Posted by Dr. Vollmer on April 4, 2013
Carrie’s comment of “I can’t complain” speaks to the pain of not feeling entitled to her feelings, or worse yet, guilty for having feelings, at all. The word “can’t,” if substituted for the word “want to” might speak to the meaning of her opening remarks. When I teach, I talk about how listening, by changing words into their opposites, sometimes clarify the person’s unconscious wishes. This luxury of complaining is a sweet event, which allows one to speak negatively, without fear of judgment, or the feeling that the listener desperately needs to change the subject. Deep relationships allow for this interchange, where the exposure of ugliness, is accepted, knowing that in most social situations, this exposure is condemned. Permission to complain is so rarely granted, that some people, like Carrie, do not know how to expose their negativity, even in a loving environment. Consequently, Carrie lives a life in which she is estranged from herself, and hence from others. Her mental space is consumed with avoiding her “complaining” and so that does not leave anything left over to care for others. If she “can’t complain,” this also means that she cannot tolerate “complaining” in others, as she can only connect with negativity by saying to herself “well, I don’t have those problems.” This parental message, that somehow she is luckier than most, gives Carrie the burden of never feeling the connection, which comes with a shared sensitivity to the world. The struggle of parenting-giving children the message that they are both special, and one of a herd, is the dialectic, which makes the job challenging. Good mental health involves maintaining these opposing points of view: feeling unique and feeling a member of a community. Too much tilt in one direction leads to self-esteem issues in which the person either feels so special that he has no peers, or so ordinary that he does not matter very much. Once again, the issue is one of balancing, and titrating feelings, to navigate a world in which one must both take care of oneself and others, at the same time. Carrie is tilted too much towards feeling like she does not belong with the masses because she is privileged. She struggles to have this belonging feeling, but at the same time, she can’t “complain”.
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Posted by Dr. Vollmer on April 3, 2013
Carrie, fifty-seven, comes to therapy and says, “I can’t complain,” implying that she feels too guilty to acknowledge the burdens she feels. Her internal script, one that goes back to her early childhood, is that she is born into a “fortunate” family, and all those who were born into other families suffer in ways that she does not, and hence, she has no right to express heaviness or disappointments. Of course, the word “fortunate” is a code word for financial privilege, which, of course, is not a privilege if Carrie is constricted emotionally. “Since when does having money mean that you cannot have negative feelings?” I ask, in order to challenge this family narrative that if one does not have financial woes, then one has no woes. This narrative is mirrored by many impoverished families who recite “well, if we had money, all our problems could be solved.” Superficially, this is obviously a weak thesis. Financial comfort does not save one from the hurt of relationships, or the threat of health problems. Sure, money does ease a lot of burdens, but at the same time, without the appreciation for friendship, for interpersonal connections, and for good health, then money serves families in very limited ways. Since Carrie cannot acknowledge her struggles to herself, she is unable to metabolize them in a way which leads to deeper understanding and compassion. As little compassion was shown to her as a young child, so she exhibits little connection to her emotional interior, and subsequently, her relationships feel shallow to her. Pushing through that guilt is my challenge. This is the guilt in which Carrie feels she is betraying her family story if she “complains,” as she was taught that she could not complain, and even worse, that she was a bad child if she attempted to voice any negativity. I need to slowly and gently unhinge her from this confining notion. The goal-some good complainin’.
Posted in Guilt, Psychoanalysis, Psychotherapy | 7 Comments »
Posted by Dr. Vollmer on March 21, 2013
Giving parents permission to have negative feelings for their children will always make them laugh. The previous cartoon posts entitled “The Joys of Parenting” are funny because without cloaking disgust in humor, parents feel horrible (code for guilty) when they feel regret about having children. I do not mean the kind of regret where people want to give their children away, but I mean the wistful fantasy of reflecting on life without kids. Even this fantasy can produce so much guilt that parents quickly reassure themselves and others, how happy they are to be with their progeny. Humor bypasses societal expectations allowing a release of negative affect with a smile. In a similar way, sex always sells in comedy shows. Most of us feel awkward about talking about sex, unless we are making a joke, in which case, we know we will get a laugh, again, as a release of tension. This tension, or mixed feelings, results from those sticky feelings of guilt and shame that we all try so hard to avoid, and thereby engage in activities which serve to protest the underlying feelings. As Shakespeare so eloquently stated, “thou does protest too much,” suggesting that underlying the protest is some hard truths. We love and hate our children, our parents, our significant others and ourselves. This cauldron of conflicting feelings challenges us to deepen our sense of ourselves and others. Those who take on that challenge are richer for it, and those who avoid the challenge, compromise the depth of their relationships. Some, who take on the challenge, become funny and charismatic folks, demonstrating a deep understanding of conscious and unconscious feelings. It is easy to get a laugh, once you know the formula for eliciting guilt and shame. Or, as Henny Youngman famously said, ”take my wife–please”.
