TRANSCRIPT OF AUDIO FILE:

Session 11 on Wednesday, January 8, 2014

BEGIN TRANSCRIPT:

THERAPIST: Hi Jessa

CLIENT: Hi, Debbie, how are you?

THERAPIST: Good, thank you. So I’d like to start our session by prefacing that I would like a strong part of our focus tonight to be on focus. We said in our last session that we would begin by looking at the homework that you did or didn’t do. There were 2 homework assignments set. We will look at them soon, however, if you are comfortable with it, I’d like to start tonight’s session with a kind of relaxation.

CLIENT: I’d be happy to. [00:01:10]

THERAPIST: The goal of which is to clear out some of the chatter or the mental remnants of the busy day you’ve just had, to help enable you to focus more stringently on what we’re doing. Feedback I’d like to offer you now, that might be surprising to you, tell me if it is, is that being the very bright, active, energetic woman that you are, with a lot going on in your life, you have a tendency to think a lot, to think fast, and to talk fast. In some of our conversations, one in particular, was during our last session, there were times when I would ask a question and you would start by answering it and then go off into this stream of a topic and that stream and that stream. Some of the times, I would eventually get us back to answering the original question! [00:02:28]

CLIENT: (laughing)

THERAPIST: At other times, and part of my therapist role is to make the following assessment, I felt where you went was worthwhile exploring, so certainly, in our sessions, and in all of my work, it serves me well and it serves who I’m working with well, to really focus. Then make a choice about what to do. So, with you, as I’ve paid attention, I have observed the way you can start answering my question, addressing an issue, and then it’s here and there and around there. So one of the things I would like us to do our best to practice tonight is – focus following the relaxation. That is my intention for the session, which may change some as time goes on, we will see.

CLIENT: So are you asking if I have a problem with that or if I think that…

THERAPIST: Not yet.

CLIENT: Oh.

THERAPIST: The relaxation and then addressing your 2 homeworks and what you did and didn’t do, etc.

CLIENT: Okay.

THERAPIST: And focusing on them, very particularly, and seeing how we go in completing our investigation, addressing those 2 areas. Then, in whatever time we have left, if we have time left, we shall see the good thing to do at that time. How does that sound to you?

CLIENT: It sounds wonderful. I think, you know, agree that I think my brain [00:04:04] tendency is that it is overactive, like an overactive bladder—no I’m joking. (laughing)

THERAPIST: (joking) That must “piss” you off.

CLIENT: (laughing) It does. That’s good, and I think we had talked about at one point is that where it affects me is when there is no distraction and there’s nothing really—no TV and no phone, and no book to read, and I’m just sort of lying as I’m getting ready to drift off in the evening hours. I think that’s when it comes sort of to light, in terms of how much anxiety I tend to create in this little brain. So I think that, if you’re offering that focus, I am more than happy to accept. One thing before, though, we do start that, one little realization that I had is I [00:05:10] think, I think that it’s very hard for me to assess whether the thought—I think we’ve had this conversation many times actually, and I continue to bring it up and pound it in—but I think what’s confusing for me is, does the body chemistry sort of get set off and then the thoughts go with the fact that the body chemistry is getting set off or vice versa? I’m willing to bet, that it’s the thoughts because the body has a body of its own. In other words, the heart pumps (inaudible) so my imagination would be that it’s the thoughts, but the reason it’s hard for me to see that is because, sometimes, I don’t think I’m thinking anything? And then I’m still having that nervous, panicky feeling. Am I making sense with that? [00:05:59]

THERAPIST: To briefly answer your question, really our thoughts, our feelings, the visceral reactions, (crosstalk) the biology are connected and influence one another. They are very much intertwined. I just want to point out to you that I started off by saying our focus will be focus! So let us now start with the relaxation and then (client laughing), and then look at your homework, (client laughing) and your active mind still brought up that question !!!so I hope you are seeing my facial expression and you’re hearing my voice, indicating that I’m not being critical. [00:06:28]

CLIENT: (laughing) Is this avoidance? I don’t know maybe it’s just…

THERAPIST: Let’s not over-analyze. Focus!

CLIENT: Okay, (laughing)

THERAPIST: I would like you to become aware…

CLIENT: Okay, okay…

THERAPIST: More aware of your tendencies, and then you may be able to change the unhelpful ones more efficiently.

CLIENT: (gurgle sound) (laughing).

THERAPIST: Got it?

CLIENT: I got it. (laughing)

THERAPIST: Okay. So my original question was…

CLIENT: (laughing)

THERAPIST: … are you comfortable with the idea of a relaxation and then focus …

CLIENT: Yes.

THERAPIST: …on the 2 homeworks. [00:06:59]

CLIENT: Okay (laughing)

THERAPIST: … and then we’ll see whatever else happens.

CLIENT: Okay.

THERAPIST: So let me point out to you that if you had taken that in and possibly not had other thoughts and ideas going on—by the way, join the human race, that is our easy tendency to let our minds meander when we are not being disciplined—but we’re working together to help you learn how to use your mind in a healthy way. You can really choose what works for you and it doesn’t mean we need to come to our easy, succumb rather, to our easy tendencies (crosstalk). So if you focus, listen well and retain that—you see when you allow yourself to think of lots of thoughts, it’s harder to retain the original one.

CLIENT: Yes it is. No wonder I never thought I had a good memory. (short pause) I’m being serious.

THERAPIST: Okay, but let’s not go there now.

CLIENT: (laughing) I knew you were going to say that. Okay, let’s not, let’s not.

THERAPIST: All right so that….

CLIENT: I think I’m feeling, I’m creating a little bit of anxiety to answer your [00:08:00] question about the relaxation because I don’t know what you’re going to do. Oh well, okay. That’s what it is. I don’t know what that is, so (laughing) I don’t know why it makes me a little—I don’t want to say it makes me nervous or I’m making—I know I’m making myself nervous because I don’t know what you’re going to do. That’s…

THERAPIST: You’re not making yourself nervous because you don’t know what I’m going to do.

CLIENT: So what is this then, because (laughing) I don’t know. (laughing)

THERAPIST: My hypothesis is you’re making yourself nervous because you don’t know what I’m going to do and you may have a belief which you add to that: “it may be too hard, too much, I may fail at it and that would be awful.” I would think that kind of flavor of thinking would make you nervous, but now, how about we just do it – the relaxation?

CLIENT: Okay. (laughing)

THERAPIST: Notice your tendencies.

CLIENT: I know.

THERAPIST: Can you see and do you believe I am not being critical?

CLIENT: Yes I do. No, no, absolutely.

THERAPIST: I’m simply pointing it out…

CLIENT: I’m happy you’re pointing it out.

THERAPIST: …so that you can choose, if you wish, to be more aware of where your [00:09:03] thoughts are going and to give you a greater ability to focus. So how about we do this “horrifyingly, scary” relaxation !!!

CLIENT: Okay. (laughing) Okay.

THERAPIST: Do you meditate?

CLIENT: Umm yes…and

THERAPIST: Okay, “yes”, that would be a sufficient answer. Do you cross your legs, sit with crossed legs when you meditate? Or …

CLIENT: I do it different every time.

THERAPIST: Okay, what position? Now you’re sitting on a couch. What position, sitting position, would be most comfortable for you, right now? We’re only going to do this for a few minutes.

CLIENT: Actually I’m fine like this.

THERAPIST: It’s better, according to some teachers of meditation to sit in a more open posture your legs are tightly crossed.

CLIENT: Oh, okay.

THERAPIST: So it would be better to uncross them or sit with your legs, you know, in kind of a lotus…

CLIENT: Like a pretzel?

THERAPIST: If that’s something you do and it’s comfortable. Otherwise …

CLIENT: Due to the back issues I have going on, it would be more comfortable for me to actually rest my back against the couch that’s here.

