TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Session 7, Monday the 25th of November, 2013. Hello Jessa. Due to my being away at a conference last week there’s been a longer interval of time between our previous session and this one. And I noted down before I left for my conference, and after our last session, the homework. So I’ll just mention that and then hear whether you did it, how you did it, and anything else. Just to recap, one of the areas that we were looking at last time was that of your mother’s behavior and tendencies and how you shared she displays behavior after which you feel guilt, and talking about the helpfulness of your developing less need for approval. [00:01:02.22] When we talked about it in the last session, you were able to see the humor in the situation. And homework included your reflecting on unconditional self-acceptance and identifying the thoughts that are counter to your attaining more of that unconditional acceptance within yourself, and the importance of disputing irrational beliefs. I recommended, and you agreed, that you might write down the E’s, the effective new philosophies, and read them every day and do some full and complete ABCDE forms. So that’s where we left off. Please fill me in!

CLIENT: Well in a perfect world...

THERAPIST: Where’s that? Which universe?

CLIENT: I know, it’s an imperfect world. But in a perfect world I would’ve been able to probably get, maybe, some more of the homework done – (pause)

THERAPIST: Keep talking.

CLIENT: And completed. [00:02:02.05] Unfortunately so after you left we I had one really good night where I was really feeling great, and I wrote myself a letter which using the dear Jessa form, which I can share or not share, whatever. But sort of using the rational beliefs or techniques or whatever. Then after that I had two really, really challenging weeks, pain management wise, where I would go to work and all I was capable of doing once I got home was just – all I was physically capable of doing was lying down, putting on some ice or some heat, and really calling it a night. And I had some really painful moments in there because I really was almost unable to even do my regular work for work let alone anything any kind of extra. [00:03:01.08] So fortunately I don’t really want to focus on that because fortunately today, I don’t know what it was, maybe it was just you connected some miracle, you being connected, but today was the first day that I actually was able to get through a whole day of work and not even be I mean I had some physical pain at different points but it was not debilitating, and I was able to get through the day. And I took an acetaminophen and was able to just feel like I could do some stuff. So when I got home today before seeing you I had some time and was able to actually write down some things because up until today it’s been quite challenging. And part of one of the things it’s interesting because one of the things I was writing while I was waiting for you to come was about how I wasn’t able to do any of the work. Not that I haven’t been doing it in my head because that’s the thing. I’ve really been thinking a lot, catching myself, doing all of that, but the actual work for that we talk about, the I guess the written down part, that’s been a little bit more of a challenge just because I haven’t really been able to write. [00:04:10.26]

THERAPIST: And not only for the last two weeks, but in the course of our sessions it’s been an interesting observation.

CLIENT: It’s been months. So I had some moments where I got really angry, really frustrated.

THERAPIST: You mean you got yourself really angry and frustrated.

CLIENT: Yeah.

THERAPIST: By telling yourself what?

CLIENT: By telling myself that I can’t I couldn’t stand well the pain, that I couldn’t stand it. That I couldn’t stand the pain, that I couldn’t take it anymore. And then one evening I said, okay, well there are things that you can do to get rid of the pain because I wasn’t really taking any pain medication. So then I took pain medication and then I got nauseous because it was like a Percocet, and it was really heavy medication. So then I told myself, you can’t even take a pain medication and get better. And so nothing is going to work. [00:05:00.08] And so it was I kind of spiraled out of control.

THERAPIST: After telling yourself that nothing is going to work, did you add something to that thought in all probability?

CLIENT: “As it should”.

THERAPIST: As it should work.

CLIENT: As it should, yeah.

THERAPIST: And might you have added that “It’s awful that it...”?

CLIENT: And it’s awful that it doesn’t, yeah, that it isn’t.

THERAPIST: That may be a way you may think in other undesirable circumstances …

CLIENT: And I was able to at least the good news is that I was able to at least catch myself.

THERAPIST: That is good news.

CLIENT: Yeah, I was able to catch myself, but it wasn’t until after. When I was in those moments where the pain was so super intense, like I can’t even describe to somebody that doesn’t have a herniated disc and recovering from major shoulder surgery. You can’t really describe it to anybody but it’s to me it felt unbearable. And so it wasn’t until after that sort of pain had gone a little bit, subsided a little bit, that I was able to recognize some of the things I was telling myself. So I think it was a little bit of two things going on because yes, I do tell myself these things, and I’m very much aware of it and I did write it, a lot of what I tell myself down and tried to work out how to make it a little more logical, but then I guess the question lies on the table of when pain doesn’t last forever. [00:06:10.08] And I think...

THERAPIST: Nothing lasts forever.

CLIENT: Well nothing lasts forever, they say, except death and taxes. But I don’t know. But...

THERAPIST: Some people might disagree with that, too.

CLIENT: Some people might disagree. I actually disagree with that because I don’t think that does either. But nevertheless, in those moments of intense physical pain that is really, really difficult for me to even describe, it is very difficult to come out, at least for myself. That’s my own experience, is that in a physical pain state it doesn’t make it any better to think in this should, must type of illogical or not rational way.

THERAPIST: Pain can make it more difficult.

CLIENT: It can make it worse. But I feel like it’s a slippery slope because it’s like what comes first, sometimes in those moments when it’s I couldn’t I really was blinded by pain. [00:07:05.13] That’s how I felt and I’m not like that today, so I know there’s a difference between...

THERAPIST: It can be helpful to make the distinction between thinking that “I feel blinded by the pain and debilitated” which may simply be a description, and “I can’t stand that I’m blinded by the pain and debilitated”, which really is weakening. One may allow soldiering on, keeping on with breathing, taking a tablet, but you’re not adding to the discomfort by then forecasting the worst – that “I can’t stand it”. Does that make sense?

CLIENT: I think I lost you only because you said taking a tablet but then...

THERAPIST: Doing something, taking some action, if you can, to help lessen the physical pain. So when you’re honestly in pain and it’s blinding and you do not have the energy to pick up a pen and do your ABCs, that’s quite understandable. [00:08:03.15] But then if you add to that, and say or imply that “this is shocking and I can’t stand it and it’s awful” that disempowers you even more.

CLIENT: Right. No, and I get that. I...

THERAPIST: And so the beauty of doing this...

CLIENT: I can see it later on.

THERAPIST: Yes, and the beauty of doing this REBT work, and keeping on doing it and doing it and doing it, especially on the more comfortable days, is that it makes it easier if there’s a really challenging day again to not catastrophize, to breathe, to sweat, to handle the pain and not add to it by saying this is awful and terrible. You see? So part of what I hope these sessions are offering you is the motivation to keep making effort to get into this healthy way of thinking habitually. [00:09:02.27] And that comes only through practice, practice. And the good news is that you told me a few minutes ago you’re watching your thinking catching yourself when you think in unhelpful ways more. Great.

CLIENT: I am catching myself. And so what I ended up doing one of the evenings when it was because it’s been it wasn’t just one evening. It had been like that. It kind of hit an all-time high, and I think maybe because I was getting treatments, and so sometimes you have to go through the really bad part when you’re getting the treatment in order for there to be some type of a rainbow at the end. But basically what I did at the time was I started looking up different, what’s it called, I can’t even think of what it’s called, specialists in herniated discs and really so trying to empower myself that way. So...

