Posted by Dr. Vollmer on May 6, 2013
Posted by Dr. Vollmer on December 13, 2011
Elaine lives out Freud’s hypothesis that negotiating the oedipal triangle is one of the big challenges of development. Elaine is thirteen, loves both her parents, yet her parents do not love each other. Gloria and Edward, Elaine’s parents, feel that it was a mistake to get married, but they cannot get divorced because “it will hurt the children.” Instead, Gloria and Edward live completely separate lives. Gloria goes to Church every Sunday. Edward does not think much of religion. Elaine is forced to go to Church, even though Edward says “that’s ridiculous.” Elaine is rude to Edward, and by Edward’s report, Gloria secretly encourages Elaine’s disrespectful behavior.
Crisis, Elaine’s crisis, has forced Gloria and Edward into my office. Elaine got suspended from her parochial school. Edward is not too unhappy. He wanted her to go to public school any way. Gloria is quite upset as there are few other school choices which suit Gloria’s criteria. Nevertheless, both Gloria and Edward are worried that Elaine is having behavior problems at school. They want help for Elaine, but they are not willing to compromise with each other. Elaine is torn between pleasing her mother and alienating her father or the other way around. Elaine cannot see how to navigate her family life such that her parents are both happy and as such, she is acting up at school in an attempt to bring her parents together, or so it seems to me. By contrast, if Gloria and Edward could present a united front, be they married or divorced, then Elaine could identify with her mother, but still feel the love from her father: a successful oedipal resolution. Elaine’s inability to come to such a resolution creates such inner torment that following the rules at school seem nearly impossible to her. Without Freud’s understanding of this oedipal triangle, it would be more difficult to articulate why Elaine is having behavior problems. Freud did not help us treat kids like Elaine, but he sure helped us understand them.
Posted by Dr. Vollmer on December 1, 2011
Shantay, twelve years chronologically and nine years in her behavior, is chronically angry at her dad for divorcing her mom. “He is a bad person?” She asks her mom. Maaki responds knowing that it is wrong to speak poorly about her dad, but also thrilled that Shantay shares her point of view about him. Maaki’s ex-husband, Albert, Shaantay’s dad, left the family three years ago, and although he denies having an affair while they were married, he quickly started a relationship with another woman and now they are married and starting their own family. Maaki is also remarried, but Albert reports that getting remarried did not stop Maaki’s resentment of him. Shantay sees the world from Maaki’s point of view. She is suspicious of her dad and protective of her mom. When Maaki is particularly mad at Albert, so is Shantay. Psychoanalysts call this identification. Shantay is so tied into Maaki’s point of view, that Shantay does not have an independent assessment of Albert as her father. As such, Shantay is deprived of experiencing a father/daughter relationship in a way in which she can come to her own conclusions about her dad and her family life. “Does this mean that Shantay will have trouble trusting men when she gets older?” Maaki asks me. “That is hard to say,” I respond, thinking that in a deep way, Maaki might want Shantay to have troubled relationships with men in order to show Albert how much he harmed his family by his behavior. I say to Maaki, “the best thing you can do is enjoy your life and help Shantay to enjoy hers.” Once again I tread the difficult waters of not being Maaki’s therapist, but as an advocate for Shantay, I know that if Maaki could work through her resentment towards Albert, then Shantay would be the better for it. Divorce hurts children when the parental alliance is broken. It is the cut in the respect and authority of the parents that is detrimental to children, not necessarily the marriage per se. Shantay has to emotionally separate from Maaki; this could take a lifetime.
Posted by Dr. Vollmer on July 6, 2011
Erika, twenty-seven, “hates holidays”. “Holidays are supposed to be with family, and when I am with my family, I feel lonely and left out,” Erika tells me, screaming at me, as if I do not understand what she is describing. Erika knows that I am going to remind her that she continues to live through the pain of her parents’ divorce, which happened when she was five years old. “I am afraid to tell you about the time with my mom and step-dad, since I think you are going to tell me that I have to learn to accept them for who they are.” Erika says, crying and yelling at the same time. “I don’t want to accept them for who they are. I want to be mad at them. I want to feel bad for myself. I want them to see how much they have destroyed my life.” Erika says, keeping up the intensity of crying and screaming simultaneously. “You want to stay that little girl who was four years old, who lived in a world where you could believe that you were the center of your parents’ universe. You don’t want to grow up and see that your parents could not stay focused on you, but rather they had to move on with their own lives and in so doing, they introduced new people into your life who are not as loving towards you as you want them to be.” I say, knowing that Erika and I have had this discussion many times, but hoping that each time we go around the bend, maybe Erika will begin to wrestle with separating from her childhood pain, so that she can begin to look forward towards making a new family for herself.
