Zach, having come consistently for a year, https://shirahvollmermd.wordpress.com/2010/07/16/the-no-show/, did it again. His standing appointment, every week, same time, comes around and he does not show up. He does not call me. Hmmm, I think, what is going on here. Do I call him, I wonder. I do call, get his voicemail, continue to wonder. Did something happen? Somehow, I do not think so, but maybe. Is he doing his avoidance thing? I think this is the most likely. What is he avoiding, I ask myself. I think long and hard about our last session. There is the upcoming family reunion that he was dreading. Maybe he felt guilty about talking about how much he did not want to spend time with his family. This seems to make sense to me. I have a working hypothesis; a theory to test out when he returns. When will he call me to let me know what is going on? I notice that. Does he worry about me worrying? I don’t think so, but I wonder why not. Is he not used to people being concerned about him? Does he resist taking care of me in that way? The richness of the no-show comes alive. It gives me pause and deep thought that helps me understand Zach, or at least stimulates questions I have for Zach, in a way that showing up every week does not. At the same time, the frustration of not knowing what is going on lingers and is uncomfortable. It feels like the picture above. There is a missing piece, and I want to find it. Something terrible could have happened. I really hope not.
Shirah Vollmer MD 