Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Families’ Category

Mothers and Daughters

Posted by Dr. Vollmer on June 15, 2016

Mothers need to separate from daughters. Daughters need to separate from mothers. Each yearns for a close relationship, and yet, there needs to be a separation before there can be a closeness, as each needs their own identity. Like a figure eight, there are times when their lives are intertwined, and other times when their lives are far apart and so the dynamic, the journey of their relationship, is hardly ever linear. Issues of rivalry, control, and independence, come in and out of the foreground as each party struggles with her own sense of being in the world. Lila and Zoe come to mind. Lila is a thirty-two year old female, insecure, and confused about her future. Zoe is a sixty-year old female, cancer survivor, retired school teacher, who is happily married to Lila’s father, but who feels that Lila needs her help to navigate her future. Lila has mixed feelings. She wants her mother’s help, her guidance, her advice, but at the same time, when she talks to her mother she is left feeling helpless and inadequate. “Why do you seek your mom’s advice?” I ask Lila, knowing that the answer is layered with conflicting feeling, but hoping to begin a dialogue about these issues. Lila understands that talking to her mother dents her self-esteem, but she also feels she has “no choice” because her mother often has “good ideas”. “You have good ideas too,” I say, hoping that Lila can come to understand that her brain is a good resource for her, if she could allow herself access to her own thoughts. Lila struggles, as if she does not quite believe me that she has the  capacity to make good decisions for herself. Our work continues, slowly, with the hope that Lila can learn to trust herself. This will allow Lila to have more self-confidence, and ultimately a more adult relationship with Zoe. The figure eight of their dance continues, now at the intersection, but working towards a separation leading to another coming together, but the figure eight is three-dimensional such that their next connection will be at a higher level.

Posted in Families, Psychotherapy | 2 Comments »


Posted by Dr. Vollmer on April 16, 2013

Posted in Cartoons, Families | Leave a Comment »

The Forgotten Aunt

Posted by Dr. Vollmer on April 2, 2013


Zoe, from my previous post about siblings, gets the sudden, although not surprising news that her father is in the hospital. Sean, eighty-six, has multiple medical problems, but still, it always catches Zoe by surprise when there is a medical incident. This time, Sean had pneumonia, requiring an inpatient stay. Zoe goes to visit and she begins to wonder about her dad’s sister, an aunt, that she has no memory of ever meeting. Sean tells Zoe to call Aunt Fay, and so within minutes, both Zoe and Fay are crying on the telephone. Fay, ninety-two, tells Zoe that she thinks about her every day and that she has kept up on Zoe’s life by her daily phone calls to Sean. Upon hearing about Sean’s pneumonia, Fay immediately says “it is because he is with all  those women. You have to tell him to slow down.” Fay tells Zoe, as if the two of them are close. Zoe leaves from seeing her dad deteriorate suddenly, with sadness, along with the odd happiness of “meeting” her 92-year-old aunt. Zoe talks to me about her mixed feelings with a heavy heart, both in terms of her dad’s deterioration and in terms of her yearning for a part of her family she never met. Zoe explains to me that her mother, Claudia, did not like Fay. Claudia never allowed her children to spend time with her, and Sean, although very close to Fay, agreed. Zoe, still recovering from her emotional wounds from Berkeley, is further faced with her family dynamics in which there were deep divides. Suddenly Zoe has another memory from her conversation with Fay. “You know she said that my mom never let us meet because we looked alike and we are both really pretty. It was such a strange comment, but I do look like my dad’s side of the family, and that could have something to do with why my mom treated me poorly.” Zoe says, with wonder, as if she does not quite believe her own words. Zoe is now immersed in more family dynamics because she cares for her dad, but this forces her to interact with her siblings. I listen and I imagine Zoe’s subjectivity. I imagine Zoe, with her dad’s illness, thrown back to her childhood memories, which bring up lies, betrayals, and heartless attempts to create children who reflect well on their parents. Once again, listening is a deep experience, like reading a good novel, takes me to a deep place, filled with my thoughts and associations to Zoe, both the Zoe of the present and the Zoe of the past.