THERAPIST: You felt less hopeless and less disempowered.

CLIENT: Right. So I had hope throughout all of it. So I guess, again, there were some really good things. I think just in terms of doing the actual written homework, that was where it was a little bit more of a challenge, only based on the fact that writing was a challenge, actually putting...

THERAPIST: Do you write at work? [00:10:10.10]

CLIENT: All the time.

THERAPIST: Okay, then you still can write.

CLIENT: No, I wasn’t able to do it at work either.

THERAPIST: Oh, you weren’t?

CLIENT: No. No. No.

THERAPIST: I was just investigating whether there’s any selective extra effort.

CLIENT: No, there really is not, actually. In fact, when I called the doctor’s office to find out if my pain was sort of to be expected based on what I the surgery that I had had done and what had happened there after, which was the herniated disc, the nurse actually told me that she’s very impressed. Most of the people that call that call her to say, is this normal because they all get this after the surgery, she said they’re either kind of doped up on some type of pain medication so they don’t really feel it, that they just want to know when the pain medication’s going when they don’t have to take it anymore, or she said, they’ll be calling and saying, I need a letter for work because I cannot go back. And she said, in fact, I just got off the phone with somebody who is not who hasn’t been going to work. So I guess in a way I wanted to kind of pat myself on the back in the sense that I’ve been able to that I have pushed conjured up something, whatever energy I have, to go to work. [00:11:19.12] And then when I’ve come home it’s been that’s it. That’s all I had had for two weeks.

THERAPIST: And also you’ve just, in the last few minutes, reported to me that you’re more aware, you catch yourself more. So that’s good. Have you noticed any changes in attitude to yourself regarding having greater unconditional acceptance of yourself?

CLIENT: Certain ways, yes. I still that’s an area where I definitely need to continue to work on because I think what happens for me is it’s and I think I’m sure this is for a lot of people, not just me, but I think...

THERAPIST: Why are we bringing in other people?

CLIENT: I don’t know. I don’t know, because I...

THERAPIST: Let’s pause there.

CLIENT: Okay, okay.

THERAPIST: Because it reminds me of what you’ve told me in the past of in the past, your tendency to even lose sleep...

CLIENT: To compare.

THERAPIST: Compare and wondering did you do the right thing. [00:12:16.12] So I just wanted to put the spotlight on this tendency of yours ...

CLIENT: No, I know.

THERAPIST: ...a seemingly habitual tendency to bring others into the picture when I’m simply asking about you.

CLIENT: About me. Well I think it’s embarr I feel shameful. I feel ashamed over the fact that I beat myself up. I don’t even I wasn’t even aware, I don’t think, until I started this REBT work of how negatively I speak to myself. And so it is that part for me, personally, has been challenging to change because I feel like it doesn’t even feel natural when I tell myself. I’m almost like ha, ha, ha, that’s not what I to me it’s not resonating yet. That’s just what I sort of about me. The part let’s separate it for a minute. I can do all the other stuff but then when it comes to actually being accepting of myself and not being super hard on myself, or not beating myself up about whatever it is, that part continues to be challenging as much as I attempt to do it.

THERAPIST: Okay, so pause, breathe, why do you think that is? Let’s explore this. [00:13:24.09]

CLIENT: I believe I know the answer.

THERAPIST: Tell me.

CLIENT: Well it has to do with past stuff. I don’t want to focus so much on the past but it does I believe it comes from that. I think it’s beliefs that for however x number of years when I don’t think we’re always so much aware of what we’re told and then how we internalize it, in other words, about ourselves. So I don’t really think I realized it so much before our working together because it was maybe a little more subtle. I didn’t have conscious ...

THERAPIST: You mean it was subconscious?

CLIENT: Subconscious, yeah, so I think that this whole REBT practice has enlightened me to maybe realizing how I think and how I feel and how I act and behave because of it. [00:14:12.28] But at the same time it has been daunting in the sense that I didn’t even know that I did. And I continue to go back to that because it’s only been a few weeks of this and my whole life of doing that. So it’s very unfamiliar...

THERAPIST: Which may explain, to go back to my question just now, why you think it’s so unfamiliar. Because it IS unfamiliar!

CLIENT: It’s really unfamiliar to me. It’s really unfamiliar to the point where I feel ashamed that I’m like and I know that’s again, and it comes up. But I do. I feel ashamed that it’s that unfamiliar. It just seems like it should...

THERAPIST: Oh, I see, so you are telling me that you “should have” been able to psychically pick up the formula of REBT before we even had these sessions?

CLIENT: No. I think it’s self-esteem though. I think that’s what it is. I don’t think it’s necessarily REBT. I think it’s how you feel about yourself. [00:15:04.28] So somebody might not have had REBT practices but they might’ve felt a certain way about themselves. And then if they got REBT I don’t know. I don’t want to talk about somebody else. For me it feels like it’s a...

THERAPIST: Good, there’s progress. Just speaking of you, not someone else …

CLIENT: For me I feel like it’s self-esteem related. That my self-esteem is that much in the gutter that it’s pretty frightening to know that’s so I think when I look at it sometimes, or I have to look at it, and again, it had nothing to do with the writing piece because I was happy to write when I had a good day before you left. So it’s not that. What it is, is in my mind. When I go there in my head I catch myself but then I’ve been thinking, thinking, thinking about the shoulds, the but it’s much more natural to think in that way. It’s my tendency...

THERAPIST: Familiar tendency.

CLIENT: Familiar, yeah. So I could definitely use some help in how to make it more familiar to have Unconditional acceptance.

THERAPIST: Unconditional self-acceptance.

CLIENT: Yeah, exactly.

THERAPIST: Yes.

CLIENT: Because I don’t want to sit here and act as though that part every time I get to that part, that’s where...

THERAPIST: Which part?

CLIENT: The part the unconditional self-acceptance piece.

THERAPIST: And you seem reluctant to change – and seem to tend to interchange the expression unconditional self-acceptance with self-esteem.

CLIENT Aren’t they kind of the same?

THERAPIST: They are not the same, although I think a huge majority of people considering those areas think they are the same. My husband (Albert Ellis) wrote a book on that, and I helped him work on that book, did research for it, that was published in 2005 called The Myth of Self Esteem the publisher chose that title because the publisher can make that choice, but Al actually wanted to call it Why Self Esteem is a Sickness.

CLIENT: It’s a sickness? Why it’s a sickness?

