Shirah Vollmer MD

The Musings of Dr. Vollmer

Desperate As A Sad Self-State

Posted by Dr. Vollmer on July 5, 2012

Nathan, twenty-five, feels “desperate” for connection, as he relates his feelings to me. “I don’t find myself very likeable, so why would anyone want to hang with me?” He asks, conveying a low self-esteem, which has persisted since he was an elementary school student. “I have never really had friends.” Nathan says, as if proving his unworthiness. “Why do you think that is?” I ask, wondering how he strings together his own impression of himself and the outside world’s impression of him. “I think that people like me initially. I mean, I am really good at parties. I ask lots of questions and I am pleasant to talk to. Yet, as people get to know me, they lose interest.” Nathan says, as we explore his vantage point with regards to his interpersonal struggles. “Why do you think they lose interest?” I ask, trying to gather a larger narrative. “I think they lose interest because I feel so bad about myself, that at some deep level I push them away. I think they recognize how needy I am, and that scares people.” “Needy of what?” I ask, again trying to draw him out. “Needy of affirmations that I am a good person.” Nathan responds quickly. “You mean that if you had more self-confidence, then your friends would have more patience with you.” I say, emphasizing how importance self-confidence is to having deep relationships. “Yes, no one wants to be around people as needy as I am. If they don’t tell me how important I am, then I begin to get insecure and feel that they don’t like me any more.” Nathan says with brutal honesty. “It is great that you can articulate that process,” I say, impressed at his insightfulness. “Maybe we can figure out why your self-confidence is so low,” I say, pointing our therapy in the direction of self-esteem and away from his direction of loneliness. “I need sunglasses to leave right now.” Nathan says as a way for me to understand how sad he is feeling in this moment. “Yea, I get that and I am sorry about that.” I say, understanding that he is feeling very deeply as the session ends.

3 Responses to “Desperate As A Sad Self-State”

  1. Shelly said

    People want to be around people who make them feel good about themselves. They don’t always want to constantly bolster, cheer, entertain, and support. Nathan needs to find enough self worth via his work through you to be a good friend to others and then he will have friends. He doesn’t feel likable because he realizes that to have friends, he must offer something in return for the friendship people offer to him. Nobody likes a downer, a complainer. Perhaps if he liked himself more then others would too.

    • Shirah said

      Yes, Shelly. Nathan exemplifies this downward sprial of loneliness leading to sadness which leads to even more loneliness since it is hard for people to be around him. Turning around this spiral, particularly really deep ones, is why the work of psychotherapy is so intense and so challenging. Thanks, as always.

  2. Dan said

    Great posting…clicks on so many levels.

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