Shirah Vollmer MD

The Musings of Dr. Vollmer

Boundary Check: No No…

Posted by Dr. Vollmer on October 22, 2014

 

All interactions have both conscious and unconscious layers. This is the premise of psychoanalytic theory and treatment. As such, fantasies, erotic and otherwise, are likely to grow in both directions, with the major vulnerability and hence, safety valve, is that fantasies led themselves to words and not actions. In other words,  fantasies must mutate into a narrative, but not into an action.

The cartoon above illustrates the point. That Dr. James (fictional, of course), wants to jump on the couch with Edna, is a rich area for exploration, but jumping on the couch is the source of cartoon and mockery. The caption illustrates that Edna, the patient, might indeed fantasize about James jumping on the couch, but narration in replace of action, leads to understanding and healing, as opposed to repetition and re-traumatizing.

This, again, is the fundamental principle of therapeutic action. Patients get better because unspeakable fantasies are speakable, and in so doing, analyzable, and in so doing, amenable to forgiveness and mourning. Edna, in this example, needs to mourn the loss of a parent who saw her as a sexual object and not a child that needed love and nurturing to grow up and flourish in the world.   This is not the loss of the death of a parent, but rather the loss of a parent she never had. Only through fantasy, both in patient and analyst, can these traumatic pasts be explored and worked through.

Fantasy, as opposed to  check-lists must be open to exploration and hence must not be limited by time. The open-ended nature of this exploration is critical to getting at deep unconscious material which troubles and disturbs functioning. These are the basic tenets of psychoanalytic psychotherapy. We must cherish these techniques and not abandon them for what sounds like a faster cure, but in fact, is a quick change to the check-list.

 

 

2 Responses to “Boundary Check: No No…”

  1. Shelly said

    I’m confused. In the cartoon I see a therapist laying on the couch with the patient. In your blog you talk about fictional Dr. James and his patient Edna, and mention that she must mourn the loss of a parent who saw her as a sexual object and not a child. So which is it? Does Edna fantasize about Dr. James, and you’re using the cartoon to illustrate the fantasy? Or does her lack of a parental figure in her life make her see men always hitting on her? Or do men really always hit on her (illustrated in the cartoon)?

    • The multiple meanings of this cartoon are meant, I believe, to confuse you. As you say, there are many ways of understanding this dyad. I was thinking of the cartoon as a platform to discuss how Edna’s need for attention, historically gratified through sexual attention, has been repeated with her relationship with James, who has his historical need to feel powerful and aggressive in order to feel good about himself. This calamity results in boundary issues in therapy, which beginning therapists need to be mindful of. Both sides of the therapeutic dyad are vulnerable, but it is the job of the therapist to keep his vulnerability in check, and not transform his vulnerability into inappropriate behaviors. Thanks.

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