Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Loneliness’ Category

Judy Garland

Posted by Dr. Vollmer on April 22, 2013


Thinking about Judy Garland, having  just seen “End of the Rainbow”, with fellow psychiatrists, we engaged in a heated debate about the nature of her suffering. ?Bipolar, ?ADHD, was the launching pad for the discussion, and yet my thoughts turned to her horribly sad childhood in which, she made money for the studios, and in the process, she was fed prescription drugs to keep the “machine” going. “Trauma,” I said firmly, in trying to understand this icon. She seemed robbed of a time in her life to “play” even though some might say that acting is a form of playing, Judy Garland had to play like she was told and so, by definition, this was not the kind of play in which she could make up her own rules, and have a time in her life in which her activities were inconsequential. This left an inner emptiness, a “zombie state,” as a colleague of mine says, in which she could never experience the sensation of being alive, but rather she enlisted her superego to do what she “was supposed to,” thereby leaving her feeling without satisfaction or fulfillment. She never had a chance to experience her ego, as her superego was running her life, from such an early age. Her many husbands, it seems to me, provided this superego, until one of them tired of the emptiness. She never seemed to know herself, to know her ego, and as such, she could never find a path towards happiness. As Ray Bolger, her co-star in the Wizard of Oz, succinctly stated, “”she just plain wore out.” Like a machine, the gears could no longer turn. Sad, sad, and sad. There is no diagnosis, as far as I can see, but only an incredibly talented woman who never developed a sense of herself. What do we call that? I call that child abuse.

Posted in Child Development, Loneliness, Mental Health and the Media, Mother/Child Relationships, personal growth, Play, State of Psychiatry, Subjectivityy | Leave a Comment »

Social Isolation Is Not Good For Your Health-Proving What We Know Intuitively!

Posted by Dr. Vollmer on March 26, 2013,0,7160788.story

Without connection, we die sooner. So, today’s article in the LA Times, tells us, as it reports from a published study in the Proceedings of the National Academy of Sciences. Sure, we want science to support what makes sense, so sure I support the study. I just hope it comes as no surprise. Emotional needs, like physical needs, are needs, and as such, when deprived, poor mental and physical states ensue. Without nutrition we die. Food is life-sustaining, and so are friends and family, if one feels that these friends and family can provide reciprocity and respect. This latter comment, is, of course, speculation. The study only shows in a gross way, how important people are to other people. I speculate further, that the interactions necessary to sustain life are those which bolster self-esteem and worthiness. Without these, the mind tells the body that life is less important and so there is less of a push for self-care. In other words, as we age, this mind/body connection is even more important, as the body becomes more vulnerable, the need for the mind to “fight” for the body’s survival is more critical. This “fighting mind” is fueled by feeling loved and valued by people deemed important. Some would argue that elderly people in communal living situations live longer because the support of the community helps them wake up each day and look forward to seeing their “friends’ whereas elderly folks who live alone have less incentive to push themselves towards activities. All this to say that “behavioral medicine,” as some call the specialty of mental health, really promotes the obvious-friendship. As I say many times in my posts, the answer is easy. The difficulty is in the execution.

Posted in Geriatrics, Loneliness, Media Coverage, Mind/Body | 8 Comments »

The “A” Team

Posted by Dr. Vollmer on July 17, 2012

“I would have been happy if my mom did not die when I was twelve,” Eliot, age thirty, says with a bold and straightforward sense of truthfulness, without the expected sadness that such a strong statement implies. “I have a lot of friends, but I just don’t feel supported,” Fred, age twenty-five, says about his emotional well-being, implying that his family of origin has emotionally abandoned him. Both Eliot and Fred lack the “A-team” I tell them, saying that a parental support system is something that one needs throughout life. There is this craving for nurturing and care taking that only a parental figure can provide. This parental love, I explain, is this asymmetrical relationship where the parental figure wants to see the childlike figure flourish to the best of his ability. This relationship is sometimes created in adulthood  through mentorship,  through marriage, and/or through psychotherapy, but friendships rarely create that kind of sustained nurturing. The lack of this parental feeling creates in both Eliot and Fred a sense of “missing,” despite having so many other important relationships in their lives. “It is hard to tell people that you wish you had parents, meaning people in your life who cared for you in that nurturing way,” I say to Eliot, as he begins to cry. The loneliness of this missing, and the difficulty in conveying this absence, is so deeply painful. “Everyone needs an ‘A’ team,” I repeat to Fred, who often wonders why he is so despairing at times. “Yea, and I don’t have one,” he says with dismay, communicating that his family of origin has let him down and that he does not feel like our relationship serves that function for him. “Maybe you will be able to create one,” I say, hinting that he can cultivate relationships, including ours, to help himself feel more loved and cared for.