THERAPIST: Sickness, yes. [00:17:10.22] And he would sometimes say, in talks, self-esteem is the greatest sickness known to humankind because according to the commonly understood definition of it, which may or not be yours Jessa, is that a person may think: “I esteem myself, I consider myself worthwhile because I’m adequate at this and I’m good at that and because, because, because…”. A lot of well-meaning counselors and teachers will talk about raising your self-esteem, focus on what you do well. And to put it in my husband’s language, if you think you’re worthwhile because you’re good at this, this, and that, well then if in the course of life you become less good or become bad at this, this, or that, thento quote him back to shithood you go. So USA and REBT strongly are about encouraging us to realize, to accept ourselves unconditionally, to work on that healthy accepting that we have worth simply because we are alive – not due to what we do well at or due to what we have. And this is very much pointed at you right now, that each one of us has worth just because we’re alive. [00:18:23.29] And if we do well at things and if we’re fortunate enough to have talents, certainly let’s enjoy the talents, but let’s work on not letting the talents define us. We have worth because we exist – we are not what we do or defined by it – what we do is simply that: what we do. It is not who we are. And we you and I spoke about this when it came to your decades of working out and fitness training.

CLIENT: Oh, I thought you were going to say the piano thing [inaudible]

THERAPIST: And that too. But I remember, also, that part of the frustration you were feeling, or worse, about the pain and injuries that you’re coping with now, was the fact that you can’t train as freely, as much, as often, in the same way as you used to, and you agreed in some sessions past that in your mind that activity had defined you for a while. [00:19:10.02] And I was hoping to have you contemplate the fact that while that’s something you do and like to do, and good on you for that – it is a healthy activity, but maybe in 75 years you won’t be able to do as much at the gym. And if you think that you’re more you because you’re so good at the gym and if/when you can’t do it some day, then the danger is you feeling diminished instead of having the attitude – “well, I’m now 105 years old, I can’t do what I did when I was 35. I wish I could, but I can’t and I can stand that and find other things to enjoy”.

CLIENT: At that age I’d be tired though, maybe.

THERAPIST: You’d be tired…that could be. Do you understand however the point I am making?

CLIENT: But I’ve gotten better at that. I mean there has been I don’t want to focus on the negative, I think, because I didn’t have the actual I feel like it’s like a presentation, so I’m sure that’s an illogical thought that I oh, I have nothing really I have things in the notebook but not as much as we said. So that’s where it comes back to. But really, in essence, there has been a lot of change with that because I don’t I no longer life circumstances, I no longer define myself by that. I haven’t been going to the gym as much and that hasn’t been an option for me to be able to do what I was doing before. So clearly I’ve gone on despite all of that. [00:20:14.22] I’m not happy about it. I really, in a way, in fact I’ve tried to kind of be happy about it because somebody said the other day oh, I would do anything not to have to go to the gym right now. I just enjoy it. I enjoy it. I think it’s that. I felt like a pleasure that was being taken away in a sense.

THERAPIST: Temporarily.

CLIENT: Temporarily, yes.

THERAPIST: Okay, but I want to go...

CLIENT: Sorry, did that make sense? I just wanted to kind of get that in there because I guess what I’m saying is there has been progress because I don’t define myself by that any more...

THERAPIST: As much.

CLIENT: As much. I don’t want to say anymore but as much, yeah.

THERAPIST: I’ve seen that, and I think in practically every session I’ve noticed, and hopefully I’ve acknowledged clearly enough that I am noticing, progress. And even earlier this evening you had said that you’re catching yourself, and that’s great.

CLIENT: I am. I am.

THERAPIST: But what I’d right now like to look at is the comment you made about feeling ashamed.

CLIENT: I do. [00:21:12.17]

THERAPIST: So that’s what I’m commenting on now. And I’d like to ask you, what do you think you’re telling yourself, specifically, to make yourself feel ashamed for not yet being habitual or an expert in the constant remembrance of REBT.

CLIENT: Okay, well I did some stuff. And maybe it would be...

THERAPIST: Can you answer that question?

CLIENT: Oh, oh, sure. I just had it right here in terms of all the things I was doing. So what am I telling myself?

THERAPIST: To make yourself ashamed.

CLIENT: Lots of things.

THERAPIST: Well tell me what they are please.

CLIENT: Yeah, but do you want you want it in a specific like what comes first. There’s so much. There’s so much.

THERAPIST: Chercher (look for) the shoulds.

CLIENT: The shoulds.

THERAPIST: What are you telling yourself to make yourself ashamed? Now it would be quite healthy enough to feel disappointed if you had a goal and you didn’t reach it. [00:22:13.24] You had the goal to have more USA and there you went, you put yourself down, oh you’re disappointed. Wouldn’t talk you out of that. It’s nothing to be ecstatic about. But the shame is unhealthy – and far from disappointment it is debilitating. It keeps you imprisoned. What are you telling yourself to make yourself feel ashamed?

CLIENT: That well I start with comparisons. Any other person that was doing REBT was getting a beautiful experience. Therapy like this for others would have gone much farther at this point. That’s one.

THERAPIST: Okay, stop. Where is the evidence that any other person doing REBT would’ve been much further at this point? And by the way, we’re talking only months, not years. [00:23:03.14]

CLIENT: Months of what?

THERAPIST: Of us doing REBT together.

CLIENT: It’s been months already?

THERAPIST: Not that many. I think we started in September. This is the seventh session.

CLIENT: It’s already September? Oh my God, things are a blur. Oh my God. We started in September?

THERAPIST: Okay. Let’s get back to the issue where is the evidence that others would have done better than you at this point? Give me any evidence.

CLIENT: When I talk to people.

THERAPIST: Oh really? How many people who’ve done REBT have you spoken to ? ...

CLIENT: No, no, not because they’ve done REBT.

THERAPIST: Then?

CLIENT: Just the way that I hear them speak. They the difference in the way that they answer a question or have a conversation.

THERAPIST: So you’re comparing apples and oranges, which are very inherently different. Focus on this Jessa I’m asking you to look at what you’re saying and thinking you’re comparing yourself with your imagined idea of how others having done REBT would be further along than you. And I’m asking: where’s the evidence? And you’re telling me, well, there are other people who think in healthier ways. Can you read their minds? Do you know they have or haven’t been doing REBT? So, do you have any evidence for your assumption? [00:24:17.13]

CLIENT: No. Hard core evidence? No.

THERAPIST: Do you have any soft core evidence?

CLIENT: No.

THERAPIST: Do you have any evidence?

CLIENT: No.

THERAPIST: Right. You do not. And yet you’re still telling yourself things that contribute to this shame you create about not being perfectly enlightened by now and not being sufficiently self-accepting, andthat others would have done better by now. Can you see how unfounded that premise is that you believe, which leads to your shame? What else are you telling yourself to make yourself feel ashamed?

CLIENT: Debbie’s not going to be proud of the work that I did while she was away. It was a long time she was gone. I had lots of weeks to get better and to be the best that I could be. [00:25:18.20] And I wasted those weeks by not being able to produce as much as I wanted to or...

THERAPIST: And therefore...

CLIENT: I’m wasting her time and everybody else’s time that’s listening.

THERAPIST: And therefore I, Jessa, am...

CLIENT: Failing at something that I’m trying to be successful at?

THERAPIST: And that makes me...

CLIENT: Not worthy I guess. I don’t want to say it but, yeah.

THERAPIST: Well you don’t want to say it but isn’t that what it boils down to?

CLIENT: Yes, that’s essentially what it is.

