TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: This is session 13 on Thursday, the 16th of January, 2014.

Hi, Jessa.

CLIENT: Hi, Debbie.

THERAPIST: Your homework centered on unconditional self-acceptance and you’re shaking your head.

CLIENT: In a yes.

THERAPIST: In a yes?

CLIENT: Yeah, the transcriber of this tape doesn’t know that is what I’m saying.

THERAPIST: So, that’s why I said —you were shaking your head—

CLIENT: [giggles]

THERAPIST: Yes?

CLIENT: That I did my homework, yes.

THERAPIST: Okay, good. Well, let’s hear it!

CLIENT: Okay. I always have my little things I have to say, but before I do the—go into the homework, just one realization that I had about the therapy, the type of therapy, the REBT, and just kind of therapy in general. And there’s one thing that maybe I wanted to clarify and understand a little bit better, because I don’t know if maybe there’s something that I am reading into a little bit too much or don’t understand. [00:01:06]

But I was starting to think – as I’ve just been thinking about it and just REBT as a whole, as a concept and unconditional self-acceptance and—I enjoy my time learning about REBT, but where it says I don’t need my—I enjoy my time with such-and-such a person but I don’t need them. Or I enjoy but I don’t need their approval.

I was kind of feeling differently, that humans need humans. And the one part that I have a difficult concept with is understanding – because no one’s ever done that experiment of just sitting in a room completely by themselves. But I think that other people do, in fact, need people.

And so I just want to say – because I was thinking about it – that I think that just like we need food and water and that to survive, we don’t need other people’s approval. We can survive without approval from others and them saying that they think that we’re the best at something or the greatest and they could think that we’re not that great.

But I feel like just that the human condition is that I don’t—unless there’s something different about me, I feel like I personally need to be around people, that that’s a need. That if I was in my apartment all day long, by myself, every day, I don’t know how well I would personally do with that. [00:02:13]

And so I feel like part of the REBT and why I feel like it’s been successful for me is the relationship. Like, I feel like the relationship is a huge piece that I don’t want to ignore that—

THERAPIST: Which relationship?

CLIENT: The relationship between you and me!

THERAPIST: The therapeutic relationship.

CLIENT: The therapeutic relationship, which would counteract the whole idea of not needing somebody. Because it’s not that I need, but I look forward to and enjoy. And if it wasn’t there, I don’t know. It’s hard to know, because it’s based on the relationship.

And so, my whole thing is I don’t think I need the approval of others. I’ve come to the conclusion. I don’t think that—

THERAPIST: Do you need my approval?

CLIENT: I mean, maybe in some ways, yes. I don’t think I’m ever going to—

THERAPIST: You mean, you think you need my approval.

CLIENT: Yes.

THERAPIST: A pity. That won’t help you. Something to work on.

CLIENT: No, no, but I’m saying in general—

THERAPIST: I hear you.

CLIENT: I think that that’s something that is—it’s like the human condition, that you have to constantly say you can survive without it. But I’m not talking about approval. That wasn’t the part I was talking about. What I’m talking about is needing just humans. Humans needing humans.

And yes, it’s nice to do alone things and enjoy your own time and unconditionally self-accept your own company and your own time, but I feel like it’s a basic need that is one of the things in there is other human beings.

And I feel firm about that. And I don’t want to let that go. I’m going to persevere that the food and the water is all very much necessary to stay alive – and human beings, as well. Even though I haven’t…

THERAPIST: So you’re saying you’re firmly going to stick to that, or that you’re firm in expressing it now but you actually want to hear my response?

CLIENT: No, if you say no—if you respond to me and say no, that you disagree, I’m okay with that. I’m okay with hearing your opinion.

THERAPIST: Would you like to hear why I disagree?!!!

CLIENT: Sure, sure. I invite it. [giggles]

THERAPIST: Okay. So what I believe – and more importantly, what REBT asserts – and I believe in REBT or I wouldn’t be practicing it with you or anyone else, or on myself in my own life – is that there are some things which are very healthy. And some things which are definitely life enhancing. And it’s important to desire them, want them, and to do your best to get them.

