May 20, 2018

Is Guilt Putting a Monkey Wrench in Your Career Transformation?

There are many kinds of guilt, Catholic Guilt, Jewish Mother Guilt, Generic Parental Guilt, Couch Potato Guilt, Not Feeling Guilty Enough Guilt, and so on. Guilt is such a pervasive emotion it will likely never be on the endangered species list, and as painful as it can be, it is not something we should try to completely eradicate like small pox. Guilt serves a worthy purpose to keep us in line, however, it can also unnecessarily hold us back. As I see it, guilt can be divided into two types:

Guilt Trip
Appropriate guilt: when you’ve done something wrong (or not done something you should have) and you rightly feel regret and hopefully make amends.

Inappropriate guilt: when you feel guilty about feeling a certain way, or wanting or needing something, yet these feelings and desires are healthy and valid.

Inappropriate guilt often arises when you’re feeling conflicted about what you want to do versus what you feel you should do.

Of course there are many instances when we need to put our shoulds over our wants. We may not want to answer a page at 1 am, but we know we should, so we do.

What I often see happening with my physician clients is they feel inappropriately guilty when it comes to making their needs and wants more of a priority, and the SHOULDS win out because guilt is a very uncomfortable and PAINFUL emotion. They end up make decisions based on avoiding the feeling of guilt, and these are not necessarily the best decisions.

Common GUILTY THOUGHTS that can get in the way

“I feel guilty taking my kids to daycare on my day off.”

“I feel guilty taking a job where my income is less; my family shouldn’t have to sacrifice because I’m  unhappy.”

“When I think about leaving my patients, I feel guilty.”

“If I don’t stay in medicine I feel guilty wasting my training.”

“If I work part-time, I feel guilty knowing others are working more.”

“I feel guilty wanting to do something by myself when I don’t get enough time with my family. Sometimes I wish I were single, not really but….”

“I feel guilty for wanting to be happy. Shouldn’t I just suck it up? How many people like their work anyway?”

Guilt is tricky. It’s good we can feel the emotion of guilt, so we have some starch to go with our moral compass. But too often we set unreasonable expectations, putting ourselves at risk for rubber-stamping “Guilty” on our psyche like a bored government worker. We don’t take the time to really understand why the charge of guilty. The gavel comes down and Bam! We’re Guilty! Case closed. No further discussion.

We keep doing what guilt tells us we should be doing, all the while building up resentment and frustration. Nothing really changes except change seems even harder.
Q – What is the way out of inappropriate guilt?

A – Take the time to understand what’s underneath the conflict you’re feeling and reassess your situation without judgment.

A “How To Guide” for Putting An End to Inappropriate Guilt

 To make this more concrete, I have included an example of a physician who wants more time for him/herself,  but feels guilty taking time from family.

Identify what you’re feeling conflicted about that’s creating guilt.

I’m not finding time to do the things I need and want for myself. Work already takes up too much of my time. I feel guilty taking more time away from family.

Write down your underlying feelings, needs, and wants in this situation (It’s key to write these down, get them out of your HEAD, and see them on paper).

All day long I am giving to patients. When I come home, I am giving to my family. After the kids are in bed, I finish my charting and I’m exhausted. I get up the next day and do the same thing over again. I don’t have hardly any time for myself. At the very least I want to exercise more regularly, and eat healthier and get more sleep. It would be great to be able to work on improving my career and just do something for myself, anything!

Look for where you are judging yourself or comparing yourself to others in this situation.

I feel it’s selfish to take time away from my family.  I made the decision to have these children and they should come first. Dr. So and So seems to find time to work and be the perfect parent. I waste what little time I have procrastinating and internet surfing.

Write down the potential benefits if you meet this need.

If I take more time for myself, I will:

Be able to exercise more and feel healthier and less stressed
Be more patient and present for my loved ones
Feel better about myself
Have better relationships (avoid jeopardizing my marriage and job)
Be able to work on my career and make progress
Be healthier and happier for the long run
Not build up underlying resentment
Realize how important my happiness is, and make it a priority

 Write down the potential negatives of meeting this need.

 If I take more time for myself:

My family could feel neglected
My spouse could feel I’m not doing my share of the household duties
I might cut my work hours and see a drop in income
My family might have to see some budget cuts
I could discover I HAVE TO make some changes and that’s scary
Others may see me as being selfish

Write down the cost to you and others if you continue to deny this need or want.

I continue to be unhappy
I become more grumpy, irritable, and resentful
I damage my relationships at work and home
My health suffers; I develop some illness or disease
I grow to hate getting up every day and feeling overwhelmed
I feel like I am wasting my life
I end up not doing anything well

Step back and look at the whole situation. Ask yourself what choices will lead in the direction of optimum mental, physical and emotional well-being and health – for you. Then make any changes you can that will support this overall move towards, not away from, healthy and joyful living. Nothing has to change overnight. Making even small steps over time in the right direction can profoundly change the course of your life. And remember – innocent until proven guilty!