THERAPIST: Very good. Make yourself comfortable. A straight back is very good. A supported back means less effort too. I suggest that you don’t think about being “perfectly” comfortable, just comfortable enough.

CLIENT: I’m comfortable (inaudible).

THERAPIST: All right, so, close your eyes now. We’re just going to do this relaxation briefly —the goal is to relax as much as possible, and if it’s not possible, I predict the world will not end.

CLIENT: That’s true.

THERAPIST: Probably not anyway, we’ll see. (laughing) All right.

CLIENT: (laughing)

THERAPIST: So, sitting comfortably, take a few clearing breaths now, without forcing, but deep comfortable breaths all the way in, slowly, slower than…

CLIENT: I have to stop for something for one second though, because I feel like I have to laugh and get it -I don’t know why (quiet laugh). [00:11:04]

THERAPIST: Go ahead.

CLIENT: (quiet laughing) Okay, okay, all right.

THERAPIST: What is striking you as funny?

CLIENT: (laughing) I can’t say it. I can’t say it. I can’t. Okay, it’s nothing, nothing. It’s just, I get, it’s like, it’s kind of …

THERAPIST: Are there any images coming up that distract you.

CLIENT: No, no, no, no, no, nothing like that, no, nothing like that. It’s fine. I got it out.

THERAPIST: Okay, all right, so close your eyes. So, again, I suggest now that you take a few deep breaths without forcing (client laughing). You’re laughing is…

CLIENT: (laughing) I don’t know why, (laughing). I don’t know.

THERAPIST: ..not unhealthy.

CLIENT: (laughing) I don’t know what that—it’s I guess, maybe—you’re the therapist, you could have an explanation, possibly you might, as to why I …

THERAPIST: I left my psychic machine at home, so no I can’t figure out what you’re thinking – how about you tell me.

CLIENT: Okay, well I think it probably is just new. It’s something new, which is not a reason to laugh, I don’t think it’s that, but… There is one thing that is funny though; there is one thing. Because when I think of you sometimes, I think of you as a character; no you are a human being, (chuckle) but I’m saying you are very funny and I do laugh a lot at some of the things that you—you have a good sense of humor—so I’m hearing you do it and I’m having a hard time taking it seriously (chuckling). Even though I know that everything you do is serious, I just…

THERAPIST: Is everything we do serious?

CLIENT: No (laughing) it’s not. So I hear your voice. Maybe it would be better if I had like an eye mask or something? I don’t know. I just…

THERAPIST: An eye mask, but your eyes are closed and you’re laughing! (client laughing) Why do you need an eye mask—maybe you want an eye mask over my mouth !

CLIENT: (laughing)

THERAPIST: All right.

CLIENT: All right, I’m ready, I’m ready. Let me take a little, okay (laughing). Whew, all right, I’ve never done anything like this before, I really haven’t so just forgive me, I need a minute. Whew. Okay, I’m good. (laughing) I’m really good, I am. I want to do this. (laughing). Once I start, it’s hard to stop.

THERAPIST: It’s rather fascinating isn’t it?

CLIENT: (laughing) I wasn’t expecting this tonight. I had my little—it was the expectation. Oh I did my homework. Debbie’s going to go over all the things, and I think that what is now happening is that you’re hitting probably what is my biggest issue, that it’s very difficult for me to focus. I know it is. So I think where—(laughing) because I don’t know what the reasoning is, or know what the rationale behind it is, but I’m imagining it’s my – I don’t know. So when I’m actually sitting here and you’re telling me, “Okay we’re going to do an activity where you just are quiet for a few minutes,” it’s not the easiest, but I will do it. I will try my best. (laughing) Don’t smile at me that way! (laughing) I want to do it, I want to. I actually really, I’m being serious now, I do, I want this for me. I want to learn how to relax, because I’m afraid I don’t know how to do it that well.

THERAPIST: Okay, this is just a brief exercise.

CLIENT: (laughing)

THERAPIST: As I think mentioned, although brief may now not apply anymore. We may have to visit the …

CLIENT: (laughing) I killed it. (laughing)

THERAPIST: All right, okay. Jessa, be aware of what’s happening now.

CLIENT: (laughing) I am. I can’t not be aware.

THERAPIST: It’s very fascinating isn’t it?

CLIENT: (laughing) Whew, okay, now what?

THERAPIST: So would you be willing to close your eyes…

CLIENT: (laughing) Yeah, okay.

THERAPIST: We’ll try one more time and, in fact, if it’s hard for you to curb your laughter, we’ll move one, that may or may not indicate that you are more relaxed than at other times and in any case we’ll go with it. So we’ll just try one more time and that will be our last attempt for tonight.

CLIENT: Okay, got it, got it. Can I turn this way though so I don’t actually (laughing) see you? It’s just that it’ll be easier for me to turn.

THERAPIST: If it…

CLIENT: (laughing) I just hear you—let me just turn, is that okay? (laughing)

THERAPIST: (Joking) Okay, would you like to sit in the corridor and I’ll shout.

CLIENT: (laughing) Okay, I’m ready. I’m going to turn. Okay.

THERAPIST: Can you get in a relaxed posture, perhaps…

CLIENT: This is relaxed.

THERAPIST: …both hands on your knees or…

CLIENT: That’s actually not….

THERAPIST: …oh because of your shoulder. All right, get comfortable. All right. Closing your eyes. I’m going to ask you now to take your awareness, Jessa, to the top of your head and become aware of the top of your head and suggest to yourself that you just relax, from the hair to the skin, in through the skull, the bone, (client laughing) the protective fluid around the brain, just see if you can let go of excess activity and just slow it down, slow it down. If you can become aware of creating that kind of “let-go” feeling for now, then let that easy feeling move down through your face, your forehead and your eyes, nose, temples, cheeks, mouth, chin, the back of your head, every part of your head and brain, just letting go now, just taking it easy, relaxing. (short pause)

Now take your awareness of that more easy feeling, and move it through your neck, skin, the tissue, the bone, the cartilage, the throat, and letting this easy feeling, a kind of warm, easy feeling, then move down through your shoulders and almost feel them drop a bit, drop some of their effort, drop tension. Down through your arms, into your hands, through every finger and thumb and then feeling this energy move down your upper torso…

CLIENT: (quietly laughing) I’m very relaxed, I am. (laughing) I’m sorry. I am actually very relaxed.

THERAPIST: You can move the energy down through your chest and upper back…

CLIENT: (laughing)

THERAPIST: All right. I think (client laughing) we’ll stop this visualization at this point. (client laughing) What’s happening Jessa?

CLIENT: (laughing) Debbie…

THERAPIST: Miss Giggles here.

CLIENT: (laughing) It’s just, I think when I hear, for some reason, like when I hear your voice (quietly laughing) and you’re so descriptive, like your torso (laughing) it’s joy. It’s not like a bad thing, but it’s (laughing) something I never saw you do, so it’s just interesting. It’s a little different than our typical, what we….

THERAPIST: Okay, all right.

CLIENT: I don’t know. I’m going to be quiet, but that actually was very relaxing, and I don’t allow myself. Here’s the problem, I don’t give myself permission to relax (laughing)

THERAPIST: Oh you don’t say? (client laughing) We might revisit that…

CLIENT: Do you think, can we come back to that after I think…

THERAPIST: At some point, if not today, another time and at some point it may be worthwhile for you to sit through the torture (client laughing) of such a procedure, not only for the sake of our doing it in session, but it’s something you could do on your own if you wake up very early, something you could do on the train in some ways, with your eyes open in that case, but still you can intend to let go of tension, telling yourself, “I relax my forehead” and so forth.

Anyway, that was very interesting.

CLIENT: (laughing)

THERAPIST: We will revisit this (client laughing) in all probability, okay?

CLIENT: Oh, okay.