And one example of that would be the having of healthy relationships with other human beings: to have that, to want it, to strive for it. If – however – a person finds they’re in unhealthy relationships and if he or she is not willing or able to work on changing them, or to look for healthier friendships, relationships, that is not a good thing. Nonetheless, there’s no disputing that most humans can be – by nature – social animals. [00:05:03]

CLIENT: Social animals, right. That was what I meant.

THERAPIST: Okay. I said “most,” I didn’t say “all.”

Now, life can be unpredictable. And sometimes, some very extreme and rotten things can happen to some people – such as losing the significant others in their lives. And if a person strongly believes that without those people – and others – that they can’t survive, they can’t live, then the chances are greater that they’re going to create severe depression or worse. They may become suicidal and worse – meaning carrying out the act – if they think their life is hopeless, worthless, and they can’t go on without others. [00:06:01]

If a person recognizes that their life is enhanced by others and the circumstance, the rotten circumstance – accident, war, murder – has deprived them of their loved ones – illness of their loved ones and then they die – if the person thinks and is realistic and healthily grieves but refuses to let themselves think that they can never, ever, ever, ever in their life be happy again because they needed those people and only those people in order to be happy, they put themselves in danger of fulfilling that self-defeating prophecy. If they realize – in a healthy way – that they will be deprived of those ones for the rest of their life, and it is very sad, but that where there’s life, there is hope – they are more likely to experience healthy emotions, appropriate grief, and still function effectively in their lives. And there is every chance – if they’re willing to make some effort – that in time, they can meet other friends. [00:07:06]

CLIENT: Well, that’s what I—but that’s—Debbie, that was exactly my point. I wasn’t saying that—I wasn’t talking about loved ones. Of course people lose loved ones and they have to accept—I was just saying human beings need human beings in general. I don’t want to use the word “replace,” but there are people that if you do lose a loved one that, yes, it’s—you have to grieve and go through that, and that you can meet another one, a loved one that potentially becomes a more permanent loved one.

But what I’m saying is that I think people do need those relationships in order to—in other words, if you’re living in solitary states, I just think that’s—I don’t know how the REBT works with that. I think that—

THERAPIST: Perhaps I didn’t express myself clearly. Shall I give the example of me?

CLIENT: Okay.

THERAPIST: So in my life, here– you know I’m from Australia, originally—

CLIENT: Yes.

THERAPIST: and I moved here. I worked with Al. Our friendship deepened. And after some time, we married. And he was my life and my focus. Our work together was a great focus. And so, I didn’t socialize. I didn’t really have a desire or opportunity to make friends here in NYC. And then years later he died. It has been around six and a half years since his passing.

And soon after Al died in 2007, my mother – in Australia – had an accident and there began her slow health decline and she had to go to a nursing home. And I was coming and going from here in NY to there in Australia, spending many months there with her, making sure she was getting the best care and attention. I would spend on average 9 months a year during that period 2007 – 2011 in Australia. And then she died.

And after that time, really, there was hardly anyone who checked in on me. And when I say “hardly,” for some weeks there was no one. There was no one reaching out, to find out how I was. I was very alone.

Now, if I believed that I need humans to survive, I would have been – in all probability – weakened and in a very rotten space. [00:09:12] I was grieving, I was in pain. My energy was low and I was appropriately sad. Missing my mother. Missing Al.

But I kept on going. I kept on going. And it’s taking a long time to make new friends, because I’m not desperate, but it is happening gradually. And it’s not that I believe I need human company. I prefer good company like-minded souls. My work brings people to me in my life. But at that time, because of all my traveling, there was a cessation of one-to-one work. I was mainly doing writing work and some presentations, which are less personal than one-to-one human contact.

My point being, Jessa, that because I didn’t think, “I need others and now I have no one significant in my life who loves me!” because I didn’t believe that, I probably moved out of an intense grief sooner than I might have if I believed, “I need, I need, I need.” [00:10:19] I didn’t experience anxiety, which I think I would have experienced if I believed, “I need them and there’s no one close to me!” Yes, I grieved, I felt sad, but those feelings did not debilitate me. I felt them, and kept on living.

Now, by the way, the reason I’m disclosing my experience to you here—and I speak to you as the person I’m working with, my client, and also knowing that you work as a counselor, as your therapist, I am disclosing it in the hope that it is of use to you. I’m not being indulgent, here. I don’t need for you to hear my story. I hope this is a useful living example making the point I’m wanting to make – that is why I am sharing it with you.

I didn’t feel anxiety about my aloneness. I felt deep, deep sadness and grief – which, frankly, was healthy given the circumstances. But I wasn’t debilitated, because I didn’t create those unhealthy emotions of depression and anxiety, because I didn’t succumb to any thinking that, “I need people to survive.” I want good people in my life because it makes my life better. That’s a healthy want. But a want is different to a need.

An additional response to you, is that if the goal of life is staying alive, I would agree it’s contingent – and certainly babies and children usually “need” others who are providing food and shelter etc to them for them to survive.

CLIENT: Okay. Maybe that was—

THERAPIST: We need water. We need food. And preferably a roof over our heads unless we live in Hawaii or Florida. But needing humans? If we are healthy and capable adults No. Is it preferable to have healthy, loving humans in our lives? When I say “healthy,” I mean people who are non-abusive – I mean psychologically healthy. Yes. Surely a good thing for most.

But if we believe we need it and we don’t have it – even for a month, even for a day – we’re less likely to create a healthy emotion if deprived of it. That’s my response.

CLIENT: [laughs] I definitely hear what you’re saying. And I agree with exactly what your point is, only because I feel like we don’t know any different. Well, I don’t want to say “we” – most human beings don’t know any different when you’re born and raised in a family, in a home. Because you’re not raised and left alone in – well, some people are – but I’m saying—in other words, we’re trained, in a sense. Our minds are trained to need each other, like a baby, like a vulnerable baby that needs to be fed and needs to be bathed. And so maybe that was where my train of thought was kind of going.

THERAPIST: Right. And by the way, again, what I said refers to adults.

CLIENT: Adults, adults.

THERAPIST: Children do need adult care to survive. So we’re talking about adults, here.

CLIENT: Right, right, right.

THERAPIST: Adults who are not, in any way—

CLIENT: Incapable of taking care of themselves—

THERAPIST: Exactly.

CLIENT: and not—

THERAPIST: Who are not disabled and so forth.

CLIENT: Well, the other reason why I’m feeling maybe slightly more vulnerable is because – no, not slightly, a lot more vulnerable – is because I’m going in for surgery next Thursday, for neck surgery. Want to make that clear that it is a bigger procedure.

I did just have surgery in August for my shoulder. And I did have a couple of people who were here and wonderful and helped me the first couple of days. And then I was completely on my own.

I was also sick the year before, diagnosed with an auto-immune disorder. And really was living on my own at the time and taking care of myself. So I do feel that I was able to go to work and handle myself when I came home and be okay. So I’m proof of that.

But I’m much more vulnerable right now because I know that the type of surgery that I’m having, I do have to be dependent on other people to (a), take care of my animals and (b), take care of me, because there’s certain things – going to the bathroom, dressing, bathing I need help with.

And so I think that that point that I’m making right now is probably more poignant in my life, just because I’m thinking I need a plan, I need someone to help me next week, and I don’t like this—I’m going to say this “feeling,” but I know it’s not a feeling. It’s what I’m telling myself. But it’s also the reality that the doctor said, “You need somebody to help you.”

And so when I felt – for a few moments – that maybe that wasn’t going to happen last night, I did start to have anxiety because I thought—I know that there are my best friends and my girlfriend that said that they were going to be here to take care of me. But then they both said, “Well, I don’t know if I can do this day,” and, “I don’t know if I can do that day,” and I started to get—to create that panic because I didn’t know if I was going to be sitting here with a brace, feeling completely vulnerable that I needed help either getting up, going to the bathroom. I don’t know what it’s like to have this surgery.

THERAPIST: So you allowed yourself to jump into catastrophizing, it sounds like.

CLIENT: Oh, absolutely, yes.

THERAPIST: Okay. Which would have been a good time to ask yourself – “what am I telling myself to make myself so anxious?”—and that process, the ABCDE process, will be easier to do if you continue to practice greater awareness of your thinking and dispute the harmful thoughts.

CLIENT: To do my homework, then.

THERAPIST: Well, if you want to call “homework”, fine, and/or think of it as the willingness to catch yourself when you are in emotional distress and ask yourself, “Hang on, what am I thinking?” Because the reality is, that we create our emotions. However – let me say now, in your initial question to me, you didn’t bring in the aspect of, “If I have surgery and have a neck brace and am physically restricted and can’t wipe my own ass…” [00:16:02]

CLIENT: [laughs]

THERAPIST: You didn’t. You were talking more generally and my response was to that.

Now, you’re having surgery. And the reality is you may be able to survive on your own following that, without help. But it surely would be preferable to receive help. Now, the two people who can do so – are glad to care for you and your cats – yes?

CLIENT: Cats need to be fed. They need to be fed. So, I want to make sure I have someone to do it, that’s all.

THERAPIST: Uh-huh. Understandably. The two people you mentioned, who are your best friends who you thought would look after you. From what you said it seems that then briefly it looked like they may not. And it sounds like you immediately jumped to the, “Then I’ll have no one!” and so forth, “It’s terrible.” Even though they were only mentioning particular times in which they might not be available. Did you catastrophize?

CLIENT: I did. I did.

THERAPIST: My hunch is that if you hadn’t immersed yourself in the worst-case scenario in your mind at that time – “They’re not here for me, how will I…?”– you might have been able to pause and think, “Okay, if they can’t, who else can?”

CLIENT: I did that. I actually did. And then I said, “I’ll call the city and see if there’s somebody,” because I figured, I live in the city—

THERAPIST: Okay, so, stop. So, did you feel less panic, then, when you were looking for solutions?

CLIENT: Slightly less. Not as much.

THERAPIST: Okay. So “slight” is better than none, because you jumped from thinking best friends would help to strangers who provide such service may help. Maybe if you thought more about it, without the anxiety, there might have been others who came to mind—you might have thought of your brother or—who knows?

But anyway, without wanting to spend too much time on this, I believe there were certain thoughts in relation to your issue and circumstance that might have minimized the anxiety. And you’re nodding in agreement.

CLIENT: [giggles]

THERAPIST: So, there you go; a good reason to practice REBT even when things are calm. Because if you do that and it becomes habitual, then when you notice catastrophization – I just made up that word ! – you will more quickly be able to take yourself out of that state.

CLIENT: [giggles]

THERAPIST: By the way, Albert Ellis – my husband – came up with the words “catastrophizing” and “awfulizing.” And what I am about to say may sound like a gossip part of our therapy session…

CLIENT: [giggles]

THERAPIST: Late last night, I was watching “Law & Order” and whatever-her-name-is says to her policeman colleague, “Now, stop catastrophizing,” and I thought, “Ah! Albert Ellis on ‘Law & Order’.”

CLIENT: Really?

THERAPIST: Yes ! Now, back to you.

CLIENT: [giggles]

THERAPIST: So, let’s try and complete this area now, unless there’s urgent stuff.

Number one, as a capable adult – and you didn’t mention surgery initially, so, as a capable adult, it will serve you well, Jessa – I believe – to remind yourself that, “I love enjoying being with compatible people in my life, and I’ll work to keep those relationships. But if for a day, a month, a year, I don’t have them, I may feel deprived— if I am deprived of them, but I can still find things to be happy about – or, at least, not sad about. And I can still have a quality life. I can create a meaningful life.” [00:19:26]

When you’re having neck surgery and you can only move from the chin up and the belly button down, or whatever’s going to be the case, certainly recuperation is hugely helped by assistance from other humans. But if you don’t think, “I need this particular person to help me,” and think, “I prefer that one but if she/he is not available, I’m resourceful. I can find ways to cope and others who can help me” – and I bet you can do so – then you’re less likely to feel panic and anxiety, which you made yourself feel, you just told me. [00:20:11]

So that’s my response. Have I answered that adequately?

CLIENT: [giggles] You were probably such a good child —I see you as being—that you were well behaved. You didn’t do anything. You didn’t act out, necessarily. I just would love to have been a fly on the wall when you were a kid. I would have loved it. [Laughs] Because there is such personality; there’s no way that you put up with—you probably did it in a quiet—anyway, that wasn’t the point of this.

THERAPIST: But that’s not the—

CLIENT: I know, but I work in a school with kids and so I was just reflecting on you as a kid.

THERAPIST: I know, I know.

CLIENT: At work I was picturing you, because I had shared with my students 50 times – over and over – this week that I’m going to be leaving (for the surgery) for a portion of time. So, I’m opening up quite a bit of wounds and they’re all sharing different things with me.

THERAPIST: Wait, wait, wait. You’re opening up wounds?

CLIENT: For them, for them, for them! Their wounds.

THERAPIST: How do you know?

CLIENT: No, but I’ve been using REBT and so they’ve been really good. [00:21:00] Because they start off with things from the past that they would say, “Oh”—and I said, “Tell me what you’re thinking right now.” And then, within two minutes, we were able to—”wounds” because some of the kids are “wounded,” in the sense that some of the kids I work with are in crisis mode.

THERAPIST: Some.

CLIENT: Yeah.

THERAPIST: But not all.

CLIENT: Not all. But I’ve been telling them, “Thank God for REBT,” because they were all looking at me and one goes, “How will I survive when you’re gone?” And I said, “I bet you will.” And I said, “Let’s talk about it.” And then I said, “What are you telling yourself?” I did this all day—I’m just tired. Literally tired, not—and emotionally drained from just doing it all day long with each kid that came in to say, “Okay. I have something to tell you” and then we talk.

THERAPIST: I don’t think you’re emotionally drained. You just may be tired. They are two different states.

CLIENT: Fine. We can beg to differ on that but—

THERAPIST: But back to your original question, Jessa. Let us focus, because there are a few things to talk about. So, you heard my response?

CLIENT: Yes.

THERAPIST: I do not believe it’s particularly helpful for an able adult to think that he or she needs others. [00:22:11] I think it’s really healthy to want others, and to work on having healthy relationships in one’s life. It is preferable, definitely. I am just talking about replacing the need with want, strongly encouraging you to do so. The more you do so – expecially during calmer times – the easier it can be to cope healthily in less calm times

CLIENT: Yeah.

THERAPIST: when sometimes you will not have anyone available!

CLIENT: Right, right.

THERAPIST: Again, it might be an hour, a day, a year, a month. Train yourself to think in healthy ways. Let’s look at worst-case scenarios: people in wars—

CLIENT: Right, right, right.

THERAPIST: who lose everyone. Or a wife or a husband and their partner and children are burned in a house fire.

CLIENT: Right, right, right.

THERAPIST: So some people – hopefully fewer – will be without very close ones in their life for a time. And they’ll cope better if they don’t think they can’t survive; in other words, they don’t need, need, need— certainly may want

CLIENT: Right, right, right.

THERAPIST: others. But if they accept the grim reality and hold firmly to the hope that in time and with some effort, they can bring into their lives other humans that can be sustaining. Will the new people or other people – be as close to them as the ones they lost? Maybe. But not necessarily, yet they can be satisfying humans.

CLIENT: But interestingly enough, though, Debbie, I feel like when doing REBT – and if you’re doing it and you’re really diligent about doing it – I feel like you create—you just create healthy relationships despite that. I feel like that’s the whole trick—it’s not a trick. That’s the wrong word. That’s the whole irony. That’s the irony, is that you’re saying, “I don’t need,” and then, in turn, you’re getting, in a sense.

THERAPIST: Yes.

CLIENT: Because that’s been my experience— in the sense that I feel like when you don’t have such a high expectation for something, then you just enjoy it even more because it happened, not because you were sitting there and waiting for it to be that way. [00:24:09] So, I feel like, in a sense, that’s been my experience with it.

THERAPIST: Very good.

CLIENT: Is that when things do happen, because I’ve lessened my expectation for people to check “Oh, are you okay?” When I do get it, I just enjoy it. And then I feel like I get it even more because I’m not [panting] like a puppy waiting.

This was a different situation, like you said, with the surgery. Because I did feel that it would be beneficial and quite necessary for me to have someone; especially not just for myself but to take care of my cats.

THERAPIST: So, yes. Beneficial and necessary if your goal is being fed and having your cats fed. However, you sounded like you created your panic when you heard those two particular people were not coming at particular times. It is not that they said they would not be coming or helping you at all.

CLIENT: Yes.

THERAPIST: Right. Instead of being more broad in your thinking and thinking, “Well, that’s really disappointing, darn.” – you catastrophized, exaggerated !

CLIENT: They said that they’ll come; they just didn’t know which days. And so, there were going to be a few days that I could potentially be by myself.

THERAPIST: So they didn’t even say they can’t come.

CLIENT: No, it was just—

THERAPIST: For a few days.

CLIENT: For a few days.

THERAPIST: So again, you allowed yourself to jump to catastrophizing – which led to panic. Instead of thinking, “Now, what can I do on those days?” and “Aren’t I lucky they can come those other days?” There are stories of people who faint or whatever, they’re stuck in their apartment for a few days.

Okay, I’m going to say something now [laughs] because humor is a part of REBT. I did read of a woman who I think was unconscious [laughs] and her hungry cat ate her face.

CLIENT: What? Wait, what? That’s not funny!

THERAPIST: Or maybe she was dead when the cat ate her.

CLIENT: [laughs] Oh my God.

THERAPIST: Don’t worry, Jessa. [laughs]

CLIENT: [laughs] That’s horrible. [00:26:00] I can’t laugh at that! But I’m laughing !

THERAPIST: It’s not horrible.

CLIENT: I mean, I could, but I don’t think that’s funny. If she was dead, that’s one thing.

THERAPIST: It’s not a funny situation.

CLIENT: No, no.

THERAPIST: I brought it up in case you think that could happen to you, in case you think that is a possibility (joking)...

CLIENT: Oh. No!

THERAPIST: Do you think that if no one comes to help you for some hours, then your two cats will eat your face?

CLIENT: [laughs]Unless they’re really hungry because they’re not giving them their daily food that they want [laughs].

THERAPIST: Anyway, are you getting my point? Trying to see things in a humorous way can put things in perspective and be helpful.

CLIENT: Yes.

THERAPIST: Now, ten or something minutes ago, you said: “I’m very firm that people need people.” And that was before you told me it was related to your surgery, okay? So, going back, minus surgery, minus the idea of convalescence and requiring assistance with your bodily needs – if the goal is better recovery – getting others to help you is certainly practical. Not necessarily your two preferred others but even other humans – preferably humans. [0 0:27:02] Or not. Monkeys could be . . . [laughs]

CLIENT: [laughs] Monkeys could be what?

THERAPIST: [laughs] Trained.

CLIENT: [laughs] To come take care of me? Oh my God, that’s the best. That’s the best. That’s all I need. I’m just going to picture it. I just have . . . [laughs] I can see, “Can you go get my neck brace?” Okay. [Look at the little monkey go] .

THERAPIST: It’s true that there are . . .

CLIENT: [laughs]

THERAPIST: Seriously, there are disabled people confined to wheelchairs.

CLIENT: [laughs]

THERAPIST: And there are animals which are trained to press emergency buttons and help in other and additional ways. Monkeys, and other animals.

CLIENT: [laughs] Okay.