Posted in Great Quotes, Guilt, humor | 13 Comments »
Posted by Dr. Vollmer on December 4, 2012
Tony, forty-one, smashed his car. “What does an accident mean?” He asks, saying that on the one hand, he did not mean to crash, but on the other hand, he could have been more careful. “Accident is a relative term,” he continues. “Yes, it is a gray area, in which you did not have intention, but that does not mean that you were not responsible,” I say, creating a spectrum of feelings. “I just feel so guilty,” Tony says, which strikes me as both logical and puzzling at the same time. “You feel guilty because you feel like you did a bad thing,” I say, trying to understand the nature of his bad internal state. “Yea, I am having trouble forgiving myself.” Tony says in a particularly harsh way. “Do you think you should be punished?” I ask, probing for greater understanding of his superego. “Well, I think I am punishing myself. I just feel uptight since it happened.” Tony says that he takes it upon himself to feel tense as a form of retribution for his behavior. “Where does this harshness come from?” I ask, thinking that he has internalized a harsh superego from his childhood. “Yes, my parents were very hard on me when I messed up, but I also think that I would be hard on myself anyway since I do not understand forgiveness.” Tony explains a nature/nurture argument in which he explains that, by his account, he was hit twice. “Forgiveness is a wonderful skill,” I say, helping him entertain this notion as something that he can work on. “Our insurance will go up. We have to get a new car. We are inconvenienced and that creates stress in my family. Forgiveness is not coming easily.” Tony says, outlining his subsequent struggles. “Those are all good opportunities to practice,” I say, trying to help him begin with a baby step. “When you can forgive yourself, you will be better at forgiving others, and that will help you feel more relaxed in relationships.” I say, emphasizing how importance forgiveness is to both self-esteem and interpersonal relationships. “You smashed your call, but you do not have to smash your soul.” I say, highlighting that he is making the experience of his accident much worse by imposing hard negative judgments on himself. “That is a challenge,” Tony looks at me with hopelessness, bordering on despair. “You are up for it,” I say, using words of encouragement, but also understanding how hard forgiveness will be for him.
Posted in Guilt, Psychoanalysis, Psychotherapy | 6 Comments »
Posted by Dr. Vollmer on November 30, 2012
Megan, forty-one, can’t shake the feeling that she caused her parents divorce because she had terrible behavior problems after her brother had a sudden death, when she was four and her brother was two. On the one hand, Megan knows that she was grieving for her brother, and that at such a tender age her grief manifested itself by terrible temper tantrums, but on the other hand, she believes that her tantrums caused so much stress in the house that her father left in order to be with his secretary who had no children. The logic of the situation is clear to Megan. The death of her brother led her father to grieve in his way, which was to withdraw from his family and seek refuge in another life. Megan’s understanding does not change her feeling of deep responsibility for her mother’s subsequent depression. Megan believes that if she was more cooperative during that tender time, then her parents would have stayed married and her mother would not have gotten depressed. “Maybe it helps to think that you could have done something to change the course of history. Maybe that is preferable to feeling completely helpless that your brother died, your parents divorced and then your mom was severely depressed,” I say, pointing out that feeling guilty is often a substitute for feeling helpless. “Yes, but that does not change the fact that I live my life, feeling terrible about myself and my behavior.” Megan says, explaining that in her mind, her low sense of herself all stems from this one extremely traumatic time in her life. “It is nice, in a way, to be able to consolidate your complicated self-image, down to one period of your long and extensive life, where you have done so many things, both good and bad. ” I say, reminding her that even though her brother’s death was a very significant time in her life, she has also done many other things, like get married, build a career, have her own children, which, if she can let those events into her mental interior, might also contribute to her sense of herself. “It is hard to keep the big picture, because I live in fear, knowing that life can change so suddenly. “Yes, managing that anxiety, which for you is so alive, is a particular challenge.” I say, reminding her that on some level all of us understand the uncertainty of life, but that for many of us, we are able to know that without letting that fact crack our core. “I know that I live in the past. I know that my brother died many decades ago. I know that it is particularly hard for me to find peace with that. You are the only person I can discuss this with, because I know that my husband, my friends and my family do not understand my anxieties.” Megan says, explaining to me that she feels alone with her feelings, in part, because she does not feel them to be legitimate. “It is hard to have feelings which go so far back in your life. It is hard for you to feel that is where you are right now.” I say, trying to help her accept where her mind is at. “Yea, I wish it made more sense to me,” Megan says with a heavy heart.
