Shirah Vollmer MD

The Musings of Dr. Vollmer

‘I Think We Are Building Back Rapport’

Posted by Dr. Vollmer on October 7, 2011

    Caitlin, forty-six, has been having a hard time with our relationship. Having seen her for ten years, over the last few months she has become antagonist towards me, for no clear reason, except that it corresponds to her going through a divorce. More recently, she has found a new relationship, and with her new-found happiness, she is suddenly more comfortable in my office. In retrospect, we both agree that her distress over the end of her twenty year marriage manifested itself by her hostility towards me and almost everything I had to say. However, at the time when she was being hostile to me, she was convinced that I had changed in the way that I related to her. Of course, this is hard to tease apart, except to say that as soon as her life got better, suddenly she perceived me as “nice again.” The clarity of this projection has come to light in a way that brings us back to our deep fondness for one another. We begin to talk about Occupy Wall Street, and she says “I think we are building back rapport,” as if to interpret that our seeming diversion away from personal issues, is in fact a therapeutic tool to enhance the trust in our relationship in order to lay the groundwork for deeper work downstream. “I see that,” I say, wanting to thank her for making my job easier, as she supplied the overview comment which usually is my responsibility. Some days are a lot easier than others.

3 Responses to “‘I Think We Are Building Back Rapport’”

  1. Holly said

    The ebb and flow in feelings in a therapeutic relationship is definitely interesting. I find myself viewing my analyst on one day as being sympathetic and appreciative of my uniqueness. On the next day, I may perceive him in a negative light, in that he does not care about me all that much.

    Transference takes me to interesting places, and I need to remind myself with these oscillations in feelings that my analyst and I do have a mutually caring relationship, and this makes it easier for me to return and continue our work together.

    Thanks again for a thought provoking post.

    • Thanks, Holly for sharing your experience.
      We absolutely have a relationship, although I agree that there is asymmetry. The asymmetry creates this discussion of what happens given the unbalance in the relationship. Typically, the relationship, for the patient, is reminiscent of previous authoritative relationships, hence the concept of transference comes into play. I think when the “click” does not happen, the patient typically feels unsatisfied and leaves therapy, sometimes to find a new therapist, and sometimes to retreat to their old ways of being in the world. As usual, it is complicated.

  2. Shelly said

    How can you describe what you have with your patients as a ‘relationship’ if it is only one sided? Your patients tell you everything about their lives and you delve in deeply into the workings of their minds, but they know nothing about yours? How is that a relationship? They care about how you feel about them, and you care about them, but still–it is professional. What happens when a therapist simply doesn’t care about a patient? I mean, what if it never really “clicks?” Does the therapist recommend the patient see someone else?

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