THERAPIST: Okay, so first of two questions here. [00:26:06.00] Number one, where is the evidence that after two whole weeks Debbie would be devastatingly disappointed at what you think is your dismal, so-called lack of progress? (And by the way we agreed a few minutes ago you have made progress). And secondly, if Debbie was disappointed, what’s the horror? What’s the terribleness about that? Two questions.

CLIENT: To the first to answer the first one, wait, what was the question for the first one? What’s the evidence...

THERAPIST: Yes, where’s the evidence that Debbie would be devastated have I cried or beaten you up in the past when you haven’t done all the homework we discussed?

CLIENT: No.

THERAPIST: Have I given you a hard time?

CLIENT: No.

THERAPIST: Have I punished you or called the police?

CLIENT: No.

THERAPIST: So where is the evidence that Debbie would be extremely disappointed or react in some adverse way as you’re implying? Where is the evidence? Has it happened before?

CLIENT: Not with you in my life.

THERAPIST: I’m talking about me because we’re...

CLIENT: Not with you. We’re here in the present.

THERAPIST: Yes (jokes), I think we are. Is this a time machine? [00:27:12.00]

CLIENT: Not with you. I project sometimes that it might happen but it hasn’t.

THERAPIST: Notice that, okay. Notice that tendency. Projecting. The more you notice your tendency, the easier it will continue to be to catch it and change it. So you have a tendency to predict, project, and believe what may not true. Important to watch that.

CLIENT: Yes.

THERAPIST: Okay. So just to clarify, is there evidence that Debbie is disappointed? And in fact, is there evidence to the contrary even when you don’t do everything that we discuss?

CLIENT: Is there evidence to the contrary? Yes.

THERAPIST: Okay. And then worst case scenario and I have a facial expression and you interpreted I disapproved and acted untrue to my role...

CLIENT: Right, right, right. What would be the worst thing?

THERAPIST: What would be the horror in that?

CLIENT: That I would continue to the horror would be that I would continue to have my irrational beliefs about it. [00:28:20.28] So it wouldn’t be actually what occurred, it would be what I would tell myself.

THERAPIST: And again, wouldn’t you have choice in that?

CLIENT: Yes, I would.

THERAPIST: Isn’t this boiling down to that familiar theme of need for approval?

CLIENT: Mm-hm.

THERAPIST: Why do you need my approval?

CLIENT: I don’t.

THERAPIST: No, you don’t. It probably feels nicer but do you need it?

CLIENT: No.

THERAPIST: And is there any evidence that if I didn’t approve of something you did, that we wouldn’t keep going forward anyway in our goal?

CLIENT: No. Of course we would keep working for improvement.

THERAPIST: So when you stop and think about your premises, do you see how you can notice when you believe falsehoods and through thinking about your thinking you can recognize how false such ideas are. Whereas as in the past you simply tended to believe what you believed without questioning those beliefs ...

CLIENT: Yeah, I know.

THERAPIST: And carry on.

CLIENT: No, there is change. [00:29:18.23] There’s been there’s definitely been a lot of change. But I keep reminding myself that, like you said, when I go back to those tendencies of thinking everybody would’ve done this by now, Debbie’s going to be all that. I remind myself I have to stop myself and really catch myself in those moments. But what I’m saying is, I guess, any I know that you say it takes practice, right, of...

THERAPIST: Ongoing effort, ongoing practice.

CLIENT: Ongoing, but I think that there’s a physical reaction that I get. Maybe I should be a little bit clearer and just say that there’s a physical...

THERAPIST: You should?

CLIENT: Oh, I’ll try to be a little clearer with it. Well maybe I’d like to be...

THERAPIST: It would be beneficial…

CLIENT: I’ve been saying that a lot. It would be beneficial. I’ve been saying it on the phone with parents actually. [00:30:01.05] So thank you for all the things you’ve taught me. But I think I get a physical reaction every time that I it happens every time. When I’m even doing the homework and I’m getting to the I’m going about my thing and I’m oh, A, wonderful. Oh B, beliefs, I know those beliefs. And it’s even fun. It’s like a journal. I love it. I love it. I almost get a little high from it. And then and the C consequences. Oh, well I feel sad, I feel anxious, I act out. I do this. I cry to my friends. I whatever X, Y, and Z, whatever I do. And then I get to the disputing part and I actually get a physical, I can’t breathe type of reaction because and I don’t know what that is. I don’t know what that is, and I think that’s the part that I feel it’s a little bit daunting because if I just get over the hump of all right Jessa, you could just do and I hear your voice in my head. What would Debbie say could be a good dispute. I look at the book. [00:31:01.13] I read the book and it’s like all of that, it’s so physically overwhelming to me that I don’t know where to go with it, if that is coming across, if it’s making sense to you the way it makes sense to me. Because it’s every time when I’m doing the work, no matter what it is, I can sit there I wrote pages, pages of the shoulds and the musts and...

THERAPIST: Okay, if you thought just before you got to that disputing part, which is the time in this process you say you get yourself into a panic...”What am I telling myself to create the panic? …”

CLIENT: I do.

THERAPIST: Because that’s what it sounds like, the panic and uncomfortable breathing … If you thought to yourself “oh, the disputing now, well I don’t yet feel anywhere near expert at this, but let me do the best I can. And if I don’t do it right, I’ll discuss it with Debbie. And if I do it partly right, I’m still in a learning process. Let me do the best I can”... [00:32:03.20] if you believed that, if you allowed yourself to believe that you didn’t have to do it perfectly well, do you think you would still experience those panicky reactions? Think about it.

CLIENT: I have thought about it. I have thought about it because I know what you’ve said other times. It doesn’t have to be perfect. I think so I’ll agree with it partially, that I think partially that I would that it would come a little bit easier because I wouldn’t be so focused on it being perfect. But the other piece of it is that sometimes I don’t even know what to say. I really somebody...

THERAPIST: So you think “I have to do this perfectly well” doesn’t it come back to the same I “should” do it well enough or perfectly well? Even if you take away the perfect out of the sentence and think “I should do it adequately”. That “Have-to/should”: isn’t that what contributes to the panic?

CLIENT: Yes.

THERAPIST: So there it is.

CLIENT: Yes.

THERAPIST: Why should you do it adequately or perfectly well? [00:33:09.08]

CLIENT: I shouldn’t, don’t need to …

THERAPIST: Right and that does not mean that it would not be a good goal to continue to work to get better at...

CLIENT: I feel like I need a tutor.

THERAPIST: You have one right here.

CLIENT: I know, but when I’m doing the actual homework I’m like oh, I want to call Debbie.

THERAPIST: Well, I elect you to be your tutor in between sessions.