Posted in Guilt, Psychoanalysis, Psychotherapy | 4 Comments »
Posted by Dr. Vollmer on November 29, 2012
“I want you to know we have a normal family,” Maureen says to me, as she admits her twelve-year old to the psychiatric hospital for serious substance abuse issues. I did not ask her about her family, so her comment made me pause. You mean, you feel very guilty, I wanted to say, but I did not have the history with Maureen which would have enabled me to speak my mind. “Parental guilt is overwhelming,” I say to my students, thinking about Maureen. “Parents feel guilty, generally speaking, no matter what happens to their children, and when this guilt is added on to things they really feel they did wrong, then they have guilt squared,” I say, trying to explain that a part of parental guilt is about understanding the enormous responsibility of another human being, whereas another part of guilt could be a knowing negligence when it comes to parenting. “When the guilt can come to the light of day, parents often feel uniquely understood,” I say to my students. “No one wants to talk to them about their guilt. Most well-meaning friends and family want to jump in and quickly reassure the mom that she did the best she could.” I say, emphasizing that the role of a mental health professional who works with children and families, is to demonstrate the understanding of the really difficult feelings which can bubble up during a mental health crises. Reassurance does not help because the parent often feels like their friends do not really understand how deeply bad they feel. Further, the loved ones often do not want to acknowledge the depth of the guilt because it can trigger in the listener their own sense of guilt towards their children. “The default assumption, until you get more information, is that the parent is feeling guilty when they see you.” I say to my students who are rookie child psychiatrists. ”Probing for that guilt is the art of our profession,” I say, thinking to myself that in some ways, this is a lost art, but also hoping that maybe, I and many of my colleagues, are slowly bringing this art back to the field. “No one wants to feel guilty, but worse than that, no one wants to feel alone in their guilt.” I say, pointing out that feeling misunderstood is worse than feeling guilty. “Understanding guilt is tricky, because you need to empathize without agreeing or disagreeing with their own sense of negligence.” I say, emphasizing that understanding guilt is a challenge. “I hear you,” I respond to Maureen, acknowledging that I hear her statement about her family, but I am also hinting that I understand that there could be a subtext.
Posted in Guilt, Parenting, Psychoanalysis, Psychotherapy, Relationships | 2 Comments »
Posted by Dr. Vollmer on August 16, 2012
Therapy is a play space, a circumscribed time, a specific place, where ideas can flow without consequences. It sounds like a dream come true for some, and an anxiety laden area for others. Within one person, there are times when both are true. Yet, people carry secrets in which the disclosure, even to a therapist, is filled with guilt and shame. Meredith, a devout Catholic, was having an affair with her male yoga teacher. Her shame and guilt around this activity made it intolerable for her to talk openly about it with me for many years, until ultimately, she wanted to “shine light” on this area of her life. Why did she decide to do it now, I always wonder. Is the “why now” issue a function of a deeper trust in our relationship, or is it that something happened in this affair that she felt like she needed to talk about it, or are both true? “This is a secret within a secret,” I say, highlighting that everything that happens in our relationship is private, or a secret, yet even without this private space, there are deeper private spaces that I am not privy to. This is always true, but in the case of Meredith, this deeper space was pressing on her consciousness causing her to feel bad about herself, yet happy and excited at the same time. The uncovering of these private spaces is the exploration of therapy. The timing and the content of these areas are what make psychotherapy a unique and ever fascinating process. Did I suspect that Meredith was having an affair? Yes and no. I detected a terrible sense of unease about her, such that there was a constant feeling which we discussed, that was pointed towards deep personal discomfort. Is there hope now that this secret has been exposed? Yes and no. Meredith worries that I judge her, even though, the problem is that she is judging herself. On the other hand, she feels relieved in the disclosure. Our work has deepened. We have had a before and after moment. She looks closely at me to detect my reaction. I look closely at her to see how she feels now that she has told me. There is intensity in the room. My job is not to look at the moral or ethical implications, but rather to help Meredith understand how she got here, to help her see how her brain leads her down a decision tree which ultimately has deep emotional consequences. Understanding is my job. Judging is her assumption. As we walk the narrow path between feeling understood versus feeling judged, Meredith might learn to heal herself from her bad feelings. She might begin to repair her relationships with those she deeply cares about. Maybe.
