blog1

There is an anecdote that I sometimes tell patients in an attempt to enlighten:

How do you get an anorexic to eat?  You have to stop WANTING them to eat.

I recently saw a patient who told me that “being in therapy with you is very different from all the other therapists I have seen”.

I believed her because the patient had recounted to me the numerous other therapists they had seen before coming to my office.  The previous therapists had all failed, and the patient’s issues persisted.  I imagined that my predecessors all tried to be helpful to the patient and failed miserably.

I did not try to be helpful, despite my patient’s determined and persistent efforts.

It appeared to me that the patient did not WANT to be helped.  They wanted me to WANT to be helpful, to want something from the patient.  This way, the patient felt they had value because someone wanted them to do something (change).  And on the few occasions where I did try to be helpful, my efforts were rebuffed and I was left feeling handcuffed and that whatever I had to offer was of no value to this patient.  They were the only ones in the consulting room who had anything of value, and they needed me to keep wanting to engage in my futile efforts to be helpful.  As long as I kept WANTING from the patient, they kept coming to my consulting room.  Once they realized that I no longer wanted  anything from them, they left.

I think at times that for some people wanting is anathema.  Wanting or wants have to be gotten rid of.  And an effective way to accomplish this is to not want anything.  Anorexics don’t want to eat, addicts don’t want to stop using, etc. etc, etc.  Their wants are projected into the persons around them.  The family and professionals who obligingly want the anorexic to eat and want the addict to stop using.

The one thing these people I am describing cannot tolerate is someone not WANTING them to do anything.

This leaves them wanting.

A fate worse than death for some people.

So the game goes on.

Dr. Brody

This was an advertising slogan from my childhood, “satisfaction guaranteed”. I believe it was for cigarettes.

And along came “Betcha can’t eat just one”.

And of course the Queen offers to Snow White a wishing apple and says, “One bite, and all your dreams will come true”. Echoes of Eve in the garden.

Now today we have “binge watching”.

None of these result in satisfaction.

But they may result in addiction.  Addiction to more and more and more.

None of these appeal to appetite.  Appetite can be satisfied.

They appeal to greed, which can never be satisfied.  Greed always demands more, and more and more.

In the consulting room, I frequently listen to patients and I sense I hear echoes of all this.

He is tormented. He works hard, never cheats on his wife, takes care of the children, cooks and gives his wife anything she wants.  And yet his wife won’t pay him any attention or be intimate with him.  His solution is to assume that there is something wrong with him.  He is never enough.  He cannot conceive that it is his wife who perceives that he is never enough to hide her own feeling of not being enough.  She hides behind her entitlement which he can never satisfy so he must be at fault.

The parents are dismayed.  They can’t understand why their child has no regard or respect for them or anyone else.  He has become a monster that does not appreciate what the parents have done for him.  After all they have done for him, he lacks any sense of value.  Nothing is ever good enough for him.

It appears that greed and addictions are alive and well, which has been known by politicians, advertisers, con men, gurus and cult leaders for eons.

To me, a central issue in all this is the feeling one grows up with of “I’m never enough”.  Curiously, it appears that if you neglect a child or spoil a child you get the same result, a feeling of “I’m not enough”.

This leads to all sorts of remedies which in the end are attempts to rid oneself of this feeling.  All these remedies are greedy.  All these remedies result in addiction.  The remedy is always more and more and more of whatever to get rid of the “I’m not enough” feeling.  But they all fail.  Because greed cannot be satisfied.

When is enough, enough?

When am I enough?

Can one be satisfied?

Can I be satisfied?

Or if I feel satisfied does that mean that I am really not enough and that I have settled for less because I couldn’t have more?

I reread this writing and find myself feeling pressured to provide some answers, some solutions.

But I resist, because if I do, then I will become just another expert, know it all with all the answers.  Another con man.

The difficult trick is to resist and allow you, if you will, to find your own answers.

It is your journey, not mine.

My journey started a long time ago.

As Fritz Perls one said, “Everybody wants to be somebody, nobody wants to grow”.

Dr. Brody

We all need some directions, except for John.

John was a handyman I employed some time ago.  He could build and fix and assemble anything.  One day I asked John if he could put together a stereo cabinet I had purchased.  It had what seemed to me like a million pieces.  John said sure and went about assembling the stereo cabinet.  When he was done, I admired the finished product.  The stereo cabinet looked just like the picture on the box it had arrived in.  Then John handed me several unused parts to the stereo cabinet.  I asked John why he didn’t use them and didn’t he read and follow the directions.  He replied, “Directions? I just looked at all the pieces and put it together”.

I guess John didn’t need directions.

In the consulting room, patients often ask me for directions.

One patient recently said to me, “You’re the doctor, just heal me.  Tell me what I am supposed to do to be cured”.

Another patient said to me,”You’re a hard man.  You have all the answers, but you don’t give me any”.

First time patients frequently start their first session by saying something like,”I have never done this before.  What do you want me to do?”

I used to give directions.  But not many these days.

I used to think that I was being helpful by giving directions.  But now I think that the only one being helped was me.

On a good day, I am better able to tolerate waiting and seeing what directions will emerge from the patient. I have less of a need to prove I have all the answers and know everything.  After all we are there to discover what is in the patient’s mind, not mine.  Even though most patients come to treatment to learn what is in my mind, assuming I have all the answers.  As I frequently hear patients say to me, “You’re the doctor. You went to school, I didn’t”.

But in order to learn about the patient’s mind, I have to empty mine.

I have to proceed without directions.

Dr. Brody