Shirah Vollmer MD

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Archive for the ‘Monte Marla’ Category

Monte and Marla: Oh Not Again

Posted by Dr. Vollmer on August 4, 2011

   As Shelly, a blog reader https://shirahvollmermd.wordpress.com/2011/08/01/monte-and-marla-the-repair/ , nailed it:

“How can Monte trust Marla if Marla didn’t explain herself and her behavior to him? It seems almost too simple that Marla apologized and suddenly appreciated the pain that she put him through. What caused Marla’s change of heart? How is it that Monte has hope that she won’t do it again, with no understanding of Marla’s motivations behind her actions? Is he so eager to accept her friendship and supervision that he can put all his torment behind him at the first sign of kindness?”

   Marla disappointed/hurt Monte again. The details, by Monte’s account are vague; the feelings are not. They discuss cases, see each other at professional meetings, occasionally share travel stories, so Monte comes to see me confused about why he feels so hurt by Marla, yet again. This relationship both grabs him and repels him. It is as if Monte’s emotional life is wrapped up with his sense of whether Marla has positive or negative regard for him; this determines his mood state for days. It is a relationship that baffles both of us. “So what happened?” I ask, as if to imply that the end of the sentence is ‘this time’. “Well, it is hard to describe. I saw her at a meeting and she dismissed everything I had to say. I suppose you could say it was subtle, but it did not feel subtle to me. I suggested that we do certain things for this upcoming professional meeting, and she said publicly that those were bad ideas and that we should do things another way.” “It sounds so mean when you describe that she said your ideas were bad,” I say, trying to understand why Monte is upset and trying to understand why Marla is so important to Monte.

     The fact that there are three psychiatrists at play in this drama seems to make little difference to the common themes of hopes and disappointments in relationships. Monte continues “I just want to feel good about what I do and I want people to support me in my profession. I need collegial validation. Sometimes I get that from Marla and I feel good, but more often I do not get that and I feel punctured. Sure, I can get collegial validation from others, but I have tried to do that and I just feel a sense of competition, not support.” I begin to feel more deeply for Monte. I say, “I can see that you need collegial validation and I can see that you have assigned Marla that role, and I can see that sometimes she has really helped you, but I also see that you are creating a drama with her which on balance seems to make you hurt. Maybe you are looking to Marla to reassure you because you seem to be unable to reassure yourself and you seem unable to find a supportive mentor who is not as unstable as Marla appears to be.” Monte looks at me as though he is feeling understood, but he does not like what he heard. “I guess the whole thing sounds nuts, but I am very sensitive to Marla and I wish I were not,” Monte says, restating his dilemma. Restating Shelly’s words, I say “Marla is not worthy of your trust. You know that.” Monte looks pained, and sheepishly says “of course I know that. I just can’t help myself.” “We need to keep digging deeper so that your thoughts and  feelings can be more in line with one another. The more we can understand what Marla means to you, the easier it will be for you to detach from her. ” I say, emphasizing that Monte’s issues with Marla will help Monte understand his deep emotional needs for this kind of relationship.  In the meantime, the Monte/Marla drama is likely to continue.

Posted in Monte Marla | 2 Comments »

Monte and Marla: The Repair

Posted by Dr. Vollmer on August 1, 2011

 Monte,https://shirahvollmermd.wordpress.com/2011/03/11/monte-and-marla-the-cancellation/ my patient the male psychiatrist in his fifties, who goes to Marla, the female psychiatrist in her seventies for supervision and support, but over the past twenty years has had a tormented relationship with Marla, comes to me with a reversal. “Well, I am sort of embarrassed to admit this, given how much I have told you that Marla was destroying my life, I have come to trust Marla again and I have resumed supervision with her.” Monte says sheepishly, as if he will now be forced to create a narrative to explain how one of the most hurtful people in his life, has now entered into his trust zone. “Wow, either something really big happened to repair your relationship, or you both suffered terrible head trauma to the point where all memories are erased,” I say, validating his thought that I would be shocked at this change of events. “She apologized to me in a nice way for letting me down so many times. She seemed to understand the hurt and pain she caused me and so that softened me towards her.”

    Monte explains in a way that reminds me that even terribly hurtful relationships can mend if there is deep compassion for the hurt that was exchanged. “Are you worried that you are back in the cycle of trust followed by disappointment?” I ask, knowing that their long history together has been marked by rupture and repair. “You know, this time I am not worried, but of course, maybe I should be.” Monte explains that his hunch is that Marla has a deeper understanding of her role in their interactions than she had previously and that gives Monte great hope.

