Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Loss’ Category

Hiking and Dying

Posted by Dr. Vollmer on September 21, 2015


7 hikers died suddenly. I knew some of them. Did they die doing what they love? I don’t think so. I think they died sad and scared. They left families and loved ones who might define their lives by this before and after moment. The question of “should they have known” will never be known, but many people have very strong opinions on both sides. Estimating risk is the discussion of every adventurer. Every step up a mountain could be one’s last, and yet the thrill of the adventure propels people forward. Most people do not die on adventures, and most people do not know people who have died on adventures, and yet, the risk still looms. There is no good way to think about this, except to say, that thinking about these seven people is how we remind ourselves that we matter, and our friends and buddies who share our passion matter too.  Tragedy has no words, only feelings of pain and confusion. Adventure tragedy is no different. Movies are made, stories are told, but the pain does not change. There is no lesson learned. Yes, slot canyons are very dangerous. Yes, flash floods means there is no way out. Skill and experience matter little. Warnings come and go, and getting information out is not always easy given the limitations of cell coverage. The search for someone to be mad at comes up empty. We cannot funnel our feelings into rage and that makes it even harder. The shock and sadness keeps coming, in waves, which feel like an emotional tsunami, similar to the water which killed these  hikers. They were trapped, as we are now, trapped in the mourning and bewilderment of sudden loss. There is one thing to do. Hold hands with people you care about, because you just never know when that won’t be possible. Yes, I have lapsed into cliché. Mourning has emptied out my language, perhaps explaining why clichés come in handy.

Posted in Loss, Trauma | 8 Comments »

Anniversary Reaction

Posted by Dr. Vollmer on July 19, 2013

A reader writes:” My brother and I were like twins growing up: 14 months apart and inseparable. When I was 25 and he was 26, he died of cancer. At the time, I didn’t grieve hardly at all, as I was raised not to talk about intense feelings much. So…I put a lot of these painful feelings away, and didn’t realize until this past year, when I was going through other stresses, that there was even something called delayed grief. The pain has been overwhelming. I am going through counseling with a really good therapist who is helping, but I am dreading my brother’s death anniversary date that is coming up next month. It is always an extremely difficult month for me. I am especially dreading it this year. I had been doing better lately but the past two days I started crying just thinking about my brother. I miss him so much. He was my best friend in the world and no one can ever replace him. On top of everything else, I have guilt feelings that I didn’t do enough to help him get diagnosed earlier. It has been so many years since he died but it feels like just yesterday.”




In cruising the internet, I found this tale, helping me pinpoint my curiosity about this idea of the “anniversary reaction.” There is something, for some folks, like this reader above, that I will call Zach, in which the anniversary becomes the focal point for grief. It is almost as if Zach’s mind has given him permission to grieve around the anniversary time, whereas at other times, he would feel foolish or “too sensitive”. On the other hand, maybe the anniversary, the time of year, the length of the days, the holidays, bring back a flood of memories which bubble up causing this psychological pain. Either way, and of course, it could be both, Zach expresses this sentiment that “the pain has been overwhelming,” leaving us, the reader, to wonder what he means by that. He is “dreading” his brother’s death anniversary, but what is he afraid of? One imagines that he is afraid of the despair, the heart-wrenching feeling, of helplessness that he cannot bring his brother back. What is “overwhelming,” I think, means that he is fearful that his ego will be taxed beyond it’s typical coping skills, leaving him with no means to soothe himself. In the event that he cannot soothe himself, he fears he will be left feeling agitated and alone, perhaps with a temptation towards conscious or unconscious self-destructive behaviors,  in order to help him escape from his psychological state. All egos, no matter how strong, or well-developed, can face circumstances which exceed it’s ability to find healthy coping skills. On this level, Zach’s fears are understandable. His “good therapist” can help him understand his fears, but by no means, can this “good therapist” protect him from his anticipated need to escape his psychological state. On the other hand, maybe understanding that the ego might, in fact, be stressed in ways that it has never been stressed before, might help Zach be more thoughtful about developing new, and deeper ways of managing, what at this time, seems to be an unbearable reality. Maybe that is what I do.

Posted in Grief, Guilt, Loss, Professional Development, Professionalism | 4 Comments »

The Nightmares

Posted by Dr. Vollmer on August 3, 2012

Madeline, fifty-two, a psychotherapist, comes in after having a “terrible night.” “I just had one nightmare after another,” she reports with utter helplessness. “Tell me about it,” I say, knowing that she was going to, but also wanting her to know that I was curious about the content. “I dreamt I got my period and then I was bleeding non-stop. I think it was like I was having a miscarriage, which I have had in the past. It was like I was reliving that horrible experience, even though that was thirty years ago.” Madeline says, offering up an interpretation of her nightmare. “Do you have any idea why it came to your mind last night?” I ask, wondering if something had triggered her. “Yes, my son is leaving for his semester abroad and I think that is triggering feelings of loss inside of me.” Madeline says, clarifying the connection between her dream and her present state of mind. “Dreams are powerful tools that remind us what we are dealing with internally.” I say, stating what she already knows, but still feeling compelled to say it. “Yes, but I did not like waking up so upset,” Madeline says, as if reminding me not to intellectualize her distress. “Of course not. I am sorry about that.” I say, reminding her that I feel for her. “And what were your other nightmares?” I ask, reminding her that I was thinking about her opening remark. “I also dreamt that I had sexual intercourse with one of my former patients and I was horrified at my behavior.” Madeline says, with some shame, but also knowing that this was a dream, and hence she has no conscious control over the content. “Again, I wonder if you have an idea about what that was about.” I say, knowing that she is aware that I want her to take her dream one step further. “Yes, I think that my eating is out of control and I am mad at myself for gaining weight, so  this dream was in line with that.” Madeline says stringing her anger at herself for her eating together with her anger at herself in the dream. “Your self-hatred came out at night.” I say, repeating her idea, to let her know that I am thinking about what she is saying. “Your internal world is pretty black right now,” I say, ending our session with a summary comment. “You got that right,” she says, leaving a little bit less distressed, compared to the beginning of our session.

Posted in Dreams, Grief, Loss, Psychoanalysis, Psychotherapy | 2 Comments »

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