THERAPIST: All right. So, I’m glad you look less serious than you did before. But, Jessa, back to my original question: putting aside the issue of you and your recuperation, your original question did imply that—you made it sound that —you expressed it in a way that, “People need people.”

CLIENT: Yes.

THERAPIST: You know that song by Barbra Streisand, “People, people who need people are the luckiest people in the world”? I don’t believe—

CLIENT: You don’t agree with that.

THERAPIST: No, I do not agree.

CLIENT: You do not agree with that.

THERAPIST: They are not the luckiest. They’re the neediest—

CLIENT: [laughs]

THERAPIST: and they increase the chances of their creating depression and anxiety.

CLIENT: No, I—

THERAPIST: But anyway, I’ll have an argument with Barbra Streisand next time I see her.

CLIENT: I was just going to say that would be an interesting—

THERAPIST: Discussion.

CLIENT: But I hear you. I do. I get the concepts of REBT. I think it takes a lot of diligence, in terms of—

THERAPIST: Yes! Yes!

CLIENT: keeping at it every day and reminding yourself—

THERAPIST: Yes!

CLIENT: and there’s many things. But it’s interesting, because I did share with a teacher, a coworker. She came in and she was really upset. She upset herself the other day. But she said to me, “Jessa,” she came in and she said, “My therapist keeps asking me, ‘Did something happen when you were young?’ and she keeps pushing.” Anyway, I said, “I think you would benefit from REBT,” because she reminds me of that type of personality that would just do really well with REBT—so anyway. She goes, “Well, what is that?” So she was in my office and I said, “Do you mind if I multitask? I’m just going to prepare for my leave and get ready and talk to you about what REBT is.” See how I’m pulling other people into it?

So I start telling her. So I said, “Well, let me do an example.” So I gave her—just to make it more, what’s the word—

THERAPIST: Applicable?

CLIENT: Applicable, yes.

THERAPIST: Or relevant?

CLIENT: Relevant, relevant. So I said, “Just give me an example.” So I said, “Can you think of something that today that you—that troubled you in some way? Like a situation that you felt troubled by or whatever it is.”

THERAPIST: That second way, don’t forget to express it when you’re doing it – even religiously the healthy way of expressing things, not saying “That made you feel troubled” but “You created—”

CLIENT: No, I knew you were going to say that. But she doesn’t know about REBT at this point, so I hadn’t explained it yet. Then I was explaining it using that purpose. And she’s thinking about it in the sense that she was troubled by something. She’s not thinking in that way.

THERAPIST: She troubled herself.

CLIENT: But she—right, exactly. So when I explained—I gave an example. And I went through the ABC’s of REBT. The A’s. Then I went through C’s, consequences, we talked about that. Then I went through the irrational thoughts that come with it. And then I went through the—the whole thing. So we did the whole thing.

So I did that with her and I gave an example. And she said – these were literally her words – “I’m exhausted. I’m too tired to even, like, think. That’s too much thinking.” She said something like that, or, “I can’t even, like, think,” or whatever.

And it was interesting because it actually – when she said it – it made me think of you when you said, “What evidence do you have that there are people that are so good at REBT and you cannot be that good?” And I walked out not feeling pompous, like, “Oh, I kept at it and I’ve continued to do it.”

THERAPIST: Can you put that in context again? Because you’re talking about last session, when you were comparing yourself to others—

CLIENT: Exactly.

THERAPIST: in your imagination.

CLIENT: Well, I—

THERAPIST: Because this is being transcribed so I just wanted to be clear.

CLIENT: Sure, sure, absolutely.

THERAPIST: So, you have shared that in the past you’ve put others on a pedestal and thought you could never do REBT well enough. Or as good as others do it.

CLIENT: Exactly. So when she said this to me—and she’s somebody that I look at as a very intelligent, attractive, young, single female with goals and she’s a pusher and she’s on student council and she pushes for good things —and I said, “You’re tired? Okay.” She was exhausted by that thought. She did not want to unearth any possibilities of anything because she’s not wanting to—and that’s fine; that was her thing.

