Polly Rost, PhD:On The Other Side Of The Couch

Since the older parts of our minds evolved long before the late appearance of consciousness their “automatic” work is not accessible to awareness.   The function of our “adaptive unconscious” (as Dr. Timothy Wilson in “Strangers to Ourselves” calls it) is completely hidden from view.  

"Strangers to Ourselves"

Through talk therapy our fears, phobias, and traumas that reside deep in the ancient parts of our brain can be brought to awareness so that they can be understood, and inhibited.  It falls to the skilled psychotherapist to help us understand how to rebalance the system and alleviate distress.  It is sad that we often have to feel our hurt intensely before we look carefully into what makes us who we are.

I had met Dr. Polly Rost many years ago, and I decided to ask her for an interview.  She enthusiastically said yes.  She is a York native, and she received her Ph.D. at Temple.  She started her practice of clinical

Dr. Polly Rost

psychology in 1986 from a small rented office on South George Street.  She said that she had “no grand plan or vision” and  that the growth of her practice was solely “due to the growing needs of the community."  The practice has thrived, and her 14 therapists help meet the needs of our town inside a stately Victorian home a bit further north on the same street in the city where she began.  

I opened the weathered front door and sat in the small sun room on the side of the house and waited for Dr. Rost.  I remembered coming here years ago in pain. Wouldn’t it be easier, I thought, to hook ourselves up to Dr. Wilson’s “Inner-Self Detector”?  After attaching electrodes to our scalp and adjusting a few dials we could ask it questions such as, “What am I really doing here today?”  And the machine would display the answer... just like that!

Anyway, Dr. Rost greeted me and I followed her into her therapy room.  Gordon, her lazy gray cat, was lying on his back displaying his belly.  Sinking into the well-worn cozy wing chairs we sat across from each other.  The stray cat and Dr. Rost had found each other years ago behind the house.  I thought, “What makes him different than the others in the house who come and go?”  Why, he lives here, he stays here, and is protected.

I asked Dr. Rost how she came to be a therapist.  She quickly said, "I love science and people.  I was delighted, even in high school, by being sought after by peers.  I was known as being a problem-solver.  And I learned in college that I was helpful to those around me too.

Before Insurance Coverage for Mental Health

 I realized, on some level, that just being available and helping people figure things out was good in and of itself."  And that is what she has done for the past three decades.  I was curious to know how her practice has changed.

Without hesitating for a second she got up from her chair and walked over to a bookshelf.  She handed me the second version of the “Diagnostic and Statistical Manual of Mental Disorders” (so-called DSM); it was about 40 pages.  She then produced the 2013  “DSM-5.”  It ran for  947 pages, more than 20 times as long!   I was struck by the difference; here was evidence of great work in understanding and treating mental illness.  

Tattered DSM II, 1968

I flipped through the tiny book and my mind wandered to what it was like in the early 1980’s when I faced cancer myself.  I was given exactly three short once-over visits with an oncologist-psychiatrist, visits to be used over two years.  No “tools” were provided to deal with the emotional trauma of a cancer diagnosis, and I was not exactly sure what these sessions were supposed to do for me.  Maybe there was no appropriate DSM code back then for young patients such as me.  No-one saw that my coat of armour was missing a few laces.

We now do better.  Just the other day (11/20/17) the BBC reported a Malaysian study in which 20% of cancer patients had full-blown post-traumatic stress disorder six months after their cancer diagnosis, and that nearly 6% still had debilitating PTSD four years later. The hopeful finding was that, compared with other cancer patients, women with breast cancer were three times less likely to have developed PTSD. The difference seemed to be due to the early counseling these patients received. Patients with serious life-threatening illness like cancer no longer have to carry the hidden burden alone. Caring and empathic doctors like Dr. Rost and her staff can help them navigate through, and come to understand, the early anxiety and fear of trauma to be able to prevent problems later.

"The Neuroscience of
Psychotherapy"

She is pleased that there is more ready access to therapy, and that our culture is more willing to include improved psychological along with physical functioning as a goal.  She feels that there is more  respect for the power of psychology now, especially seeing that as a culture we have come to value the quality of life; our personal lives, our relationships with others, the all-important parent-child bond.  She is glad that the medical community and the schools recognize that a multidisciplinary approach to psychological stress “can make all the difference.”  

Dr. Rost is an optimist, noting that our understanding of biochemistry and the brain's workings has enhanced our ability to relieve suffering, and she predicts that “one day there will be a blending of psychology and neurology.”  

Who are your most difficult patients?" I asked.  She paused, and said that after she sees patients at the hospital for "group" and she leaves the third floor Psychiatry Unit someone may see her stumble and ask, “Are you okay, Polly?"  Her quick response is to say that she’s fine.  She said that she never leaves these moving sessions without being deeply touched by the depth of the pain experienced by the hurting patients.   

She wishes that “others could somehow appreciate how dark it can be at times” for those who suffer.   And she works “very hard to bring sunshine to them.”   Her patients know that she will never give up on them, and that they will somehow work things through together.

Feeling her own emotion surface as she spoke, I asked if she is spiritual.

“Yes,” she replied, “I am one of the few people that can be sitting still and sweating at the same time that all of my being is (invested) in the patient in front of me.  There are times when I hear it, but I am not sure how to get things across to the patient.  I say a quiet little prayer,  ‘Please help me put this in a fashion that can be tolerated and is useful,’ and then something magically comes.” That is good, in and of itself.  

The Couch (Freud's, not Dr. Rost's!)