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Daniel E.

daniel@psychlinks.ca
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When The Patient Walks Through The Door
by Dr. Barry Brody
Retrieved 11/11/2018

When the patient walks through the door…

When the patient walks through the door…

When the patient walks through the door into the consulting room will I be ready to meet/discover them? Who are they today?

If I am not, then I will meet the patient I saw in the last session and in the session before that ad infinitum. Same problems, same patient, different day. Like the patient is one of the chairs in my waiting room–-never changing, always there, always the same.

I had a supervisor in graduate school that said that every session had to be “minted” anew. Each session was fresh and had to be discovered-–like starting from zero. I didn’t understand that back then, but I think I do now.

There is a scene from the movie “The Natural” where Robert Redford realizes that his pitcher is throwing the baseball game. So Redford tells the pitcher, “Give ’em the real stuff”.

Here is a scene from the consulting room:

He starts twice-weekly treatment complaining of anxiety and depression. He eventually reduces treatment to once weekly and then will end treatment. From the outside looking in every session appeared to be all the same. Same complaints, same problems, same lack of movement or progress. I could see that he was different from session to session, but I was unable to have him allow himself to discover that he was different–-that the same complaints and problems were really all a way to hide the “real stuff”. He was so desperately afraid of discovering/revealing the “real stuff” that he ferociously clung to his unchanging problems, complaints and feelings.

I imagine that when we are babies we discover a lot-–sometimes what we find is terrifying, sometimes joyous, and everything in between.

But then we grow(?) , the process of discovery frequently is ignored or becomes calcified and hardened. We prefer to discover the latest technology, what’s on TV, what’s playing at the movies. But the discoveries of ourself are left in the dust sometimes to be triggered by a shock-wave from life that inadvertently gives us a peek at the “real stuff”. Perhaps this is what drives people to enter therapy. They are shocked at the discovery and want to understand it or make it go away.

I understand that discovering the “real stuff” is a painful and potentially dangerous process. We all need to balance our sense of security and identity with the process of uncovering the “real stuff”. Too much “real stuff” can upset the apple cart. It can lead to divorce, a breakdown or breakthrough or a sudden change in our lives. There is a certain security in believing that we are constant. That we are who we are. That there is no more to discover about ourselves. We all desperately cling to our unchanging life circumstances as a sense of security, even if our lives are dull and unsatisfying. There is a certain sense of security in knowing that this is the way it’s supposed to be.

Another view is that life is not constant, nor are we. That there is an endless supply of the “real stuff” waiting to be discovered. And that the only constants are objects–-chairs, trees, etc. But hurricanes quickly destroy this notion, for a brief time.

But if we are not constant, if we are not finite, if we are not pieces of furniture, then what? Where are we to get a sense of security from?

I am always in awe of couples I see that start every session with the same argument they have been having for years. I usually get the courage to tell them how I marvel at their ability to keep their relationship in the very same place. I also will tell them that a relationship is alive and it takes a great deal of energy and persistence to keep it from growing and changing–to avoid the discovery of the “real stuff”. While this avoids any growth or change in the relationship, it also provides a sense of security. The security that comes from knowing the unchanging landscape of my life is a never-ending argument with my partner. But then what would be the cost of changing this?

Most patients, at the beginning of therapy, tell me that they are willing to do anything to get rid of their problems and change their lives. I believe that consciously this is what they want-–anything to remove the pain.

I also believe that the “anything” that may be required is to discover their “real stuff”, and these discoveries will be mightily resisted.


Barry Brody, Ph.D., L.M.F.T. is a licensed marriage and family therapist with a Ph.D. in clinical psychology. He has his private practice in Lake City, Florida. He also maintains a forensic mental health practice and is an expert on Parental Alienation Syndrome.
 
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