Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for July 11th, 2011

The Doorknob Comment

Posted by Dr. Vollmer on July 11, 2011

“There is one thing I want to tell you,” Vivian, sixty-two, says as we both look at the clock and know it is time to stop. I have a hunch that what comes next is the most pressing issue on Vivian’s mind. I suspect it is something like a confession; like she is about to tell me she is using too much medication, or that she has a hidden substance abuse problem. I wonder whether I should remind her that we are going to have to stop, or should I allow her a little more time to express herself. Vivian is handing me the classical doorknob comment; the comment that one says as they are about to leave the session. I could see this behavior as classic avoidance. She knows we will not be able to explore the issue in-depth on this day, but she also postponed telling me. Perhaps telling me at the last moment is a compromise; a balance between complete avoidance and meaningful exploration. In addition, maybe Vivien is pushing the boundaries. Maybe she is testing me to see if I will give her more time under these self-made critical circumstances. I am in a predictable bind. If I allow her to go over the time, then I am rewarding her avoidance. If I strictly adhere to my time limits, then I might seem rigid and uncaring.

I say, as Vivien knew I would, “I don’t mean to interrupt, but whatever you tell me, we won’t have time to talk about it very much today, and I am sorry about that since I suspect that what you are going to tell me is a challenging subject.” Vivien nods her head with understanding and proceeds to tell me that she just found out that her husband has been lying to her about giving money to his adult son, her step-son. Vivien is furious. “I can understand why you are furious, but why did you wait until the end to bring it up? I ask, thinking that Vivien struggles so much with her anger and her shame at being angry, that it is hard for her to be forthright. “No one likes being lied to,” I say, trying to help her shame, but also realizing that I did not let her answer my question, likely because I am feeling so rushed. “I wanted to mention it. Maybe it is not such a big deal.” Vivien says, with consistent defenses of  avoidance and minimization. “I think you left it to the end because it is a big deal.” I say, implying that her style is clear and self-injurious. It does not help her to minimize her pain in the way that she often does. I was surprised by the content, but not the method of delivery. The lay person might say it is “Vivien’s style” to be indirect and curvaceous in her communication. I would say that it is “Vivien’s coping mechanisms” to delay and avoid important subjects.  I suppose we are saying the same thing.

Posted in avoidance, doorknob comments, Psychotherapy | 6 Comments »

%d bloggers like this: