Shirah Vollmer MD

The Musings of Dr. Vollmer


Posted by Dr. Vollmer on March 20, 2014

Cliche as a defense is my topic this morning. Lapsing into clichés’ often gives people the opportunity to hide behind more difficult, more complicated and more nuanced experiences. Byron, sixty-four, was recently diagnosed with a catastrophic diagnosis, in which he was told he has about eight years to live, in which he will likely experience a  deteriorating mental course. He is upset, devastated, yet to maintain his always pleasant demeanor, he speaks in clichés. “I need to live each day. Carpe Diem. I am so happy I am alive.” He says with complete sincerity, but with a tone of falsehood and denial about his fear and profound feeling about the unfairness of life. “If I am to be honest about how I feel, I will be Negative Nancy,” he says, as if he has no choice other than to lapse into clichés. “Yes, but when you are here, and we are together, you do not need to put on your pleasant demeanor for me. I suspect that you are so polished with your clichés, that you do not give yourself the opportunity, even with me, to be honest with your experience.” I say, highlighting that although I understand he wants to maintain relationships by avoiding negativity, at the same time, he loses touch with his internal process. “There are many truths,” Byron tells me, again, a cliché, I think to myself. “Yes, but I do not know your many truths,” I say, reminding him that he hides behind these over-used mantras. “I am not ready to know my truths,” Byron says with uncharacteristic refusal. “When you are ready, we can go there,” I remind him. “Yes, but some truths are better not known,” he argues. “And some truths seem to be better not known, but when known, are less terrible than imagined. Name it to tame it,” I say, “yes, that is a cliché,” I needlessly remind him.

4 Responses to “Cliches”

  1. Eleanor said

    Continuing on the topic of avoiding cliches and using the psychodynamic method to help with difficult life experiences I would like share a medically traumatic experience I recently had and how it intertwined in a necessary and vital way with my lengthly psychoanalysis years ago. (This psychoanalysis originally helped me with my daughter’s disability and eventually her sudden unexpected death from one aspect of that disability. )

    Six weeks ago I went into the Texas Heart Institute for an elective atrial ablation proceedure for atrial flutter on an otherwise healthly heart. This invasive procedure is considered “low risk” and my husband and I choose a highly respected skilled expert in the field. (I’ve lived in the medical arena for 48 plus years and have learned over those years that sometimes things happen despite the fact that everything was done as best as possible under the circumstances…according to protocol, etc., by the best in their field of expertise. Sometimes, unfortunately, many factors come into play that are unique and unexpected. Unfortunately something did happen. I’ll use only one cliche here,” I’m fortunate to be here writing this”.

    Forgive the medical details to follow, but they help me make my end point…how earlier lasting psychoanalytically based treatments can help with the present day mental dynamics of emotion vs. facts vs.reason, including understanding how past experiences influence reactions to the present traumatic experience. …

    There was a unusual complication toward the end of my procedure..for complex reasons I began bleeding and went into heart failure. Twenty or so minutes of CPR while conservative attempts were made to correct the situation which usually works but not in my case. ….Present in the lab were my cardiologist/electrophysiologist, also a seasoned heart surgeon, an anesthesiologist, and a cardiologist expert with the heart lung bypass machine. The latter, the ECMO machine, eventually gave them time to get me to the heart surgery section. Repair open heart surgery was started, blood and fluids were pumped into me as fast as was possible. After successful surgery I was put into a medically induced hypothermic coma to protect my brain as they didn’t know how much, if any, oxygen deprivation I’d experienced. I woke a little less than 3 days later (as per protocol) and even tho I was still drugged I could clearly see that more than an ablation had taken place.

    Some of my first thoughts were, “ohhh my, I’m going to be needing all of the psychoanalytic insights from past psychotherapeutic treatment” to help me mentally work through this current traumatic experience…(being that close to sudden unexpected death mentally takes a while to “sink in”) I was in ICU for a week and left the hospital on day 11. All of my body systems had been shocked. I needed a team of 7 specialists while in the hospital….yes they are “physicians”, expert ones..all of them….they are not “providers”. (They recognized what happened immediately, worked fast and coordinated their efforts skillfully). I was treated with compassion, kindness and honesty….yes I was their “patient”, not their “client”. Thanks to their efforts I’m home recovering with a mind as good as before, with a bit of further wisdom added in. My heart is also in excellent shape and beating along in smooth sinus rhythm……

    Finally back to my purpose for sharing all this…… my many years in earlier psychoanalysis have been invaluable in recognizing and thinking through the gamut of my emotions in this medical trauma… Psychoanalysis (as opposed to the “manual based treatments”) is a treatment method, when done properly, by a skilled physician or psychologist, for a long enough time, lasts a lifetime and makes a deeper self understanding possible when later traumas happen. To this day it saddens me when I hear jokes and criticisms of psychodynamic and psychoanalytic approaches….something I’ve heard all too often over the years…….If only they knew……

    • Hi Eleanor,
      Your response is so touching. Thank you for explaining how psychoanalytic treatment takes the long-view of treatment, such that I call it “giving someone a new brain” so that as life deals out obstacles, the “patient” has ways of thinking about how to handle them. The patient is less trapped with previous coping mechanisms and less trapped by their relationships with their parents such that they are free-thinking individuals, capable of versatility and adaptation. Your story illustrates the point nicely. Thank you again.

  2. Shelly said

    I almost get the feeling that Byron feels that he can’t put together sentences as artistically and eloquently on his own and therefore needs to use cliches to express himself. Or that if he uses the cliches, people will understand his meaning clearer. Could that be true? Byron probably always spoke this way, even before his devastating diagnosis, right? My husband always throws in puns in his sentences. He thinks it sounds intelligent, or amusing, even though it annoys me. Could Byron be doing the same thing? Just a thought.

    • My sense is that people who have a hard time exploring their emotional interior default into puns and/or cliches. This annoys you because it is shallow. The over-use of puns or cliches prevents a relationship from deepening, as there is no exposition of the individual experience, and hence there is an emptiness to that conversation. Yes, Byron has trouble putting together his own experience, but whether that is the stress of his diagnosis and/or his inexperience in doing that, and/or a neurological problem with his brain, is what we are trying to explore.

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