Gone to the Dogs

April 22, 2010

Insurance restrictions sometimes make for strange bedfellows. My story begins with a phone call from a man about to lose his job. He said that he had been placed on probation and was about to be fired. He asked if he could see me. We met the following day.

Insurance restrictions sometimes make for strange bedfellows. My story begins with a phone call from a man about to lose his job. He said that he had been placed on probation and was about to be fired. He asked if he could see me. We met the following day.

I found Mr Paul to be a pleasant, intelligent, articulate, moderately depressed, middle-aged man whose passivity and self-doubt had handicapped him all his life. He managed an important office for a large corporation.

His immediate anxious depression grew out of his problem with Sally, one of the office staff. Sally did very little work and what work she did do was incomplete or inaccurate. As the chief, he was charged to set priorities, to delegate projects to office staff, and to supervise and monitor office personnel. He needed to write a corrective memo to Sally detailing the specifics of her difficulties and the steps she needed to take to rectify her problems. Mr Paul needed either to help Sally improve her work habits or fire her. He couldn’t write the memo. He was fearful that such actions would be cruel, that Sally might be hurt.

In addition, among the office personal were several aggressive, opinionated employees who held very strong views about priorities and assignments. He felt helpless before their onslaught. He could not delegate their assignments or monitor their behavior. He dithered; he froze. Mr Paul’s in-basket piled up. Tasks were not completed. He sat in silence behind his overflowing desk and became depressed. Morale collapsed, and office efficiency plummeted.

I asked about other parts of his life and found that at home-wife, 3 children, 2 dogs-he also had a real problem being the “bad guy.” “Yes…but” was his most frequently used expression. The children and dogs ran amuck. In fact, the dogs-like his employees-were the ones in control. Every time the doorbell rang, the dogs charged into the front hall, knocking over furniture and people in their path. Two jumping, licking dogs threw themselves at guests and frightened children entering the house. He was the passive standby-frightened, fuming, and becoming more depressed.

Mr Paul’s dynamics were similar to those of a number of men I had treated successfully with intensive psychotherapy. However, his lack of finances and an insurance program that limited treatment to 10 visits made this option impossible.

I prescribed an antidepressant that was somewhat helpful. My quandary was what to do with his passive traits that had gotten him into this state and would continue to sabotage his life. He spoke in vague, abstract terms; denied his emotions; and confused assertiveness with aggression. With such a severe and long-standing problem, 10 sessions of the usual psychotherapeutic treatment would not likely be helpful. Words would bounce off his intellectual defenses like water bounces off a duck’s back. Somehow, I needed to engage him emotionally as well as intellectually.

In musing about Mr Paul’s problems at work and at home, I became aware of the parallels of the 2 settings. His passivity resulted in failure with subsequent chaos in both. In thinking about his dogs’ behaviors, I thought of my family dogs (we usually had several in our household) and I recalled my experiences in obedience training. In these classes, I had observed that a dog’s failure to learn or behave appropriately was often a reflection of the owner’s problems and failure to maintain consistent discipline. These sessions were frequently emotionally charged-dogs barking, whining, and dragging their owners about the field with their owners crying or cursing.

I theorized that I might be able to help him become less passive and more appropriately assertive (Mr Paul’s central problem) by involving him in training his dogs. In this way, we might break through his psychological defenses-a kind of hands on, down-and-dirty approach. I told him training his dogs would be a central part of our work. He gave me many reasons why his dogs’ behaviors could not be changed. I ignored his rationalizations, gave him 3 dog-training books and sent him home. I said we were ready to start; and in the next session, we would review his progress.

He began the next session with a long list of reasons why the family and his work schedule made it impossible for him to train the dogs. I showed him that he used these excuses in every part of his life, and I ordered him to return to the fray.

Mr Paul began training the dogs. He tried demanding their attention. It was a struggle. “Who’s boss? Who’s in control?” He was jolted by a host of strong emotions: confusion, impatience, frustration, and anger. This was no intellectual exercise-he and the dogs were locked in mortal combat. In each session, he gave reason after reason why he should stop “tormenting” the dogs. I kept pointing out parallels between what was happening with the dogs and what was happening with people. I managed to convince him to continue.

Over the weeks, he became more consistent, able to set limits, and comfortably assertive with the dogs. Their behavior changed, and they no longer ran pell-mell to the door, jumping on guests. Mr Paul succeeded in teaching them to sit in the kitchen when the doorbell rang; however, they did yelp and whine. His wife clucked her tongue, and the children cringed, afraid he was “torturing” the dogs.

He felt horribly guilty as dogs, children, and wife all expressed their unhappiness. The good news was that now he recognized he was in familiar territory. My patient had gained some awareness that he viewed as sadistic what most people would view as appropriately assertive behavior. Most importantly, his struggle with dogs had brought him into direct conflict with powerful emotions and new perspectives.

When we parted 2½ months later, Mr Paul was no longer depressed; the dogs were better behaved; and, in several instances, he had been able to be appropriately assertive with his children and wife. Unfortunately, he had lost his job. But, with a changed mindset and newfound energy, he was effective in arranging transitional support and in applying for new positions. He had survived psychic bumps and bruises from the dogs and family members. He had gained insight and psychic muscle. He was better prepared for the future.

Ten years later, I met with Mr Paul briefly to request his permission to tell this story, which he granted. He had not been taking antidepressant medication for years and no longer suffered from depression. He was working. He had coped competently with a family tragedy, and his children were launched successfully in their careers.