Shirah Vollmer MD

The Musings of Dr. Vollmer

The Dangerous Business of the Unconscious

Posted by Dr. Vollmer on April 20, 2016

Guilt and self-doubt are often major players in the unconscious mind, often buried under defenses such as intellectualization and compulsive behaviors. Suggesting intensive work is to offer the opportunity to get closer to ugly feelings which are uncomfortable,  and yet at the same time this opportunity might give the patient a mental freedom that they never experienced before. So the dilemma begins. Is it worth it to dig up uncomfortable feelings with the hope that eventually, those feelings will be set free and released from the unconscious? Who is to make this decision? The patient, the psychoanalyst or both? The therapist, knowing that the journey will be rocky might hesitate to suggest deeper work for fear that those rocky patches might, as the cartoon below suggests, turns out to be his life.


The patient, in turn, might say he does not have time or money to do intensive work, but deeper down he resists for fear of bringing up painful feelings. Seth, thirty-three, comes to mind. He lives off of his dad’s money, reporting, at first, that this does not bother him “because my dad is rich,” but on further exploration, Seth reveals that the pain of taking money from his dad is unbearable, but the idea of getting a full-time job is also unbearable, so he would rather take money from his dad. He continues to say how small he feels as a person because he is not financially independent. As we slowly explore the bind that he has put himself into, we more clearly see how his dad wanted to make Seth dependent on him, so the dad could feel good about himself, such that if Seth were to break free from his dad, his dad’s self-esteem would suffer terribly. Understanding that part of Seth’s behavior is an effort to keep his dad feeling good about himself, freed Seth to examine if he really wants to take care of his dad in this way. Yet, to get to that point, Seth had to feel the guilt of taking money from his dad and the associated guilt for refusing to grow up and make adult decisions. This was a tough journey, mostly for Seth, but for me, as the therapist, as well. The growth from this experience seemed to be worth the agony, but it is not always an easy call.

4 Responses to “The Dangerous Business of the Unconscious”

  1. Eleanor said

    Shirah, from my personal perspective, you have been doing some impressive and very interesting and well thought out blog posts lately….probably beginning with “The Analytic Surface” post forward I have been captivated because the points you have been making I am all to familiar with from my own experiences…..the intricacies of psychoanalysis and deep intense thinking on so many levels, the world of the unconscious, and in addition, our current day medical climate in general, along with the specific issues psychiatry is having. I’m just so thankful to see you talking in depth and sharing your perspectives specifically about the psychoanalytic method, our unconscious and the important part the latter plays in our lives….. I am sad that so many others in todays “modern fast paced culture” don’t see just how this “talking cure”, understanding of the transference, the therapeutic alliance/relationship, etc etc. in psychoanalysis (or intense psychoanalytic therapy) can lead to long term healing on deeper levels (as opposed to the “quick fix” more superficial treatment approaches).…..

    Just wanted to thank you for this latest series of blog writings. I can identify with so much you are saying and it makes so much sense. I hope others are listening. Thanks again and keep it up!

  2. Shelly said

    This was an interesting piece. I wonder why, even though I really know, you write that this was a tough journey for Seth, but also for you, as the therapist? While I understand that the therapist invests alot of himself in the therapy, how does helping Seth make it difficult for you? In this fictional situation, wasn’t Seth’s taking his father’s money basically a win-win for both of them if they maintained the status quo? Seth got to take his father’s money and not get a full-time job, and his father got to get his ego stroked by supporting Seth. On the other hand, Seth didn’t get to grow up and make adult decisions, but did Seth really want to?

    • The struggle, as you clearly articulate, is the issue. There is the push/pull of development where Seth wanted independence while at the same time deeply fearing it. The same is likely true for Seth’s father. To bear witness to this struggle, as the therapist, is also taxing, not as much as it is for Seth, but it is still demanding an intense emotional experience. Thanks.

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