Posted by Dr. Vollmer on January 29, 2012
A particular thrill…..http://en.gravatar.com/nyupostdoc….a new follower!
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Posted by Dr. Vollmer on January 27, 2012
Frankie, twenty-one, female, senior in college is elated today. She is doing well at school. She enjoys her friends. She is eating and sleeping well and by her report she has “watched it with the alcohol.” By contrast, a week ago, Frankie felt her life was in the “dumper”. She hated school. She hated her friends. She did not leave her dormitory. What difference did one week do? I am not sure. She did not like how she was feeling so she reversed her mental state very quickly, such that now she is not quite manic, but close. The beauty of seeing adolescents is to witness this rapidly shifting mood state, which means that sometimes just waiting and being patient, the adolescent pulls herself out of one mood and into another mood with the agility that only young people seem to have. Sure, I could try to take credit for Frankie’s improved mood. She saw me last week and we talked about things she could do to improve her self-regulation. I think this helped, but it also helps to have the biology along with today’s culture which allows for a roller coaster of emotion, as somehow a normal and socially acceptable experience in these adolescent years. This rapid shift in mood in an older person would be seen as strange or suspicious, but within our society, we allow it by attributing these mood swings to “normal adolescent turmoil.” Whether we as a society should or should not accept these mood swings is another question. For now, I feel like the beneficiary, as youthful enthusiasm feels like a nice experience to absorb.
Posted in Adolescence, Psychotherapy | 2 Comments »
Posted by Dr. Vollmer on January 26, 2012
Moses Laufer says that the key to understanding adolescence is to have a deep appreciation for the ability to make a human being, the ability to reproduce. This dawning creates anxiety and hope which shapes the adolescent mind, he claims. Willow, age twenty-four, has never had a serious relationship and she cannot figure out why. Mr. Laufer would say that she is afraid of the sexual demands in such a relationship and the threat of reproduction. He has an interesting point. As an alcoholic cannot have the first drink, otherwise he/she will get drunk, it is possible that Willow avoids the threat of having a baby by avoiding relationships all together. It does make sense that the appreciation of one’s reproductive potential creates, for some, unbearable anxiety. As one moves through the train of adolescence, and one feels egocentric, the threat of being responsible for another human being can be seen as a challenge to one’s developmentally appropriate selfishness. How one deals with this potential says a lot about personality and personality development. I am sure there are many reasons for Willow’s loneliness. Now, Mr. Laufer has added one that I did not consider before. Thanks.
Posted in Adolescence, Psychoanalysis, Psychotherapy | 4 Comments »
Posted by Dr. Vollmer on January 25, 2012
Wendy and Jo, both age fifty, have been good friends for twenty years. They met when they worked together, but they both separated from that employer nineteen years ago. Still, they remained good friends. They were both married when they met. Now, Jo is remarried. Wendy is single and dating on and off. Wendy and Jo are not getting along, according to Wendy, my patient, who reports with dismay about how Jo disappoints her. Jo seems not to be interested in Wendy’s dating life. “It sounds like you have such a deep bank of good feeling that it is hard for you to reconcile what is in the bank, versus the feelings that are currently in your wallet.” I say, trying to talk about how relationships are complicated because past, present and future feelings are always at play. “That’s right,” Wendy says. ” I don’t know how much that bank should count for things, since Wendy is so not there for me now, but she used to be, when we were both single.” “It is a terrible dilemma,” I reply, understanding that it is hard to give up a relationship that used to be satisfying, even if it has felt empty for many years. “I think the bank is running dry,” Wendy says, working with my metaphor. “That is too bad,” I reply, helping her grieve a relationship that is no longer there for her.
Posted in Friendship, Psychotherapy | 2 Comments »
Posted by Dr. Vollmer on January 24, 2012
Marello Dapretto PhD http://faculty.bri.ucla.edu/institution/personnel?personnel%5fid=46838 spoke today about how mirror neurons are abnormal in those with ASD-autism spectrum disorder. It was one of those lectures where I felt like I already knew this, and so I was not learning anything, but at the same time, she was demonstrating with pretty fMRI pictures that what I/we have suspected for years, is finally being proven with our imaging technology. That is, we now can demonstrate that those individuals with ASD have a defective wiring in their ability to imagine what others are thinking or imagining. In other words, their “theory of mind” is impaired, and the level of their impairment matches the level of defect in their mirror neurons. In other words, this is a continuum of damage, resulting in the “S” or the spectrum concept. Sure, there are workarounds to the mirror neuron system. Children can learn to understand human behavior and they can learn empathy, but they will have to bring in another neurological system since their mirror neurons do not fire properly. For years, in my training from 1986-1991, we told families of those with ASD that there was a “wiring problem” without any specific knowledge about what that wiring problem might be. We felt certain that parents should not blame themselves for the social awkwardness of their children, but at the same time, parents can help fix the problem. Listening to Dr. Dapretto today, confirmed what we told parents, back in the day. Phew!
Posted in Asperger's Disorder, Autism, Neurobiology of Behavior, Parenting, Psychobiology | 8 Comments »
Posted by Dr. Vollmer on January 23, 2012
Stability of self-esteem is the hallmark of the closure of adolescence. As self-esteem improves, compromise is possible. The adolescent can compromise on their ideals and begin to see all humans as flawed beings who are trying their best to succeed. The arrogance often recedes such that the emerging adult develops a more sanguine approach to the compromises demanded by life’s circumstances.
