Shirah Vollmer MD

The Musings of Dr. Vollmer

Patient Sculpting

Posted by Dr. Vollmer on December 19, 2017

Image result for patient sculpting psychological


Hans Loewald  discusses the idea of patient sculpting, meaning that the therapist imagines the patient without his neurosis, and in so doing, imagines the patient having a more fulfilling life. What would the patient be like if he did not live out the guilt of his parents, for example. Lewis, sixty-six comes to mind. He is the son of holocaust survivors. Parents who instilled in him a sense that the world is a frightening place and he must be suspicious at all times. Lewis has embraced this philosophy unwittingly, living his life in constant fear, but not exactly understanding what he is afraid of. Imagining Lewis without anxiety is what some theoreticians call an “analytic stance”. If Lewis could come to understand that he “inherited” this fear from the trauma his parents experienced, then he could begin to separate out his reality from theirs. In so doing, Lewis could come to experience life in a more relaxed and engaging manner. Moreover, his physical symptoms of irritable bowel and intermittent headaches might improve substantially. A patient without anxiety uncovers the goodness of his soul, as anxiety can obscure that. Keeping the vision provides hope for patients. All of this is not spoken, and yet, magically transmitted between therapist and patient. How to teach these concepts is challenging and yet also very fulfilling. As with sculpture, each student has to find his method. The art of psychotherapy lies in its creativity and in its uniqueness with each therapist/patient dyad. There, I have said it again.

4 Responses to “Patient Sculpting”

  1. Jon said

    Shirah, your comments about Patient Sculpting had me think of the erroneous quote of Michelangelo about chipping away any stone that does not look like David. Looking further, I find two quotes that do seem to be from the renaissance sculptor of stone:

    • Every block of stone has a statue inside it and it is the task of the sculptor to discover it.
    • I saw the angel in the marble and carved until I set him free.

    As you have said correctly again, “The art of psychotherapy lies in its creativity and in its uniqueness with each therapist/patient dyad.” I suggest that Michelangelo’s comments about marble also apply to your comments of the modern psychiatrist.

  2. Shelly said

    I like the thought of a therapist sculpting a patient/client. On the other hand, as you have read, a person’s anxieties may be somewhat transmitted to him from the mother’s state of mind during pregnancy, and also from the environment in which he/she grew up in. Also, his own personal experiences in life as an adult shape his responses to given situations as well. It would be lovely if both patient and therapist could indeed chip away at the layers of anxiety and imagine a life without these stressors, however one would have to go back to the beginning of life to undo them.

    • I beg to differ, Shelly, as one needs to go back to the beginning of life, by using his/her imagination, to help reconfigure the mind such that triggers for anxiety no longer create mental instability. The journey is a mental one. It does not need to involve time travel. Thanks, as always, for your comments.

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