PSYCHVINE

The following is a second excerpt from Fred’s court referred psychotherapy. Dr. Smelt continues to grapple with achieving a better therapeutic relationship with Fred who remains resistant to this point.

Dr. Smelt asks for more information, “Fred, tell me a little bit more about your feeling of embarrassment. Do you feel that way because you’re coming here to see me or is there more?”

“I really don’t mind coming to this office all that much. I realize that lots of normal people see shrinks. What’s humiliating though is that my neighbor called the police and that I ended up being treated like a criminal.”

“So, are you worried about what your neighbor thinks about you?”

Fred retorts, raising his voice, “I don’t give a shit about what my neighbor thinks about me. He should mind his own business.”

Dr. Smelt responds, “That’s interesting. You started out feeling humiliated and ended up getting angry. Is that right?”
Fred acknowledges, “Hmm, I guess that’s true. So what does that mean? Is that weird or something?”

“Oh, it’s not weird at all. Fact is, anger serves many purposes for people. Tell me; would you rather feel humiliated or angry?” “That’s easy. Angry!”

“So, in your case, Fred, one of the benefits of your anger is that it can keep you from feeling more painful emotions like humiliation and embarrassment. Does that make sense to you?”

“So, what you’re saying,” Fred replies, “is that it’s actually good to be angry, right?”

“Well, not exactly. What I’m actually saying is that anger has a range of benefits, but also costs. I don’t usually recommend that people start trying to change their anger before they understand its costs and benefits first.”

Fred observes, “Well, in the case of my neighbor, I don’t see any costs. We’ve never gotten along and never will. If I quit being angry with him, he’d just walk all over me. What’s the point in that?”

Dr. Smelt processes what Fred has told her. She realizes that she could dive into doing a cost/benefit analysis of Fred’s anger. Much as she’d like to do that, she concludes that right now, Fred is too defensive and guarded to explore his anger productively in that way. She hopes to get there, but not yet. There’s still important work to be done in preparing the groundwork for forming a collaborative relationship. Therefore, she empathizes with Fred instead, “I can understand how you might feel that way. Has your neighbor walked all over you in the past?”

“Darn right he has. He has parties where people park on my front curb right in front of my house.”

Dr. Smelt queries, “Hold on Fred; I’m not quite getting this. Why shouldn’t people park in front of your house?” “It’s my house. They block my view of the park across the street. That’s why I bought this house.”

“So, is it illegal for people to park in front of your house?”

Fred snorts, “That’s another problem. I call the police to tow the cars and they do nothing. The party goers turn around in my driveway and leave oil spots.”

“Really? I guess that could be annoying. I’m curious though, where would you think they should park?”

“I don’t care where they park; just so long it’s not in front of my house!”

Dr. Smelt chooses to avoid confronting Fred for now. She concludes that Fred clearly has problems with anger at work, with neighbors, and with his wife. He seems both volatile and fragile to her. For the remainder of the session, she continues asking questions and makes occasional empathic statements. She realizes that she will need to proceed slowly and cautiously.

Photo Credit: Justin Walther

In Therapy Session 2.0: Fred
In Therapy Session 3.0: Fred

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