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


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