THERAPIST: So just center yourself now Jessa, and tell me when you’re back. Tell me when you’re here, ready for whatever we will do in the time we have remaining in our session.

CLIENT: I’m ready, I think.

THERAPIST: So, listen to me. Listen, listen, listen. Focus.

CLIENT: Yeah.

THERAPIST: Our focus of this session is focus. My challenge to you is to stick with a particular, one at a time issue that we are going to look at and, specifically we’re [00:21:05] starting with looking at the two homeworks. So we’re going to stick with one and pretty much stay within that parameter, unless there is a very beneficial reason not to. Are you with me?

CLIENT: Yeah, I am.

THERAPIST: Reminding you the focus of tonight is partly practicing focus, okay?

CLIENT: Flow?

THERAPIST: Focus. Okay, focus is a much more determined conscious application of your attention and thinking than flow, which actually doesn’t necessarily involve conscious focus discipline. So flow is different from focus.

CLIENT: Okay, I didn’t know. I really didn’t.

THERAPIST: So let’s stick to looking at your homework and perhaps in the future we can talk about flow versus focus.

CLIENT: Okay. (quiet laugh)

THERAPIST: So what were your two homeworks. Focus Jessa. [00:22:00]

CLIENT: Okay, my two homeworks were: The first one was to come up with effective new philosophies, and then second one was to come up with ways to soothe myself.

THERAPIST: Self-soothing comments is what I jotted down. So, yes if you’ve thought of other ways such as (laughing) and relaxing (client laughing) – fine, but specifically there was the invitation to find some self-soothing thoughts, comments, words you could tell yourself if…

CLIENT: Exactly.

THERAPIST: All right, so the first one was the effective new philosophy.

CLIENT: The way I did it was, it was sort of—the effective new philosophy is I didn’t do it with the old homework. I did it with the self-soothing.

THERAPIST: That is interesting that you modified the homework…

CLIENT: The homework that you gave me…

THERAPIST: Why? [00:23:02]

CLIENT: Because when I did the actual homework, I didn’t have the old stuff with me.

THERAPIST: And did it occur to you do it later when you had the old stuff?

CLIENT: (chuckle) Yeah, it did.

THERAPIST: I’m noticing, again, now boldly giving you feedback here that

CLIENT: No I know what your feedback…

THERAPIST: That, at times…

CLIENT: I don’t do what you ask…

THERAPIST: You don’t do the homework. And you’re smiling and

CLIENT: Yeah I know.

THERAPIST: …but this is important feedback and you have a little bit of a rebellious look on your face. (Client laughing) So what do you think is behind that and let us be maintaining focus. We are looking at your first homework which you modified.

CLIENT: Yes.

THERAPIST: Because?

CLIENT: Because I felt—I was concerned that, well I guess for the purpose of the [00:24:00] therapy, I knew what you had asked me was very clear with the self-soothing, but effective new philosophies, I still don’t feel like I’m good at those.

THERAPIST: Which was the reason for us selecting that homework.

CLIENT: I know.

THERAPIST: Yes.

CLIENT: So I sort of, yeah—(clears throat) how do I say this? I think it’s becoming easier. Each piece, piece by piece, is becoming easier and easier or more natural for me to do. For instance, the …

THERAPIST: You use the word, natural. I’m going to discourage that ….

CLIENT: Okay. I’m sorry, go ahead, no, no I have nothing to say, go ahead.

THERAPIST: … simply because that implies that you already have a feeling of ease with it and do it automatically. However when you haven’t been doing that habitually in your life so far, there’s the danger of you, just by thinking in that way, using that word, of your having a too harsh, possibly perfectionistic expectation of yourself. Setting yourself up for a fall.

CLIENT: I’m aware.

THERAPIST: That’s a good start. What are you going to do about it, if anything? Does it serve you to use that expression?

CLIENT: No, it doesn’t. Umm, no it doesn’t. There’s nothing to really say, except no.

THERAPIST: Will it benefit you to dare to just do whatever tasks you choose to focus on doing, without expecting that they feel natural or that you’re good at them real fast, real soon, and that you must succeed in no time?

CLIENT: Yeah, I guess when I go to do the homework, I hear your voice in my head saying…

THERAPIST: There’s my voice again. [00:26:08]

CLIENT: I know (laughing) giving me an effective new philosophy and it always sounds so good and, I guess, for me, I steer away from things that I don’t—it’s exactly what you just talked about. The setting myself up to fail before I even just go full throttle.

THERAPIST: And when you steer away from trying to make the effort, from making the effort, you can prevent yourself from seeing how wise you can be.

CLIENT: I know, I know.

THERAPIST: Then you continue to reach out and, and want your parents’ approval, and want to get your girlfriend’s support, and then you deprive yourself of assessing your efforts on your own. And enjoying the fruits of doing so.

CLIENT: Exactly.

THERAPIST: And you miss out experiencing how strong you can be.

CLIENT: I know.

THERAPIST: Which you have witnessed in yourself in the past when you were there for others, but you’re not allowing yourself to develop the muscle of doing that now with your thinking. Diligently you go to work out at the gym, Jessa. Even when your shoulder and neck are pulsing in agony, you go to the gym, and you build up some of your other healthier muscles and…

CLIENT: Because I know I’m good at that; that’s what it is. This is what I tend to do. Something that I…

THERAPIST: When you first started, you weren’t as good, is my suspicion. [00:27:07]

CLIENT: At the gym?

THERAPIST: Uh-huh.

CLIENT: I started when I was little, so I don’t remember really.

THERAPIST: Well my hunch is you’re probably better now than you were then in the gym, and you’re definitely bigger than you were (client laughing) and your muscles are stronger than they were, so there’s been development, is my point. Only because you’ve been doing it a long time. Same with this, with exercising healthy thinking and focus.

CLIENT: That’s true.

THERAPIST: You’re not giving yourself the chance to see how successful you can be. Being human, you may fall back. Hello, that’s part of being human, but you’re not even daring to give yourself that chance.

CLIENT: I love that we’re having this conversation. Can I say one thing that I think will be helpful, for myself, but also, I just want to say…

THERAPIST: Say it. You don’t need my permission. But I suggest you focus on what we are speaking of now.

CLIENT: Okay, with staying focused with that, this particular topic came up, and it hasn’t come up about giving myself the credit and taking the risk and doing things. But it’s interesting that I think back to sort of where that whole thing began. When I was a young girl, it sort of [00:28:10] started where I had very intelligent, sort of, controlling-type of parental figures and, from a very young age, I never did any of my work—this is definitely I hope not getting out there. So when I say really never did any of my work—for an example, I would get a project to make a diorama was what I specifically remembered and I was about maybe 7 or 8, and I brought the diorama to school to obviously bring it in for a grade, and I remember being so proud because it was the most beautiful diorama, but I didn’t do it. My father did. And then the same thing would continue with different projects. My college essay, I said, here, can you look it over. The whole essay changed and became something different.

THERAPIST: So…

CLIENT: I’m not saying, let’s continue to stay there. What I’m saying is that I’ve sort of yearned to have those feelings of self-efficacy and to know that I am a very bright, [00:29:05] intelligent woman who can do things on my own. But I think, when I think back sort of to how did that all sort of come to be, of being so, umm so afraid to take a risk or to do something; I think it was because I did say “Mom, Dad” – wanting help and then it was done and then it was done their way, not my way and there was a lot of criticism all mixed in one. So, without going back and blaming … without blaming, saying I want to be able to—I recognize that is where that came from and I recognize it more now than just recognizing. I’m putting sort of the pieces together a little bit that, you know? That I might not have had that experience when I was a young child, but that I can have it now. I think that’s where I wanted to rely on myself.

THERAPIST: You can if you let yourself, which brings us back to the homework.

CLIENT: It’s harder, it’s harder I think.