 “You must feel so good Monte to have this relationship repaired. I know it was dragging on you for many years and I know that most of your friends and colleagues told you to move on. I suspect that you are really glad you hung in there.” I said, struggling to understand if this repair will last or if that is just wishful thinking on Monte’s part. “Oh, yes. I am so glad I stuck with Marla. I just don’t have that kind of history with anyone. She watched me grow from a resident to a practicing psychiatrist. That is a long journey, and I relied on her for years and years to support me in my professional development. ” Monte say, with tears in his eyes, explaining that the making of a mental health professional requires both personal and professional growth and that he is amazed that he has matured into his profession. He credits Marla, despite all the hardship, with staying the course. He is grateful to her and he wants her to know that. If their relationship ended with anger and resentments, then the gratitude would be lost and he was scared of that throughout their stormy course. I am happy for Monte, but again, I am a bit weary that he is re-entering a dangerous relationship. “I am glad that you feel so much better about Marla. I just hope you are mindful of possible disappointments down the road. I can imagine that she really wants to maintain a relationship with you, as much as you do with her, but the ingredients for future pain is still there, so I hope you will watch out for that.” I say, speaking like a mother who is happy, but also pleads for caution. “Of course, past behavior predicts future behavior, but if I did not believe in change, I could not be in this profession.” Monte says to me, as if I am being too negative, but at the same time, he appears to appreciate my concerned words.

Posted in Monte Marla | 4 Comments »

Monte and Marla: The Cancellation

Posted by Dr. Vollmer on March 11, 2011

   Monte and Marla reconnect, yes, despite Monte’s better judgment. https://shirahvollmermd.wordpress.com/2011/02/25/monte-and-marlathe-drama-returns/. They agree to meet: in two weeks, Thursday at 3:00 pm. The Tuesday prior to the appointment, Marla calls, unapologetically and cancels the appointment. “I am going out-of-town,” Marla says in a flat tone to Monte, seemingly not mindful that Monte might have changed his schedule to make that appointment work and not mindful of Monte’s possible feelings of disappointment. Monte pauses, thinks to himself, whether he should call Marla out on her insensitivity or whether she should not it to himself and let it go.

      After an extended silence, Monte decides to say in a calm fashion, “gee, when I cancel appointments I feel very bad about it, but you seem to cancel with little regard for how I might be feeling right now, and with little regard for the effort I made in carving out that time.” Marla, as she often does, begins to get angry, and says “of course, I am upset I have to do this.” Monte, staying calm, although feeling aggressive says “well, it is so interesting that you cancel an appointment and now you are angry that you are not understood. That is messed up. Actually, that is narcissistic, since you manage to turn a situation in which you assault me with a cancellation, but now, you feel assaulted. It is amazing how every situation turns into a drama in which you are injured.” Marla is silent for a few seconds, but then she says “guilty, as charged.” “It is not about guilt,” Monte responds quickly, “it is about thinking about my feelings and not yours.” Monte responded that way because the word “guilt” struck him as a deeper narcissistic experience for Marla as now she is wrapped up with feeling bad about herself, and not trying to connect with Monte’s experience. “The problem,” Monte continues “is not the cancellation, but how you keep giving me examples of how you think about your own inner experience, but you are incapable, or uninterested, in considering mine.”  “I think about your experience all the time,” Marla responds with shock at Monte’s comment. “Well, you don’t express that very well, or rather, not at all,” Monte responds, feeling angst that on the one hand Marla says how important Monte is to her, but on the other hand, the conversation feels so one-sided.

    Monte begins to thinks to himself if the reason for the cancellation matters. He concludes in his head that Marla probably is taking time off to spend time with her grandchildren while they are on Spring break. Marla, according to Monte, is too arrogant to confess that, as such an admission would make Marla “too human” and it is Monte’s impression that Marla tries to brand herself as extremely devoted to her work, and in keeping that branding she would not state the reason for the cancellation. Monte is left where he began; understanding the destructive nature of this relationship on his sense of himself, and feeling let down, yet again, by Marla’s insensitivity.  As in Sartre’s play ‘No Exit’ http://en.wikipedia.org/wiki/No_Exit with his most famous line “hell is other people,” Monte’s desire from Marla for validation parallels Garcin’s persistence with Ines. The bind continues.

Posted in Monte Marla, Psychotherapy | 4 Comments »

Monte and Marla

Posted by Dr. Vollmer on March 2, 2011

https://shirahvollmermd.wordpress.com/2011/02/25/monte-and-marlathe-drama-returns/

Posted in Cartoons, Monte Marla | 2 Comments »

Monte and Marla:The Drama Returns

Posted by Dr. Vollmer on February 25, 2011

  Monte returns to Marla, https://shirahvollmermd.wordpress.com/2010/08/26/monte-and-marla-at-it-again/, partly for that sense of continuity, partly for a strong desire for rapprochement, partly because Monte’s therapist took ill. Monte craves for some affirmations, some loving feelings and some mentorship. Marla craves admiration. Predictably, there was an emotional collision. Monte suddenly was confronted with Marla’s insensitivity to his struggles in his practice. Likewise, Marla was suddenly confronted with her angry feelings, stemming from not feeling appreciated. Yet, both acknowledged that there were good feelings between them and that the relationship, however one might characterize this atypical union, is worth maintaining. Monte expresses his disappointment in her. Marla expresses her inability to tolerate his disappointment in her. At the end, they set up another meeting. Both parties are confused. Yes, both are therapists/psychoanalysts with a lot of clinical experience. Some relationships defy explanation.

