Shirah Vollmer MD

The Musings of Dr. Vollmer

Relationship Drama

Posted by Dr. Vollmer on September 16, 2011

      Joe, twenty-two, Jaclyn, also twenty-two,  just had a big fight in their apartment in New York. Jaclyn was throwing dishes at him. Joe was telling her she is “crazy.” Jaclyn, by her report, goes to see a psychiatrist shortly thereafter and she is diagnosed with bipolar disorder and placed on the mood stabilizer Lamictal. She calls her parents who are “very uncomfortable with mental health care,” as Jaclyn reports, and they begin to embrace this diagnosis. They read about it. They tell their friends. They give her a lot of support now that they see her issues as “medical.”  A few months later, Joe and Jaclyn go at it again. This time, Jaclyn wants to come home to Calabassas. I see Jaclyn and I question her bipolar diagnosis. “It seems to me that you had stress in your relationship and you became violent. I am not hearing any other history of bipolar symptoms,” I say, thinking that this is a common problem, where heated emotional moments in a young person get characterized quickly as bipolar disorder; at least that is the way it seems to me, of late. “I am hearing that you and Joe were hurting each other feelings, and one time you responded to those hurt feelings with violent behavior.” I say, trying to show Jaclyn that her behavior might be a result of her pain in the relationship, and not necessarily a chronic mental illness.

     Serena and Enzo, also both twenty-two, also just got in a big argument, where Serena was physically attacking Enzo while he was driving. “It was dangerous and scary,” Serena reports to me. “I just lost it with him. I was so mad. I asked him to take me home, but he wouldn’t so I started to hit him. I just could not control myself.” Serena tells me with some regret, but also with a sense of justification. In the past, Serena has been diagnosed with Borderline Personality Disorder, but I did not agree.  As such, I said,  “it sounds like you were so disappointed that you needed Enzo to see how you were feeling, and that you wanted to go home, such that when he ignored your plea, you became very frustrated. That frustration, led to violence, which you used to do as a small child towards your siblings, and now you are doing it with Enzo.” I say, trying to help Serena understand that she was in pain because of Enzo’s poor responsiveness, but her tendency towards violence, seems to stem from patterned behaviors which she did as a child. “In other words,” I continue, “this episode with Enzo, where he did not listen to you, reminded you of so many times when your mom did not listen to you, such that in the past you would have taken that frustration out on your little brothers, here you took it out on Enzo.”   

   The quick trigger to diagnosing bipolar disorder, or personality disorder in young adults often stems from the heated nature of their relationships. Both Jaclyn and Serena acted strongly to hurt feelings within the context of disappointments with their boyfriends. This strong reaction does not give evidence of a psychiatric diagnosis, but rather the reaction sheds light into the psychodynamics of Jaclyn and Serena. They are each acting out the past and the present, within the framework of a loving relationship. Their behavior helps me to understand how their minds work in the event of stress and disappointment. It does not give me reason to think that they are mentally ill. Young people are new to relationships, and as such, they bring an intensity which often leads to the roller coaster quality of their dynamics. Time, experience and maturity tend to mellow them out with age. The diagnoses do not disappear as they enter the next developmental phase; this is the value of waiting to see how the next chapter plays out before placing a diagnostic label on an emerging adult. My hunch is that both Jaclyn and Serena will be fine. They are struggling with how to maintain love in their lives, while still feeling strong and valued. I admire their energy in defending their sense of themselves, even though this energy may be misplaced at times. These tender relationships will shape their emotional lives; it is my privilege to be on the sidelines.

2 Responses to “Relationship Drama”

  1. Shelly said

    How did Jaclyn and Serena end up with you if other psychiatrists diagnosed them with their mental disorders? Do you think that medications would not help them? Did they not feel better on the medications? Were they simply reacting to their experiences as normal young adults do when they have stresses in their relationships, and not as those with mental illnesses? Is it ok to hit?

    • Both Jaclyn and Serena find their way to me after seeing other psychiatrists because they are looking for a “fresh start.” Medications might help them, but this does not necessarily mean they suffer from a mental disorder. It is not OK to become violent, but again, violence does not necessarily imply a mental disorder. Bad behavior does not mean ill behavior.

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