Shirah Vollmer MD

The Musings of Dr. Vollmer

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.

8 Responses to “Dazed and Confused”

  1. Go to Therapy Now said

    Is that first sentence a quote? It is a really lovely sentence.

  2. Go to Therapy Now said

    I am new to the clinical blogging world, as both writer and reader, but this is absolutely one of the most lovely pieces I have read. I hope you wont mind me sharing it.

  3. Go to Therapy Now said

    Reblogged this on Go To Therapy Now and commented:
    Lovely piece on anxiety, uncertainty, and everyday life.

  4. Shelly said

    I’m not sure that calling psychic bruising, anxiety, or a feeling of uncertainty “immaturity.” We all feel this way at some time or another, no matter what the age or level of mental health. Someone who never questions their decisions and is so confident that every single action he/she performs is 100% on track is actually pretty arrogant and is not a team-player. This piece can apply to anyone, at any age. While you use Calla (28) as your example, it would be appropriate for Calla at 45 or Calla at 62, or at 83. We all question ourselves sometimes. Does that make us mentally immature?

    • The answer is to what degree, to what intensity and frequency, do we question our decisions. You are right that reflection is timeless, but some major life decisions are time critical, and as such, more agony might accompany those junctures. As with most health issues, moderation is the key to good health. Some reflection and uncertainty is useful for personal growth, but when it becomes excessive, then growth is paralyzed and help is needed. Further, maturity is a life-long goal, which is non-linear, and as such, we all have trajectories which involve forward and backward movements of maturity.

  5. Eleanor said

    I see much of life in general plagued by various uncertainties…that’s just part of being human and living in this complex world we all inhabit. I can say that the psychodynamic methods such as psychoanalysis teaches one to ” think differently”…to see things from many varied angles…to tolerate ambiguity and ambivalence as a part of being human. I try to see things as a piece of sculpture…from every conceivable angle and light…or as a well printed black and white photograph in many shades of gray and only small areas of true black and white….Yes, under stress and anxiety we can revert to imagining our world…our circumstances, more in black and white…more certainty, but the wonder, if you will, lies in more complex thinking and reasoning. And yes….the growth for “maturity” is a life long quest! I’m still workin’ on it, thankfully šŸ™‚

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