THERAPIST: You use that word a lot in some of our sessions (client moaning). So it’s “hard”. That doesn’t mean it is TOO hard. [00:30:04]

CLIENT: Really?

THERAPIST: Well if you convince yourself it’s too hard, then you’ll restrict yourself.

CLIENT: Okay.

THERAPIST: But…

CLIENT: This is a lot of new territory though. I mean, I say that every time, but it’s only been—I say it every time because it’s still new. Do you understand?

THERAPIST: That’s right, so given that it’s new, I wonder if you’d give yourself a break and be willing…

CLIENT: I am training…

THERAPIST: …to imperfectly do your homework instead of modifying it so that in your own mind you don’t do it wrongly.

CLIENT: Okay.

THERAPIST: Do you hear what I’m saying?

CLIENT: Yeah.

THERAPIST: Which is, like right now, we’re exploring the homework realm and the fact that you modified it (client laughing) and seeing what you told yourself...

CLIENT: That I wouldn’t, yeah.

THERAPIST: …that led to your doing that. So it’s all very informative and interesting, the more aware you are of what you do and whether it helps you or sabotages healthy goals. In your case, the area you’ve just touched on, is knowing within yourself, your efficacy and potential and smartness much more than you let yourself have a chance to know. So, it’s not been a waste.

CLIENT: What? What hasn’t been a waste?

THERAPIST: Well, the fact that you didn’t do the homework as we discussed. We’re learning from it. You also didn’t do it. But we make use of that experience by seeing how it is a tendency which doesn’t serve you. With awareness, you can change it. Now you also did your version of homework, so I’d like to hear that now. (Client laughing) and then we’ll look at the second homework which was?

CLIENT: There was the self-soothe and then there was the effective new philosophy.

THERAPIST: Aren’t we talking about the effective new philosophies now?

CLIENT: No, no. I did the self-soothing, but I—what? [00:32:04]

THERAPIST: What have we just been talking about that you modified? That you didn’t do exactly.

CLIENT: Well I did the self-soothing, but what I was attempting to say was that I kind of felt they blended, the self-soothing and the effective new philosophies. I really didn’t know the difference. Because I knew that what I was writing were self-soothing philosophies, but I thought that they were also effective. I didn’t do the effective new philosophies for the old—wasn’t that what you had wanted, had asked? Was for the old…

THERAPIST: The ABC procedure that you did in our last session.

CLIENT: Right, no I did not do effective new philosophies for those.

THERAPIST: For those.

CLIENT: Correct.

THERAPIST: Because?

CLIENT: As what we said.

THERAPIST: Because of what we said.

CLIENT: I don’t want to repeat them. (laughing)

THERAPIST: So the second one…

CLIENT: I didn’t mean that, just…

THERAPIST: So the second homework was…

CLIENT: Self-soothing.

THERAPIST: Self-soothing statements and the idea of that came from the fact that you brought up that you, at times wake up at all hours and you can’t go to sleep and you get yourself into a panic. (Client sighs) You know it’s part of having tools there at the ready in case that happens again, if that happens again. It helps you to have some soothing statements at the ready that you can repeat. That was the purpose of my suggesting that. So, did you do that?

CLIENT: Yeah.

THERAPIST: Okay, so let’s hear it.

CLIENT: Okay, so, (flipping pages) let’s see. So the first thing I said is “Nothing is as bad as it seems”—so this is what I tell myself when I’m actually in that state, anyway. This is how I …

THERAPIST: State of panic?

CLIENT: Yeah, of panic. “Nothing is as bad as it seems when you’re in it than when you’re out of it.” “Nothing is as bad as it seems when you’re in it than when you’re out of it” Yeah. It made sense to me.

THERAPIST: When you’re out of it, it doesn’t seem that bad.

CLIENT: Yeah, exactly. Exactly. “If I get carried away, I can recognize I’m allowing myself to get carried away, take deep breaths and get a healthier perspective.” [00:34:03]

THERAPIST: Oh yes, you could take deep breaths! (Laughing)

CLIENT: Not tonight. That was not happening.

THERAPIST: All right, very good. No, no, very good.

CLIENT: Another one “I learn to be more patient and work on not predicting the worst.”

THERAPIST: Very good.

CLIENT: “If I don’t fall asleep when I want to because my mind is preoccupied or because I’m experiencing anxiety about the anxiety, I can remind myself that I will survive and that eventually my body will tire.” I guess it does eventually.

In fact, I’m going to stay focused, but I would seriously be curious to know if anyone died from not enough sleep?

THERAPIST: Stay focused Jessa. Stay with what we are talking about

CLIENT: (laughing) Okay. Oh, all right, hold on, let me get out the laugh. Next one “I do not have to compete”—oh here, “I do not have to compete with my body to make it do something I’m not ready to do, and that includes sleep.”

THERAPIST: I don’t understand that, please clarify how do you “compete with your body”?

CLIENT: No I don’t compete with my body. (laughing) I meant to actually say, I don’t know why I put my body, compete with others who do sleep well (therapist saying “ahh”) and make my body do something I’m not ready to do, and that includes sleep. [00:35:10]

THERAPIST: When you compare to yourself …

CLIENT: When you have sleep issues, (crosstalk) comparing, exactly. Okay, “I will stop creating anxiety over what people will think of me. Most people are too busy to care and the ones who care enough need a life.” Well, they don’t really need a life, but—In other words, I create anxiety over what are people going to think if I’m not productive, you know, that kind of stuff, okay.

Next, now I talk to myself in this one. “Jessa, be your own best friend. Only I know what I have been through and I will forge ahead with the person who knows best, which is me.” I don’t know if that’s a new philosophy, but that’s what I think.

“I do not need to prove myself to anyone. At the end of the day, I live with me and I know I am imperfect, so is everyone else, and I can live with that.”

“I can forgive others and I can live with the fact that,” –wait, I can’t read my own writing. “I can forgive others and I can live with the fact that others have wronged me at some point. Life is full of disappointment, but I have the choice to allow it to bring me down or to raise myself up to a higher spiritual level.”

THERAPIST: Watch out for overgeneralizing. Is life FULL of disappointment, as you say?

CLIENT: No. Next one -

“Panic may set in at another time in the future, but I can deal with it and wait for it to pass, because it will. Nothing lasts forever.”

“It’s okay. I’ve made mistakes. I’m human…”

THERAPIST: The panic “will set in”? – that is what you just said.

CLIENT: I don’t want to be so extreme to assume that I’m not going to ever feel that panic again.

THERAPIST: Might it be more beneficial to phrase it, “If I allow myself to experience panic, to create panic.” That kind of comment is actually empowering. Instead of assuming that it will set in.

CLIENT: Yes. That way of putting it is empowering, yeah.

THERAPIST: Because it is reminding you, you created the panic. And can therefore UNcreate it.

CLIENT: I see, okay.

THERAPIST: Again it reminds you, with effort, you can uncreate it. This is an empowering approach when you apply it, and it doesn’t let you get away with not taking responsibility. That’s the good news.

CLIENT: Okay.

THERAPIST: But it’s bad news for people who like to blame others or circumstances.

CLIENT: Got ya. I like that actually. “If I allow myself to create panic another time in the future, I can deal with it and wait for it to pass. Nothing lasts forever.” So it’s still the same, but not.

THERAPIST: It is putting it differently and in a healthier way.

CLIENT: Okay, so now I talk to myself again. “It’s okay, Jessa. You have made mistakes. You’re human. You’re fallible and you still have worth. Just because I’m human and I’m alive. I don’t like my situation right now, but I can behave differently despite pain, frustration, and everything else going on, plus I always have hope.” That was it, and then I have some stuff.

THERAPIST: Hang on. You say “I always have hope?” No, you don’t always have hope.

CLIENT: Well, I mean nobody can take that—it isn’t without hope…

THERAPIST: “I always have it?”

