The Disease of “I Don’t Know…”

By Jonathon Nixon, LMFT

“Great to see you today, Mike, how you feeling?” The therapist said to his client after taking his seat.” 

“I don’t know, couldn’t really tell you.  Fine, I guess.”  Mike replied with a somber look in his face.

The therapist was quick to point out the concerning expression, “your face is telling me that it doesn’t look ‘fine.’  Tell me a story about your week and include details,” 

“I don’t know, nothing really happened this week.  I went to work, came home, played my games went to bed and that was kind of it.” 

The therapist smiled, “sounds like I could fit all that on a index card. Any particular interesting thoughts or ideas come up during the week, maybe while you were at work or playing your games”

“I don’t think so, if so, I can’t remember.” Mike replied. 

“What prevented you from keeping that journal on your person that we talked about from our last session?” The therapist asked.

“I don’t know, I bought one when I went to the store to get groceries, but I guess I left it on my counter.”

“Okay, so the plot thickens,” the therapist teased, “looks like I can add, ‘went to the store’ to this particular chapter in your life. Tell me, what was the thought that reminded you to pick up a journal when you were at the store?”

“I don’t know,” Mike groaned, “I think I just happened to walk by the office isle and just sort of remembered it, I probably wasn’t really paying attention.” 

The therapist saw an opportunity to push his client into a state of free association so he started to ask his following questions faster and non-sequentially to test a thought he was having around Mike’s thought process. “Mike, when I say the word ‘journal’ what comes up for you?” 

“What do you mean?” Mike curiously replied. 

“Just anything, what is the first thought you have when I say the word, ‘journal’?”

“I don’t know, maybe like book or something.”

The therapist jotted down a squiggly note on the pad in his lap and rapidly followed up with, “Okay, if you were to write a journal entry right now what would be the first line on the page say.” 

Looking more perplexed, Mike responded, “I don’t know,” and groaned to himself underneath his breath. 

The therapist continued with their line of questioning, “what would be one thing that you could right about that would reflect on of your greatest qualities?”

Mike continued to groan as the therapist moved on to their next question, “how about your first thought when you woke up this morning, what was that first thought you had when the alarm when off.” 

“I don’t know, probably I want to go back to bed.” 

“What about your second thought, or maybe a feeling, what was your first feeling you had when you woke up this morning?”  The therapist rapidly said. 

Mike could be seen becoming visibly distressed as his eye browns started to lean in over his wrinkled forehead, “I don’t know, I don’t really think about that.”

“What kind of feeling are you looking to achieve with your mental health goals?”  The therapist continued.

Mike’s tone started to become combative, “I don’t know! Like I said before I’m just sort of trying this out, I don’t know.”

The therapist clapped there hands together, “perfect, this is what I wanted to see, hello ‘Angry Mike,’ welcome to the therapy room.  Now before you go stomping out of my office, I want you to take a large deep breath because I want to share with a pattern, I am picking up that I think is contributing to your indifference about life.” 

Mike’s facial features softened and he followed the deep breathing prompt provided by the therapist sitting across from him.

The therapist started speaking, “Mike, I’m going to tell you that in the short time we’ve been with one another today I have counted around 11 times you have told me the phrase, ‘I don’t know,’ which is alarming to me because it makes me wonder if there is some psychological decision at play that might be translated into something like ‘don’t think,’ or ‘don’t seem to care,’ which maybe at the root of your unhappiness.” 

“What do you mean?” Mike leaned in from his chair looking more interested to what the therapist had to say next.

“We’ll get to that the more I get to know about you, but for starters I want to address these ‘I don’t knows,’ because frankly they will drive me absolutely bonkers if I continue to hear them unregulated in our sessions, so let’s reframe this phrase into what it really means, repeat after me.” 

“’Let me think about that for one minute.’”  Mike repeated after the therapist.

The therapist continued, “so let’s start our session over and instead of saying, ‘I don’t know,’ use that phrase you just said and let’s see what is different.” 

Mike nodded his head, “okay.”

“So Mike!” The therapist boasted, “how goes it? How are you feeling today?”

“I don’t…” Mike abruptly stopped at the sight of the therapist giving him a concerned look.

“I mean…” he corrected, “let me think about that for one minute.”

The therapist didn’t reply just sat and looked at him quietly as a full minute passed between then.  The therapist broke the silence, “so Mike since you’ve had a minute to think about it what did you come up with?”

“I feel sort of okay, right now.’ Mike softly replied.

“Where you able to do some journaling in the past week?”

“No, not really.” 

“What prevented you from jotting down a few notes about yourself?”

“I don’t …” again Mike stopped himself, “this is weird,” he confessed. 

The therapist looking intrigued replied, “how so?”

“I don’t know,” mike instinctually said. 

The therapist waved his finger in a reverse wheel motion indicating to mike to apply the rule which prompted Mike to retreat on the phrase, “oh sorry, I mean let me think about that for a minute.” 

Again, a heavy minute passed between them before the therapist spoke up, “and? What did you conclude about that ‘weirdness’ you were talking about a few minutes ago?”

“It just feels different, like it’s very awkward and unfamiliar, but it does have me thinking about how many times I use the phrase, ‘I don’t know,’ and it’s a lot.”

“Excellent! Let’s expand that ‘awkwardness’ and create a totally new experience for you today.  This time instead of saying ‘let me think about that for one minute,’ let’s boost it up to five minutes and see what happens?” 

“That seems like a long time,” Mike suspiciously replied.  

“Good. So, Mike if you were to start a journal entry for today what would be the first line of that entry?” The therapist said and cues to Mike for the conditioned response.

“Let me think about that for five minutes.”

The therapist kept a steady stare on Mike who started to fidget and reposition himself in his chair over and over for the following five minutes

The therapist spoke up again, “so Mike tell me about that experience of sitting in that five minutes of silence?”

“It’s really weird, seems like it took forever.”

“Did you come up with a answer for my question?” The therapist asked.

“I did, actually.  The line would go, ‘I was sitting in a chair feeling weird as shit in my therapist’s office.”

The therapist asked, “sounds like a more interesting story then you just ‘going to work’ and ‘playing video games.’

“Yeah, I guess.”  Mike said with an enthusiastic tone. 

“Great! you are going to use that as a tool when we start exploring some of the decisions you are currently making about your life.” The therapist said before standing up from his chair and concluding the session for the day. 

*** The following story is a fictional representation of a fictionalized clinical situation that no way reflects any identifiable information that could reflect any active case within my current caseload.