Shirah Vollmer MD

The Musings of Dr. Vollmer

Making Ideas Stick

Posted by Dr. Vollmer on July 31, 2013

Sand slipping through my patient’s hand, is how I often think about ideas which we discuss, but for powerful unconscious reasons, never seem to materialize into action. Or, as my colleague says, “people pay us money, not to take our advice.” The key here is to penetrate the patient’s brain, so the new way of seeing the world, is not merely cognitive, but also visceral. Without this visceral component, people tend to relapse into their old habits, their old defenses. Milly, for example, thirty-six, continually has relationships which ultimately make her feel used and worthless. All of the men in her life have ended their relationship by having an affair, which upon revelation, was lasting for most of their time together. This pattern, Milly sees, is a result of her not acting on her deep suspicion that the men she chooses to be with, are disloyal and sensing Milly’s desperation for a relationship. Although she understands this dynamic, she feels powerless to change it. We discuss the repetition in her mates, and how it reminds her of how she was treated by her mother, dismissed and overlooked. Yet, to her frustration, she continues this pattern. “You must need to continue this routine, perhaps with the wish that you will finally get a better outcome.” I say, highlighting that within the repetition is a wish. Milly begins to see that if the wish were more conscious, then she could see that instead of wishing that these men would take a different course, it is she who has to change. Still, even with that insight, the pattern continues. The depth of her initial pain lives on in the persistent repetition. As we spiral inside her unconscious, there is hope for relief from that pain, freeing her to use better judgment for her suitor. The deeper we go, the more likely it is that Milly will break the cycle of degradation.

4 Responses to “Making Ideas Stick”

  1. Jon said

    Milly seems to be stuck in a vicious circle of unsatisfying and unhealthy relationships with men. I have long thought that the concept of moving in circles is too constraining a view. Rather than consider one’s effective motion in two dimensions – a circle, it could be understood in three dimensions – a helix. Each time one goes through the trajectory of a circle, one has the opportunity to gain understand, and that understanding is in a different dimension than the circle. Since Milly’s circle is needs breaking, the understanding that is gain upon reflection may allow her to change the trajectory of her relationships. It may be that the “sand slipping through” her hands could allow her traction to change both her depth of understanding and the course of her relationships.

    • Shelly said

      Well said, Jon. But I wonder what it is about Milly’s personality that men see and make her a “mark” as someone who can be cheated on? Does she project poor self-esteem? If so, then she may attract men who are selfish and who think they can have Milly and other women on the side. I don’t think that Milly is resistant to change and to look deeper inside. She is probably scared to change, scared to take the first step, and scared and bewildered how to attract men other than she has been doing her entire life.

      • Yes, Milly’s behavior is fear-based, but understanding the origin of that fear, and all of the associations to that fear, is the hope for her to master these anxieties so she can develop more self-confidence. Thanks.

    • Yes, the circle or the helix is often the question in psychotherapy. Both therapist and patient wish for the helix, but when it feels like a circle, despair ensues. Thanks.

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