  1. Salil Gupta says:

    Sadly we all put ourselves first. Medicine is about patients and their lives. We would not be here i they were not here. Why do we always put ourselves first. People who excel and succeed go the extra mile and go above and beyond to achieve something. We look up to them but do not want to be them. Doctors have become paycheck workers and punch in and out. Work 12 h shits to make money and live our lives o luxury. Now you can easily make 250,000+ working one week on and one week off and have no responsibility. just collect your paycheck at the end o the week and go enjoy.
    I wish we did what we should and ask ourselves, why we went into medicine. I can go on and on and on but will leave everyone to reflect on these few things.

  2. Heather this article is so specific and helpful.
    Especially for women, who are often torn between the expectations of various roles- guilt can be debilitating.

    • Thank you very much for your comment Deborah! And since you do leadership coaching for women physicians, you have an insider’s perspective on the challenges women face balancing their different roles.

  3. Lynette Charity MD says:

    I have guilt over my decision to retire. “Doctor Charity, YOU can’t retire! We need YOU! What will we do without YOU!” As an Anesthesiologist for over 35 years, I’ve felt guilty about getting married, having children, going part-time, having a nanny, not cooking for my family because I was on-call for 24hrs, choosing sleep over sex, not taking certain positions in the academic sector. Medicine is certainly a big part of my being, but as I’ve aged, I’ve found that along with the drive to help others, there was a drive to help ME! Now I don’t need a nanny anymore, my marriage is stable and I still don’t cook, but I am okay with retiring and feel content that I have given a lifetime to medicine and it’s now time for me to “have a life”. Now I guess I will feel guilty about that! NOT!!!!

    • That’s some awesome sauce Dr. Charity! Thank you for your candid post. You raise a great point in that we have different seasons in our life – there are times when we give an incredible amount to our career, and then times when we seek greater balance. Each individual must determine what the balance for him or herself. Congratulations on your 35+ years of doctoring and all the best for your new direction.

  4. Jane Zendarski says:

    Thank you for a very helpful post!

  5. Don Salzberg says:

    Good AM. I fell into your website and see so much burnout around me. I’m 62 and still truly love what I do (Ophthalmology). I have my own solo practice. I’ve avoided EMR as I will take the penalty over the pain. I’m divorced for 2 years and if not for another 3 big years of alimony I’d consider changing careeets or maybe selling my busy practice and work part time. Guilt. I feel like I’ve given up many passions like tennis and family and stamp collecting and replaced them with work and meaningless dating. I have little time. But giving people eyesight either via surgery or simple glasses/contacts still gives me immense satisfaction. I guess I am writing to figure out what my next step is. Or just keep doing what I enjoy but tweak it. I give myself a lot of free time but I am a typical control guy who wants to be sure others (I have an Optometrist) are doing everything right (or my way!!). I guess I fear burning out. I can’t imagine another “career””.” Don.

    • Hi Don, thanks for sharing some background on your situation. It sounds like you have a very successful career and have sacrificed a lot in different ways, but I am glad that you still derive satisfaction from helping patients. I imagine it would be incredibly gratifying to restore someone’s eyesight or improve their vision. You are smart to be thinking about what direction would be most enjoyable for you, short of another career, with an eye (no pun intended) towards avoiding burnout. I’m curious if you plan on selling/transitioning your practice? As this might a way to be able to cut back some, while still working, and have a bit more time for yourself. There are some good books that have come out recently on physician burnout:

      I have found that addressing burnout is a very individual and there are not ‘one-size-fits-all” solutions, but making your own well-being a priority is a good place to start!

      Please feel free to keep us updated on your situation. Thank you for reading on The Doctor’s Crossing.

  6. Mandy Armitage says:

    Yes! This is great, Heather. Guilt is a major obstacle when it comes to transitioning out of clinical medicine.

  7. Very interesting post share. What are some career types that go well for a 6 personality type?

    Thank you for an amazing resource also, this blog has helped me in ways I did not think possible 🙂

    Erin –

    • Hi Erin!
      It sounds like you may have been reading the blog on the Enneagram personality types, Burning Out? Recommendations For Your Personality Type. Thank you for your kind comments and interest. The Enneagram Type 6 personality is a fascinating type, and because 6’s are known to be responsible, hard-working, focused on meeting expectations and being a loyal member of teams and organizations, they can excel in almost any job where they have talent and interest. Many physicians are Type 6’s, which capitalizes well on the common preferences of 6’s for critical thinking, exactness, identifying with others, skepticism, and taking precautions, as described by Wagele and Stabb in their book, The Career Within You. Other fields where 6’s may gravitate towards are business, finance, journalism, engineering/math, and acting. But please know that any area you choose to work in, can work for you as 6, as long as you don’t have a lot of unmanaged anxiety and self-doubt in this particular job.

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