Posted in Mentorship, Monte Marla | 4 Comments »

Monte and Marla: At it Again

Posted by Dr. Vollmer on August 26, 2010

  Two o’ clock in the morning  Monte  https://shirahvollmermd.wordpress.com/2010/07/05/supervision-ii/ , wakes up, as if invaded by aliens, knows what he wants to do about his troubles with Marla; call Beatrice, Marla’s supervisor. The thought, mysteriously enters Monte’s mind,  seems like such a sensible thing to do. Maybe if Beatrice knew that Marla’s behavior was defensive, inappropriate, and hurtful, then maybe Beatrice could help Marla regain some traction with Monte. Oh, Monte thinks more deeply. By calling Beatrice, he is making  some assumptions. Monte knows that Marla goes to Beatrice for consultation, but he cannot assume that he is the topic of conversation. On the other hand, maybe he is. Monte goes back to sleep. A few days pass, Monte leaps forward; he emails Beatrice, sheepishly, but he does it. Beatrice responds in a kind and sensitive manner saying “I acknowledge receipt of your email. I hope you are well.” Wow, Monte thinks, that went well. Monte breathes relief.

     Monte, a middle-aged psychoanalyst similar to Aaron Green https://shirahvollmermd.wordpress.com/2010/07/20/book-review-psychoanalysis-the-impossible-profession/, has looked to Marla for help with his practice, his interpersonal struggles, and his existential questions. The complicated nature of working in a helping field makes getting help from a therapist/colleague different from it is for lay folks. Monte envies his non-therapist friends who can go to a therapist and then not see them again at a professional meeting or seminar. The overlapping roles of patient and colleague can deepen a relationship, but it can also create a crevice of unsettling feelings. Monte has a large crevice. Calling Beatrice settled Monte down for a bit; momentarily Monte could feel hope that this crevice might shrink.

    Weeks pass, Monte calls Marla. They agree to talk at 3:00 pm that day. An hour after they make that arrangement, Marla calls and said she made a mistake; she has a client at 3:00 pm. Monte is aware, yet again, there is no apology; just a statement of  fact. Marla has no time to talk about it. In an angry voice, she says “gotta go”. Monte is brought back to that feeling of being an open wound. Marla lets Monte down, but somehow Marla is the one expressing anger. Monte decides to let it go; he is not going to talk to Marla. Thirty minutes later, Marla calls apologizing for not being able to talk at 3:00 pm and apologizing for being hasty on the telephone. Monte’s unsettled feelings are now making a bigger crevice. He could attempt to call Marla again, or he could let it go. Either way feels bad.

Posted in Monte Marla, Musings | 6 Comments »

Ambivalent Relationships-II

Posted by Dr. Vollmer on July 29, 2010

    

Marla, https://shirahvollmermd.wordpress.com/2010/07/12/ambivalent-relationships/ called Monte on the anniversary of Monte’s mother passing. “Wait a minute, ” Monte says, “I thought we were ‘broken up’. ” https://shirahvollmermd.wordpress.com/2010/06/18/were-breaking-up/. “I don’t want an ongoing thing,” Marla states emphatically. “An ongoing thing?” Monte repeats. “Then why did you call me?” Monte asks. “Well, I was thinking about you and I thought it might be a hard day for you,” Marla says kindly. “Yes, but your call implies an ‘ongoing thing’. Further, we are colleagues, so we have an ‘ongoing thing’,” Monte responds with overwhelming anger. Marla goes silent. “Besides,” Monte continues, “the nature of our relationship is professional, although it did not start out that way.” Marla continues to be silent.

    The mixed message, the approach/avoidance behavior, that Marla exhibits is painful and understandable. Marla is deeply afraid of Monte’s anger and disappointment. As such, Marla attempts to ward off her vulnerability by saying that she does not want an ‘ongoing thing’. For Marla, this means that she does not want to feel that over and over again she does not give Monte what he needs. At the same time, Marla cares for Monte and she wants to let Monte know  that.

      Marla is a seasoned therapist, and as such, one hopes that she has worked out these ambivalent feelings such that she presents a clear message. The reality however is that for many patients Marla is helpful and clear, but when it comes to Monte, Marla is twisted and unsure of herself. Likewise, Monte is generally even keeled, but when he interacts with Marla, he is irritable and aggressive. As such, the interaction between Monte and Marla is heated with feelings which are unique for both. This uniqueness makes their relationship mutually interesting and scary; hence the ambivalence.

