“Dr. Vollmer, you have no idea how hard it is for me to sit in front of you,” my patient Jane says. Jane is a 45-year-old woman who I have worked with intensively for 15 years. By intensively I mean that for ten of those fifteen years I saw her multiple times a week. Yet, despite our many hours together, each visit still brings up overwhelming anxiety. Fundamentally, Jane does not feel entitled to be part of the world. She is the youngest of four children, but her three older siblings were born close together. There is eight years between her and her next sibling. Her mom was profoundly depressed when Jane was born, since Jane’s maternal grandmother had passed away when Jane’s mom was pregnant with Jane.
I have theorized that Jane is crippled with anxiety, partly for genetic reasons, partly because her parents never made her feel like an important part of her family. Jane always felt, and she still feels, like her family was burdened by her birth. This feeling of being a burden has spilled over into every other aspect of Jane’s life. That is, wherever Jane goes, she feels that other people do not like her.
I want to help Jane. I have gone to many hours of supervision http://shirahvollmermd.wordpress.com/2010/02/18/supervision/, looking for new ways to work with Jane so she can feel more comfortable in my presence. Jane remains unbelievably anxious. At the same time, Jane and I both look forward to our time together. Jane reads my blogs, and like many of my folks, she finds them to be comforting for her. She appreciates looking into my thinking process in a way that helps her to feel connected to me in between our sessions. She looks forward to coming in and talking to me about my posts. I look forward to seeing her. Each visit I wonder how I can help her to feel comfortable in my presence so that we can go deeper into her dynamics.
Years of working with Jane has taught me that I cannot take away her anxiety, not even her anxiety about our sessions. I need to tolerate her anxious and uncertain state. I need to tolerate that sometimes, more times than not, Jane cannot finish a sentence because she is too busy worrying what I am thinking. I used to try to fix that. Now, I accept it. I used to challenge her anxiety by asking her why she so firmly believes that I think negatively about her. Now, I realize that challenge is not helpful; it only makes her more anxious. I feel Jane’s anxiety. Jane appreciates that. It is a first step.