Posted in Families, Psychoanalysis, Psychotherapy, Relationships | 4 Comments »

The Forgotten Sibling

Posted by Dr. Vollmer on August 21, 2012

Theresa,, went to Becky’s house for a gathering of family and friends. Becky is one of Theresa’s older sisters and she lives around the corner from Theresa, yet Becky and Theresa hardly speak. Theresa introduces herself as “Becky’s sister” to a consistent response of “oh, I did not know about you.” One friend went even further. “We had dinner with Becky on many Friday nights, and your parents were always there, but we never heard about you.” Theresa, not shocked, but hurt, understood that in her younger years, her siblings and her parents were mean to her, but now she discovered that in her later years, they mentally erased her from their internal landscape. “In a way, this makes sense,” Theresa tells me. “I avoided them for years because they were so cruel to me, so I can understand that rather than feeling rejected by me, they just pretended I did not exist. Still, I was really hurt to hear this.” Theresa tells me, with a confused sense of pain and disappointment. “I can understand you being hit by not being recognized as a sibling, both by your sister and by your parents.” I say, trying to picture Theresa standing at this party, realizing how her family tried to delete her from their lives, while at the same time, they maintained enough contact to invite her to this recent gathering. “It is hard to process,” I say, seeing confusion and pain on Theresa’s face. “Yes and no.” Theresa says, referring to the many years where we have discussed the painful dynamics of her family. “I knew that whenever I go to Becky’s house, which fortunately is not that often, I am going to be hit by something. I always am. I always brace myself. There has been so much bad blood for so many years, that I know that more will surface with each contact. On the other hand, I did not know it would hit me like this. Imagine how her friends felt, knowing Becky for over thirty years and not knowing that I existed. That must reflect poorly on Becky. I would imagine. During that time, I have had significant trauma in my life, so I can’t imagine how Becky did not talk about this with her friends, but maybe she didn’t. Maybe her lack of concern for me is worse than I thought.” Theresa says, as if she is reaching a new level of pain as she thinks about her relationship with Becky. “My friends know Becky exists, even though they have never met her. I guess I care more about Becky than she cares about me. As the younger sister, I so intensely looked up to all of my siblings. I can imagine that as the older sibling, Becky wished that I was not born because I took away our parents’ attention. I guess that wish never went away.” Theresa says realizing that sibling rivaly is so different, depending on birth order. “She might have wished you were not born, and then pretended that as she got older.” I say, highlighting that people speak in wishes. “Wow, that is deep,” Theresa says as she leaves the consultation room.

Posted in Families, Psychoanalysis, Psychotherapy, Siblings | 2 Comments »

Feral Cat

Posted by Dr. Vollmer on July 25, 2012

Ursula, forty-one, has been orphaned since she was sixteen. Both her parents were killed in a car accident, leaving her to the care of her not-so maternal grandmother, who then passed away when Ursula was twenty-one. For the last twenty years, Ursula has had menial jobs, “getting by” as she says. Ursula, to her surprise, met Patrick, forty-five, ten years ago and now they have been happily married for ten years. Ursula’s issue is with Patrick’s parents. She feels them to be “abusive” to Patrick, since they sometimes comment on his life’s choices. “I feel like a feral cat,” she says, “since I can’t really remember having parents, I am not sure what role they play in adult children’s lives.” I begin to think about her “feral cat” comment. When are parents helpful and nurturing and when do they become intrusive?  How does an adult child take in the advice of parents without feeling shamed and bewildered? Is the issue one of self-confidence? If Ursula were more internally secure, then maybe she would be more appreciative of the support offered by Patrick’s parents? Or, are Patrick’s parents trying to ground themselves by latching on to the lives of Ursula and Patrick? “Tell me more” I say, in characteristic fashion. “They think that Patrick should shoot for a better job and I think it is not their business.” Ursula says with a tone of self-doubt. “I mean, I agree that Patrick could do better, but that is for Patrick to decide,” Ursula says, almost inviting me to argue with her. “What if we entertained the thought that Patrick’s parents have a point. Maybe they see a problem and they want to prod Patrick into a more challenging job.” I say, trying to examine this issue from all sides. “That is what confuses me. Maybe that is true, but I just don’t understand parents. I am not a parent, so I do not understand that relationship.” Ursula says, with humility and confusion. She also points to her own sadness for her losses. “Maybe, you feel envious that Patrick have parents who think about his life, and maybe it is just so painful for you to think about what you don’t have.” I say, treading lightly on a profoundly difficult subject. “Maybe,” Ursula says, as she cries deeply.

Posted in Families, Grief, Psychoanalysis, Psychotherapy, Shame | 6 Comments »

Re-Posting With A Question: Why Is This Post So Popular? ‘Advocating For Kids’

