Shirah Vollmer MD

The Musings of Dr. Vollmer

Unwanted Mental Contents

Posted by Dr. Vollmer on January 26, 2015

Receptivity is mental sophistication. The ability to listen to a new idea without the need to dismiss it, or to change the subject back to a more comfortable zone, is yet another hallmark of mental health. The ability to say “that’s interesting” relaxes the mind, as opposed to feeling that you must fight with the idea being proposed. New ideas makes one think, challenges one’s preconceptions, and hence, for most of us, when presented with an idea that alters our way of thinking, we recoil back to our original thought, with very little interest or desire to expand our mental universe. We see this with Republicans versus Democrats. We have come to a period in which neither side listens to the other. Neither side seems to want to know what the other is thinking, and so each side reinforces itself by surrounding themselves with like-minded folks. Perhaps the internet has made this parochial-minded approach more prominent, since we can pick and choose our news and how we receive media, such that we can fall back on our childlike tendency to “dig our heels in” and stick with our original way of thinking. The media then, is used to reinforce our views, rather than challenge them.

Psychotherapy and psychoanalysis is yet another opportunity for mental expansion, but this presupposes that the patient is capable of piecing together a new narrative. The fight against this new narrative is called resistance, since Freud liked to use machine metaphors. If the therapist is not capable of coping with this resistance, then there is a therapeutic impasse. The treatment is stuck. On the other hand, pulling at the resistance could increase the fight, and the treatment could be stuck in that direction as well. The art of psychoanalytic psychotherapy is to learn to dance around this resistance through dreams and free association, such that the patient can learn to play with ideas without threatening his narrative. In other words, the mandate to say what is on your mind, without trying to create a coherent narrative allows the patient a play space to see what his mind produces, without the immediate pressure of making meaning out of his thoughts. The meaning may come later, much later in fact, and this is yet one more reason why unlimited time in psychotherapy is critical to its success.

John Steiner http://en.wikipedia.org/wiki/John_Steiner_%28psychoanalyst%29 makes the distinction about understanding versus the need to be understood. The latter is about empathy, whereas the former is about growth. To make the patient feel understood is the first step towards understanding, or making a new narrative. Being understood does not create a new narrative, but understanding does. Travis, forty-one, comes to mind. He has a very close relationship with his mother and a very contentious relationship with his wife. In psychotherapy, with a female therapist, he never wants to talk about his wife or his mother. He is terribly afraid that the therapist will tell him that his relationship with his mom is “sick” and that is why he cannot connect with his wife. The therapist has never said this, but Travis “knows that is what she is thinking,” in all likelihood because that is what Travis is thinking. Travis becomes angry at his therapist for “not listening.” His therapist, feeling this to be resistance, as opposed to a legitimate criticism, says “maybe you are afraid that I will listen, and that would be hard for you, so you need to see me as ‘not listening’ in order to cope with your terrible dilemma of wanting help and being afraid of help at the same time.” The therapist attempts to help Travis be understood, but she perceives that he is not emotionally ready to handle the idea that when Travis says his therapist is ‘not listening’ that this is a projection in that Travis is ‘not listening’ to himself. To create an understanding of projection, Travis would need to see himself as the author of his struggles, and not a victim of them. This transition can take a lot of patience and time. Unwanted mental contents are unwanted for good reason. They hurt.

2 Responses to “Unwanted Mental Contents”

  1. Shelly said

    In your example, why does Travis seek out a female therapist? If he is so afraid of hearing all these painful things from a female (who may or may not remind him of his mother or his wife), wouldn’t a better fit be a male therapist? Then he could relate better, understand and be understood, free associate at will without the worry as you so describe….all attributed to the fact that you are a woman.

    • Yes, Travis sought out a female therapist because he knew he needed help with his relationships with women, but on a deeper level, when in the presence of a female therapist, he freezes up and gets angry at her for “not listening”. This apparent contradiction is understood in terms of the layers of the mind which contradict each other, but are sometimes only known to the individual at a later time. In other words, it can take time for the person to understand the layers, and hence the contradiction in his behavior. Thanks.

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