Most individuals who choose to become physicians in the US come from dysfunctional families. They tend to have low self-esteem. However, they often function in the role of “rescuer” or “the successful child” and that is how they get any recognition at all.
Because of their background they feel it is their duty to continue to be the “healer”. They want to solve all of the problems in others, ignoring themselves and their own problems and inadequacies.
Denial and rationalization are two of the common defense mechanisms used by these physicians in dealing with themselves and their own problems. Most people who enter medical school are driven to be successful in order to avoid facing their own inadequacies and low self-esteem.
While in medical school and residency young doctors must deal with the arrogance and constant criticism of mentors, sleep deprivation, overwork, and the harsh realities of illness and death. Their role models are overworked (this becomes a value worn like a prize around their necks) and lack life balance.
Their education is strictly cognitive and evidence based. Through it all any demonstration of feelings is discouraged and belittled. Most residents are in a persistent state of burnout and depression is common.
To cope with this, individuals build a hard impenetrable outer veneer, the “bounded self”, and it is from there that they operate as physicians. The bounded self values the concrete and superficial things such as money, power, status, possessions, title, and having the best evidence-based statistics.
These wounded doctors lose touch with their deeper “essential self” and its purpose of helping and serving others. Their lives become all work. Their relationships suffer, they are fearful of emotions and their own perceived inadequacies; they are vulnerable.
I have been working with individual physicians and groups of physicians for 20 years in both therapeutic and educational settings. Rarely have I encountered arrogance or coldness underneath the physician’s outer veneer of superficial boundedness.