Posted by Dr. Vollmer on April 16, 2015
Irving Yalom MD, http://en.wikipedia.org/wiki/Irvin_D._Yalom, states that psychotherapists are “fellow travelers” with their patients on the journey of self-discovery, as the patient struggles with the existential issues of death, meaning, isolation and freedom. This is a wonderful characterization of the intimacy in psychotherapy, as, despite the asymmetry in the doctor/patient relationship, there is still a sense of sharing the road together. This is the contradiction in therapy, which is to say that on the one hand the patient travels alone in that only he is sharing is the intimate details of his inner world, and yet on the other hand there is a joining together of the experience as the patient narrates his tale. Leon, sixty-four, comes to mind, as I work with him around the slow decline of his ninety-seven year old father, whom I only imagine, having never met him. Yet, through Leon, through a son’s perspective. I come to understand his father. In that way Leon and I are fellow travelers on the journey which witnesses the slow exit of his father. This sense of joining between patient and therapist, the sharing of interest in the changing emotional landscape, gives way to a unique relationship in which the external world, the decline of his father does not change, but the internal world, the world of sharing feelings does change. Feelings, once shared, become owned, and in so doing, define the person who has those feelings. A deepening of the self ensues, as feelings are expressed in psychotherapy, as, at times in friendship, both travelers have a greater connection to each other, and to themselves. Giving the patient permission to express feelings opens the path towards traveling together, which for some people, is virgin territory. The “fellow travelers” notion gives the imagery of journeys, and sites, yet to be seen, with a sense of discovery and wonder. This contrasts with the T therapies (CBT, DBT, FFT), in which the answers are given, sometimes even before the questions are asked, and hence there is no discovery and hence there is no excitement. Dr. Yalom speaks to this old-fashioned notion of “letting the patient matter,” meaning developing a doctor/patient relationship, or more specifically a doctor/patient traveling relationship. I join hands with him with the hope of creating a chain of physicians who want to be “fellow travelers” with their patients.