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Archive for February 2nd, 2010

I can’t complain.

Really, I shouldn’t.

But I will.

Because it feels good.

We all need to ventilate anger.  That means containing it, taking it to an appropriate place (like a therapist), and putting it into words.

A patient told me last week about his elderly mother, who, after a long, healthy life, was struck down unexpectedly in her mid-eighties with a severe illness, and hospitalized for two months.

Now, recently released and confined to her bed, she is miserable – and making everyone around her miserable, too.

She has plenty of reason to be angry.  This illness was plain bad luck, and it seems unfair that it should strike a woman who has always exercised and taken care of herself and never before been sick a day in her life.

It’s a lot to adjust to.  She will require kidney dialysis every other day for the rest of her life.  Her limbs are swollen and painful. Her attention span is short, and she has painful headaches.  She was once an avid tennis player, but is now reduced to using a walker to get around.

The problem, my patient told me, is that his mother is taking her anger out on the people around her, specifically her long-suffering husband.  She barks at him, criticizes everything he does – essentially makes his life miserable.

I proposed psychotherapy, but my patient only shook his head.  His mother’s rule has always been self-sufficiency.  Asking for help is out of the question.  She survived the Holocaust, and she’s tough as nails.  It is a point of pride for her never to complain, and never to ask for any assistance whatsoever.

That’s a shame.  Admitting weakness can be a sign of strength.

The problem with my patient’s mother is that she’s filled with anger, but has no healthy way to express it.  Putting it into words – complaining – is forbidden to her.  Instead it leaks out as misdirected anger, which usually ends up aimed at those who happen to be closest to her but least deserve it, like her husband.

Since his mother absolutely refuses to speak with a therapist, I told my patient he’d have to fill that role – to try to be the therapist his mother refuses to see.  I gave him a few pointers.

First of all, he has to get her talking – and keep her talking.  That means staying syntonic – going her way, not offering any resistance to any of her thoughts and feelings, but encouraging them.  Active listening, or “mirroring” would help, too.  That’s a technique in which you repeat back snatches or paraphrases of what the other person is saying, so she knows you’re there, and that you’re paying attention.

Like this:

His mom – “I hate this damned walker!  It’s humiliating to be disabled like this!”

Him – “It must be tough for you to have to use a walker after always being so active.”

A couple more pointers:

He will have to monitor and contain his own responses to her.  It wouldn’t be very productive if he lost his temper in the middle of their time together and started yelling back at her.  I recommended he wear “emotional insulation” while listening to her.  He could have his reactions – anger at the outrageous things she might say, or fear at the terrible experiences she’d endured – but he would contain them so they didn’t distract from his mission.  He couldn’t lose track of the goal:  to let her vent her upset in a way that would provide her relief.

One final thing:  I told him not to try to problem solve.  His mother – and most people – don’t want advice.  They want to be listened to and heard.  Real problems don’t have easy solutions, and the person with the problem is best-positioned to find one if it exists.  The goal is to parallel process.  While he listens, she explains the problem – and in doing so, works out an answer on her own.

I warned him that it might take a while – maybe an hour, the length of a psychotherapy session – maybe several hours divided over multiple sessions.  But eventually, if he stuck with it and got her to vent some upset and unhappiness, he’d detect a change.  I would expect to see a lightening of mood, with a return of interest in other people.  She might suddenly snap out of her gloom and say, “wow – it’s good to get that off my chest. So how have you been?”

There are a lot of ways a psychotherapy session can play out.  One of them is simply a release of pent-up feelings.  It might not sound as inspiring as a breakthrough session in which the therapist produces a startling intellectual insight.  But sometimes just listening – good, focused, active listening – can make all the difference.  An hour of bitching and moaning to someone, who’s job is to listen, can feel good – and stop all that anger from leaking out or being discharged on some poor, unfortunate by-stander.

One of my patients said therapy sometimes feels to him like a psychic massage.  You walk out feeling relaxed, looser and ready to face the world.

That’s what my patient’s mother needs.  I hope he’s able to provide it.

We all need a good kvetch once in a while.  If you’re in a therapist’s office – or with someone who’s willing to listen and tolerate your feelings – I don’t see how it does any harm.

It might even help.

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