Shirah Vollmer MD

The Musings of Dr. Vollmer

Angry Patients

Posted by Dr. Vollmer on July 21, 2011


   Karen, sixty-two, sees me twice a week, like clockwork. Recently, I had to change one of her times, an action I resist, but I had no choice. “That’s OK, I will just come one time next week. It does not matter.” Karen says, with hostility that hits me in a way that is consistent with her quiet way of being angry. The following session she says “I don’t know what to talk about,” again, I am feeling a passive-aggressive feeling where she resigns from initiating a discussion, but she is mad that not more happens in psychotherapy.

      “I have been thinking about our last session,” I say, making her look surprised. “When I was sorry to have to change our schedule, you said it did not matter and that made me think that you were angry.” I said, expecting her to be taken aback by my comment, but instead she said “of course, I am angry. Wouldn’t you be?” “I am not sure what you mean,” I say, knowing that Karen’s style is to obscure what she is talking about by not telling me her entire thought. “My life is ruined. My husband walked out on me. My kids are doing their own things. I am old. I am fat. I am lonely. Of course, I am angry.” Karen says, with tears running down her face. The tone changed dramatically. Her sadness came through after her anger subsided. Instead of feeling devalued by Karen, I began to feel her pain. She was struggling and her anger was her defense.

   “I can see why you are angry,” I said. “It seems like your life is not what you expected it to be; not what you want it to be.It also seems like you don’t feel much hope that you can make it better.” I said, feeling like I was understanding her feeling state. I began to learn more about her childhood, as she told me how she felt her life was going to turn out when she was growing up. She wanted to share with me how she felt about her mom and dad. I felt like we surprisingly opened up a new chapter in our relationship. She did not seem angry. She was comfortable sharing her history. Anger is pretty interesting; there is always some deeply meaningful material behind it. Anger, to me, feels like a door. Sometimes they are hard to open, sometimes pretty easy, but either way, when you can get in, there are rooms to explore.

5 Responses to “Angry Patients”

  1. Shelly said

    Why was Karen angry that you had to change the time of your scheduled appointment? Did she take it to mean that your time with her wasn’t important to you? I understand that she needed to share with you her pain, but what was her anger with you about? Is anger also about insecurity? So if we feel anger, underneath the anger, are we feeling insecure or threatened?

    • I think of my appointment times as “little homes,” so to move them can feel very disruptive. She might have taken my need to change as a personal slight, but I am not aware of that. Anger is such an interesting feeling. It gets directed at people, sometimes with cause, and sometimes without cause, and most of the time with some cause, and some displacement. Yes, often times, anger is a symptom of a threat to one’s sense of self. Heinz Kohut spoke a lot about that. Understanding anger as a threat to the “self” is often very helpful. Thinking of it in that way diffuses the anger, rather than incites it.

  2. Danny said

    I just saw that these blogs are also oniPhone and the font at least for me easier to read than the regular version.

  3. Danny said

    Hi, thank you for these blogs , enjoy reading them especially now with the iPhone version so convenient to access ! Thanks !

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