CLIENT: Oh, okay.

THERAPIST: Because, when you’re panicking, in that moment, I don’t know how much hope is experienced.

CLIENT: That’s true. [00:38:00]

THERAPIST: You CAN always (client talking over, saying oh, okay). You can. That is accurate. But saying that you always have it when you don’t, that is lying to yourself, and is that helpful? You can work on having it more of the time. You can work on disputing hopelessness.

CLIENT: Okay. So that was that part of the homework, and then I think that was easier to do than after other sessions. This was also the soothing. I did both. I stayed away from the—I did double of the (giggling.) Still to be considered a good student, but, no I’m teasing, but I really. I did. I also felt that this was—not to say that the—I don’t want to go against what you had asked me to do, even though it probably appears that that was rebellious and, maybe partially; but, in addition to that, I feel that, because I’ve been having sleep issues, because I’ve created sleep issues, I thought that this was more pertinent rather than just doing the homework just to do it. I felt that I really needed this at this moment.

THERAPIST: To rephrase You felt that you could really benefit from this?

CLIENT: Oh, yes, I can really benefit from…

THERAPIST: Let’s hear it.

CLIENT: Okay, “Jessa, everything is going to be okay. You are not going to die if you don’t get enough sleep. I know you think that everything is a mess right now.” This is more of a novel, (small chuckle). “But in the scheme of life, it’s not a catastrophe. Enjoy the darkness and being alone. You never really are alone.” It’s a little spiritual is that all right?

THERAPIST: Of course it is.

CLIENT: Okay, “God is always with you and even when I decide to torture myself” (laughing.).That’s funny. I didn’t even realize that I wrote that. It was a few days ago. “And even when I decide to torture myself, He is still there, guiding me from the other side. Most things in life happen for a reason. Jessa, you are not a bad person for missing work today. You have the option of being kinder to yourself...” This is pretty good. “…and not beating the crap out of myself…” (laughing) Oh my God. (laughing) I like this. “…and not beating the crap out of myself for not having the answers right now during this very difficult period in my life. I am doing what I need to do in order to get to the bottom of what I’ve been dealing with for 7 months. At least, now, I am aware of what’s causing my pain and I have choices in how to proceed. Everyone will have their own personal opinions about how they think ‘I should proceed.’ I can stand their opinions. They may not match mine. I may not like it if I make a choice that ends up being not ideal in this situation, but I can stand it. I can live with all of this. I may even be able to find some pleasure…” Wait, “…in not the pain necessarily, but the journey that I have been on to get there.” This is really good. (laughing) “The journey has been my own unique journey that no other person in the world has had. I can appreciate my journey myself with my pain and without my pain. I can enjoy my tendencies and laugh at them a little more.” I don’t know where this came from. “There can be humor in some of the tendencies…”

THERAPIST: You don’t know where it came from?

CLIENT: No, I feel like I’m actually getting this now. Because I did it several days ago and I… (laughing)

THERAPIST: You did it 1 day ago.

CLIENT: Oh, yeah, I did it yesterday. (laughing) I’m going to laugh. I did have a little, anyway. I’m…

THERAPIST: You did have a little what?

CLIENT: (laughing) No, I’m laughing. When I laugh like this, it’s sometimes (laughing) hard for me to stop. Okay. “I can enjoy my tendencies and laugh at them a little more. There can be humor in some of my tendencies and thoughts that I have used in the past. I can work on calming myself down, and if I do not do it perfectly the first time.” I stopped there. I don’t know why I stopped, but I did, but I can finish it now. “If I do not do it perfectly the first time, I will try again.”

THERAPIST: Do it perfectly?

CLIENT: No, no, I will try…

THERAPIST: Again, can I suggest to do it imperfectly, but well enough?

CLIENT: Okay, fine. Like the other homework that I didn’t do. (sighs) Okay. I probably got distracted and that’s why I didn’t finish. (laughing) “I will try do it imperfectly, but well enough you said?” I just want to have that.

THERAPIST: Focus now Jessa. Stop and think. Rather than just writing down what I said, what would be the healthy statement for you to reflect on? You used the word, ‘perfectly’, there. You know you have had the tendency to strive for perfection and that doing so hurts you. So you tell me a useful way of putting it, in your own words. [00:42:00]

CLIENT: Okay.

THERAPIST: I don’t think the “perfect” helps you.

CLIENT: No, it doesn’t, so “I will work on calming myself down and if I do not do it perfectly ” So I want to take that word out then. I want to take the word, perfect…

THERAPIST: Rephrase.

CLIENT: Okay, “I want to work on calming myself—I can work on calming myself down and, if I am not successful—and if I do not succeed, do not succeed the first time around, I can give it another go.”

THERAPIST: What’s that old saying, “If at first you don’t succeed …?”

CLIENT: Try and try again. I mean, I’ll just say “I can keep trying. I can keep it up without” hold on, this is important, “without self-blame for not doing it right the first time.” [00:43:02]

THERAPIST: That is important. And helpful.

CLIENT: …and not doing it right because there’s no right or wrong in that. It’s me calming down, so without succeeding or without—no, I’ll be more specific, “without self-blame for not being able to calm down.”

THERAPIST: Both.

CLIENT: Okay. “and not succeed…”

THERAPIST: And not achieving the calmness and not putting yourself down, not damning yourself and any inefficiency.

CLIENT: Okay, (sighs) so, that was that.

THERAPIST: All right, well it seems to have had more of an effect on you now than when you originally wrote it. It seems almost as if you’ve been experiencing this for the first time. So my hypothesis is that you were doing the homework, to do the homework, rather than fully being immersed in it and feeling its results. Would that be right?

CLIENT: No, that’s not. That’s not really correct.

THERAPIST: Good, I’m glad.

CLIENT: I think what’s happening is that it’s slowly—I’ve been reading a lot about it in yours and Al’s books that you’ve been kind enough to share with me, and I think eventually when you read, read and get the weekly sessions, I think eventually it does drip in. It just takes…

THERAPIST: The more effort you make, the more you maintain and retain, and the better it can be.

CLIENT: I just think it’s—I used an example last time where, you know, you study, study, study for a test and you think you don’t know anything and then you go to take the test and you actually get an A and that’s what I felt when I was reading it just now. Wait a minute, I do know more about this than I gave myself credit for.

THERAPIST: Which was my point earlier on when we were talking about you modifying the homework because you don’t feel you’ve really got it yet. The…

CLIENT: The effective new techniques that…

THERAPIST: Yes.

CLIENT: I do still need maybe a little work with that.

THERAPIST: And so by not trying at all, you don’t even know how much you do or don’t have ability or facility with that part of the ABC process. So the homework I want to give you—we’re not quite finishing up yet, but in the light of what you’ve shared, the homework that I want to give you, and tell me if you think that it’s something you will do, is ….

CLIENT: (laughing)

THERAPIST: You have 2 REBT books. You’ve got the one authored by me and Al (Albert Ellis), you’ve got “Rational Emotive Behavior Therapy”, and you’ve got the book Al wrote which I did much of the research for, “The Myth of Self-Esteem”. CLIENT: (sneeze) Yeah.

THERAPIST: Each one, if you look in the index, has a section on the ABCDE method. So my suggestion to you for the coming week’s homework is to read, the sections in both books, slowly and thoroughly. We are not going to meet again for our next session until next week, so you’ve got a few days and nights. You’ve already probably read them quickly from what you once told me, or read parts of them, but since you’re telling me that you’re not comfortable yet with the E, it’s not—what’s the expression? “It’s not…”

CLIENT: Rocket science?

THERAPIST: Yeah. You can come to see that it is not complicated. You know if you understand ABC, there’s nothing all that more complicated with E stage. And yet, for you, there is something that you’ve not been comfortable with. So I’m suggesting, asking, are you willing to take your time to read those 2 books, at least those sections on the A B C D E method, which are not long…?

