Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Couples Therapy’ Category

The Complicated Marriage

Posted by Dr. Vollmer on September 18, 2012

Jo, fifty-one, female, got a huge job promotion. Her husband, Joey, told her not to take it. “We have five kids, and I have a big job, and I just don’t think it is good for our marriage or our family,” Joey says to her, in my presence. “Yes, but what about me? What about what I want? I won’t get this opportunity again. This is an executive position that I have wanted my entire professional career. How can he tell me not to take it?” Jo, looks at me, almost begging for support from a fellow female. “Look,” Joey responds. “Our kids need a lot of attention. I mean all kids do, but ours especially. Brittany, our twelve-year old needs to go to educational therapy twice a week. Rachel, our ten-year old, does club soccer and she needs our support to take her places. Sure, we can hire help, but I just don’t think it is good for our kids.” Joey says, as if appealing to me that I should arbitrate this major crossroads in their marriage. I stay neutral. “It must be hard to navigate these waters when there are so many things to think about.” I say, trying to help them problem solve through this dilemma. Jo, though, is not interested in problem-solving. “I am taking the job and that’s that.” She says, almost defiantly. “How will you feel about Joey’s disappointment with your decision?” I ask, curious to see how she thinks about how her actions impact her marriage. “I have been plenty disappointed with many decisions he has made and we have dealt with that,” Jo says, almost as if she is taking the job out of a sense of retaliation. “There seems to be so much bitterness in your voice,” I say, trying to help Jo reflect on her tone. “I am bitter, but we will deal with it and the kids will be fine, and we will appreciate the increase in my salary,” Jo says, reminding me that there is a big financial gain from her perspective. “I think it is important for your marriage and for your children for the two of you to have a relationship of mutual respect and bitterness could interfere with that.” I say, trying to help them be more supportive of one another. “We will be fine,” Jo says in a dismissive tone. “I hope so,” I repeat, suggesting that there is still work to be done.

Posted in Couples Therapy, marriage, Psychotherapy, Relationships | 4 Comments »

Relationship Problems, Otherwise Known As The Porcupine Dilemma

Posted by Dr. Vollmer on August 20, 2012

In Parerga und Paralipomena, published in 1851, Arthur Schopenhauer created a parable about the dilemma faced by porcupines in cold weather. He described a “company of porcupines” who “crowded themselves very close together one cold winter’s day so as to profit by one another’s warmth and so save themselves from being frozen to death. But soon they felt one another’s quills, which induced them to separate again.” And so on. The porcupines were “driven backwards and forwards from one trouble to the other,” until they found “a mean distance at which they could most tolerably exist.”



Posted in Couples Therapy, Relationships | 2 Comments »

The Language of Love

Posted by Dr. Vollmer on December 21, 2011

   Ashley and Eli, both in their thirties, have been married for ten years. Ashley turns to Eli, while in couples therapy, and asks “are you going to take care of me when I get sick?” Eli quickly responds, “it is my duty, so yes, I will do that.” Ashley breaks down into tears. Eli is painfully confused. “Duty” I repeat, “was the trigger.” I say, looking at Eli. Eli gets obstinate. “It is my duty,” he insists. “Maybe so,” I respond, but there might be more loving words you could use to describe your loyalty to Ashley. Eli digs in his heels. He continues to use the word “duty” and he continues to make Ashley cry and feel scared and disappointed in her marriage.

  “Words are such powerful weapons,” I say, trying to describe the brutality of Eli’s insistence on using the word “duty”. Eli seems to resist feeling bad about his word choice and so he becomes more defensive. I realize I have to try another way to help Eli understand why Ashley is feeling so discouraged in their relationship. Understanding and using the language of feelings happens early on in development. I am not sure it can be taught later on in life, but at the same time, as with most things, learning new ways of being in the world is very dependent on motivation.

In the moment of our session, Eli was not interested in seeing the world from Ashley’s point of view. Ashley was left feeling alone, as she often does in her marriage. The time between sessions allows for Eli’s defenses to diminish and so we will have another chance. For now, Ashley clings to hope.

Posted in Couples Therapy | 4 Comments »

Marital Discord

Posted by Dr. Vollmer on February 15, 2011

   Susie, forty-one, feels abused and persecuted by Zane, forty-eight. Zane tells Susie that she is “stupid” and “slow”. Susie does not respond. “What am I supposed to do?” Susie asks me. I love Zane but I hate the way he treats me. “Maybe you can do some pushback,” I say, wondering if she has ever considered that. “Well, yes, I know I need to set limits on him,” Susie says as if she has talked about this issue with a previous therapist. “So, what gets in your way?” I ask, thinking about what she is going through. “I just retreat,” she says with a great deal of sadness. “You retreat because you feel helpless and ineffective,” I say, gently reminding her that she is not helpless, but that she feels helpless. “What if you said that words like ‘stupid’ and ‘slow’ are unfair fighting words and that if Zane wants to help you understand your behavior you are willing to listen, but if he is going to use nasty words, then you are going to walk away.” I say, trying to help Susie have words to set limits with Zane, but at the same time, remind him that she is willing to engage in a constructive discussion about their relationship. “When you say it, it makes so much sense, but how am I going to be able to say that in the heat of the argument.” Susie says, reminding me that rational behavior often gets cast aside when a deep relationship is threatened. “Write it down and keep it in your pocket,” I say, trying to lighten up our discussion, but also being somewhat serious at the same time. “Well, I like the word pushback, so that part I can remember,” Susie says, feeling somewhat encouraged and empowered by our discussion. “Communication involves strategy, so keep that in mind,” I say, thinking about the executive functioning of the brain and how important it is to use higher level thinking when engaged in important conversations. “Easy for you to say,” Susie says as she leaves, half smiling, half serious.

