Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for March, 2013

The Psychiatrist Seeks A Consultation

Posted by Dr. Vollmer on March 28, 2013

Monte, the middle-age psychiatrist, continues to seek Marla, the elderly psychiatrist for consultation about his work. In so doing he presents his therapeutic dilemmas and Marla sheds her words of wisdom. Sometimes the “session” goes smoothly, and other times, as previously reported in this blog, Monte and Marla get entangled in personal issues which leaves Monte feeling disappointed that Marla, although sometimes wise, is not always a good mentor, meaning that she does not always seem to want Monte to succeed professionally. This is manifested by Marla giving helpful work opportunities to other psychiatrists. Monte comes to me, wondering about how to handle Marla. “Variable reinforcement is really tough, since sometimes you get a lot out of her, and sometimes you feel that she does not have your back. It must be hard to weigh these competing feelings.” I say, outlining the equation where Monte has to come up with a summation of his relationship with Marla in order to decide whether to continue to see her. Like all relationship dilemmas, the challenge lies in trying to weigh the good with the bad, given that different times yield different experiences, and given that the twenty-five year history with one another cannot be duplicated. The length of their drama speaks to the depth of the good and the bad. I hope Monte can navigate his way through to find peace with that relationship. A deeper consciousness about their dynamics will help him. In that, I can be helpful.

Posted in Monte Marla | 11 Comments »

The Joys Of Parenting-Continued!

Posted by Dr. Vollmer on March 28, 2013

Posted in Cartoons, Mother/Child Relationships, Parenting | 2 Comments »

Disappointing Siblings

Posted by Dr. Vollmer on March 27, 2013

Zoe, fifty-seven, does not know how to handle her anger towards her sister Berkeley, fifty-nine. They are the youngest of six children, with four older sisters and an older brother. They have never gotten along, through good times and bad, they have looked at each other with contempt, or rather Berkeley has looked down on Zoe, making Zoe feel little and ineffective, although at the same time, Zoe understands that Berkeley feels little and ineffective. With never-ending, perhaps naïve optimism, Zoe extended kindness to Berkeley, looking both consciously and unconsciously for appreciation and love, knowing that the most likely outcome is anger, resentment and a deep sense of ingratitude. Sure enough, when Berkeley was visiting from out-of-town, Zoe invited Berkeley to join her for home yoga. Actually, Berkeley was staying with Zoe for a spring break, which was startling given that the last time Zoe stayed with Berkeley, twenty-five years ago, Zoe was so profoundly miserable and felt so deeply unwanted that she swore, and until now, kept her promise never to share a residence with Berkeley ever again. With all those years gone by, and with Berkeley sweet talking her way with Zoe, Zoe began, on a deep level, to hope that maybe their relationship could pivot. So, part of sharing Zoe’s home, was sharing Zoe’s experience of home yoga. This, Zoe  thought, was a special treat, given that Berkeley is a big yogi, and that the two of them doing it together, could be a memorable and unique experience. True to character, however, Berkeley, without telling Zoe ahead of time, scheduled someone to come to Zoe’s house at the time of Shavasana, the time in yoga, which requires deep quiet and concentration as one transitions from a meditative, internal stance,  to a stance of being open to the external world. As this time came, the doorbell rang. Berkeley was leaving to visit relatives, and she had their niece pick her up at the house, such that when the niece arrived, she said “oh, am I interrupting your yoga,” suggesting that Berkeley was aware of how things would play out. The yoga session closed, as Berkeley hurriedly, left, without much appreciation or gratitude for the experience, and with a deep sense left in Zoe that the effort to please Berkeley was not only wasted, but assaulted. The relationship is strained even more. I listened to this sibling tale with sadness for Zoe and Berkeley. They are not caring for one another. They do not watch each other’s back. They hurt each other or they are estranged from one another. There is occasional hope followed by deep disappointment. Acceptance of this cycle of pain and coldness is hard for Zoe. I can understand that. Downloading the tale was helpful to Zoe, but the pain was still there. Zoe knows she needs to find support from folks who are capable of giving it to her. Still, harsh reminders hurt.

See also…

Posted in Musings, Siblings, Sisters | 20 Comments »

Social Isolation Is Not Good For Your Health-Proving What We Know Intuitively!

Posted by Dr. Vollmer on March 26, 2013,0,7160788.story

Without connection, we die sooner. So, today’s article in the LA Times, tells us, as it reports from a published study in the Proceedings of the National Academy of Sciences. Sure, we want science to support what makes sense, so sure I support the study. I just hope it comes as no surprise. Emotional needs, like physical needs, are needs, and as such, when deprived, poor mental and physical states ensue. Without nutrition we die. Food is life-sustaining, and so are friends and family, if one feels that these friends and family can provide reciprocity and respect. This latter comment, is, of course, speculation. The study only shows in a gross way, how important people are to other people. I speculate further, that the interactions necessary to sustain life are those which bolster self-esteem and worthiness. Without these, the mind tells the body that life is less important and so there is less of a push for self-care. In other words, as we age, this mind/body connection is even more important, as the body becomes more vulnerable, the need for the mind to “fight” for the body’s survival is more critical. This “fighting mind” is fueled by feeling loved and valued by people deemed important. Some would argue that elderly people in communal living situations live longer because the support of the community helps them wake up each day and look forward to seeing their “friends’ whereas elderly folks who live alone have less incentive to push themselves towards activities. All this to say that “behavioral medicine,” as some call the specialty of mental health, really promotes the obvious-friendship. As I say many times in my posts, the answer is easy. The difficulty is in the execution.

