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Anesthesiologist and clinical mental health counselor Maire Daugharty discusses her article “How therapy helps uncover hidden patterns.” Maire explains how psychotherapy leverages the brain’s pattern-seeking nature to reveal implicit beliefs formed in early life, often outside conscious awareness. She describes how therapy provides a unique relational space for exploring assumptions, processing emotions, and reframing expectations—leading to profound shifts in self-reliance, resilience, and meaning-making. Drawing on depth psychology and Erik Erikson’s stages of psychosocial growth, Maire illustrates how uncovering hidden narratives can transform relationships, ease life transitions, and help individuals face aging and mortality with integrity. Listeners will learn how therapy can dismantle limiting beliefs, foster autonomy, and cultivate deeper well-being across the lifespan.

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Transcript

Kevin Pho: Hi, welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Maire Daugharty, an anesthesiologist and clinical mental health counselor. Today’s KevinMD article is “How therapy helps uncover hidden patterns.” Maire, welcome back to the show.

Maire Daugharty: Thank you.

Kevin Pho: All right. Tell us what this latest article is about.

Maire Daugharty: This latest article is part of an ongoing attempt to discuss the process of psychotherapy from a depth perspective because I find that people often don’t really understand what the process is. People often come in believing, “Well, you’re going to give me some advice to make my life better,” and that, of course, is not at all how it works.

It is also a response to a number of comments that I run across in our physician community forums on social media. I see questions come up over and over and over again, and so this was also, in part, an attempt to address some of those questions.

Kevin Pho: What kind of questions are you seeing about psychotherapy that you run across on these physician forums?

Maire Daugharty: They’re not necessarily specifically about psychotherapy, but more aligned with, “I am so unhappy. What do I do to navigate this circumstance?” Some of the contemporary common unhappinesses that come up for discussion revolve around work circumstances, particularly in medicine. Questions are often, “How on earth do I balance my life given that I’m working full-time and my responsibilities continue to increase and I just don’t feel like I can do it all? Do I have a responsibility to continue practicing full-time?”

Is it a social impetus, or can I go part-time? How do I do that without feeling guilty or lazy or somehow less than? People are reaching out to determine, “Is this environment that I’m working in the rest of my life? It’s awful. Is there anything I can do about it?”

The questions that I’m looking to address are, in fact, there are things you can do about the circumstances that you find yourself in. Part and parcel of that is reflecting on what it is that you want in life and recognizing that, at least from many perspectives, we have one life to live. Looking back on that life, do you really want to look back and say, “I spent most of my life working and I missed the significant aspects of life, like watching my children grow up and being a present partner”? All of the other things in life that are so important that we learn to neglect, in particular in a practice in medicine.

Kevin Pho: When you talk to these physicians and give them that perspective, how do you want to be remembered in life in general? What are some of their responses?

Maire Daugharty: On social media, comments are basically in response to the original post, and I find rarely do people look at all of the comments and respond to them. Occasionally somebody will be very thoughtful about it. In my clinical practice, it becomes a conversation that evolves around recognizing some of the assumptions that people bring to the table. This is really part and parcel of depth work and psychotherapy: beginning to recognize how some of our expectations and assumptions drive our decisions and our behaviors.

Being able to recognize that this is an underlying driver gives us more choice. It doesn’t necessarily have to be this way, and now that I recognize that, I can choose to do things differently. For example, the idea that “I have to be perfect, I can’t fail, I can’t make mistakes,” drives a lot of our behavior. Recognizing that sort of changes our perspective and our ability to do things in a way that is more satisfying for the individual. So this is a question that comes up in psychotherapy not infrequently.

Kevin Pho: One of the things that in your article you describe is the brain is a pattern-seeking organ. So tell me, how do prior experiences shape the hidden patterns that we carry into adulthood and affect physicians as adults?

Maire Daugharty: This is a fundamental piece of psychodynamic therapy, which is really a developmental approach to therapy. It recognizes that when we are born as infants, we are born without recognizing that we are an individual self and that the person taking care of us is also an individual self. We also don’t recognize that that rumbling in our tummy is happiness or sadness or anxiety or any of the other feelings that we have. We learn that in relationship with our primary caregiver, and that very much formulates a perspective that we have on the world. Erik Erikson actually recognized that and identified it, naming it as learning trust versus mistrust.

When you see somebody whose particular stance towards the world is, “The world is not a safe place. People are not safe. I’m not going to get what I want. I’m going to be disappointed,” you start to think about what those early experiences were that taught somebody this fundamental belief that they’re not overtly aware of. That is a very important part of the detective work that we do in a psychodynamic therapy: understanding what those underlying messages are that people carry forward in adulthood. I like to follow that up very quickly with the fact that that isn’t a life sentence. We change our perspective over time in relationships over the course of a lifetime. So while we might carry some fundamental distrust, we learn differently over time. Nonetheless, that shapes our perspective and our choices and how we move through the world.