Posted in Attachment, Loneliness, Psychoanalysis, Psychotherapy | 4 Comments »

Desperate As A Sad Self-State

Posted by Dr. Vollmer on July 5, 2012

Nathan, twenty-five, feels “desperate” for connection, as he relates his feelings to me. “I don’t find myself very likeable, so why would anyone want to hang with me?” He asks, conveying a low self-esteem, which has persisted since he was an elementary school student. “I have never really had friends.” Nathan says, as if proving his unworthiness. “Why do you think that is?” I ask, wondering how he strings together his own impression of himself and the outside world’s impression of him. “I think that people like me initially. I mean, I am really good at parties. I ask lots of questions and I am pleasant to talk to. Yet, as people get to know me, they lose interest.” Nathan says, as we explore his vantage point with regards to his interpersonal struggles. “Why do you think they lose interest?” I ask, trying to gather a larger narrative. “I think they lose interest because I feel so bad about myself, that at some deep level I push them away. I think they recognize how needy I am, and that scares people.” “Needy of what?” I ask, again trying to draw him out. “Needy of affirmations that I am a good person.” Nathan responds quickly. “You mean that if you had more self-confidence, then your friends would have more patience with you.” I say, emphasizing how importance self-confidence is to having deep relationships. “Yes, no one wants to be around people as needy as I am. If they don’t tell me how important I am, then I begin to get insecure and feel that they don’t like me any more.” Nathan says with brutal honesty. “It is great that you can articulate that process,” I say, impressed at his insightfulness. “Maybe we can figure out why your self-confidence is so low,” I say, pointing our therapy in the direction of self-esteem and away from his direction of loneliness. “I need sunglasses to leave right now.” Nathan says as a way for me to understand how sad he is feeling in this moment. “Yea, I get that and I am sorry about that.” I say, understanding that he is feeling very deeply as the session ends.

Posted in Loneliness, Psychoanalysis, Psychotherapy | 3 Comments »

Unloveable Loneliness Turns

Posted by Dr. Vollmer on August 16, 2011

Roger,, did break-up with his girlfriend, predictably, having recently found Roni, his new girlfriend. The security of his new love  helped him transition away from Charlotte. “I am so weak,” Roger reports. “I can’t seem to be without a woman in my life, otherwise I feel horrible.” “I remember when we worked together when you were a teenager and you only felt good when you were high.” I remind him, pointing out that throughout his adolescent and adult years, he has always relied on an external source for validation. In the past, illegal substances made a big impact on his self-esteem; they made him feel confident, a feeling he rarely experienced sober. Now, it seems that he has substituted female attention for drugs, such that without a romantic interest, Roger feels fragmented and anxious. “I guess I am moving in the right direction. It is better to rely on other people, rather than drugs to make me feel good,” he says with a combination of sarcasm and authenticity. Roger realizes that the defect is internal, and he needs to work on that, but he does not know how. “The more we can try to understand your insecurities, the more you can form relationships which are based on reciprocity and not neediness.” I say, telling him what he already knows, but feeling like some points need to be re-stated to focus the conversation. “I want to write,” Roger says, “that would help me understand myself better.” “Maybe you should start a blog,” I say, knowing that I do this blog, and knowing that his generation is a lot closer to this world than I am. “Yea, maybe I should. I think I need to put words to paper to illustrate my internal process better, although I say that, it is very hard for me to get started.” Thinking about my blog, I understand the problem with initiation, along with the fear of what might come out of one’s head. “I know what we are talking about is important, but I have to say I am happy now. I am excited to go see Roni.” Roger reports with great enthusiasm. “That’s great. I will look forward to hearing about your new relationship.” I respond, both with happiness for him, but also with a bit of wonder whether Charlotte will return.

Posted in Loneliness, Musings, Psychotherapy | 4 Comments »

Loneliness Recedes

Posted by Dr. Vollmer on August 15, 2011

Rosie,    is happy today. The loneliness of the previous week receded, replaced by a feeling that life is full and interesting. “What happened?” I asked, trying to weave a narrative which is more integrative, rather than fragmented. “I met some new people over the weekend, and they were really fun. I had good times with some old friends. I just felt better and more excited about things. I am still distracted by my thoughts about Ryan, but they did not dominate my mental existence like they have in the past. I saw Ryan and that was nice too. I just don’t feel so obsessed. What you said last week made sense to me. I can’t let Ryan rule my thoughts. I need to expand my head to think about other people.” Rosie explains this to me with the enthusiasm, so characteristic of young adulthood. Hearing her excited tone, I think back to just a few short days ago when she felt so isolated, so alone. “Wow, your mood is so much better. I can really feel it.” I say, wanting to point out to her that although she has low times, she also has excited times, and it is hard for her to keep in mind these ebbs and flows. “I am just proud of myself about the way I arranged my weekend. Everything worked out exactly as I had hoped. It was really nice. I tried new activities and I was scared at first, but in the end I was glad I went.” Rosie continues with her upbeat tone and enthusiasm, along with a self-congratulatory experience which feels to me like the beginning of her building self-esteem. “Maybe facing your loneliness propelled you forward to taking some social risks.” I said, appreciating her courage in the last session where she spoke about her obsession with Ryan. “Maybe,” Rosie says. “All I know is that I feel really good right now.”

