Building good relational habits during radiology residency: the four horsemen

Radiology residency takes more than just completing the formal requirements of training. Substantial demands can affect residents' well-being and their lives outside of work. Relationships can play an important role in their wellness and support them throughout training. One framework that may help residents recognize harmful relationship patterns is Gottman's Four Horsemen, developed primarily from studies of romantic relationships. The framework identifies four patterns associated with relationship deterioration: criticism, defensiveness, stonewalling, and contempt. This article discusses how these patterns may arise during radiology residency and considers practical antidotes that may promote healthier responses. By promoting awareness of these patterns and healthier responses, radiology residency programs can support resident wellness while ensuring access to professional support when needed.