Chapter 60 Section 7. Belittle yourself to a patient with a lot of shit

Psychotherapy can be a funny thing sometimes.Facing such a patient who is desperately reducing herself to a shit, I have to follow her logic and break down her fallacies one by one.In fact, there is no certain criterion for judging the beauty and ugliness of one's own appearance, so appearance is actually only a target for patients to project their inner self-feelings.A particular preoccupation with one part of one's appearance, which sometimes manifests as obsessive-compulsive disorder and sometimes paranoia. Structural problems of the pelvis I once ran into a female student on campus who shyly wanted to ask me a secret question.After sitting down in the consulting room, I closed the door specially to show my importance and secrecy to her secret question.

The female student glanced at me and said, "I always feel that the position of my pelvis is different from that of other girls." Facing such a strange question, I involuntarily glanced at the girl's pelvis.I immediately realized that it was inappropriate, but I couldn't express my opinion without taking a look.Now that I have taken a look, I might as well say bluntly: "I don't see any difference between your pelvis and other girls'?"Because my words have put me in the position of an expert judge, which seems to mean that as long as I think there is no problem, you have no problem.The implication is: In order for me, an expert, to make the most authoritative diagnosis for you, you have to open yourself up and let me understand.

Realizing the problem with my reply, I added: "I'm not an anatomy expert, and I really don't understand what a girl's pelvis is, so I suggest you go to a gynecologist for a diagnosis." , take a look to see if there is any problem with your pelvis." "I've been to a gynecologist. The doctor downplays me and says everything is normal, but I just don't believe it." "I think you actually believe there's nothing wrong with your pelvis, it's just that you think your pelvic structure is a little weird." "Yes, I found that my pelvic structure is different from that of ordinary girls." She blushed in front of me, the psychological authority, and talked about her pelvis desperately. "My pelvis was opening too far to the sides, which was very disturbing to me."

Talking to a girl about her pelvic structure is also an interesting experience for me as a therapist.As a man, I entered into the "scientific" discussion of this issue naturally and confidently.I can continue to explore this line, which of course can help girls understand themselves, and at the same time unconsciously satisfy my unscrupulous peeping of a woman's privacy as a man.Acting selfishly and concealing the truth in the name of scientific ethics is a psychological trap that psychiatrists must be aware of at all times. Aware of the deep danger of this kind of inquiry, I braked in time and shifted the focus of the discussion from the pelvic structure in a narrow sense to the psychological meaning of the issue itself: "In my opinion, your worries about the pelvic structure are actually your concerns about the self. Structural concerns, pelvic problems are the projection of your inner inferiority complex on the body structure. When this projection turns to any point in your body, that point will become the target of your worry day and night."

"You mean that there is no problem with my pelvis. It is my inner inferiority complex that makes me think there is a problem with my pelvis." "right." "But my pelvis really has a structural problem." The girl circled around and went back to her knot. The patient's obsessive-compulsive ideas are the most difficult problem to solve in psychotherapy.The stubbornness, contradiction and irrationality make obsessive-compulsive ideas extremely resistant to external intervention.Confusion about one's own body structure, if simple reasoning fails, can sometimes be put into practice with cosmetic surgery and bodybuilding training to achieve goals that speech therapy cannot.

When the discussion on a topic such as the pelvis is deadlocked, there are two options: one is to make a thorough and in-depth analysis of the psychological significance of the pelvis; the other is to temporarily abandon the pursuit of the pelvis topic and start with other topics , in order to achieve a winding path leading to seclusion, to encircle Wei and save Zhao Zhimiao. The thorough and in-depth analysis of the psychological meaning of the pelvis that I am talking about here seems to be contradictory to the avoidance attitude towards the meaning of the pelvis that I adopted in the actual operation.In fact, from a comprehensive point of view, a thorough and in-depth analysis of the psychological meaning of the pelvis is like "how can you catch a tiger if you don't enter the tiger's den", taking certain risks to solve problems that cannot be solved by ordinary methods, sometimes it is A must-have option for psychiatrists.

The pelvis is clearly sexual.The openness of the pelvis can be seen symbolically as openness to the entry of the opposite sex.From a conservative point of view, an overly open pelvis makes women feel sexually insecure and prone to being invaded by sexual objects, and also makes women have a tendency to reject sexual objects.But from an open perspective, an outward pelvis makes sex easy, while an inward pelvis craves to be opened by the sexual object.It can be seen that the worry about the structure of the pelvis is only the projection of women's inner anxiety.At the core of this inner anxiety is women's uncertainty about their sexual roles and functions.From the perspective of psychological development, excessive worry about the pelvis may mean that girls received poor sex education or sexual abuse in childhood.In most of these cases, it is eventually found that the girl has been sexually abused.