“You just don’t understand, Dr. Vollmer,” Erika says, screaming at me, but also conveying a deep sense of connection to me. “It is so important to you that I understand your pain. That, I understand. I also know that when I say something that does not resonate with your pain, you feel I don’t understand, but at the same time, I you also appreciate that I am offering another way of understanding your pain.” I say to her, with a sense of repetition which rather than seeming redundant, seems like a necessary ritual that we go through after she has had particularly painful experiences with her family. I see her yelling at me and her crying as a release of her tension; not as a way of giving me feedback that I am losing touch with her emotional experience. The ten years that Erika and I have worked together has shown me that to be true. Still, the intensity of youth strikes me. Actually, Erika’s intensity penetrates me, and maybe that is not in large measure about her age, but her temperament. Either way, Erika and I have learned a dance which seems to work for her, although an outside observer may heartily disagree.
Posted by Dr. Vollmer on November 8, 2010
Posted by Dr. Vollmer on March 3, 2010
Following up from http://shirahvollmermd.wordpress.com/2010/02/24/understanding-as-action/, Lisa’s dad called me to reschedule our appointment. As we took care of the logistics, her dad, David, said ” wasn’t that amazing?” I knew immediately what he was talking about. As I stated before, ten-year old Lisa’s courage was simply inspiring. David went on to tell me a touching story about how Lisa has a friend whose parents are getting divorced so Lisa told her buddy that she should go to a “talking doctor” because “it really helps.” I felt good.
David continues to say that Laura, Lisa’s mom, thought “someone put words in Lisa’s mouth.” I had a pang in my stomach. “Does Laura think that I scripted Lisa?” I asked David. He said “no, she thinks that I did.” Although I have not spoken to Laura, I had a terrible hunch that Laura did not appreciate Lisa’s heartfelt plea for understanding. Laura, perhaps because of her guilt about the divorce, felt, according to David, that Lisa was not being genuine, but rather she was trying to manipulate her parents. I felt concerned. Although it is sometimes tricky to discern genuine feelings from manipulative behaviors, in this case, I felt certain that Lisa was not trying to “get” anything other than empathy. I am also aware that Laura is in a bind since if she empathized with Lisa, she then must also feel responsible for causing Lisa to have pain. At the moment, it seems that Laura is navigating these waters by being dismissive of Lisa. My good feeling turned into an uncomfortable feeling. Understanding is not easy.
Posted by Dr. Vollmer on February 24, 2010
Lisa, a ten-year old girl, came to my office with her recently divorced parents. In tears she said to her parents “you ruined my life.” She continues, “everything about my life is bad.” Her mother says “can you be more specific?” Lisa repeats “everything about my life is bad”. I can see what Lisa is saying. I can see that both parents are confused because Lisa is vague, yet passionate at the same time. I say “I think Lisa is trying to describe what it feels like to have divorced parents”. I continue “it is like a house with a bad foundation, it looks fine, but the owner knows that in a strong wind, or a minor earthquake, the house would fall.” “In other words,” I say, “Lisa is talking about her profound sense of vulnerability since the two of you have separated.” Both parents, with unbelievably sad expressions, nodded with a sigh of recognition. They seemed to both understand the concept that looking fine is not the same as feeling fine. They also seemed to understand the concept of vulnerability, which is to say, that although everything is stable at this moment, it is hard to live in the world with the feeling that a minor perturbation could cause a very large setback. “What can we do?” The mother asked me. My response was predictable, and yet it needed to be said. “Understanding is what you need to do.”
Lisa felt that the only thing that could make her world “whole” again was for her parents to reconcile. Her parents love her deeply, but they are clear that they cannot live with each other. Lisa has to learn to accept her new reality of what feels to her to be a shaken world. Her parents are not going to change the reality, but they can learn to understand how their decision has changed Lisa.