People often say the first three years of life don’t really matter because children don’t remember what happens in that period. The reality is it matters very much because children don’t remember explicitly, but they very much remember implicitly, and it guides how we navigate relationships throughout the course of our lives.

Kevin Pho: If a physician or clinician comes to you for, say, burnout, which is a common reason, how often do these prior experiences impact what they’re feeling today? Do you dig deep into some of the impetuses that are leading them to potentially feel burnt out?

Maire Daugharty: Absolutely. And I would say always, always. How does a person find themselves in a position of working themselves utterly into the ground? Not everybody does that. There are people who are very much able to say, “Yeah, no, that’s too much for me,” or “No, I don’t want to take on that responsibility. I already have these responsibilities. I know I don’t get paid for that, but if you want to talk about changing our contract, I’m open to that.”

This is in contrast to the perspective of the person that ultimately presents with burnout, who cannot say no, who never says no, who never thinks about the question from the perspective of, “Does this work for me? How does this fit into my life?” which is a very important self-protection that we often come to our work not having and having had that trained out of us. In medicine, it’s “you put the self aside and you focus entirely on patient care,” whereas what we’re doing is sacrificing our most important instrument, which is us, which is our self. Somebody who presents with burnout is generally, typically somebody who does not know how to do that or why to do that or would have even considered doing it. It’s just not part of their thinking, and so that’s part of the first work we do: “Where are you in this picture?”

Kevin Pho: One of the other things that you bring up are intergenerational rules and assumptions, and they influence the way people see themselves in the world. So talk more about that.

Maire Daugharty: That leans really into intergenerational trauma, but it also applies in day-to-day life that doesn’t necessarily incorporate trauma. That leans back into the pattern-seeking organ of the brain, which is always working to make things predictable and which begins in infancy. It’s what my parents taught me. For example, when I’m in the c-section room and a baby is initially delivered, the parents can have a handful of different reactions. There can be an, “Oh my God, this is amazing. I love this baby with all my heart. I don’t know anything about them.” Or there can be a, “Is this baby OK? I feel something weird on the head. Are all their fingers there?”

There’s a difference between an overwhelming love for this new child and a sense of extreme anxiety when this child is born, and that is communicated to the infant. The infant grows into a person incorporating that perspective, which often leads to an adult with tremendous anxiety that they don’t understand because they don’t remember being an infant in the room. They don’t remember their first couple of years of experience and exposure.

Kevin Pho: So it sounds like psychotherapy can be a guide map or an approach for a lot of physicians who are feeling burnt out today. They can’t just blame it all on the system, although the system sure plays a part, but a lot of it is some work that they could do within themselves as well. With that in mind, give us a typical case or a successful story that you’ve helped a physician with using this psychodynamic approach.

Maire Daugharty: Gosh, so many options to think about, and I don’t want to betray any confidences. But a common scenario is someone comes in with the idea that things are the way they are, and there’s no other way to think about it. There are no other choices. So we do an enormous amount of work around the idea of where that perspective came from, that you have to tolerate this circumstance and that you have no choices. What does it mean that that’s your perspective? What is it that you give up if you decide to do things differently?

Because it’s always a tradeoff. If I am, I’ll just use a very close example. If I am a cardiac anesthesiologist performing at the top of my skillset and I choose to give that up, it’s a tradeoff. On the one hand, I get rid of all of that stress associated with doing those cases, but I am now also not the person on the pedestal, the best of the best of anesthesia practitioners. In anesthesia, cardiac anesthesia is often considered to be the top of the heap. So if somebody is going to make that decision, they have to process through everything that it means, what they’re giving up, what they’re gaining, and how that becomes a part of their personal identity, which is also important to consider.

The ability to move through that and process that and come to a place of peace in a decision that works better for your life is the overarching process of a psychodynamic therapy, especially with respect to burnout and physician environments, which are very challenging today.

Kevin Pho: What do you say to those physicians who may be skeptical of psychotherapy or hesitant to even try it?

Maire Daugharty: That is always a question, because physicians I think do tend to be skeptical and do tend to be hesitant because we’re supposed to be the caregivers, right? We’re not supposed to be the ones that need help. The reality is we’re all human. We all make mistakes. We all struggle with decisions. We all struggle with the choices that we have in front of us. Therapy can open space to reflect on what it is that you want, what your meaning in life is, perhaps before you end up eighty in the rocking chair, thinking back and regretting all of the things that you could have done and appreciated if you hadn’t stopped to think about it.

Kevin Pho: We’re talking to Maire Daugharty. She’s an anesthesiologist and clinical mental health counselor. Today’s KevinMD article is “How Therapy Can Uncover Hidden Patterns.” Maire, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Maire Daugharty: Your assumptions get in your way. It took me a long time to learn what that meant. We say that we’re all biased, but we don’t think we’re biased, and in fact, there is a discovery process in which you can learn how your assumptions get in your way. That can be very meaningful.

Kevin Pho: All right, as always, thank you so much for sharing your perspective and insight and thanks again for coming back on the show.

Maire Daugharty: Thank you.