Posted in Monte Marla, Musings | 4 Comments »

Ambivalent Relationships

Posted by Dr. Vollmer on July 12, 2010

  

     Monte and Marla https://shirahvollmermd.wordpress.com/2010/06/18/were-breaking-up/  suffer from a deeply ambivalent relationship, which one day, after twenty-one years  tipped over the edge towards “breaking up”. They had always found each other compelling and repelling at the same time. Marla took great pride in helping Monte through difficult times. Monte took great solace in Marla’s availability and interest. At the same time, Marla could not stand Monte’s tendency towards disappointment with Marla. Monte could not stand Marla’s need to always be the “good mother.” The balancing of these factors stayed in check for many years, until Monte was vulnerable; Marla was unavailable, and Monte was disappointed. At this point, the balance for Marla was tipped towards ending the relationship because the idea of facing Monte’s disappointment was unbearable.

    Joy, thirty, was in love with Jeff for ten years. They had wonderful times together, shared intimate conversations and had a lot of mutual friends. Joy admired Jeff to the point that she returned to school and followed in his footsteps to become a doctor. As Joy went through her medical training, she began to meet other men who interested her. She began to feel that she wanted more experiences so she broke up with Jeff, but she begged him to stay “friends”. Jeff, said “no way”. After six months of Joy and Jeff being apart from one another, Joy asked Jeff to get back together. Jeff excitedly said “yes”. They were together for six months at which point, Joy felt the same way she did before and she broke up with Jeff a second time. Jeff, terribly distraught, said to me “I don’t get it.” I replied “she must be deeply ambivalent”. Jeff says “I guess, but she did not seem ambivalent when I was with her.”

     The to and fro of relationships are part of our culture. We seek happiness, while at the same time, we wonder how much pain we should endure to regain the happiness that once existed. Marla first decided that the pain was no longer worth it for her, yet later, https://shirahvollmermd.wordpress.com/2010/06/28/anger/, she relented and agreed to talk to Monte. Joy broke up with Jeff, and then returned, only to break up a second time. The pain of this ambivalence can be excruciating. Examining the ambivalence is helpful, but it does not necessarily mitigate the agony.

Posted in Monte Marla, Musings | 8 Comments »

Supervision-II

Posted by Dr. Vollmer on July 5, 2010

Marla, https://shirahvollmermd.wordpress.com/2010/06/18/were-breaking-up was struggling with her relationship with Monte. On the one hand, she felt that Monte’s anger interfered with her ability to listen, and on the other hand, she felt that Monte was a valuable member of her committee and so she should work hard at keeping Monte engaged. With this struggle, Marla turned to her supervisor,https://shirahvollmermd.wordpress.com/2010/02/18/supervision/ https://shirahvollmermd.wordpress.com/2010/06/18/were-breaking-up/ Beatrice, whom she had seen for over twenty years. Beatrice, age eighty-six, is long retired from doing psychotherapy, but she supervises a number of her colleagues. She is smart, thoughtful and helpful to Marla. Over the years, Marla and Beatrice have become friends, although they do not socialize together.

Marla tells Beatrice a different story than Monte would have told her. https://shirahvollmermd.wordpress.com/2010/06/27/rewriting-history/. Marla explained that Monte came to Marla for help teaching her class at which time, Marla had some positive input for Monte. Monte would have added that there was no follow-up, and when Monte asked for follow-up, Marla did not respond. Leaving out that piece, Marla explained to Beatrice that Monte is angry with Marla; that she is not sure why. Since Monte has so much anger towards Marla, Marla tells Beatrice that she wants to avoid  Monte.

Beatrice wants to help Marla; she is also Marla’s friend. Beatrice has one version of a story, which Beatrice understands, and yet that is the version she needs to work with. Beatrice says, “Marla you have really helped Monte over the years, and now he has really gotten to you. What is up with that?” Marla replies “well, his anger just makes me shut down. I cannot think.” Beatrice responds “maybe you should think.”

Marla, with deep guilt, begins to review her history with Monte. As stated previously,https://shirahvollmermd.wordpress.com/2010/06/27/rewriting-history/ ,  Marla then offers Monte a face to face meeting. Monte refuses. Marla remains hopeful that he can work things out with Monte. Beatrice has encouraged her to do so. Monte though, feels less optimistic. He feels that Marla has betrayed him such that he cannot forgive her. They are at a standoff. Monte does not know that Beatrice is part of their universe, yet he senses the change in Marla’s attitude and he wonders where that comes from. Supervision can be a powerful experience. Monte knows that. He speculates that supervision has changed Marla’s tune; for the good and bad of that.

Posted in Monte Marla, Musings | 4 Comments »

 
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