George
George came to see me complaining of memory problems. At the age of 56, he was worried he might be growing senile. Medically, there was no evidence for any of this. However brain scans cannot detect Alzheimer's nor some other causes of senility, so George remained worried. As I talked to this man, I found myself getting oddly irritated. In reviewing just when in session this happened, I began to suspect that George was retreating into "memory problems" to avoid things, a discussion, feeling, encounter, or person that made him uncomfortable. If so, this is an irritation I know well. It comes when I have the vague and barely conscious sense of being controlled. You see, by adopting this helpless stance of memory loss, thereby avoiding whatever is confronting him (a question, a demand, etc.), George in effect controls the conversation and even demands my sympathy. This is not something he would be conscious of doing, of course. If it were, he could simply stop.
Sounds interesting, but how do we know any of this is true? I administered a neuropsychological battery -- a long series of tests specifically aimed at assessing brain functioning, including memory. Sure enough, the tests showed only minimal loss of memory, not nearly enough to account for how often George reported it. More important proof came as we were able to stop and catch his specific moments of "memory loss" during our talks. George began to notice that he retreated into this symptom whenever he felt uncomfortable, especially when he felt pressure, angered, or "under the spotlight". He then began to describe a lifetime of avoiding such interpersonal stress by adopting a soft spoken and uncompetitive persona, minimizing his ambitiousness, using humor to defuse any tense moment, etc. Finally, and here's the real proof, George's "memory problem" abated and he began to express his anxieties more directly, in words.
George was lost. He was unaware of his anxieties, his interpersonal behavior, his tactics of avoidance, even what symptom he had. Instead he'd latched onto the idea of a memory problem, itself another way of avoiding confrontation -- at uncomfortable moments in session, he would plead loss of memory, ending the conversation.
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