Mom Dies. Appointments Missed. What’s Up?
Posted by Dr. Vollmer on September 4, 2012
Sherry’s https://shirahvollmermd.wordpress.com/2012/06/13/slippery-attachment/ mom, age seventy-five, just passed away after a short battle with a brain tumor. Uncharacteristically, Sherry misses multiple appointments. I wait for her, and then about five minutes before our appointment will end, she calls to say she can’t come. She overslept, there was too much traffic, or she just did not make it out of bed. “This seems to be related to your mom’s passing,” I say, knowing what a huge and devastating loss this has been for her. “Yea, maybe, but I don’t see how,” Sherry says in a barely audible tone over the telephone. “Maybe you are just withdrawing since you feel that attachments are so fleeting.” I say, pointing out that loss of important people make it hard to stay connected with others for fear of losing them too. “Maybe I just should not come any more,” Sherry says, not seeming to really mean what she says. “I don’t think now is a good time to make decisions,” I say, stating the obvious, but also knowing that Sherry might be looking for reassurance that I still want to be a part of her life. “Yea, of course,” Sherry says, “but I have to get my act together,” she states with anger towards herself. “You will,” I say, feeling that this is a deep period of grief, which at some point, not sure when, will pass.
Shirah Vollmer MD 
Shelly said
Maybe, just maybe, it has nothing to do with Sherry’s fear of making new attachments, and everything to do with the devastation of her loss? I know that when someone so significant in one’s life passes away, even if someone is not “close” with the other, a great upheaval is felt. Sherry has been your patient for a long time, and you know her tactics. You know that she isn’t using the death of her mom as an excuse not to “get close” to you. The lack of enthusiasm to simply get out of bed is likely the reason why she missed your appointment. It was to be expected, was it not?
Dr. Vollmer said
Interesting, Shelly. You are postulating that this behavior is strictly a result of her deep loss and not also a reflection of her attachment to me. Of course, we agree that this deep whole in her life is profoundly disturbing and is in large measure a reason for her pulling into herself. I add on to that by saying that it could also be true that this loss has triggered fears of relationships in general. Since my posts are all about hypothesis testing, time and observation will give us some clues as to what these missed appointments meant to Sherry. For now, with her absence, I am left to speculate. Thanks, again!
Sandra said
Absolutely….This is a great column. Sandra
Dr. Vollmer said
Hi Sandra,
Welcome to my blog. Thank you for your comments.
Jon said
When there is a major upheaval, like the death of a parent, it helps to have consistency in the rest of a routine. Missing appointments is indeed a mark of the declivitous decline into despair. With luck and fortitude Sherry will be able to keep her appointments, and thus more stability in her now even more tumultuous life.
Dr. Vollmer said
Interesting, Jon. Certainly routines help some, but breaking routines can also be useful to rearrange one’s interior life. Routines can stifle as well as comfort. The death of a parent is often an opportunity, if you will, to re-evaluate one’s routines. I am not sure Sherry needs luck or fortitude. Maybe, she needs time to herself to see where this loss takes her emotionally. Maybe she does not know how to ask for time to herself and so she “just can’t make it” at the last minute. As I said to Shelly, since Sherry is not present at the moment, I am left to speculate. Stay tuned.
ashanam said
I don’t know if this has any relevance to this situation, but I noticed not long ago that I had difficulty with sequencing when a student had a seizure in class not long ago. I actually remembered the events surrounding her seizing in a different order than they occurred (this was verifiable). There was no particular reason for this. I just got mixed up. Being distressed seems to impact my ability to order events, which impacts planning and organizing activities like making an appointment. I doubt I’m only the one affected in this way–I can’t be that unique. It’s frustrating, but seems to be unavoidable. There may be other factors involved, like fear of attachment, but I wonder if sometimes our brains just don’t work the way we want them to during stressful times. This can exacerbate our mental state, as our normal degree of competence in life is also called into question.
Shirah said
Hi Ashanam,
Thank you for your comments. I agree. Stress interferes with executive functioning skills. Thanks Again!