catharsis, clients might experience a personal release for a period of time, but don’t really end up with practicable ways of sustaining a more passionate relationship. These are just a couple of things to watch for as you seek out an approach that works for you.

BM: Quite often couples are afraid of therapy, because they think,
that it will mostly result in divorce. Is that your experience too?

Moseley: (N) Couples are afraid of their emotions so they avoid going to therapy. Somehow the sense is that stirring up emotions will put the relationship at risk. Unfortunately it’s the avoidance of emotions that creates the major troubles over the long term and eventually leads to divorce. We wish couples wouldn’t wait until a crisis hits before they seriously seek counseling but unfortunately that’s often the way it goes. It is very sad to us, because it would be a lot better for couples and a lot easier for us, if they would come for some training before they get too close to the edge.

(D) In a way it is also good, because when a couple is in crisis, they are ready to go, they are more available on some levels, but it is harder work.

(N) If your choice is to be dead or to risk going into your body and become more intimate; you have to be willing to risk what you have.

(D) And the truth is, all growing marriages come to edges! probably more than a couple of times in the life of the marriage. So there is a time of reevaluation, and it is a scary time but it can also be very fruitful, because there is the opportunity for something new to come in. When a marriage is stable and comfortable, partners don’t have that much impetus for personal growth.

BM: The German physicians have a lower percentage of divorce, compared to the general public, but nevertheless there are quite a few with a second marriage. In what ways is there a difference between the first and the second marriage?

Moseley: (D) Second marriages can be a lot more complicated because there is often a blending of the families and there are more complex issues around money. Blending a family is probably the most difficult task in any relationship and as soon as one issue is solved another one usually isn’t far behind. In the romantic phase partners have a strong tendency to gloss over potential difficulties by telling themselves something like “We have such strong love for each other that everything will work out just fine.” But in reality when you mix two or more families under one roof and also attempt to deal with all the diversions created by dealing with ex-spouses you end up in a very challenging scenario.

(N) But usually the second time around couples are more willing to do therapy, because they failed one time! So the second time we notice that people don`t wait quite as long, before they do work on the relationship. Often they are up against the same kind of problems – as in the first marriage- and it’s harder to blame the spouse.

(D) They recognize the issues earlier, because they have seen the same issues before; they are more willing to do the work, because there is only one common denominator in the problems of both marriages and that is themselves. Of course some people take more than two marriages to learn this.

BM: How can your book ” How To Make Your Second Marriage A First Class Success” help the professional readers in Germany?

Moseley: (N) In additional to some good material on second marriages, including stepparenting issues and money issues (including pre-nuptial agreements), it is about how to be emotional with your partner. There is some good material about the emotional expression that is pertinent to all intimate relationships.

BM: In your experience – what are some of the most important DO’s and DON’T s for a quality relationship?

Moseley: (D) Well we always talk about the three major needs: time, attention, and touch. Again it comes back to the boundary issue of making enough time for each other. During those times together partners must learn how to give quality attention to each other. Usually that attention includes lots of talk preferably with some expressions of feelings in those times of attention and communication. Regular touch is also very important to most couples it a way to ensure that couples stay connected, more in their bodies, not just go drifting of into their heads as would otherwise be the tendency. We see incredible numbers of couples who devote their time and attention to everything but each other: children, work, community affairs, and house maintenance. The idea is to keep everything else functioning well, assuming that the marriage will hold, but when the relationship itself is not functioning well all these others areas are even more difficult to keep up with.

(N) Making a continual effort to take personal responsibility for all that is happening is a ‘must-do’. If partners in a marriage are not taking responsibility for what is happening, if they are playing out ‘victim’ to their circumstances, or victim to their partner, then their marriage will never be very exciting or alive. All partners must begin to see what their participation is in whatever difficulties they are having and if they can’t do that, they will never have a very nourishing intimate life. In order for partners to take this kind of responsibility, they have to grow from a child more to a more adult person, always asking, “what am I doing” or “how am I participating in this?”

