Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Aging’ Category

Lost Years Stimulated By Turning 50

Posted by Dr. Vollmer on July 6, 2012

Tea, turned 50 in December, but she is still fixated on this number. “I finally figured it out,” she tells me with great enthusiasm. “Yes,” I say, nodding that she has built up suspense. “Well, as you know, my son died twenty years ago and for me, the world just stopped. I was in a grief period, of course I still am, but I was really in another world for so many years, that turning 50 does not seem real to me. Everyone looks at me with a sense of recognition about how hard it is to turn 50, but I know that I am experiencing something that they do not connect to. I feel the loss of so many years where all I could think about was my son. That distortion, if you will, made me lose the normal tracking of time, such that I cannot latch on to my age. Sure, I have the other issues of aging, both body and brain, but that is not what is getting to me.” Tea relates this to me, as if she has solved a challenging puzzle. She is enthusiastic and not sad about her disclosure. “You know, it makes me sad to hear you talk about your son and particularly sad to hear how you feel you have so many lost years because of it. I am a bit perplexed as to why you don’t sound sad as you talk about it. At the same time, I can understand that you had an itch, which was the mystery of the meaning of turning 50, and now you have scratched it.” I say, knowing that we have discussed on numerous occasions how talking about her son is sad for both of us, but that does not mean we should not talk about him. “Yes, I do feel like I scratched an itch. That nails it. Before, I just felt so uneasy about my age, but it did not make sense to me, because normally I am not sensitive in that way. Now, it makes sense to me, so I feel better.” Tea, has done self-analysis, in a way in which she is communicating to me that the tools from our work together have helped her dig into her mind and test out hypotheses, until she lands on a concept that feels satisfying to her. “It must be so hard to ‘lose’ so many years, and have the people in your world not appreciate your feelings. I mean, I can connect with what you are saying, but it still must feel lonely.” I say, highlighting an old discussion about how Tea feels so alone in her grief. “Maybe you lost many years, but now that you have turned 50, you will be starting to appreciate time in a different way.” I say, highlighting that maybe this self-discovery will yield a deeper presence for her. “I can only  hope,” Tea says, now looking sad, but appreciative of our discussion.

Posted in Aging, Aging Brain, personal growth, Psychoanalysis, Psychotherapy, PTSD | 6 Comments »

Harsh Superego: Inability To Forgive Yourself

Posted by Dr. Vollmer on December 6, 2011

     Sherry, recently turned fifty, spends her internal life being mad at herself. She hates her body, and she is mad that she is overweight, even though she is not. She wishes she had more money, even though she pays off her bills every month. She wishes she had better friendships, even though she is beloved my many. In essence, Sherry never lives up to her own expectations and so she lives with a chronic anger inside of her. To meet Sherry, one sees an exuberant, curious and engaged person. Her exterior is both charming and attentive to others. Yet, her interior is tortured “beyond belief,” as she says.

   Sherry’s sister, Ruby,  died when she was four years old and her sister  was eighteen months. Ruby tragically died suddenly as she choked on a walnut at the dinner table, surrounded by her helpless sister (Sherry) and their mom, Rosemarie. Sherry, although she understands she was four years old at the time, never recovered from that fateful day. Rosemarie did not either, according to Sherry. Sherry feels close to Rosemarie, now seventy-three, but they stopped talking about Ruby years ago, knowing that when they did talk about Ruby, they both got upset and so it was not comforting. Sherry believes that this traumatic event, even though decades have past, has created an indelible internal experience of guilt and bad feelings which she cannot describe or resolve.

