Listening And Vulnerability
Posted by Dr. Vollmer on October 24, 2013
In-depth listening, the work of the psychotherapist, mandates a vulnerability to uncomfortable feelings. Listening to trauma, difficult and sometimes horrendous experience, determining the meaning of this difficult experience in the context of the patient’s prior experiences, requires an openness to the imagination of terror, fear, sadness and a disintegration of the ego, or the complete inability to formulate thought, in the face of a traumatic event. Salman Akhtar MD, says that the therapist cannot be “manic,” meaning they must provide a calmness, which allows the patient to pour their experiences into a welcome receptacle. He further explains that this receptacle is a “maternal” function, analogous to the sexual organs of receptivity. This vulnerability in the therapist, as in the vulnerability of motherhood, means that the therapist must tolerate whatever uncomfortable experiences or feelings the patient brings into the consultation room. Once again, I am reminded that my argument against the “T” therapies, those that are manual-based, never address this necessary vulnerability, critical for the patient to feel heard, understood and important. Lesley, forty-two, had a long childhood history of cruel and unusual treatment by her uncle. Her terror, withdrawal, dissociative, at times, leading to anger, resentment and self-hatred, were just a few of her experiences through her psychotherapeutic journey. My psychological pain in listening to her story is real, and profound, and Lesley knows and appreciates my emotional resonance. This therapist-vulnerability needs to be preserved as we go through this major transition in our health care delivery system. There, I have said it again and so I will keep saying it. The patient/therapist relationship deeply matters.