CLIENT: Okay. Each situation is so different and so unique. It’s there’s never one, and I think that’s actually actually, one of the things not to cut you off because I know you were saying something but one of the things that I had in my mind and I said, bring that up to Debbie because it was so powerful for me that I couldn’t really I really couldn’t, in the moment anyway. Maybe we can look at it together today. But last week, I guess it was or, no, two weeks ago. It was right after you one of our last sessions, before you left. I was on the crosstown bus and there was a young I was on the bus and I’m standing on the bus and I’m in pain so I’m not in a very I wasn’t in a good mind frame. [00:34:07.16] Let me just tell you that. And I felt physically weak because I was holding on and it was I felt like I wanted to sit down but there was no seats; it was a packed bus. So physically I remember not feeling good. And this little boy, he was probably like 10 or so, starts running after the bus when the bus was driving. So he’s going miles a minute and this kid comes up and starts slamming the window of the bus. So the next thing I know all I see I see him slamming this window and I’m thinking to myself okay, that’s not smart but whatever. And then the next thing I know the bus stops because he was stopping at the stop and then the kid, all you see is no more kid. I laugh about it now because thank God he was okay, but I see no more kid. And everybody on the bus saw no more kid. They all saw the same thing I saw. I screamed out and I said, no. Because immediately you think okay, this child is now under the bus. [00:35:05.02]

THERAPIST: No, immediately you thought...

CLIENT: Yeah, this is probably a good well yes...

THERAPIST: Go ahead, keep going.

CLIENT: He wasn’t anywhere to be seen at the bus stop so...

THERAPIST: Okay, but other people didn’t assume that.

CLIENT: No, they did.

THERAPIST: All of the other people...?

CLIENT: Yeah, they did because we talked about it.

THERAPIST: I’m sure I could be wrong. I don’t doubt that some others assumed that. My hunch is that very possibly some others didn’t assume it and wouldn’t have assumed it until they saw evidence.

CLIENT: Okay.

THERAPIST: I just want to point out that although many people might have had your tendency to freak themselves out[sharp intake of breath] initially, but I want to point out to you that not necessarily everyone would. There are people who might have the presence and steadiness of mind to think wow, that looks fishy, I wonder if whether that happened – let me check it out. So don’t assume, unless you have evidence, that all or even many people think the same as you do. [00:36:01.24]

CLIENT: So after all of this happened I was in a tizzy to say oh, and then I thought I was superwoman and I’m getting off the bus to help this kid. I’m supposed to be at an appointment, I’m running off to go do my due diligence. I don’t know what I was going to do. And meanwhile the next thing I see is the mother literally picking up her son, grabbing him. He looked like he did fall but was not under the bus. But he did fall and was maybe pushed, I don’t know, by the force. Did fall. And then she grabbed him up and he had just a mark on his face and that was it. So I was beating myself up the whole ride to my appointment after that happened because the [sharp intake of breath] freak out, the panicky breathing, all that, I was having a really hard time coming down from the excitement of the whole incident. And it wasn’t anything. And so this one woman’s looking at me, they’re all discussing it on the bus, and they were like oh, I saw your face. They all saw my face. They’re like we saw you were ready to I was like there we go, here it is. So it was hard for me to calm down physically, and then even after I did calm down, I have to tell you, I was still thinking about it for like into the hours into the night. [00:37:16.24] And I said, how can I talk to Debbie about this when she gets back because it was a physical so I didn’t know what I was telling myself. I really didn’t because I was so consumed with the crisis that I thought had occurred that I couldn’t even calm down.

THERAPIST: At that time.

CLIENT: At that time, yeah. Obviously now I’m telling the story and but...

THERAPIST: So now might be a good time to look for the shoulds and the demands and or any catastrophizing. So go ahead.

CLIENT: Well I catastrophized the whole thing. I definitely believed that he was under cut in half under the bus. It was something that I had the mother, I had the whole scenario of what this poor mother was going to feel without her child and...

THERAPIST: What flowers would there be at the funeral? What color?

CLIENT: I didn’t really go that far. [00:38:09.09]

THERAPIST: Near enough. Just pointing out your tendency.

CLIENT: Yeah, to think the worst.

THERAPIST: And dramatize and extrapolate and just get yourself absorbed in that narrative. How’s that serving you?

CLIENT: No, I want to change that.

THERAPIST: What’s stopping you?

CLIENT: I thinking that each scenario is different and that...

THERAPIST: But it is. So that’s not stopping you.

CLIENT: Oh. Okay. Thinking that when my heart starts racing in those moments that my mind doesn’t really isn’t a steady mind. I’m not an ER doctor, I don’t see those things every day, and it’s a child. And the thought that it was I’m not saying I wouldn’t have reacted if it was an adult. I probably would’ve reacted the same way if it was an adult, but it felt even more so because it was a young person. [00:39:05.19] And...

THERAPIST: You’re justifying your catastrophizing now.

CLIENT: Yeah, because I don’t really know why I do it. And so I think I maybe want to understand that before anything else, to even know why...

THERAPIST: So that was my question to you.

CLIENT: I don’t know. I don’t I mean I could tell you why I know how I was raised. I know but I...

THERAPIST: Stick to the situation Jessa. Focus. Were you telling yourself it’s not looking good but let’s see if he actually got hit?

CLIENT: No, I did not tell myself that.

THERAPIST: What were you telling yourself?

CLIENT: I didn’t see him under the I didn’t see him anywhere so he’s under the bus. And he’s...

THERAPIST: And...

CLIENT: I didn’t really think much. That’s the thing. There wasn’t really a lot of thought. Or maybe there was and I wasn’t aware of the thought.

THERAPIST: What in all probability was your view about the situation?

CLIENT: It’s not looking good. That’s it. I don’t know what that was. It probably scared me to even go any further with it. I just...

THERAPIST: Correct. And I think, and you tell me now if you think I’m wrong, but I think isn’t that what might frequently happen when you experience physical panic, that there’s a thought that’s frightening and there’s (sharp intake of breath) an arrest. [00:40:14.29] And you aren’t assessing things clearly and realistically – you feel panic and you don’t think it through.

CLIENT: Yeah.

THERAPIST: Which is how REBT can help you, because it invites you to think it through.

CLIENT: Okay.

THERAPIST: And so my hypothesis is, going back to your telling me that when you’re doing the homework and you get to the D you find it hard to breathe, when you get to the stage of disputing, and it comes back to what I started proposing before, that in all probability you’re telling yourself ideas connected to “I should, and if I don’t it’s awful and it has to be adequate and if not perfectly adequate and when it’s not it proves what a shitty person I am and not good enough and unworthy”. [00:41:03.12] So I think this cocktail of beliefs that seem, from what you’ve told me, to have been habitual up until now, may cause this [sharp intake of breath] physical response, and then you don’t question it and hence it grips you until you distract yourself, do something else, which doesn’t really remove, lessen, or resolve the frankly false beliefs and resulting panic. Those irrational beliefs. The word ‘false’ is perhaps not the right word to use in this context, because at the time of the experience, it’s truly what you believe. That does not mean it is factual. Such beliefs are not rational, they’re not based on reality. So do you see how you’re creating that panic by thinking the irrational thoughts?

CLIENT: Yeah.

THERAPIST: Not intentionally but just through succumbing to habitual self-putdowns, and not making more effort to do whatever task, even if it’s not adequate, and even if it will be imperfect, which in all...

CLIENT: So in that particular situation then...

THERAPIST: Which one?

CLIENT: The one with the boy and the...

THERAPIST: Do you mean the homework and your panic, or the boy and your panic?

CLIENT: The boy, the boy. [00:42:09.13] Yeah, the homework, I see well it’s all related. I mean it’s I can’t really separate the boy and the homework, so all of it. So you’re saying...

