It’s not so much what I do with a patient when I find myself bored, it’s, rather, what I do with myself. I have learned over the decades that when boredom starts making me susceptible to all sorts of more comfortable positions gravity has to offer than sitting upright, that I am either closing myself off to whatever is being stirred in me or the patient has stepped out of emotional contact with me; sometimes both as they are reciprocal behaviors and motivations.
As I listen to the patient I am also letting a part of my mind wander over and through me to see if there are any clues sprouting where an unconscious idea is pressing for awareness.
If I find myself being defensive I open myself to what that may be and the best evidence for this lies in whatever story s/he is telling us at any moment. I have found that if I temporarily disconnect it is always for defensive purposes that are surely also related to what is going on in my patient. If I listen closely about some social/psychological interaction the patient had, say at work, wherein the patient felt unheard, dismissed and all under the growing shade of abandonment fears.
I then think that my temporary withdrawal triggered those very same emotions in my patient that s/he had in an earlier encounter with a coworker. I then invite the patient to examine all this more closely, that is after I apologize for my temporary detachment.
I then encourage the patient to tell me whatever fleeting thoughts s/he had when s/he sensed something off with me. I confirm what is accurate about me and wonder with the patient about that which seems on the surface not connected to what had just happened between us.
I help the patient and me identify what each of us consciously and possibly unconsciously contributed to what we enacted between and with each other.
In short, boredom can be a partially open door encouraging us to open it more widely and see what is and isn’t there.