     “Gee, you must not come to therapy to deal with those bad feelings, as it seems like you feel pretty confident that that area is untouchable for you.” I say, with some compassion and some confusion. “Yes, I come to therapy to deal with more superficial experiences, like my frustrations at work, or trouble with my husband.” Sherry explains with a sense of painful resignation. “The part of your personality which is punishing, your superego, has a loud and chronic roar,” I say, bringing in Freud’s useful concept of a layer to our brain which judges ourselves and others. “You could say that,” Sherry says as she starts to cry. “I just don’t like myself,” she says as she cries more deeply. “I am sorry,” I respond, knowing that in this moment I cannot help her like herself, but I can join her in feeling bad that she carries this weight of self-hate. “Maybe turning fifty has made you realize that this feeling is not going away and maybe you hoped it would have disappeared by now,” I say, postulating that her birthday was a disappointment to her in that her dark interior world still persists. “Yea, it was a hard birthday,” Sherry says with the tone of recognition along with a feeling that she was relieved to say that aloud. “Maybe fifty-one will be better,” I say, pointing out that fifty is just an arbitrary number. “Maybe” she says, as if to please me, but not convincing me that she has any hope.

Posted in Aging, Grief, Psychoanalysis, Psychotherapy | 4 Comments »

Sibling Rivalry: Revisited

Posted by Dr. Vollmer on April 5, 2011

elderly care

Tamara, comes in saying “I don’t want to talk about my mom today. I want to talk about my older sister Thais. Thais was two years ahead of me in school and she was an absolute genius, according to my mom. So, when I came along, my teachers expected me to do as well as she did in school so when I did not catch on to things as quickly as Thais did, my teachers seemed really disappointed in me. My whole life I have tried to define myself as just as good as Thais, but deep down, I have never felt that I am.” “I am curious why this is coming up now,” I ask, trying to tie together Tamara’s struggle with her ailing mom and her presentation today about her life-long feelings of inadequacies which she attributes to being the younger sister of Thais. “Well, I guess I see my mom’s passing and I am thinking a lot about my childhood and I am thinking about how even though I am fifty years old, I still carry around a lot of very old feelings which don’t seem to go away.” Tamara explains with a sense of agony and frustration. “These feelings are hurtful and persistent,” I say, “and it sounds like you wish these feelings would go away but they seem to stick around like they are cemented into your core.” “Yes, that is exactly right. They are cemented to my core and I hate that,” Tamara says with a tone that conveys both  the recognition of feeling understood and the pain of a life-long feeling of inadequacy. “Maybe these feelings were cemented in because it was not just the teachers that you felt to be disappointed, but also your parents as well,” I say, thinking that her parents might also have compared Thais to Tamara and in so doing, her parents could have been disappointed by Tamara’s intelligence relative to Thais’ cognitive abilities. “It is impossible for me to think that I disappointed my parents, especially now that my mom is dying,” Tamara says with overwhelming sadness and teariness. “You mean the last chapter in your mom’s life reminds you that you are losing the chance to ever impress her with your accomplishments,” I say, trying to convey a sense of understanding how hard it is to lose that opportunity. “Yes, I am going to have to accept that my mom saw me how she saw me, even if that makes me feel that she was chronically disappointed in me,” Tamara says with strength in understanding and deep pain at the same time. “Needless to say, your mom’s failing health has become a focal point for you to focus on how the past inserts itself into the present,” I say, trying to summarize how Tamara is filled with a stew of complicated and painful feelings, set off by her mom’s failing health. “Maybe there is opportunity here to begin to see yourself independent of how your family saw you,” I say, trying to introduce the notion that she does not have to see herself the way she feels her family sees her. “That would be nice,” Tamara says, “very very nice.”

Posted in Aging, Siblings | 2 Comments »