Posted by Dr. Vollmer on June 4, 2012

“I can’t deal with that one,” a father says to me as I cringe at the expression “that one”. “You mean Samantha,” I say naming their nine-year old daughter so as to point out that the phrase “that one” conveys tremendous hostility and resentment. “Yes, Samantha has made my life a living hell. She is all I talk about in my therapy. She has made me more crazy than my parents, than my wife, or my work.” This father, Liam, explains to me, causing me to feel for Samantha and wonder how Samantha integrates her father’s resentment of her into her budding self-esteem. I am caught between wanting to explain how his resentment might be deleterious to Samantha’s sense of herself and wanting to support Liam in expressing his feelings about raising what he perceives to be a very difficult child. Having known Liam for ten years, I feel our relationship can tolerate me taking what I imagine to be Samantha’s point of view. “It must be hard for Samantha to feel that she has caused you so much grief,” I say, conveying that Liam’s attitude could be hurtful to Samantha. Liam gets angry and hurt. “Are you saying that I am hurting my child?” he says as tears roll down his face. “I am saying that all parents hurt their children unwittingly, and the job of parents is to become aware of that when that happens so that one can straighten things out, as best they can.” I explain, trying to say that parenting is challenging, resulting in both positive and negative outcomes, always. Liam seems to calm down. “Today might be a hard day,” I say as we close our visit. “You did not do anything wrong,” he says. I needed to hear that.

Posted in Blogosphere Fans, Child Psychiatry, Child Psychotherapy, Families | 5 Comments »

Munchausen By Proxy-II

Posted by Dr. Vollmer on April 12, 2012

A mom makes her child sick and then acts like a wonderful and caring mother who devotes herself to her ill child. Her friends feel sorry for her because she has a “sick” child. Is this hard to believe? Only if you believe in the myth that all mothers want to see their children healthy and happy. Monique was giving her four-year old Ana a laxative and then taking Ana to multiple gastroenterologists complaining about Ana’s chronic diarrhea. Why would Monique do this? You ask. One reason might be that Monique craves the medical attention. She feels the medical attention given to Ana to be nurturing for herself. She might also appreciate the secondary gain of being seen as this “angelic” mother who cares so deeply for her “sick” child. This theme of parents destroying their children supports Freud’s ideas that rivalries can be vicious and the fight for much needed attention, at times, knows no boundaries. Is there any hope for Ana? You wonder. That depends, is my response. In extreme situations, there is no hope. Monique will  physically and/or emotionally kill off Ana’s potential for a healthy development. In more subtle situations, where Monique, when she is in her own personal struggle causes Ana physical harm, where the issue is more intermittent as opposed to chronic, then Ana has hope to rise above Monique’s desire to poison her. Still, even in that situation, Ana is in a bind of loving and depending on a caretaker who is, at times, trying to harm her. This bind can take years and years to unravel. Ana’s desire to protect Monique is at war with her hatred towards Monique. This internal battle is exquisitely painful and unspeakable. Monique’s friends and family see her as a very loving and wonderful mom, yet Ana knows a different narrative. This discrepancy causes the painful confusion which is seen with so many kinds of child abuse, including Munchausen By Proxy. Some mothers consistently love and care for their children. Some mothers consistently try to harm their children. Most mothers love and hurt their children, to some degree, but fortunately, on a much lighter level. Winnicott’s concept of the “good enough” mother comes to mind. The exception, the outliers, help us understand the more subtle issues of parenting. Seeing Munchausen By Proxy deepens this understanding of what parents can be capable of. The stories amaze.

See also…

Posted in Child Psychiatry, Families, Parenting, Psychoanalysis, Winnicott | 4 Comments »

Fathers Always Want Their Sons To Do Well: Not

Posted by Dr. Vollmer on April 9, 2012

“Footnote” describes the dynamics between fathers and sons, where the idealized version of a father who wants to see his son flourish is dismissed quickly. From the first scene, we see the bitterness and resentment that the father has for his successful son. On the one hand, why should this come as a surprise? As a species we tend to feel better when we perceive ourselves as “ahead” and we feel worse when we think we are “less than”. On the other hand, there is a notion that our children are extensions of us, and hence their accomplishment is a reflection on us, hence parents would be proud of the success in their children. Both are true and both are at play, in some measure,  all of the time.

This movie depicts the former scenario in which father and son are rivalrous, perhaps for the love of the wife/mother, as Freud might say. What was charming about this flawed movie was that it felt so real. The accomplishments of the son led to bitterness in the father which led the son to feel bad about himself. No one was happy. As long as they needed to please each other, there would be no joy or fulfillment. Their connection prohibited them from seeing outside of themselves, and hence they were stuck in a very negative place. There was no happy ending.

I would like to think that therapy would have helped all of them. Actually, I feel pretty sure that psychotherapy for any of the pained family members would have helped them separate and see themselves as worthwhile human beings independent of the disappointment experienced by the other. Without psychotherapy, this family seemed stuck in a pattern in which negativity kept spreading wider and wider. It was a depressing movie, representing a depressing family. As expected, the third generation was also afflicted with this disease of disappointment. Like a malignancy, without intervention, it kept spreading. In an odd way, the movie endorsed my profession. For that, I recommend it.

Posted in Adolescence, Families, fathers and sons, Movie Review, Parenting, Psychoanalysis, Psychotherapy, Relationships | 2 Comments »

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