Zara, twenty-four, exemplifies this transition period from late adolescence to young adult. Whereas in the past, all the adults in her life had “sold out” to corporate interests, now she sees the value of a steady paycheck and the compromises inherent in starting a family. Her stormy period of self-harm, substance abuse, school refusal and school failure are behind her. Now, she is a reliable and responsible person, anxious to become more financially and emotionally independent from her parents. Although she still has issues with how her parents’ conduct their lives, she also sees that choices in life can be agonizing, and so there needs to be some forgiveness for compromising one’s value system. Her judgmental attitude has diminished considerably.
It would be easy for me to take credit for Zara’s emotional growth, and although I do think I should take some, it is also true that the pressure of development, the neurologically pre-programmed wiring to become independent beings, is also at play. As Zara’s brain matures, she feels more of a need to start her own life, and hence be less focused on the flaws of her parental figures. Psychotherapy and development work together to shape Zara’s emerging self. This is a common theme in my blog. Forgive the repetition, but my amazement about the power of development never ceases.
Posted in Adolescence, Psychotherapy | 4 Comments »
Posted by Dr. Vollmer on January 22, 2012
Marina Abramovic, http://en.wikipedia.org/wiki/Marina_Abramovi%C4%87 a sixty-four year old performing artist, sat for three months at the Museum of Modern Art in an exhibit she called “The Artist is Present” which has been made into an independent film of the same title http://www.imdb.com/title/tt2073029/ . People lined up for hours to sit in her presence, without words. Some cried. Some felt love. Others were confused. I think she simulated the first psychotherapy session. The expectations of the individual “customer” were met with the physical appearance along with her nonverbal communication. This situation brought up surprising emotions for both Marina and the consumer. Since she worked in an art museum, her work is called performance art. Had she had an office in a building, her work would be called psychotherapy. This overlap between art and psychotherapy intrigues me. It is only the setting which changes the frame. Psychotherapy is often a creative process and art is frequently therapeutic. Yet, no one thinks of Marina like a therapist, and no one calls me an artist. Yet, maybe the beauty of her work is that she has hit the outer edge of both processes. When her movie hits the local theatres, let me know what you think.
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Posted by Dr. Vollmer on January 20, 2012
Douglas and Barbara Schave proposed that early adolescence, ages eleven to fourteen is a distinct developmental stage, marked by shame as the main disruptive affect, which can be further differentiated into affects of dishonor, ridicule, humiliation, mortification, chagrin, embarrassment or disgust. Reading their paper made me think of Lela, fifty-two, who did not follow-up with her primary care physician in getting her mammogram and her colonoscopy, such that she felt such shame that although she had a relationship with this physician for fifteen years, she felt she could no longer go back. She was convinced that because she did not do what he recommended that he would think so poorly of her that their relationship could not continue. “What if you explained to him that you were nervous to get these screening tests done and so you procrastinated?” I asked, knowing that the issue is not one subject to logic, but to deep-seated feelings of shame and humiliation, leading Lela to need to hide and withdraw. Lela said “well, I just could not face him.” “That reminds me of how twelve-year-old girls feel when they get a pimple. They feel that everyone is looking at their face, so they just cannot go out in public,” I say, trying to tie Lela’s feelings to a developmental phase without further humiliating her. “Yes, it may be like that,” she says without getting defensive, “but I am trying to explain to you how I feel.” “Yes, I appreciate that. I think I understand the deep feelings of shame because I can relate it to that phase in life in which shame is felt so much of the time.” Lela looks at me a little calmer now. “Compared to my mom, I have a lot less shame,” she says, with a touch of defensiveness. “Well, I am sure that your mom’s sense of shame has a lot to do with yours as well,” trying to tie the two together, rather than making it a competition. “Yea, of course, but I am glad I am not as bad as she is,” Lela says to comfort herself. “Maybe you can go back to your physician. Maybe it is important to maintain the relationship, since he has known you for so long,” I say, encouraging her to re-examine her resistance. “I will think about it,” she says, convincing me that our session meant something to her.
Posted in Adolescence, Psychoanalysis, Psychotherapy, Shame | 2 Comments »
Posted by Dr. Vollmer on January 19, 2012
Pubescence is an act of nature. Adolescence is an act of man. It is only in the last century that “children” are given a time to mature into adulthood. That is, they are given an opportunity to “find themselves” or have “identity formation” as Erik Erikson would say. This is a time where the emerging adult must reconcile his wished for self with his actual self. Peter Blos, a psychoanalyst who was interested in adolescence, coined the phrase a “miscarried adolescence” to suggest that this is a vulnerable time of life, such that when the psychological development unfolds poorly, then this can have life-long implications. In other words, one has to master adolescent challenges of finding love and finding work in order to set up a life which yields fulfillment and pleasure.
Micky, a seventeen year-old female, might be an example of this “miscarried adolescent.” She fought with her parents over which high school to go to. She wanted to go to the local public school. The parents insisted on a private arts-oriented high school. They won. She got mad. She failed out of high school and she started hanging out with the local kids who were going to the public school. They bonded, such that much to the parent’s dismay, Micky showed no interest in college, any college. Mickey did not use drugs, she did not drink, but she did like to spend a lot of time hanging with her friends. It was not clear what they were doing with their time. Mickey is not unhappy, but her parents fear that her life will never get on track. They might be right. Micky has no plans or worries about her future. She has no desire to be forward-thinking. She is stuck, or “fixated,” as analysts like to say in a childlike state of mind. This is not to say there is no hope for Micky, only that she needs to progress through an adolescent period of finding her wants and desires, leading to an independent way to make a living, and meaningful relationships, so that she can psychologically separate from her parents. She has a long journey ahead. I hope she opts in.
Posted in Adolescence, Psychoanalysis | 4 Comments »