Shirah Vollmer MD

The Musings of Dr. Vollmer

The Talker

Posted by Dr. Vollmer on October 14, 2010

     Salvatore, seventy, loved talking, got angry when I interrupted him, had a lot of interesting things to say, but he changed the subject so often, that it was hard for me to think about any topic in great depth. Each session, I would gently reflect that he has so many things on his mind, maybe we can start to think about each topic from different points of view. After about six months, Sal, as he liked to be called, began to slow down and allow us to have a dialogue; his need for a monologue diminished. I commented on this change and he said, “well, I wanted you to understand everything I am dealing with.” “Yes, I can see that you were giving me the overture, but I also think that as you spoke, you were too anxious to allow other thoughts into your brain, so you changed the subject to avoid the uncertainty of a conversation.” I said, thinking that his talking was a way in which he protected himself from what he feared would be my shaming comments. “I am just a lot more comfortable with you now,” he says. “Yes, I can feel that. We have built up some trust such that you are less worried that I want to humiliate you.” I reply, wondering why I chose the word humiliate, and curious how he is going to respond to that word. “Yes, I do sometimes feel that you are going to scold me for making bad judgments,” Sal says in a way that seems to reverse our age difference. “What makes you think I would scold you?” I say, wondering if I have ever sounded that way to him. “Well, I have just felt that way my whole life; mostly around women.” Sal says with a sad tone. “We have to stop,” I say, thinking about his relationship with his mother. “Let’s think about this some more. Women seem to make you anxious because you project on to them the feeling that they are making negative judgments of you. That is really interesting. ” I am wishing we had more time to explore this topic. Sal says “overall, I am feeling so much better. Sure we can talk about that next time.” Sal leaves looking at me, making me think that this session was hard for me to stop, but it was not hard for him to leave.

6 Responses to “The Talker”

  1. kristin said

    I love this, but I’m not sure I understand the last line. Could you clarify? Do you mean that he was happy to take a tiny step and then leave instead of having to continue?

    Do you think that Sal’s issue with the women in his life “scolding” him would have come up if he had selected a male therapist? How does a patient decide whether to see a male or female therapist? How important is that choice?

    • A reader said

      P.S. Might the illustration be unintentionally hurtful? You depict Sal as an interesting person with lots to say, and the cartoon, while funny, doesn’t seem to match the tone or content of your post. Might your more paranoid patients who see themselves in Sal read too much into the illustration? Just a thought! 🙂

  2. I had the same thought at first, but then I decided that the point is the same. Some people monopolize the conversation because they are anxious about the uncertainty involved in letting other people speak their mind.

    As for the last line, I was saying that there is sometimes an asymmetry. I am thinking that most people think that the patient never wants to leave, but the doctor is always pushing them out the door. In this situation it was the opposite.

    Yes, I think his issue with women could have come out with a male therapist who at times acted more feminine. How a patient decides to see a therapist is complicated-a book in and of itself.

  3. Shelly said

    Very interesting blog. I had never thought that someone who monopolizes the conversation may be afraid or anxious about the uncertainty involved in letting other people speak their mind. I always had believed it was about a need to tell every single detail in their lives due to anxiety and needing approval. But if the speaker needs other people’s approval, then why not let other people talk?

  4. […] The Talker […]

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