Intimate Portrait: Marsha D. Rosenberg, MD

Psychiatric TimesPsychiatric Times Vol 29 No 12
Volume 29
Issue 12

Therapy is a matter of cleaning the dust off so that you can see what's underneath.

I like to work with people who genuinely want to change their lives . . . who don’t just want to feel better, but who really want to give themselves new options. Some people have a tremendous drive to change and to make their lives better. You treat them to increase their freedom, to make choices. If they want to change, they’ll change; if they want to stay the way they are, they will remain the way they are. But at least they are able to make a free decision about what to do. They are not encumbered by neurotic conflicts.

A neurotic conflict is something that keeps you from doing what a major part of you really wants to do. You want to live a certain way or have a particular kind of relationship, but you find yourself not living that way or not having that relationship. Something stops you . . . be it fear, guilt, anger. You either can’t go ahead with what you want or you don’t know what you want. Therapy is a matter of cleaning the dust off so that you can see what’s underneath.

You have to go layer by layer. You want the information, but not in a form that the patient can’t deal with it. You have to ease the patient into it. Things are hidden, covered up because they are intolerable. If you just expose it, a patient can have a dissociative reaction, or can be in denial. There is no point. You can’t script somebody and say, “Okay, now go ahead and do it.” It does not work that way. It’s not constructive.

I can’t draw some people out, and that’s very difficult. Every now and then, something gets through and there is a glimmer of some movement. I probe and might even provoke to get some kind of reaction. People are so well defended or so afraid to crack the surface. And you cannot cure everybody. That’s a hard thing to accept.

In my office, I keep a lot of plants and flowers. They create an atmosphere. The light illuminates things. You see very clearly with the light. It nurtures you. This is where people grow, develop, and evolve. People and plants.

If the plants are not doing well, some patients get very upset. They wonder what I am doing wrong. They might say, “What’s the matter with that plant?” I think they want me to make the plant better rather than to discard it. The fear is that if the plant does not get better, I will throw it out. And some plants die.

Being a therapist can be draining. I was tired one day and one of my kids asked, “Mom, why are you so tired? I explained, “I had a long day in the office.” He laughed, “All you do is sit around all day and listen to people’s stories.” It’s true: you sit and listen to people’s stories. But it’s extremely active listening. And that’s hard work.

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