Posted in Loneliness, Psychotherapy | 2 Comments »


Posted by Dr. Vollmer on August 12, 2011

   Rosie, twenty-five, just told her long-term  friend Ryan, also twenty-five, that they had to “stop seeing each other.” At one time, Rosie and Ryan were lovers, but then they transitioned into “friends with benefits,” then they changed to “just friends” until Rosie finally decided that Ryan “was not good for me” so she “ended it.” Now, Rosie feels at sea. Despite having few other deep friendships, she still wonders why no “one calls me, ever.” Rosie did not anticipate the gaping hole in her emotional life that would appear after she asked Ryan to leave her friendship circle. Rosie now feels depressed and wants to “take it back. ” Despite the problems she had with Ryan over the past ten years, this feeling of emptiness is so bad, that she wants to call Ryan and see if they can be friends again. Sure, she has done this dance many times. Sure again, Ryan always agrees to return to the friendship. Ryan is also a lonely guy and he has trouble making new friends. So, the cycle of Rosie and Ryan, like the cycle of Monte and Marla goes on for quite some time. Rosie comes in saying “you just don’t understand. I am so unhappy. I did not like having Ryan in my life, but I don’t like my life now either. ” Her bind seems so painful. I see that Rosie is too afraid to be vulnerable with other people such that she constantly retreats to the safety of Ryan, who although she feels bored by him, she is also comforted by the fact that she can feel comfortable with him because he is so devoted to her. This comfort has allowed Rosie to be mean to Ryan, because she knows that despite that, Ryan, also desperate for attention, stays in the relationship. This dynamic makes Rosie feel guilty about her behavior towards Ryan, but she also appreciates that she needs Ryan because he withstands her cruelty towards him. Ryan, for Rosie, is in many ways a stand-in for Rosie’s mom, who also was unable to set any limits with Rosie. “It is hard for you to be vulnerable in relationships,” I say, making a clear and obvious statement, hoping to help Rosie see how her dynamics lead to her loneliness. “Yes, that is right,” Rosie says, “but I am still going to call Ryan and see if he is free for dinner tonight. I know it is the wrong thing to do, but I can’t help myself.” “I understand your dilemma, ” I say, “but I hope you have thought this through. “

Posted in Loneliness | 2 Comments »

Unloveable Loneliness

Posted by Dr. Vollmer on July 28, 2011

    Roger, thirty, is terribly afraid to break up with his girlfriend, Charlotte, also thirty. His emotional life feels very black and white. When he talks to Charlotte and they have a good conversation, he likes his life, he likes his family, he likes his friends. On the other hand, when they have a disagreement, he gets scared they will break-up, and then he imagines a loneliness which is unspeakable. On those days, he does not want to get out of bed; he does not want to go to work and he does not want to talk to his friends. As he puts it, “I just want to cry all day long.”

   Roger is a strikingly handsome, wildly successful man who comes from a stable and loving family. From the outside, it is hard to imagine that his internal world is so dark. “My family loves me. I have no doubt about that,” he says, in a way that makes it sound like he is so puzzled that he is going through such a hard time. “I can feel that your family loved you, but what is interesting is that somehow you do not feel loveable,” I say, trying to explain that his fear of breaking-up with Charlotte, is based on a primitive fear that he will never find anyone to love him; that he is essentially not worthy of love. “Maybe that is why I drink too much,” he says, looking at me with deep understanding about what I am saying. “Numbing the pain only goes so far,” I say.

   Roger, despite his good looks, and despite his material success, he  has not had many girlfriends, nor has he had many “hook-ups.” It seems, from the outside, that he has been reluctant to share his heart with anyone. Charlotte won him over by pursuing him aggressively, he explained to me. “She would not stop bugging me,” he said, with deep admiration and gratitude for her persistence. “So now, when you worry that she could pull the plug, you see that she can go after what she wants, but you are more hesitant to do that,” I say, stating how passive he has been with romantic relationships. I was trying to tie his passivity to his fear that if they part ways, he will feel unable to reconnect with someone else. “I have no confidence,” Roger says, with a sad and moving expression. “I am insecure,” he repeats. “It is really good you can see that,” I respond, saying that his insight allows us to probe deeper. “This is going to take forever,” he says with impatience, touched with a bit of humor. “We will see,” I say, closing the session on a note which felt both deep and hopeful.

Posted in Loneliness, Psychotherapy, Relationships | Tagged: | 6 Comments »

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