Shirah Vollmer MD

The Musings of Dr. Vollmer

Wanting Change/Wanting Stability: Push/Pull Continued

Posted by Dr. Vollmer on February 5, 2013

As Bromberg says, every patient enters into the consultation room with the internal dialogue saying “I’m here because I’m in trouble, but the trouble I’m in is not something I need rescuing from, even though it may look that way. However, I fully expect you to try to cure me and I’m prepared to defeat you. I don’t have an illness; I am my illness and I won’t let you cure me of being who I am.” In other words, the patient comes, as Phillip Bromberg PhD continues, “for a secure nest in which to stay safe and accepted forever, not having to bear the discomfort of the new and unfamiliar, while at the same time, looking for metamorphosis (growth, movement, transition).” Bromberg continues to describe this paradox by suggesting that the fear of therapy is represented by Prometheus, the Titan who in trying to create a better civilization, ultimately was punished and tormented. Bromberg says that therapy moves along by “enhancing the patient’s perceptual capacity….creating a change in the structure of his personality organization.”

Clarissa, fifty-five, an endocrinologist, wants to retire. She has plenty of financial resources, so that is not the issue. What stops her is her perception that her parents will disapprove of that decision. “My parents immigrated from India so that I could be a doctor. They would be devastated if I stopped working. They would feel that they wasted their life supporting my education, only to see it used for such a brief period of time.” Clarissa says, clinging to her need to please her parents, while at the same time, hoping that our work together will free her from the shackles of parental affirmations. “You have quite the dilemma on your hands,” I say. “You can please yourself or you can please your parents, but in this moment, it feels impossible to do both, or even to reach a compromise.” “There is no way I am going to upset my folks,” she insists, as if I have just told her to disregard their opinion. “I can see that option feels very uncomfortable for you,” I say, again, highlighting her conflict. Clarissa’s inner tension has come to light in my office. She is at war with herself. I am not championing her to retire, nor am I supporting her belief that she needs to keep her parents content, but I am listening to her struggle and helping her consciously make decisions which will impact her future. Her dynamics with her parents have been life-long. Changing those relationships are really scary. At the same time, Clarissa is flirting with the option to have a life of flexibility and relaxation which she has longed for, for many years. I do not know how she will sort out her conflict, but I am interested in helping her explore this internal process.


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11 Responses to “Wanting Change/Wanting Stability: Push/Pull Continued”

  1. Jon said

    I do not see Clarissa’s predicament as quite as binary as you imply by your statement “You can please yourself or you can please your parents, but in this moment, it feels impossible to do both, or even to reach a compromise.” Would not the concept of partial retirement – working part time – give Clarissa some of the freedom that retirement might bring while still showing her parents that their “investment” has not been “wasted”? Would it be possible for Clarissa to enter a discussion with her parents as to how the ROI, “return on investment,” has paid off well? She might even be able to financially help her folks out. However, to your main point, this seems to require a shift in family dynamics, and that can indeed be scary.

    • Clarissa illustrates the trap of getting locked into a certain way of thinking, without considering the self-imposed narrowness of her choices. She might be able to work part-time, but she does not see that as a good option, for reasons that are not clear to me. To your point, addressing my point, the shift in family dynamics is scary because it will cause a shift in the internal dynamics. This internal shift, causes a “not-me” feeling, which on the one hand, people, like Clarissa come to therapy because they want to change, but on the other hand, the “not me” feeling is unfamiliar and uncertain. Thanks.

  2. Thanks for the very interesting post. What you wrote reminds me once again of how difficult it can be to be a patient and a therapist. Since I have been a patient much more recently than the last time I sat in a therapist’s chair, I relate first and foremost to Clarissa’s situation. But I know both from my own training and from sitting across from a psychoanalyst last year that the therapist is also just another human being doing his or her best to be present and open to what the patient experiences. I admire your honesty about what happens in the process that is a session, and I am sure Clarissa does as well.

    • Thanks, Paul. Transparency is our new world in psychotherapy/psychoanalysis. I think the internet has opened us all up to exposure, which on the positive side, has created a space for authenticity, which, after all, is what psychotherapy/psychoanalysis tries to promote. Thanks Again.

  3. Ashana M said

    I relayed this story to an Indian friend and she just laughed and said, “She won’t retire.” Then she did a very entertaining impression of the complaints of a typical Indian parent if the daughter were to bring the issue up. She says Indian parents would not understand the daughter “wasting her time.” It’s very hard to be caught in a world where we expect children to develop quite a lot of independence from their parents but still have parents who have their whole lives wrapped up in child’s.

  4. Shelly said

    I want to comment about Bromberg’s statement, “…I don’t have an illness; I am my illness and I won’t let you cure me of being who I am.” In today’s world, people prefer to be defined less by having an illness. They are people first and foremost, and they suffer from illnesses. The illnesses do not define who they are. Who is Bromberg and why would he make such a statement? I fully understand Clarissa’s predicament: those of us who are brought up in more traditional households where the parents are the central characters of the family will do anything not to go against the word of the parental figures. Even if it means putting our own wishes and desires on back burners–we never will go against the grain.

    • Shirah said

      Bromberg is trying to illustrate the inherent dilemma in every patient as they enter into therapy. The dialectic between wanting change, feeling like life could be better, versus, the security of the familiar, no matter how awful that might feel.

      Yes, Clarissa’s predicament is a classic illustration of whose needs are more important? As a psychotherapist/pyschoanalyst, my job is not to weigh in on the question, but only to expose the dilemma to the light of day.


  5. “Wanting Change/Wanting Stability: Push/Pull Continued |
    Shirah Vollmer MD” genuinely causes me think a
    little bit further. I cherished each and every
    single section of this blog post. Thanks for your effort ,Steve

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