Posted by Dr. Vollmer on January 8, 2014
Are psychiatrists/psychoanalysts gadflies? I wonder. Creating discomfort, in an effort to make greater comfort, is the theme of my work; it is the defining struggle of my work existence. Clara, forty-one, comes to mind. “I love my life,” she says, making me confused, as to why she is in my office. “Go on,” I say, remembering these two words as a possible means of going deeper. “I mean, I want to love my life,” she says, highlighting the wish in her previous statement. I think to myself that sometimes I add the word “wish,” but this time Clara tuned into that, or at least I think so at the moment. “So, what is stopping you?” I ask, thinking that she likely will point to an external constraint, whereas I will highlight the internal constraint, and in so being, I will be the gadfly. “I have my elderly mother who is like a ball and chain. I cannot leave town, and if I do, I feel so guilty it is simply not worth it.” Clara says with the certainty that she must be tied to her mother and there are no other options. “Maybe you could find a way to loosen those chains,” I say, knowing that I could be accused of being cold-hearted, and not valuing family loyalty. “Yes, but when I leave or I am not attentive to my mom, she misses me, and then I feel awful,” Clara says, as if there is only one way to deal with her mom’s need for her. “You need to take care of her, but you also need to take care of yourself, and how you navigate those waters is, in large measure, up to you,” I say, stating the obvious, but hoping to open up a discussion of possibilities as opposed to rigidly adhering to her previous schema. I know I am being provocative, but Clara understands that this perturbation is in an effort to create new ways of understanding family boundaries. Scripts in families are often carried out unconsciously, and so to bring these scripts to consciousness may bring up defenses of anger and attack. It is my job to tolerate that discomfort, knowing, that as a gadfly, good things can come from shaking the cage.