CLIENT: On this specifically, on the effective new…

THERAPIST: On the whole ABCDE, because the E effective new philosophies follow the disputing, which follows the detective work, finding the irrational ideas. Doing at least one thorough ABCDE. Being willing to not to do it perfectly, but well enough. Being willing to have a giggling fit or a crying fit when it comes to E and baking a cake instead for a distraction (client giggling) but see how you go persisting. That is the homework between now and next time, read and let yourself substantially take it in. Read it. Read it. Don’t do your ABCDE until the next day, after reading it. Read it again. Let it sink in and then do it and see how you go. And if there are real stumbling blocks, we will look at them the next time. How does that sound?

CLIENT: That sounds good. [00:47:50]

THERAPIST: Good.

CLIENT: So I just want to make sure I’m understanding correctly. So, I get the reading piece of it and that is from both books, you said in the index. I can go specifically to the ABCDE…

…but then you said just sort of going from one thorough …

THERAPIST: At least one.

CLIENT: Okay.

THERAPIST: If the inspiration takes you to do two, three or five hundred, go for it, but I’m not wanting to give you too much. At least one thorough ABCDE process, with mindful focus and attention on every letter of the process, including E. Do-able?

CLIENT: Yeah that’s doable. I’m going to really, (giggling) attempt to not modify. No, I’m not on that.

THERAPIST: Well you can choose to modify it, but where will that get you? Homework It’s not about you pleasing me.

CLIENT: I know, it’s about me, I know. Can I ask you then, can we do an example together then again, of an effective new, if I give you one of the things…

THERAPIST: Now?

CLIENT: Yeah.

THERAPIST: Let’s do that.

CLIENT: Okay, so I’ll go over one from last week and then we can make one up.

THERAPIST: Make one up? (client small giggle) It’s better if you do it with a real experience.

CLIENT: Well, based on me, is what I’m saying. They are real experiences.

THERAPIST: You just said “make one up”.

CLIENT: No, make one up, create an effective new philosophy based on one of the old…

THERAPIST: Oh, but this is a real experience. I misunderstood. I thought you meant make up a situation.

CLIENT: No, no, no, no. What I actually did …

THERAPIST: You have enough real stuff for us to work on.

CLIENT: (small giggle) Okay, so, this was. I’ll just pick any—okay. “If I make a mistake…” No I don’t want that one.

THERAPIST: Wait, wait, wait. Focus Jessa. Start with A an activating event. How about something very fresh, did something happen today that resulted in an emotion that was not healthy? Or was today a particularly good day?

CLIENT: It was a wonderful day. Today was a wonderful day.

THERAPIST: Oh! Good. I thought however that you said you woke up at 3 in the morning?

CLIENT: Last night? No.

THERAPIST: A couple of nights ago.

CLIENT: Yeah.

THERAPIST: And did not go to sleep and take the day off.

CLIENT: Yes.

THERAPIST: And you told me that you were feeling extreme anxiety?

CLIENT: Yeah.

THERAPIST: How about we look at that?

CLIENT: No, I was very happy today. Be happy to look—Oh I see what you’re saying, how do we look at when that happened. Oh yeah…

THERAPIST: Do the ABCDE on that situation.

CLIENT: Okay, okay, okay. Oh (sigh) geez there were so many things that I was creating at that moment, I mean a lot of anxiety. Okay so…

THERAPIST: Wait, wait, wait. Focus. At what moment?

CLIENT: You wanted to use that as an example just now, right?

THERAPIST: So right now, you’re telling yourself there were so many things. The beauty of the ABCDE procedure is it gives you a chance to use specific neat categories.

CLIENT: I see. So the activating events…

THERAPIST: Systematic isn’t it.

CLIENT: Structured. I see, yeah, yeah. I need, I meanI would like structure. I’m not going to watch my—structure is very helpful. So the A, the activating event, was that I was attempting to go to sleep in the evening before work the next day, and I started to think and over-think and over-think and over-think about all of, number one, the options that I have right now in regards to getting surgery, not getting surgery. And then I took that, that little portion of what is up to me right at this moment and then went with, “and if I do this, what if I make a mistake and if I do that would be a catastrophe and if I decide to go with surgery and then everybody has to help out or people have …”

THERAPIST: Wait, wait, wait. The activating event consisted of those thoughts? So in the ABCDE process, the next step is to clarify, the C, the consequences.

CLIENT: Well the consequences the anxiety, the panic and all of that.

THERAPIST: Okay, and now you go to the B – the irrational beliefs, which you were just starting to say.

CLIENT: Right, so the irrational beliefs were if I have the surgery and it doesn’t work and I’m not feeling well afterwards, that is the worst thing? I can’t live with that. That I made a mistake. I would have regrets. Lots.

THERAPIST: This is the stage in the process to take time to really clarify. Now when you say, for example, you know if you don’t take time to do this, you’ll do what you just did which is assume, you know if I make a mistake, I’ll regret it. That’s not irrational. That’s quite rational, but what would make it irrational…would be your adding should and awfulizing.

CLIENT: No I said it, then that would be the worst thing, that I couldn’t live with that.

THERAPIST: You said that in relation to another thought. This is the beauty of writing it down Jessa. Then you see it and then you can find more easily any errors, you know, tack on the “should” as appropriate and notice awfulizing. You see?

CLIENT: Yes. Okay.

THERAPIST: So there was your describing the issue of the right choice or not making the right decision, that would be awful, and as you “should” make the right choice, and any other irrational beliefs and think. Form them into statements that make it clear they’re irrational. The shoulds, the musts, the oughts, the catastrophizing. Identify them clearly– then disputing follows more easily.

CLIEMT: If I—no, well I guess the things I said to myself in terms of self-blame, that’s rational as well. “Jessa (ph) it’s your—people—It was all here. It was all on this paper. I mean I can say it now, but it was “people will think I’m irrational,” not irrational, “people will think I’m impulsive if I just jump to surgery instead of waiting more time to see, or instead of trying another…”

THERAPIST: “People will think I’m impulsive” that’s not an irrational statement, what do you add to it that makes it irrational?

CLIENT: I know. That’s not irrational, exactly. “And if other people think that, that’s the worst thing and I can’t live with what other people think about me in terms of how I proceeded with my surgery or not surgery.” Next one “I don’t know if I’m bright enough to know which doctor is the best for me. Some people have said go with my heart, but I’m not…

THERAPIST: That’s not irrational.

CLIENT: That’s not irrational, right. Well some people said go with my heart and because I don’t think I’m going with my heart and because I feel like I don’t know how, that’s the worst thing and I can’t stand that.

THERAPIST: Aren’t you including: “I should be able to… “?

CLIENT: I should be, I should be, yes, exactly, yes that’s it. Yes, that’s it. I should be able to know the difference between what my head is telling me, what my heart is telling me, what my heart is telling me, (laughing) what my hand is telling me (laughing) . I just love people. Oh, that’s another one. I said “I take what people say to me to heart and that’s stupid, the worst possible thing I can do because these people don’t necessarily know what they’re thinking, so in doing that, I’m creating,”

THERAPIST: You think “I’m stupid”…?

CLIENT: Yeah, I’m stupid. I’m an idiot. I’m, you know. It’s not up here when I say in my head, by the way, it gets …

THERAPIST: And that is why I recommend you write it down, Though together we’re just talking it through now. So, how is saying, “I am stupid”, irrational and unhealthy?

CLIENT: How is it irrational?

THERAPIST: Is it accurate? Can you be stupid?

CLIENT: Can ‘somebody’ be stupid or ‘me’?

THERAPIST: I’m talking to you now.

CLIENT: Can I be stupid? Yeah, I don’t know. I never got my IQ.