THERAPIST: When talking about your panic… The boy and the homework are the A, the activating event.

CLIENT: I’m sorry, the boy and the homework are the activating event.

THERAPIST: And then we’re talking about what you described as symptoms of panic, [sharp intake of breath] holding the breath and...

CLIENT: Yeah. Oh, it’s like a little panic attack. So what’s my question now. I forgot.

THERAPIST: What is your question?

CLIENT: I always get tired when I do this. It’s like not a bad tired but I just it’s...

THERAPIST: It’s an effort. It’s a stretch.

CLIENT: I did forget what I was going oh, in those moments, I don’t know, maybe as my tutor, maybe we can go over one I know we do that a lot but maybe I could kind of say it out loud this time and then maybe you can sort of chime in after, like let me sort of say what I think the dispute would be and then maybe you could say it after instead of in the moment when I’m saying it. [00:43:20.26] Okay. So we can use the boy and the bus because that was pretty significant for me. So the activating event was that I saw this child hit the bus.

THERAPIST: When you say hit the bus, he actively banged, and it’s not...

CLIENT: He actively banged on...

THERAPIST: It’s not like he fell into...

CLIENT: Oh yeah, no. Yeah, sorry. He hit the bus with his hand to probably try to stop the bus. Right. And then the bus pulled over and the boy was no longer in my sight and I thought the worst, that he fell under the bus and that he was hit. Oh, I forgot. I left out one part. There was a big bang. That was what it was. There was a thump. That was [laughing]

THERAPIST: The universe is conspiring against you, eh? [laughter from both]

CLIENT: So I had so that was the activating event. And then I don’t know if this is part of the activating event but then I felt a rush of [sharp intake of breath] like that, and I don’t know, is that still activating event?

THERAPIST: Well the rush of [sharp intake of breath] meaning panic, if you’re panicking about the panic, that also...

CLIENT: Yeah, it was like my anxiety has an anxiety.

THERAPIST: So that’s a related one, yes.

CLIENT: So, okay. That was the A. That’s enough.

THERAPIST: Two As.

CLIENT: Two As?

THERAPIST: Well the boy and the thump and then your panic, which you just told me you panic about, which is a secondary...

CLIENT: Exactly. Panicking about the panic, right. Oh yeah, I do remember you and Albert Ellis talking about that in your book. So...

THERAPIST: That’s A.

CLIENT: Right. So I panicked about the panic, yeah.

THERAPIST: And the consequence...

CLIENT: There’s a lot to remember, but yeah, that’s that is...

THERAPIST: It’s not that much to remember actually, from what you told me. [00:45:16.09]

CLIENT: Okay, there’s just all these different things. Okay, so the panic about the panic. Right. Now C, the consequence, right.

THERAPIST: Panic about the panic.

CLIENT: Panic about the panic. Okay. That’s so that’s the same thing as anxiety. I don’t know why I would say the consequence would be oh, here we go. Okay, it’s coming together now. Worthless. So now I understand... Okay. So the worthless I well I can kind of pinpoint what I was telling myself but we’ll do that...

THERAPIST: Feeling worthless.

CLIENT: Okay, I’m feeling worthless but can I should I say, or can I say, where that comes where the I’m feeling worthless part comes...

THERAPIST: It’s from the B, is it not?

CLIENT: Yeah, it is, but I’m saying that it came from the in other words I just recognized I wasn’t able to break it down, but I was wondering why would I feel worthless if this happened with this boy. [00:46:12.07] What does that have to do with me feeling worthless. And it’s because I looked at other people and said, they’re not letting this affect their day like I do. I shouldn’t be letting this affect my day like I do. That’s it. I mean that was basically and then I saw a woman and she was kissing her son and she...

THERAPIST: …..and her son were thankfully all right. So we got that.

CLIENT: Right, but anyway, I just recognized that because when you break it down it’s definitely a lot more interesting and fun. But...

THERAPIST: And informative.

CLIENT: Informative.

THERAPIST: And impactful.

CLIENT: Yes, definitely, definitely.

THERAPIST: Okay, so that’s the first irrational belief you’ve just identified relating to the worthlessness. What other rational beliefs relating to that or the anxiety or the panic...

CLIENT: “You should have more control”.

THERAPIST: You mean to say “I, Jessa... “

CLIENT: I should have more control in this situation. [00:47:02.23] I’m not really much of a help to anybody else if I’m panicking myself. I don’t know if I really feel...

THERAPIST: You thinking: “I’m not really much of a help to anybody else if I’m panicking myself” -That’s not an irrational belief by the way.

CLIENT: Yeah, and I didn’t really think that. I just said that just now. I never had that thought. Because...

THERAPIST: Now back to the truth.

CLIENT: Okay.

THERAPIST: Irrational belief. Beliefs.

CLIENT: I just don’t remember really what I was thinking.

THERAPIST: Since we’re doing this exercise now so hypothesize. In all probability you were telling yourself...

CLIENT: I was telling myself this is awful. There’s – “I can’t stand this. I can’t stand seeing this little boy or what I’m about to see. I can’t stand what I’m about to see. I won’t be able to cope with what I’m about to see”.

THERAPIST: That’s an important recognition, that you thought such thoughts. Good.

CLIENT: Yeah, “I will not be able to function after seeing this boy split in half” because that’s what I had in my head. So the beautiful vision of that. And guilt. [00:48:11.08] There was a lot of guilt, too, thinking I’m on the bus and about to head to my appointment and I have my physical ailments that I’m going that I’m experiencing but it’s nothing like what just happened. I mean I had a few minutes to think because the bus stopped and everyone ran over and...

THERAPIST: So you were also thinking that you shouldn’t be thinking about where you’re going when a boy is lying dead in front of you? Hence guilt ?

CLIENT: Yeah.

THERAPIST: Makes lovely sense (joking), why not make yourself guilty while you’re feeling these other lovely things?!!!

CLIENT: [laughter] So the capacity of making myself feel terrible is...

THERAPIST: What are you finding funny now? Which is good by the way…that you are seeing humor ….

CLIENT: It is. It’s hilarious. Because I can step back at least and look at it and find the ridiculousness in it.

THERAPIST: Good, good, good.

CLIENT: Okay, okay. I just think in the moment sometimes I it’s harder for me.

THERAPIST: And why in the moment is it harder?

CLIENT: Because I’m telling myself that...

THERAPIST: Taking it all too seriously. Now, not to diminish the seriousness if, in fact, the boy had been hit by a bus, but you seemed to very quickly jump to that conclusion and then extrapolate the drama before you had any evidence whatsoever. [00:49:26.06] All right. So you’ve now done the ABCs. Would you like to do the D?

CLIENT: Yes.

THERAPIST: And even if you wouldn’t ‘like to” would you please do it?

CLIENT: I’m panicking right now by the way.

THERAPIST: Okay, right now, what are you telling yourself to create the panic?

CLIENT: You’re not going to be able to do the D. That’s what I’m telling myself.

THERAPIST: No.

CLIENT: It’s not?

THERAPIST: That will not create panic. You’re adding something to that thought.

