Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for February 24th, 2015

Dazed and Confused

Posted by Dr. Vollmer on February 24, 2015

 

It is so hard to not know, to not feel certain, to wonder or question decisions, big or little. This uncertainty often floats downstream and manifests as anxiety. Sometimes, it floats to a search for certainty, with a powerful search for people, or ideas, who seem to “know”. Other times, the “not knowing” floats towards organizations in which lives are tied to, giving the person a feeling of belonging, and hence a feeling of greater certainty. To stay in the island of wonder requires a psychic maturity in which life can still go on, despite the constant threat of unforeseeable change. This, one might, or I might say, is the art of living. In deeply uncertain times, are people mentally ill? Again, I say they are dazed, confused and psychically uncomfortable, but that does not define an illness, only a psychic bruise which offers up a range of painful feelings. Behavioral therapies offer certainty, which on the one hand, can give the patient comfort, but on the other hand, does not help with the maturational process of coping with uncertainty. It is not that behavioral interventions are problematic, it is only that their offer of relief is short-term, whereas helping someone mature offers long-term benefit.

“I really do not know what I want to do with my life,” Calla, twenty-eight says, with fear and panic in her voice. “Do you have to decide today?” I ask, wondering why there is such acute panic. “I feel a pressure to answer that question, and yet my mind goes totally blank,” Calla says while she sits and stares at me with a painful look of confusion. “If your mind goes blank, then I wonder whether you are too frightened right now to consider possibilities, and so maybe you need to think about why your mind goes blank? Perhaps you are so afraid of making a bad decision, or you are afraid of disappointing your parents, then instead of thinking about those ideas out loud, you shut down the engine so you cannot move forward?” I say, suggesting that the “blank mind” is a symptom of competing ideas which she does not allow to see the light of day. She is running away from herself, a psychic retreat, by not accessing her mental processes, and hence she experiences a “blankness.” “The circuits have shut down, so now we need to think about why that might have happened.” I say, opening up the idea that her mind is rich, but she has shut off access, for fear of what she might find.

Calla is not mentally ill, and nor does she suffer from an anxiety disorder, but she is paralyzed in her life right now, and medication might help her move forward in tolerating difficult mental states such as uncertainty and fear. Behavioral techniques such as deep breathing might help her feel more in control and this could help her reflection. Ultimately though, Calla’s task is to get to know herself. To find out what makes her happy and to leverage that in a way such that she can be financially independent from her parents. Calla, in essence, needs to grow up. She knows that. She wants that. She is working on it.

Posted in Psychoanalysis, Psychotherapy | 8 Comments »

 
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