THERAPIST: According to REBT, no. No-one IS stupid. You might act stupidly sometimes, you might make a stupid decision. But that doesn’t make you in your entirety, in your wholeness as a person, all stupid.

CLIENT: Well I didn’t say stupid in my head, I said I’m not bright enough to know, so let me rephrase that. I did say that. I said I’m not bright enough to know the…

THERAPIST: Well then, the implication seems to be, “as you should be”. Why should you be bright enough to know all things, you know, to be omniscient. Even if it were do-able (and really is it ?!!) – but why should you ?

CLIENT: Right.

THERAPIST: All right, so we have now identified some heavy duty irrational beliefs. So is it clear to you, the helpfulness of phrasing them in a truthful honest way that reveals the irrationality? In other words, making the should, the must, the ‘it’s awful’, the self-damnation, calling yourself stupid instead of saying – “I could make a stupid choice”... Do you see the difference? Do you want any of your students, clients to think they’re stupid?

CLIENT: Do I want them to? No.

THERAPIST: Wouldn’t you rather, if they screw up, think that they did a silly thing that time, but they’re not wholly and entirelysilly. They’re not stupid. They did an act that was Studpid. Ad does that not apply to you? So, look at phraseology, words, and semantics. All right, so now comes the D.

CLIENT: The D, the D, ABCD. I’m sorry, the disputing. So…

THERAPIST: Yes and it’s often easier to do when you’ve got the irrational statements that are clearly phrased with the shoulds and the musts. You can hone right in for the irrational comments, so that’s the benefit of doing the B thoroughly and accurately, doing the D gets easier. The E gets easier (emphasized.) .

CLIENT: (laughing) Okay, so, let’s see, what was the first one I said, whether, if I, umm, oh the one I remembered just now was that people would think that—this was the irrational. “People would think that I was impulsive and that if I did proceed with surgery before trying something else and that would be the worst thing; I couldn’t stand that.” So people may, so disputing, people …

THERAPIST: Start with: “Even if people…”

CLIENT: “Even if people think (laughing) that’s funny, even if they think I’m impulsive, which they may, it’s a possibility; I can live with the fact that I made a decision that I felt was right at the time and was a decision that I felt would ultimately benefit me in the long run and it would be difficult to—it wouldn’t benefit me in the long run to blame myself for what other people (laughingly) either think or don’t think about me and, quite frankly, that’s not the important, that’s not the essence of getting better,” you know, at the end of—well there’s no end, but I’m saying…

THERAPIST: Now focus Jessa, focus back on the specific belief. Do you need the approval of others?

CLIENT: No. To survive, no.

THERAPIST: Could that not be applicable here?

CLIENT: Yeah, I don’t need them to survive. It would be nice if somebody said, “good job,” you know that would—I would, I would take that, you know, and put it away in my pocket …

THERAPIST: However …

CLIENT: However, if I don’t receive that, I can live despite their approval or not. So that was one. Okay so now let’s do the one where I said that I’m not bright enough to make the right decision so …

THERAPIST: “As I should be…”

CLIENT: As I should be, as I should be.

THERAPIST: Do you see why it’s helpful to say the whole irrational statement?

CLIENT: I do.

THERAPIST: Don’t just infer it nonverbally.

CLIENT: So, let’s see, how to dispute that one. Even though I am basing my intelligence on making a decision that’s something that’s very…

THERAPIST: Basing my intelligence?

CLIENT: Basing my intelligence on …

THERAPIST: My assessment of my intelligence…

CLIENT: My assessment of my intelligence on something that is new territory, that’s—wait, even, hold on. You know what’s funny, when you do these, I never realized how much I give myself a hard time, even when I’m just sitting here trying to do them with you.

THERAPIST: It’s important that you realize it, so you stop it.

CLIENT: I know. It’s like I can’t think clear…

THERAPIST: That’s why I say it’s easier to write it down. See that?

CLIENT: Yeah. It is easier to write it down.

THERAPIST: Okay, so in the last one, essentially are you not basing your worth on your ability to make intelligent decisions?

CLIENT: Yeah.

THERAPIST: So it’s what you want to break down, dispute.

CLIENT: Okay, so it’s possible to make stupid choices and it’s possible to not have the highest—I don’t want to say the highest, it’s possible to not have, (laughingly) sometimes even possibly not utilize my intelligence in a certain situation, but that doesn’t change the value of me ultimately. I am a human being with worth despite my possible ridiculous choices and possibly not as intellectually superb as I’d like them to be, or not like them to be, but as they could be.

THERAPIST: Your abilities.

CLIENT: My abilities.

THERAPIST: That’s really important for you to get. You know some of the things, when doing REBT, we can come up with these appropriate disputes and effective new philosophies, and it’s a good start, but initially we may only believe the new effective philosophies lightly or mainly intellectually.

CLIENT: Exactly.

THERAPIST: And then some people will unfortunately give up because they don’t feel the conviction, not realizing the helpfulness of patience and persistence and that conviction can come with ongoing effort, in all probability, if one doesn’t give up too soon.

CLIENT: I was thinking that last night because I was actually having a difficult time at first, drifting off to sleep, and I kept reminding myself of what we had spoken about earlier, which is, don’t give up on yourself. I did, and I kept saying that, and that actually helped. I said, “Do not give up” because I don’t think I realized that just giving in to that panic and anxiety is a form of giving up on yourself and I wasn’t putting that really together, but once you had phrased it in that way. I said, “You know what, that’s exactly what I’m doing and I refuse.” But then that all comes together with how much you do give yourself worth because if you feel that you’re worth it, or if you think that you have that worth and then act on it, then you don’t give up. So, it’s all—that’s what I felt like. I felt like I’m worthy enough to say “I’m not going to give up at this point” from a lot of the work that we’ve been doing.

THERAPIST: Did you do it?

CLIENT: No I fell asleep and I had a—I ended up doing some type of meditation thing and I said, “Oh, here we go” and created anxiety about the anxiety. “You didn’t go to sleep the night before, this is what happened,” you know and started doing that, I said “What is this crap?” I actually had that little internally. I did have your voice in my head and I said, “This is crap.” I said, “This is really crap, Jessa, that you’re doing right now.” I said this is like, it’s like a child that gets a punishment. I said “But you’re not a child, you’re an adult and you need to go to sleep and that’s what is going to help you right now.” I was really having that dialogue instead of just letting the other irrational stuff sort of take over.

THERAPIST: You mean letting it go unchallenged?

CLIENT: So I enjoyed that last night because I don’t think I’ve really had a challenge where I would be able to do it.

THERAPIST: I will mention here, because as you know, some of our sessions are being transcribed.

CLIENT: Yeah, that’s nice.

THERAPIST: And I will mention, the day after our last session we had a 5-minute conversation. You called me and I was luckily available to pick up at that time, and you shared with me the fact that you had not gone to school that day because, the night before, you hadn’t slept sufficiently and you felt such anxiety and panic, and felt you couldn’t go to school. So one of the things I reminded you, or pointed out to you, which you agreed with, was that you gave up too soon, the possibility of calming yourself down. You went with the drama of, “Oh I’m not asleep and it’ll be awful,” and we spoke then and I shared with you then, or reminded you that you would not, if a student, client, child came to you crying, look at your watch and after 60 seconds say, “Shut up!” (client laughing) You would keep on comforting them. You adore your cats. If one of your cats was in some pain, you wouldn’t say, after 120 seconds, “Shut up stupid cat!” You’d keep stroking it. Yet you’ve not been so kind to yourself in the past. You haven’t been so kind to yourself and that struck a chord with you, and then I think I said something and you laughed. Laughter seems to be a very good medicine for you and most of us to use at times.

CLIENT: Yes. (laughing)

THERAPIST: It helps us have a healthy perspective also. Well in just 5 minutes, it seemed your emotion changed 180 degrees because you lightened up.

CLIENT: Exactly.