CLIENT: All right. Debbie is not going to be happy with my D that I have right now.

THERAPIST: You’re adding something to that.

CLIENT: I need to have a good D.

THERAPIST: Because if I don’t?

CLIENT: Then there’s something wrong with me. [00:50:01.25] I really do feel that. I’m...

THERAPIST: And if there’s something wrong with me, which in itself is something for us to look at...

CLIENT: I’m going to have to be put away.

THERAPIST: That’s not causing the panic Jessa. Because I don’t think you really believe anyone’s going to put you away.

CLIENT: No.

THERAPIST: I mean I might throw you out the window, but I’m not going to put you away. I’m joking! Breathe and steady yourself. What is creating the panic right now about doing a dispute? Think it through. And you don’t have to rush.

CLIENT: I guess one of the things being it’s not going to be the perfect answer.

THERAPIST: And that’s not irrational.

CLIENT: It’s not?

THERAPIST: No. That could be a statement of fact, and that doesn’t cause panic. You’re adding something to that to create the panic. What are you adding? It might not be perfect and...

CLIENT: It may not be perfect and...

THERAPIST: Therefore...

CLIENT: I don’t know what I’m adding. I’m not sure. [00:51:16.03]

THERAPIST: Think it through. What recipe creates panic? It’s not going to be perfect. Finish the sentence.

CLIENT: It’s not going to be perfect wait. I’m finishing the sentence of a dispute or what the...

THERAPIST: The sentence that begins it’s not going to be perfect. My disputing...

CLIENT: Oh, my disputing is not going to be perfect and (pause) I’m I feel afraid. I do feel fearful of getting out of my old habit of going just jumping to the negative conclusion instead of it’s scary to have a healthier response because I’m not it’s not something I’m familiar with. [00:52:19.06]

THERAPIST: So you think I need...

CLIENT: I think that’s it. I don’t really know.

THERAPIST: So do you think “I would rather suffer panic than think in unfamiliar, right now unfamiliar, ways”.

CLIENT: Yes.

THERAPIST: Think about that. It’s kind of like someone in an abusive relationship who knows they’re in an abusive relationship but it’s familiar. So they don’t change.

CLIENT: It’s very familiar to me, the idea of...

THERAPIST: So if your girlfriend was with a partner who beat her up, would you say I understand, you’re more comfortable with the partner. Yeah, stick with him. Would you say that?

CLIENT: No.

THERAPIST: What would you say?

CLIENT: Get out.

THERAPIST: So you’ve identified a few other times earlier tonight, in different contexts, your comfort with the familiar, even when you know it’s not good for you.

CLIENT: Yeah, I do know it’s not good.

THERAPIST: So what’s your advice to yourself, given your recognition of that right now? [00:53:23.18]

CLIENT: My advice to myself is to begin to really focus on or start to begin to recognize healthier patterns so that the panic doesn’t continue to take over.

THERAPIST: So you don’t allow it to take over. How about contemplating a willingness, if you work to have it Jessa, of allowing yourself to feel uncomfortable with what now is unfamiliar until you get more comfortable with it. Accepting it’s going to feel uncomfortable but it’s healthier. And the more you practice it the more familiar it gets. [00:54:15.15]

CLIENT: But you know what’s interesting, though, this helps me, too, because it makes when I get frustrated...

THERAPIST: When you get yourself frustrated...

CLIENT: When I get myself frustrated, when I see somebody who’s in an abusive relationship, let’s say, or somebody who has you watch them and say, how could they not I, in a way, I’m starting to see that it all runs under the same sort of gamut of what’s comfortable.

THERAPIST: Or familiar.

CLIENT: Familiar. Familiar, not comfortable, right. Familiar. And I just think as much and again, I don’t I really, really don’t want to continue to revisit childhood stuff, but I think the reason...

THERAPIST: It’s okay. The longer you keep believing it the more harm it can be it’s very relevant to look and let’s keep working on disputing it.

CLIENT: Well yeah, because I think I don’t think I realize I don’t even think I realize that that panic was something that was I thought that I was the one that was panicking, and then when I was a child I would run to my parents and say, oh my God, I’m panicking, and then they’d fix it. [00:55:11.24] And now that I’ve gotten older it’s taken me a long time to see that they, too, panic about different things. They just have their way of showing it so that it doesn’t look like panic. It’s panic disguised. So it is it’s a way to be completely real in this situation and to share what it is, I feel my fear, my deep, deep, deep fear is that if I, let’s say, become healthier or start disputing things, that I’m going to distance myself from my family. That’s really what it is because I hear in their language and the way that they speak. And we are close, I’m close with my family, I can hear the irrational beliefs. So every time that I get closer to disputing it, I feel farther away from my relationship with them, if that makes sense.

THERAPIST: I understand what you’re saying. If you say to me does it make sense, well what’s your definition of sense? [00:56:10.21] Is it inevitable that if you stop thinking in healthy ways the way they do you’re going to be distant from them? There’s as much, in my view, potential, if not greater potential, to be closer to them than distant. These sessions are not about you converting your family. They’re about you living comfortably as YOU within the family, within the world, within your life, within yourself. So it would be like you being part of an alcoholic family and your being an alcoholic and then you stop drinking excessively and then you say, no, I better get back to it because if I don’t then I won’t be part of or as accepted or as comfortable in my family. [00:57:08.15] Do you see that scenario?

CLIENT: I do.

THERAPIST: Can you see that’s similar to what you’re doing now?

CLIENT: Yeah, I do see it.

THERAPIST: Your work had better not be a mission to change them, it’s a mission of recognizing what was modeled for you, recognizing how for so long you thought that was normal, truth or the way reality was. Now you’re getting new insights that can enable you to view family more objectively without being like them and therefore step by step finding it easier to live comfortably in your own ski. For example, to allow yourself not to make the bed perfectly, as mummy says you should. But being flexible and telling yourself I’m in a hurry today, I’m going to make the bed imperfectly and it is no big deal. Not hearing your mother severely reprimanding you for an imperfect bed, though she did so many years ago when you were a child. You can tell yourself On Saturday I’ll have more time, I’ll make it a little better. No big deal. Do you see what I am getting at? [00:58:06.01]

CLIENT: I do, yeah.

THERAPIST: Just being easier on yourself is not the formula for separation from your family. Frankly it more likely could result in the contrary. You may find it easier on the inside to have a giggle when you’re with them. Maybe outwardly there may be differences, which would begin a whole new drama perhaps. But on the inside you wouldn’t have to suffer emotionally, when you see things from a healthy perspective. Do you see the point?

CLIENT: I do. I do.

THERAPIST: Now our session time is coming to an end for tonight. So we haven’t fully completed, or you haven’t, going over the ABCDE real time of panic about disputing, or coming back to the instant of thinking that the boy was under the bus – though he thankfully wasn’t under the bus. Thankfully. So I hope from what we’ve done so far, with this example you brought to us to look at, that what contributed to your panic, tell me if you think I’m wrong, was largely your anticipating the worst before you had evidence. [00:59:05.07]

CLIENT: Yes, that’s true.