(D) In order to recognize your own ‘victim’ character within, you have to be able to swallow your own un-egoenhancing aspects. We would consider this one of the must-do’s for individuals who desire a growing and fulfilling relationship.

(N) One of the ‘Don’ts’ that comes to mind for me is ‘talking about your partner as opposed to talking more personally about yourself.’ It’s a lot easier to work through issues when partners are making a continual effort to talk more personally from within themselves as opposed to observing, reacting, and talking about the other. Because when you observe the other, you go into a form of judgment, where you detach from them, and intimacy is about attachment. And so you have to begin to ‘feel’ them rather then ‘see’ them.

BM: For many physicians in Germany the professional environment has greatly deteriorated- longer hours, more clients, less pay, more litigation- and to them emotional work seems even more of a demand.

Moseley: (N) If physicians can’t find a balance in their own lives, how can they expect the government to be balanced? Where does it start? I would imagine that many of the physicians you are talking about are waiting for things to change outside of themselves and I am just saying: you must change inside first before there is much real hope of change outside yourself. Physicians are being caught in a squeeze because nobody in the culture really wants to sacrifice anything. And physicians are caught in this squeeze because they themselves are unwilling to pay the costs of working less.

(D) Whether a person is willing to make the added effort to add more emotional balance in their lives is up to them. We can just point out some of the costs of NOT doing that. Wasn’t it Freud who said that life is about work and love? Emotional training is about taking care of the love side of life and if people refuse to do that because they are too caught up in work, they are asking for a more stressful and less nourishing life.

(N) You have to realize that if you want a love life, an emotional life, there has to be time devoted to it. Most people waste more time on TV, movies, and newspapers than it would take to improve their emotional relating. Physicians can look at their lives, like they would look at the schedule of their patients, and see where they could make changes, and I bet they can find an hour or two in their day. Once the rewards of doing this start to become more obvious, it starts to become a lot easier.

BM: At the end of a long day in my practice I am often exhausted, I cannot just jump into quality time as a couple, instead I need some time for lazy rest.

Moseley: (D) That is true, what is left at the end of the day is the most tired out hours, and there has to be a way of de-stressing as an individual after coming home from work. We suggest that couples who are really serious try to organize their lives so it is not only the last shreds of the day that are devoted to the relationship.

(N) We suggest that you get up a half hour early and have quality time while you are fresh, before you begin the day. We suggest that you do a ten-minute touch every morning with your partner. That will help you throughout the whole day and it will also help you come through the evening, because you had this lovely time together in the morning. This might be a little contrary to the Germanic way, but we take out time every morning and so we connect in a much better way. As a couple you have also to find out about your rhythm, one may be a morning person, the other a night person, you have to adapt to that. A couple has to have a commitment to balancing life for love, not just work.

BM: Is there an age limit, to a successful work as a couple?

Moseley: (N) No, we’ve worked with couples in their seventies even eighties. Very long-term marriages sometimes have difficult habits to overcome but if there’s any life left, they still gain from instruction.

BM: How many years do couples come to work with you on the average?

Moseley: (N) We find that individuals and couples who are really serious about changing deep patterns might average about 5 sessions in a two to three year period. Many come for one session and they still get a lot out of it. We have a few clients who have been to more than a dozen sessions.

(D) Usually the first session rocks them and changes their perceptions. A few are even afraid to come back for seconds, but if they do come back for the second session then they start to really integrate what they learned in the first session; they anchor it. The third session they start to really move, they start to do their own individual personal work; in the subsequent session they are able run with it and really get lasting results.

BM: Many thanks for this interview.

Doug & Naomi Moseley, based in Taos, New Mexico, are authors and psychotherapists who specialize in leading week long personal growth residential retreats for individuals and couples.
For more information about their books or the work that they do, look up their website: or contact them directly at 1-505-776-1074.

For further questions please contact:
Douglas Moseley
P.O. Box 430,
Arroyo Seco, NM 87514
(ph. (505) 776-1074; fax (505) 776-5658)