The Ailing Mom

Posted by Dr. Vollmer on April 4, 2011

elderly care

 Tamara, fifty, is watching her mother’s slow and long decline as her mom travels in her last chapter of her life. Tamara’s mom, Thelma is eighty-eight years old and her health has been slowly declining for thirty years. She has type II diabetes, heart disease and rheumatoid arthritis. Her mind is good and active, but Thelma’s body betrays her more and more every decade. Her diabetes, although well controlled, seems to have caused her significant mobility problems along with problems transferring from a bed to a chair. Without limited ability to transition, Thelma is almost, although not completely bed-bound. Tamara is helpless and sad. I offer Tamara support, but the realities of Tamara’s struggle watching Thelma slowly lose functioning is heart-breaking and lonely. Sure, Tamara has siblings, three of them, but for reasons which are not clear to Tamara, they do not seem to feel sad or helpless about Thelma’s situation. They seem to take it in stride, or at least that is how Tamara perceives it. Tamara has a husband; she has been married for twenty-eight years. “He tries, but I don’t think he understands how I am feeling either,” Tamara explains to me. “And your children?” I ask, knowing that Tamara has three children between the ages of eighteen and twenty-two. “They try, just like my husband, but it still feels really lonely,” Tamara persists in telling me how alone she is feeling dealing with Thelma. “What would make you feel less alone?” I ask. “If I had someone I could talk to every day about what it was like for me to visit Thelma. I mean I can talk to my husband every day but he changes the subject and that drives me nuts,” Tamara explains.  “Is there a way you can soothe yourself?” I ask, wondering if she is taking care of herself through the stress of Thelma’s decline. “Well, I am here,” she says, almost humiliating me with my question. “So, does coming here feel nurturing?” I ask, so as not to assume I know the answer, since I don’t. “Yes and no,” Tamara says. “I think you understand, but it is not like I can call and chat with you after I see my mom and sometimes I feel like I really need that,” Tamara explains. “Maybe you can tell your husband that you need him to listen better,” I say, trying to have Tamara’s support system work better for her. “That’s a lot of work to teach him to listen, but I guess I have no choice,” Tamara says with dismay. “I am sorry about your mom,” I say, implying that we have to stop soon. “Yea, thanks,” Tamara says, with a tone of appreciation and a tone of sarcasm at the same time. I wonder to myself how much Tamara has trouble taking in the support of others who really care about her. I think I will weave that into our next session, if that still makes sense. The epidemic of middle-aged folks dealing with ailing parents hits me once again. I wonder about community support systems that can help people like Tamara. I will look into that. A multi-pronged approach makes sense, yet again. It is time to bring out the big tool box.

Posted in Aging | 3 Comments »

The Accidental Patient

Posted by Dr. Vollmer on March 1, 2011

Jack, fifty-four, was telling me how hard it was to cope with his ailing ninety-three year old father. He agonized over how much stress his dad was putting on his fifty-six year old sister, Juliana. I wondered aloud, “maybe I could meet her; maybe that will help me understand you better. Also, maybe I can suggest some ways for her to get some relief.” Jack, hesitant and enthusiastic at the same time, said “well, I will ask her.” Six months later, Juliana and Jack come for a session. Jack sits there quietly as Juliana and I get to know each other. Juliana is there as an informant, not a patient. I need to tread gently, so as not to make her feel like she is the focus of attention, yet at the same time, my questions are directed at her about her concerns about her dad. Some moments are more sensitive than others. She tells me that certain things are private and she would rather not discuss them. I readily agree, but I am curious about whether the issues are private or shameful. Maybe that is the same thing. At the end, Juliana and Jack leave. I think the session went well, but I am not sure. Jack returns to his next appointment with great enthusiasm. “Juliana wants to go to therapy,” he says with great hope. Juliana has never been in psychotherapy, and in the past she had little respect for the process,  but she is now open to going. Although she has had struggles before her father became frail, she has refused any mental health intervention. Now, Jack feels the tides are turning. The one session with me, according to Jack, made Juliana realize that she could be understood; that her conflicts could be resolved, at least partly. Maybe she also felt unburdened. It seemed that way to me, although I am not sure she would agree.  “The accidental patient,” I say aloud to Jack, thinking that I was not sure that Juliana would be open to  psychotherapy. In the end, Juliana felt like a dry plant, with psychotherapy giving her the needed water in order for her to survive her fears. The experience of feeling heard can be powerful. I know that, but it is always a challenge.

Posted in Aging, Death and Dying, Psychotherapy | 2 Comments »

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