Posted By Gloria Vanderhorst on 01/25/2018

The Collapse of Bob


Bob is happily married with 2 children: one in middle school and one in high school.  Bob is a lawyer and partner in a successful law firm.

Bob was sent to therapy by his Internist following an emergency surgery.

Imagine being a successful lawyer arguing a case and suddenly having a fog creep into your brain and your intestines twist into knots and dropping to your knees in the middle of a powerful argument.  The paramedics rush you to the ER and all symptoms you describe point to a bowel blockage.  You have a history of irritable bowel syndrome so this makes perfect sense.

They open Bob up to find nothing and stitch him back together to report to his Internist that there were no physical causes for his symptoms or collapse. 

His internist makes a clear demand that he come to meet with me and engage in therapy.

For years, Bob has carried an extra pair of underwear in his briefcase.  This rescue pair has saved him many times. 

Now we must work together to discern the underlining experiences and traumas that have manifest as irritable bowel syndrome. 

Bob is a practicing Christian, an accomplished lawyer, a pillar of his community and a strict father with his two boys.  He expects much from himself and from his children.  Academic excellence is a must even though grades are not necessarily the measure of that.  The questions that he asks about his children are the same ones that he asks about himself.  Can he see that you are working, asking questions, seeking knowledge?  Do you manage your time wisely?  Are you preparing diligently for the next project or exam?  If the outcome is an A, great.  If the outcome is a B, he understands because he has seen behind the scenes.  However, those are the only 2 ranges that his gut can tolerate.

He and his wife work long hours outside of the home and have a trusted Nanny to care for their children.  However, they do not have insight into the dynamics of that relationship as the children are protective and silent, giving only the expected answers about the afternoon going well.

Bob’s early attachment is to performance and the demanding expectations of his own parents.  In therapy we need to make space for other forms of attachment.  Can Bob attach to play or being comforted or being heard.  As we work, Bob is at first resistant to the “touchy feelly” stuff that he believes will be the essence of treatment.  As we move deeper into his life experiences, we find the loneliness associated with a lack of play and relaxation.  As his childhood rigidity gives way, he can grieve and then long for deeper connections and more varied interactions with his children and his wife.  As this relaxation increases, his physical symptoms disappear. 

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