THERAPIST: And, oh yes, then you created new anxiety that you were going to be fired for yet another sick day. You thought that you were going to lose your job and then I think I proposed, well let’s look for lawyers (client laughing) because if you get fired, (client laughing) that would not be sufficient grounds for being dismissed. I offered to come and cheer you on in the courtroom (client laughing) and we had a little laugh about that and again you felt a whole lot differently because you thought about it differently.

CLIENT: Exactly.

THERAPIST: All right, our time is running out for tonight’s session, so let’s come back to the ABCDE. The situation we were looking at, you have identified some of the irrational beliefs. We are doing this off the top of your head. You’re not writing it down. You’ve done a little bit of disputing. So, your favorite part may be effective new philosophy or philosophies that come on the heels of your disputing. You do your best to do some imperfect E’s now, imperfect, meaning not perfect, meaning not pressured. Making a good effort.

CLIENT: I can definitely try to do that, but the question I have before I start is I’m having a hard time seeing the difference between the effective new philosophies and disputing…

THERAPIST: Right, here’s the difference. So, the irrational belief is toxic, and disputing is “No, I’m not going to accept this unchallenged!” And you challenge it, and the effective new philosophy is not this kind of, you could call it, argumentative challenge to the toxic beliefs. It’s more like, “I am a resilient human. I can’t stand what I don’t like.” Affirming, realistic statements.

CLIENT: Oh, I see, okay.

THERAPIST: “If I don’t sleep, I’ll still survive and I may even do better than I thought I would”.

CLIENT: So it’s cheering yourself on.

THERAPIST: It is. Other people might liken it to an affirmation. Use the language you prefer.

CLIENT: Yeah, I kind of like, just, if that’s okay, I’m going to call it that, affirmations.

THERAPIST: Let’s put an E in front of it.

CLIENT: I’ll put an E in front of it, but for my own, that resonates for me, affirmation.

THERAPIST: All right, E…affirmation.

CLIENT: Okay, I am a valuable person. I’m a valuable human being and a woman of worth despite past mistakes I may have made and despite being a fallible human, I still have worth, irregardless, if that’s word. Irregardless of some fallacies that we all have as just part of being a human being.

THERAPIST: Watch out for overgeneralizing ; “we all have..”. Now – look at your need for approval.

CLIENT: Do one on that, you’re saying?

THERAPIST: Yes. Focus.

CLIENT: “Not everybody will approve of my actions or …”

THERAPIST: “If not everybody…”

CLIENT: I don’t think it’s possible that everybody, but “if not everybody approves of the decisions that I make or the person that I am or the personality that I have, if they have something that they’re not really finding approval with or likability within me, I can stand it. I can survive. I can live.”

THERAPIST: And simply put, “I don’t need the approval of others, even though I like it.”

CLIENT: Okay, “I don’t need it, even though I like it.”

THERAPIST: That’s simple.

CLIENT: Okay, let’s see. I think I probably would benefit from another one of the self-worth. Something along those lines.

THERAPIST: Good to come up with as many as you can think of.

CLIENT: Just, how do I say it? Despite what I tell myself about who I am as a person, like just value and intelligence and qualities. Qualities about myself despite what I’ve told myself in the past. I don’t have to believe everything that I tell myself. I don’t necessarily have to go with what I’m telling myself. I can take a different path. I can take a different course. I can choose basically to not believe and I can encourage myself to not sort of fall into the trap of panic and anxiety, which any human is probably, given the…

THERAPIST: Stop comparing now. Keep it simple. You don’t have to do a whole long monologue here. (client laughing) These are effective new philosophies, but you’re on a good track.

CLIENT: Okay, if my life isn’t—what else do you want about my—I’m going to do one about my physical health right now. Despite my physical health not being, me not being in the best physical condition at this moment in time, there’s always room for change and for growth and nothing set in stone. There’s no permanency in terms of I can forge ahead despite my physical ailments and there’s hope for the future that I will get better and that I won’t stay stuck in a situation simply because it’s been going on for X amount of times. I can continue to repeat how many months (laughingly) and how many years I’ve been in pain if I choose. But I can also decide to say, that might be the case, but things can get better and possibly will.

THERAPIST: Right, and I think it’s valuable to put in the consideration of worst case scenario. Remember this is effective new philosophy. “So if things don’t go as well I expect, I’m a human with resilience. I can find other things to focus on if I will be restricted physically in any ways, and my life can still have meaning and some joys.” We can put those worst case scenarios in because, left unspoken, they can be like little haunting ghosts in your head, if you allow them to be.

So you get the idea. Now what’s really good to do after the ABCDE, and this will be very helpful when we’re no longer having sessions, is for you to give yourself homework. Things to do as a result of the ABCDE, to help you enforce and reinforce the effective new awarenesses and philosophies. So it may be as simple as writing down the E’s and reading them before you go to sleep and when you wake up. Something like that. Giving yourself an activity, something to do to maintain and reinforce the gain. Make sense?

CLIENT: Yeah.

THERAPIST: All right, so now it is time for tonight to finish up. How you feeling right now?

CLIENT: I feel good. I feel okay. I feel okay.

THERAPIST: Any final comments or questions before we finish?

CLIENT: (turning pages) No. Just reiterating homework was to read the ABCDE, go over it again. I just want to clarify that it was to go at the ABCDE.

THERAPIST: Because you shared you’re not sure that you understand it that well, particularly the D and the E. So yes. Take time studying it in the 2 books I mentioned.

CLIENT:I think it’s clicking in a little bit more for me tonight though.

THERAPIST: Good. But the homework is?

CLIENT: The homework is to do that, to do it.

THERAPIST: To read and…

CLIENT: Yeah to read it, no but it is actually clicking the most after (laughing)…

THERAPIST: Good.

CLIENT: Only half a year now. (laughing)

THERAPIST: To read, and was there something else?

CLIENT: Yeah to do the ABCDE.

THERAPIST: To do at least one thoroughly.

CLIENT: Yeah.

THERAPIST: Okay, all right.

CLIENT: I do have one question actually.

THERAPIST: Has anyone died from lack of sleep? I think you asked earlier.

CLIENT: I forgot about that, but yeah.

THERAPIST: I predict that when you die, it won’t be from that cause. (client laughing) What’s your question?

CLIENT: (laughing) Is there a description or word for when there’s so many (laughing) thoughts all at once. I mean with this work, with REBT in general? So, is there (pause.) Is there sort of a way, a definition of what you can call it when the mind does the shoulds and then you don’t even know sometimes what it is? That’s there’s so many thoughts that you can’t even catch them and you don’t know what they are, and not about having to be perfect. I’m not talking about that or the shoulds or anything, but when there’s so many and then you have to—is that called focus?

THERAPIST: Focus is forcing yourself to look at one thought or thing at a time. What you’ve described could be simply put, having lots of thoughts and when you say not knowing what they are, one could suggest there are some subconscious attitudes, thoughts and beliefs. However, with awareness that the mind is being like a monkey jumping around here and there and all over the place one can choose to take some deep breaths, do a relaxation technique (that leads some humans called Jessa to laugh themselves to death)... (client laughing). Anyway to steady oneself and to just start writing them down and getting them out of the head and onto paper – ready to dispute and replace when helpful.

CLIENT: Is that called attention deficit disorder though?

THERAPIST: Jessa, we have to finish now. Bottom line, for you and your tendency to have many thoughts, it will be helpful to make time to stop and write them down and then look at them with a more objective eye, dispute and replace.

CLIENT: Got ya.

THERAPIST: From a more objective stance. Did I answer your question?

CLIENT: Yeah, yeah, yeah, no you did, yeah.

THERAPIST: All right. So you have some homework to do.

CLIENT: Yes I do, thanks for reminding me.

THERAPIST: We will speak again next week.

CLIENT: Okay, excellent. Thank you Debbie.

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