Monday, March 4, 2013


The trial of the dissident Amish sect convicted last month of conspiracy and hate crimes, brought to mind the experience I once had of being shunned. No, it wasn’t connected to the Amish or to any religious group at all. I was shunned by a patient. And it felt awful, worse than feeling invisible, it was as though I was dead.

Donald was very removed and distanced. He could sit in my office week after week and say nothing. At times I made interpretations about his silence, at other times I joined him in the silence. My sense was that he found the sessions tortuous, but he would neither confirm nor deny my perception. He never missed a session; he was always on time. 

There were times Donald would speak, but never about his silence or his feelings about me and our sessions. He told me a little about himself – he was thirty-five, had never been married, had a few friends, worked as an accountant, like to read and attend concerts. His parents divorced when he was little. They never paid much attention to him before the divorce and even less after it. He wanted more out of life. That’s why he came into therapy. But he couldn’t engage with me on any meaningful level. I talked with him about his difficulty in connecting beyond a surface level, but he didn’t respond to that either.

Working with him was both sad and frustrating. When I felt sad, I’d see him as an extremely damaged man who wanted desperately to connect, but was unable to do so. When I felt frustrated, I saw his withdrawal as hostile, as if he were saying either, “You can’t make me play by your rules” or “I’m not giving you what you want.” Interpreting either or both of my reactions got us nowhere. 

One day while standing in line at the grocery store, I looked around and saw my patient behind me. I knew he saw me. There was no way he couldn’t have. I started to smile and nod at him when I realized that he was most definitely not going to acknowledge me. It wasn’t that he looked away. It was as though he was looking through me, as though I wasn’t there, as though I were dead. I remembering thinking immediately that this must be what the Amish feel like if they’re being shunned – cut off from the community, dead to all friends and family.

I found the experience extremely unsettling. And also enlightening. This must be what my patient had felt as a child, so ignored by his parents that he felt he wasn’t there, that he didn’t matter, that he might as well be dead. And this was the experience he was unconsciously trying to convey to me when he sat totally unresponsive in my office. He wanted me to feel completely ignored and unimportant, just as he had as a child. No wonder I felt him to be both damaged and angry. He was. I was eager for our next session. Now that I understood, I could finally help him. 

I glance at my watch. It’s five o’clock. He’s usually a bit early. Five after five. Donald’s never late. I start pacing my office. Ten after five. I reach for the phone and call him. No answer. I leave a message. The entire session passes. I haven’t heard from him.

And I don’t. Despite several phone calls and a letter, I get no response. I send yet another note with my final bill. He sends a check. He writes nothing.

I am again shunned. 

I have my own thoughts about what happened here, although of course they can never be confirmed. I think that even that brief non-connection in the grocery store was both too exposing and too intimate for Donald. If only for a moment, Donald would have had to perceive me as a person and personhood was not something that Donald could grant me when he had never experienced it himself. To open himself up to real human connection, Donald would have to feel all the pain and rage of being an ignored, neglected child. He couldn’t take the risk. 

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