Shirah Vollmer MD

The Musings of Dr. Vollmer

Lethargy As A Sign Of Aggression

Posted by Dr. Vollmer on November 13, 2012

The classic passive-aggressive response-one feels tired, but the underlying emotion is aggression and anger. This, some theoreticians state, is how a psychoanalyst should,at times,  decode the feelings of boredom or exhaustion. The fear of rage can lead to shut-down. The concept is simple. Yet, to flip lethargy into anger requires a deep unconscious connection and comfort with internal hostility. This comfort level is hard to come by. Many people, both analysts and patients, fear that feelings of rage are equal to behaviors of rage. Lack of acceptance leads to reversal which leads to a feeling of deadness, which helps the person avoid, or resist, feeling aggressive. Teaching my students to talk about getting tired in session is another related challenge. As with all behavior, there may be multiple explanations, layers, if you will, of understanding. Yet, the shame of admitting fatigue, when there is a pressure to find every minute “fascinating” is prominent in newbies to psychoanalytic work. The overlap of teaching and supporting comes to mind. My job, along with the trust amongst the students, is to help therapeutic rookies become accepting of their own foibles, as a means of allowing for a space for reflection over what is going on. Opening up minds is a bilateral process. For therapy to work, both patient and analyst must reflect. The “intersubjective field” as some call it, is the area of study. From this inquiry comes creative thinking, greater understanding of motivation, and, with the risk of being grandiose, a new brain. Lethargy is allowed.

4 Responses to “Lethargy As A Sign Of Aggression”

  1. Shelly said

    At first I thought you were writing about lethargy in your patients until I realized you were talking about lethargy in therapists-in-training. In most cases, it can be attributed to both patients and therapists. This subconscious rage that you describe–what is that about? I mean, I understand it exists in your patients for that may be a reason they come to the therapist to get treatment. But what about in the therapist? Can’t the boredom in the therapist be boredom, and the rage be attributed to the fact that therapy may be boring and not what they had expected? What is this internal hostility that you describe?

    • Shirah said

      Yes, I was vague as to who had the lethargy, as I think that this “intersubjective field” can cause lethargy on both sides. The point of my post is that sometimes, this lethargy, either in the therapist or the patient, can be a sign of rage, which is suppressed. The internal hostility could be a result of unmet needs, or frustration, which is too shameful to discuss. In the case of the therapist, the therapist may have rage that the treatment is not progressing at the rate that he/she hoped it would. Thanks.

  2. ashanam said

    I become tired in session. Sometimes fatigue and lethargy just means that you have worked hard. Being a therapist is hard work. No shame in that.

    I’ve come to understand boredom as an indication that the attentional controls have become overtaxed. This can occur because there is inadequate stimulation, attention is required over too long a period, or too much attention is required. We tend to assume it only occurs when there isn’t enough stimulation, but it is often someone’s first reaction to a very complex idea–in other words, when too much attention is required.

    Staying alert and attuned to someone for hours is terribly taxing–most people can maintain attention for about five minutes, in my experience, and a lot more than that is required both to be a good therapist and a good patient.

    You may be right about the rage, but sometimes fatigue is just fatigue.

    • Shirah said

      I agree. Fatigue, like any other mental state, is the tip, in which the underpinnings need to be explored. Your comments are quite interesting and useful. You bring together the issues of attention and fatigue and boredom. Focus is hard both on a physical and emotional level. Sustained focus requires an acceptance of the subject, and therein lies the possibility for psychological resistance. Thank you for contributing to this discussion.

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