Lisa’s parents were admirable in their ability to hear Lisa, without getting defensive. Their tears spoke volumes about how deeply sad and helpless they felt. Both of them wanted to take Lisa’s pain away. Both of them knew they could not do that without an unbearable sacrifice to their own sense of themselves. They were torn, but at the same time, they were focused on how they could aid Lisa in her struggle to adjust to her new life.
In this session, I felt that my role was to state the obvious. I did not tell Lisa or her parents anything they did not know before they walked into my office. Still, they needed to have an analogy, in this case, the foundation of a house, to grab on to Lisa’s vulnerability. They also needed to be reassured that understanding was an action. Listening to Lisa’s pain was hard, but necessary. They knew that, but they seemed to appreciate the gentle reminder.
I fantasize that Lisa will grow up to be a psychotherapist. I was in awe at Lisa’s ability to state directly, to both her parents at the same time, how she was feeling. Although she was very sad, she also seemed hopeful that if they could understand her pain, she could plow through this experience. She also seemed to feel that if her parents got defensive, then she would feel worse. She took a big risk. Her courage was palpable. Eventually, she stopped crying. I think to myself that the combination of Lisa’s courage, her sensitivity and her eloquence are the essential ingredients for a mental health professional.
Understanding is an action. That is a simple concept. Yet, as with Lisa’s parents, when the people who have to understand are also the people who caused the pain, understanding is a really hard action to take. My office provided an opportunity to take this really difficult, but necessary step. Although it is trite to say, in this case, a little help seemed to go a long way.
Posted by Dr. Vollmer on January 24, 2010
This blog is part of my series on divorce.
“The central hazard of divorce for the child is not his acute unhappiness, however tragic this may be, but the possibility that the family disruption will in some way discourage his progress along the developmental ladder.” Wallerstein and Kelly (1980)
A 24 year year old man, a patient I have seen multiple times a week for four years, comes into my office sobbing. He explains that once again, he is being treated poorly by his mother. He says, as he has said many times before, that she prefers his two half-siblings, ages 14 and 10. My patient believes that these children are part of an intact family, whereas he is the product of her big “mistake”. As such, he constantly feels that he is getting the short end of the stick. My hunch, after working with him for so many years is that he is right. What should I do? I could validate his feelings. I could be present and allow him to express himself. I could probe to try to understand more about what he is feeling on this particular day. I could consider a psychotropic medication. With the exception of prescribing, I try all of those things, but I do not feel I am making an impact.
One out of every two marriages today ends in divorce and many divorcing families include children. Parents who are getting a divorce are frequently worried about the effect the divorce will have on their children, but during this time parents may be preoccupied with their own problems. While parents may be devastated or relieved by the divorce, children are invariably frightened by the threat to their security. The omnipotent thinking of children often lead them to conclude that they caused the conflict between their parents.
After about twenty minutes of crying, my patient calms down. He knows that he is jealous of his half-siblings who are growing up in an intact family. From his point of view, his mother’s “new family” has the big house, the vacations and the family friends, that he never grew up with. In his fantasy life, he would not be suffering if he had the life of his siblings. He is angry and he is sad. Ultimately, I tell him that I am not sure what to say except that despite all the pain that he is describing, I have borne witness to his psychological growth and I am impressed by how he is struggling to deal with his feelings. I tell him that I by no means want to negate what he is saying, but I wanted to remind him that he has focused on his internal world and as a result his coping skills have improved enormously. He no longer avoids responsibility and he no longer hides from his friends.
To my surprise, he tells me that he knows what I am talking about. He describes to me that he feels like a piece of fruit that used to have a mushy interior, but now he is filled with fibrous connections. He is still sad and he is still angry, but simultaneously, he is also proud of himself. He feels stronger internally than he has ever felt before. I want to think that this is from our work together, but I also know that this is a remarkable young man. This is a man who had the courage to face his pain, feel his pain, and try to grow from his pain. His parents divorced when he was three. Twenty one years later he is still feeling the pain. His internal growth is impressive, but then again, so is his distress. We have more work to do.
Disclaimer: Details have been changed in order to maintain privacy. This blog is for illustrative purposes only.