Posted in Geriatrics, Loneliness, Media Coverage, Mind/Body | 8 Comments »

Quote For The Day….Source Not Known…

Posted by Dr. Vollmer on March 25, 2013





“Fluency with tools is like fluency with language. The more capable you become, the more expressive and playful you can be.”

Posted in communication skills | Leave a Comment »

Why ‘The Joys of Parenting’ Gets A Laugh

Posted by Dr. Vollmer on March 21, 2013

Giving parents permission to have negative feelings for their children will always make them laugh. The previous cartoon posts entitled “The Joys of Parenting” are funny because without cloaking disgust in humor, parents feel horrible (code for guilty) when they feel regret about having children. I do not mean the kind of regret where people want to give their children away, but I mean the wistful fantasy of reflecting on life without kids. Even this fantasy can produce so much guilt that parents quickly reassure themselves and others, how happy they are to be with their progeny. Humor bypasses societal expectations allowing a release of negative affect with a smile. In a similar way, sex always sells in comedy shows. Most of us feel awkward about talking about sex, unless we are making a joke, in which case, we know we will get a laugh, again, as a release of tension. This tension, or mixed feelings, results from those sticky feelings of guilt and shame that we all try so hard to avoid, and thereby engage in activities which serve to protest the underlying feelings. As Shakespeare so eloquently stated, “thou does protest too much,” suggesting that underlying the protest is some hard truths. We love and hate our children, our parents, our significant others and ourselves. This cauldron of conflicting feelings challenges us to deepen our sense of ourselves and others. Those who take on that challenge are richer for it, and those who avoid the challenge, compromise the depth of their relationships. Some, who take on the challenge, become funny and charismatic folks, demonstrating a deep understanding of conscious and unconscious feelings. It is easy to get a laugh, once you know the formula for eliciting guilt and shame. Or, as Henny Youngman famously said,  “take my wife–please”.

Posted in Great Quotes, Guilt, humor | 13 Comments »

Joys of Parenting: II

Posted by Dr. Vollmer on March 21, 2013


Posted in Cartoons, Parenting | Leave a Comment »

Enlightened Self-Interest

Posted by Dr. Vollmer on March 20, 2013

When do we take care of others for the sake of ourselves? Jolie, fifty-four was about to lose battery power on her iphone5. Her husband, Shawn started to get anxious on Jolie’s behalf? “Why do you care about my battery?” Jolie asks Shawn. “Because I don’t want to deal with your tantrum when you can’t use your cell phone,” Shawn answers, startling Jolie. One could say it is sweet that Shawn is looking after Jolie, but one could also say that Shawn is looking after Shawn. In fact, Shawn could say he is caring for his wife, and/or he could say that he is protecting himself from future harm. Of course, Shawn is doing both, such that to say that Shawn is being selfish is not completely true, nor is it true that he is being altruistic. One could argue that enlightened self-interest is the best kind of love, since Shawn is caring for himself and Jolie at the same time. Too much selfishness, like too much altruism is a set-up for an unbalanced, and hence an unstable relationship. Having said that, should Shawn be honest about his consciousness that he is acting in his own self-interest, or should he emphasize the caring nature of his behavior? Perhaps Shawn could learn to say both parts to initiate a deeper understanding of their relationship. The most enduring kind of caring involves self-care, as well as care for others. As in my previous post about volunteering, one gives of oneself, as a way of getting back self-esteem-another form of enlightened self-interest. The narrow path resumes. Like the diagram above, the challenge in life is that very narrow, middle path.

Posted in altruism, Narcissism | 6 Comments »

Joys of Parenting

Posted by Dr. Vollmer on March 20, 2013


Posted in Cartoons, Parenting | 2 Comments »

Volunteering? What Does That Mean?

Posted by Dr. Vollmer on March 19, 2013


I return to the issue of volunteer teaching, thinking about what the word volunteer, actually means. Clearly, working for no pay is the first association to the word ‘volunteer’. Yet, the second, and sometimes most important association to the word ‘volunteer’ is the notion that one is helping out those who cannot help themselves, like volunteering in an animal shelter, because the animals need the attention. Where is the line between ‘volunteer’ and ‘slave labor’? I wonder. Plus, one can volunteer their time, but expect to be ‘paid’ with appreciation and/or respect. If this ‘payment’ does not happen, resentment ensues. What about love of the work? One could volunteer because they love the task, but committing to a time and place could be a strain, no matter how much one loves one’s work. Then, there is the peer group. When one volunteers along with others, then the socialization is part of the “pay-off’. Many docents, for example, not only love the museum, but they also love their colleagues. So, how does one decide where to put their volunteer chips? Like any decision, it is a pro/con dilemma, along with the opportunity cost of being limited by time and energy. Teaching at a University on a voluntary basis is tricky. It could be a set-up for low-respect and hence high resentment. On the other hand, access to bright ‘young’ things is fun and interesting. Working in parallel with W-2 folks could also be the seeds of ill feelings, but on the other hand, it could give the  freedom of leaving at the end of every class. Volunteers need to be celebrated, both to encourage more people into the field, and to stroke those who choose to put their chips in that particular bucket. To volunteer is to expect to be celebrated, in one way or another. To ask someone to volunteer is to promise, directly or indirectly, to celebrate them. Missing that point hurts the institution asking for volunteers. Nothing is free in the world. That saying, although trite, fits. We give in one way, always with the expectation of reward, but in the case of volunteering, it is not a financial reward, but rather a narcissistic, or self-affirming one. I state the obvious, and yet, sometimes this is missed.

Posted in Teaching | 4 Comments »

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