Posted in Couples Therapy | 2 Comments »

‘I Am Glad That is Not Happening to Me’

Posted by Dr. Vollmer on January 13, 2011

    Nora,  complains to Liam that she has broken out in hives. Liam turns to her and says, to Nora’s shock, “well, I am glad that is not happening to me.” Nora responds “well it is happening to you, because it is happening to me and you have to live with me.” Enlightened self-interest is another aspect of empathy, Nora tries to explain to Liam. The narcissistic bubble,, incorporating one’s friends and family in one’s own sense of oneself is essential for survival. In other words, when trouble happens to people in your “bubble” , then it behooves all parties concerned to feel the experience, at least in part. Otherwise, there is a sense of alienation and distance. On the other hand, when unfortunate circumstances arise, it is understandable to feel the relief that one dodged a bullet. The goal is to embrace both feelings for the other, while at the same time  maintaining a sense of separateness. This is the art of a relationships. I support Nora in her plea for understanding from Liam. “You need to teach him how to care about you,” I say, and she agrees.  “It is frustrating though,” Nora says. “Yep” I can hear that, I respond, feeling Nora’s frustration.

Posted in Couples Therapy, Musings | 4 Comments »

Thanksgiving Drama

Posted by Dr. Vollmer on November 27, 2010

   Javier and Luisa, both in their sixties, married for thirty years, three grown children, have verbally violent confrontations almost every day. Mostly, Javier yells at Luisa about something she is doing wrong: folding the laundry, taking care of the dog, taking care of the fish, working too hard. Mostly, Luisa stands there and takes the verbal assault, with little pushback. Internally, Luisa feels helpless and confused, not angry or revengeful. Javier, by contrast, feels self-righteous; he feels like he is “helping” Luisa lead a better life. Javier and Luisa do not come for marital therapy; they come because they are worried about their thirty-year old daughter, Isabel, who is trying to find her way, but in the meantime, she is financially dependent on Javier and Luisa.

    “How was Thanksgiving?” I asked, just wanting to break the ice after a three week separation from our sessions. Luisa begins, “well, we were an hour late to our friend’s house  because Javier started screaming at me about how I did not feed the dog on time. It was a holiday so instead of feeding Spot at 8:00 am, as I usually do, I did not feed him until 10:00 am.” “Let me get this straight,” I say. “Javier screams at you when you are supposed to be leaving. You stand there for an hour, as he is screaming, then you gather your stuff together, arrive at your host’s home, and then you act as if nothing happened.” “That’s right,” Luisa says flatly. “How do you go from feeling traumatized to being social,” I wonder aloud. “I have  years of practice,” Luisa says with her same flat tone. “Maybe we should change the focus of our sessions away from Isabel and towards your marriage,” I say with trepidation. “Javier does not think there is anything wrong with our marriage,” Luisa maintains her flat tone. “Is that true?” I ask Javier. “Yes, that’s true,” he says dryly. “Luisa needs to learn things from me, so I needed to explain to her why it was so wrong that she fed Spot late today,” he stated in a matter of fact way. “Did you need to yell at her?” I ask, thinking that I am defending Luisa, but maybe I need to do that now. “Yes, I needed to yell at her, that is how she listens.” I am feeling bad for Luisa, but I know I need to focus on the task that Luisa and Javier outlined. “Where would you like to go from here?” I ask, hoping they will agree to marital therapy. Javier says bluntly, “I think we have to go back to talking about Isabel.” “OK,” I say, “but if you want to talk about your marriage, we could do that, or I could refer you to someone else,” I say as a further attempt to help them with their dynamics.

Posted in Couples Therapy | 2 Comments »

Staying Together For the Kids

Posted by Dr. Vollmer on August 29, 2010

    “We can’t break-up, it would ruin our kids’ lives,” Randolph and Judy tell me repeatedly. “What makes you say that?” I ask, feeling like I probably know the answer, but I am still curious as to what they will say. “A broken home is such a terrible thing,” Judy answers in a vague way. “And living with marital discord is not a terrible thing,” I respond, trying to be gentle, but realizing that this could sound sarcastic. So often I find myself wanting to expand thinking, knowing that stress narrows the mind. Children are hurt by the actions of their parents; that is a given. Most parents do not want to hurt their children. Finding the narrow path between protecting the children and living an authentic life is the challenge. The answers are not one-size fits all, nor are they necessarily clear from one moment to the next. However, the extreme situations open the discussion. There are situations where it is better for the children when the parents divorce. Domestic violence is the obvious example. Having said that, most of the time the issue is not the gross issue of physical violence, but the more subtle issues of self-esteem, both in the parents and the children. Children suffer when their parents suffer. Parents suffer when their children suffer. Selfish behavior causes suffering; so does martyrdom. Compromise is the challenge; compromise is the goal. How can parents find a way to live a life they enjoy, while at the same time protecting their children from unnecessary trauma and disappointment? These questions are tortuous; the process of sorting it out is troubling. Yet, without a deep thoughtful process, quick and shallow judgments flow rapidly. Words are important. Divorce is not always bad for kids. Kids lives are not necessarily “ruined”. Rather, there are times in life, like with this family now, where there are rough patches. These rough patches are opportunities for the family to re-examine their earlier assumption of family harmony. Randolph and Judy have hit a reflective time in their lives. My hope is that they stick with the reflection so that they can go ahead with a careful examination of the consequences, for themselves and for their children. The outcome is hard to say; the process is key.

Posted in Couples Therapy, Musings | 5 Comments »

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