THERAPIST: Then your automatically comfortably familiar way of creating guilt about your telling yourself at the time – “and I’m thinking about my appointment when a boy is bleeding to death”.

CLIENT: Yes.

THERAPIST: So how easy you fall to self...

CLIENT: Self-blame.

THERAPIST: What’s the word? Self-flagellation. And blame, yes. You see? And with awareness in a moment of panic, a panic can be your alarm clock, like waking you up in the morning. An alarm waking you up – reminding you to think about your thinking.

CLIENT: I have an alarm clock too. Okay.

THERAPIST: Okay. So you have your alarm and you wake up and you say, oh, it’s time for me to get up. In the same way, if you feel this panic, if you take some breaths, step back, make the effort, that can be like your alarm to yourself saying, oh, I’m telling myself harmful stuff again. And then you could dispute it as you started to do and then come up with effective new philosophy or attitude and behavior, which could be – “ let me see if anything happened to the boy and look for the evidence”. [01:00:20.00] And then, assuming you see he’s okay, then notice what you were telling yourself to make yourself panic. And also noticing the “should” on yourself, how you should, Saint Jessa, not think about work when there’s crisis now and then after identifying your should disputing them, and coming up with effective new philosophies. Even if there was a bad accident, telling yourself:” I’ll do what I can. Accidents happen. I didn’t throw the boy under the bus. I give myself permission to be human. And being diligent. I was on my way to an appointment. There was no sin in remembering that”.

CLIENT: In remembering my appointment? [01:01:06.05]

THERAPIST: Yes. And so I accept myself...

CLIENT: And that he made us 10 minutes late. No I’m kidding.

THERAPIST: Well then I accept myself with my tendency to catastrophize and I’ll keep on working to reduce it. That’s an effective new philosophy of self-acceptance and I’ll work on reducing what’s...

CLIENT: I’ll work on reducing it.

THERAPIST: Yes, and I’ll work on noticing when I’m jumping to worst case scenario and make effort to be looking for evidence and so forth. Does that make sense?

CLIENT: Yeah, it does. It does.

THERAPIST: Do you have some greater clarity on how you create your panic?

CLIENT: Yeah, I do.

THERAPIST: About disputing and many other situations?

CLIENT: I do. Maybe I’ll e-mail you this week if I’m in the middle of a situation where I’m creating panic and maybe just need a little sentence or two. I don’t know if that’s maybe we could talk...

THERAPIST: How about e-mailing me your disputing at that moment.

CLIENT: Oh, I see what you’re saying. Okay.

THERAPIST: E-mail me what you’re doing about it.

CLIENT: Okay.

THERAPIST: And I will respond as soon as I get the e-mail.

CLIENT: No, I understand what you’re saying. But yeah, get I actually did do that. I did do that. I e-mailed you when you were away. It never it was the weirdest thing. I was writing, writing, writing, writing, writing. I wrote at least half a page. I mean it was a lot. No, it was maybe almost a full page. It was a long e-mail and it was I guess it was partially anyway, it was I pressed send; it was gone. I could not retrieve it.

THERAPIST: I didn’t get it.

CLIENT: I know. That’s the point. It wasn’t meant to go through. It was so bizarre.

THERAPIST: Interesting. Well...

CLIENT: I was on a rant. Debbie I know you’re away and blah, blah, blah, but na, na, na, na, na, went on and on and on and it was just all the things, and I don’t even remember what I said now because it was one of the nights that had been typical but I was able to type. And so I said let me write her. But anyway, not the point. But I’ll do that.

THERAPIST: I think that’s a good idea, which I do welcome you to do.

CLIENT: Okay. But it’s easier for me to type sometimes anyway than it is for now.

THERAPIST: Then I’m giving you another piece of homework and you can type it, which is completing ABC forms on your tendency to create panic. [01:03:40.10]

CLIENT: Oh, just do the regular self-help form.

THERAPIST: On creating panic.

CLIENT: Oh, that the A is creating panic? Okay.

THERAPIST: The “B’s” create it. And do the forms about anything else. But that is your homework. And next time we have a session that’s what I’m going to ask about.

CLIENT: Oh great. Okay. I’m joking. It’ll be wonderful. It may be; it may not be. I don’t know what it’s going to be. I’m not a prophet.

THERAPIST: Any final questions? By the way sometimes you act like you are a prophet, do you not? Assuming you know the future ! So catch yourself. Any other questions or comments before we finish?

CLIENT: Yes, if next week, also, if or next session, whenever we do, I forgot to ask it tonight, but if we can address just gut not about panic but just gut instinct about certain things and how that fits into REBT?

THERAPIST: Bring it up after we discuss your homework. [01:01.21]

CLIENT: That’s what I was going to okay, so I might feel differently.

THERAPIST: Let’s see.

CLIENT: Because that was my other question for tonight.

THERAPIST: Okay, now how are you feeling now?

CLIENT: Oh better. Definitely better.

THERAPIST: Better than what?

CLIENT: Than I was when I was waiting for you to come.

THERAPIST: Which was feeling? – tell me briefly.

CLIENT: I guess panic, looking back on it, probably panicky.

THERAPIST: And now do you feel panicky?

CLIENT: No.

THERAPIST: And why do you think that is?

CLIENT: Because we talked about it, number one, we addressed it.

THERAPIST: That’s too general. What’s different in your mind?

CLIENT: Well what I’m telling myself is that, number one, that it’s okay that I’m going through these things and that I’m figuring it out. I’m learning. It’s not a new it’s something new, and anything new or unfamiliar takes time to sort of understand. And I’m not sitting here and beating the crap out of myself over the fact that I that there were things I didn’t know, and continue to maybe not know, and over time I’ll hopefully have a better sense of what those philosophies and ideas are. [01:06:14.09] They’re not necessarily going to just come to me like I thought that they should. I’m catching myself. I no, I but I mean that’s how I’m thinking. I thought they should. They must.

THERAPIST: And now you realize...

CLIENT: No, and it’s for my own personal experience with this whole thing. I think it’s a little bit of what’s the word I’m looking for it’s a little it’s a little shocking. It’s a little bit of a surprise to think that it’s a little humbling. That’s the word I was looking for, humbling.

THERAPIST: Careful about changing humbling into anything that could be self-depreciating.

CLIENT: No, I didn’t feel that it was. I actually didn’t feel that when I said it. I feel like it’s humbling because of what I thought that I knew before but not but a factual thing, that I went to graduate school, this, that, I was so reading all the time, how do I not know. But it’s not that. It’s just you learn something new all the time.

THERAPIST: Not everyone learns something new all the time. You’re electing to learn this new thing, and it seems very...

CLIENT: I enjoy learning new things.

THERAPIST: ...beneficial. So just ending on the note that you feel different now than you did an hour and a bit before, because you are thinking differently about it. Correct?

CLIENT: Yeah, it’s correct.

THERAPIST: You’re feeling less panicky now because you have a different attitude. And that is the point. Good job. Good job. You are becoming more aware. You are catching yourself more often. It’s an ongoing process and you’re going along, humanly, with some good progress and some insights, especially when you are not appearing to progress in some matters. So the journey continues.

CLIENT: Oh my God I get tired. But thank you …

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