Posted in Confidentiality, Guilt, judgment, Psychoanalysis, Psychotherapy | 4 Comments »
Posted by Dr. Vollmer on April 24, 2012
Lea, astonished me, when she says “I just feel very guilty for how I have behaved towards you,” as she refers to her incessant curiosity about my life. The surprise is not that she feels badly about her behavior, but the surprise is that she chose the word “guilt,” as if she has committed a crime. For the first time, in ten years of seeing her, I began to understand that she grew up feeling guilty about her behavior. Her mother, Carolyn, was very jealous that Lea was the focus of her husband, Joe’s, Lea’s father’s, affection. Consequently, it seems that Carolyn made Lea feel guilty for taking Joe away from her. All of these dynamics were subtle on one level and not so subtle on another. Through our work together, this feeling of guilt was reactivated in our relationship, in the transference, thereby illuminating a longstanding feeling which she has absorbed into every fiber of her being. To talk about the guilt she felt as a child is one avenue into this pain, but to reactivate this feeling with me, makes the work feel so much more alive and interesting. It also gives Lea tremendous pain, which we work with in a patient way in which we peel away the agony in order for us to look at Lea’s history in a more detached way. The emotional pain is important to process, but so is her family dynamics. Lea is beginning to see how she fit into her parents’ marriage in a way in which she was robbed of certain aspects of her childhood. Living with guilt on a daily basis and not understanding the source, was a cause of huge confusion for Lea. Almost within an instance, clarity came.
Posted in Guilt, Psychoanalysis | 10 Comments »
Posted by Dr. Vollmer on March 30, 2012
Milly, age seventy-nine, is conflicted about her two grandchildren, ages seven and nine. She favors the nine-year old boy, Moe, the son of her son Matt, over the seven-year old girl Nona, the daughter of her daughter Olivia. When it is obvious that she favors Moe, which then bothers Olivia, Milly will call Olivia obsessively to say that she does not favor Moe, even though deep down she feels she does. Olivia understands that Matt was her favorite child, but at the same time, she resists this notion. “Those phone calls are guilt dribble,” I say, highlighting the issue that the conflict is so layered that Milly seems to deal with her mixed feelings by trying to persuade Olivia that Olivia’s perceptions are wrong, even though they are not. “I know, right,” Olivia tells me. Olivia understands cognitively that her mom plays favorites, but emotionally she tries to get her mom to make her and her daughter a higher priority in her life. The “guilt dribble” as I called it gives Olivia hope that Milly can change her ways, because Milly gives Olivia a lot of attention after she spends a lot of time and energy with Moe. To see this energy as “guilt dribble” casts a different light since Olivia is hoping that this “guilt dribble” is actually Milly reflecting on her own behavior in an effort to change her patterns. By contrast, I emphasize that the “guilt dribble” cements the pattern in further, in that the pattern is for Milly to play favorites and then dribble her guilt on to Olivia. Olivia sobs in despair. She cannot change Milly, her mom. I remind her that the hope is in herself. That, she can change.
Posted in Guilt, Psychotherapy | 2 Comments »
Posted by Dr. Vollmer on October 26, 2011
Max, eighty-five, just cheated on his girlfriend Beatrice, age eighty-seven. Max says “I just love Sophie (age ninety), so I had to let Beatrice go.” The guilt in Max’s voice is palpable. “Beatrice really loved me,” Max tells me, with what seems like is a mixture of uncomfortable feelings. “It seems like you have never found a woman that meets all your needs,” I say, referring to the fact that Max has never had a monogamous relationship. “I guess that is true,” Max says, with a sad and thoughtful tone. In this interchange, Max becomes sympathetic. He did not set out to hurt Beatrice, although he did hurt her very much. Max is trying to make himself feel whole, and in so doing, he has betrayed Beatrice. Max believes that Sophie is more suitable to him, even though in his lifetime, he has never found anyone who he felt was a good fit. On the one hand, Max gets a lot of credit for trying, despite his advanced age, to find his soul mate. On the other hand, after all these years, one might hope that Max could be more honest in his relationships. Max seems to understand this. He seems both proud of himself for finding a new partner and angry with himself for letting down Beatrice. It is too simple to say that Max is a “bad person” even though he has been consciously hurtful to others. His long life has shown that he repeats the pattern of falling in and out of love, humiliating the previous girlfriend each time. His awareness of his pattern brings up a stew of feelings which makes him alternate between elation and guilt. Max has children, but his love life dominates his mental existence. Maybe Sophie will be the one, he hopes.
Posted in Geriatrics, Guilt, Psychotherapy | 2 Comments »