But my point being, that I then realized that I didn’t have evidence that other people just take to REBT and that they do it so well. And no matter how—that if they’re intelligent that they—because this is my little convoluted head really did believe that if you had given it to anybody at my job, that because they’re all teachers and they’re—that these teachers would take it on they would—and I think to myself, “A lot of teachers speak in REBT language and don’t even realize that they’re doing it, so they would definitely be good at it once they realize more about it.” [00:33:05] This is what I say.

Then when she said that, I said, “Oh, well, there you go, Jessa. You were wrong.” And not in a self-damning way but in an encouraging way to myself, that, “Look what you’ve done. You’ve kept at it.” Because it can sometimes be exhausting when we’re finished with the session; it can. There are definitely times where I’m, like, “Oh my God.” But then I see the benefits of getting to understand, and once that concept is understood and once you get or understand what you’re – in a way – fighting against but you’re really not fighting, you’re inviting. I look at it as inviting those thoughts to then dispute them. But until you get to the understanding the concepts—

THERAPIST: Not inviting, identifying.

CLIENT: Oh, identifying. But either way, I think that there’s a lot of thought that goes into it.

THERAPIST: That’s true. Anyway, pausing here, because I haven’t really heard an answer to my question, and then I want to move to something else.

CLIENT: Okay.

THERAPIST: My question was: at the beginning, you said you’re very firm that people need people—

CLIENT: Okay.

THERAPIST: and I’ve been asking you, “Do you think differently now?” And your main answer, before you started talking about the teacher – and I know it relates, but – your response was, “I hear you.”

CLIENT: [laughs] I do.

THERAPIST: Well, I’m glad.

CLIENT: I still disagree.

THERAPIST: The point is—

CLIENT: I still disagree. I’m still going to disagree and I’m okay with disagreeing. I think that I hear what you’re saying in terms of the needy factor. And I think that when we tell ourselves we need…

THERAPIST: There can be desperation.

CLIENT: we need – desperation and all of that – but I think that there’s something. I can’t explain it. It’s something that I can’t actually explain. But I think that there’s just—you don’t have to approve of me or even necessarily talk to me. But it’s almost like a person just being in the room with another person—

THERAPIST: Can be helpful. It is helpful for many, depending on who the person is. Helpful, not necessarily necessary.

CLIENT: Okay. Okay.

THERAPIST: It’s nice. It’s wonderful. To be with supportive or kind people. But, again . . .

CLIENT: But that’s just my opinion. It doesn’t mean that I don’t think REBT works in the grand scheme of life, it’s just my—and because it’s never been tested? You used yourself as an example, right? You used yourself, which—

THERAPIST: I can give a lot of other examples, and REBT is supported by research and such evidence, but we don’t have time to go further into that now.

CLIENT: No, and I thought that that was a great example. But I guess maybe I go to the extreme and I’m picturing just somebody on the earth completely by themselves. That’s maybe what—

THERAPIST: Okay. Yes, you are going to the extreme.

CLIENT: That’s what I tend to do.

THERAPIST: And if someone – or, let’s say, there’s a movie now with Sandra Bullock—

CLIENT: Yeah, yeah, the astronaut …

THERAPIST: called “Gravity,” which I haven’t seen. But apparently her cord to her spacecraft is cut or something and she’s floating alone in the universe.

CLIENT: So, I create anxiety when I think of that, by the way, if I picture that that was me. I personally feel that I don’t know that I would make it, because I would just be out there and I like to talk.

THERAPIST: And you would be thinking, “I cannot survive without humans.”

THERAPIST: My hunch is that, unless you take some flight to the moon, that isn’t going to happen to you.

CLIENT: [laughs]

THERAPIST: My hunch and hope is you will not end up on this planet alone. It’s not very likely. At worst, in all probability, you might be alone some days—

CLIENT: It’s happened.

THERAPIST: in your life.

CLIENT: And I’ve survived.

THERAPIST: Yes. So if you hang onto that thought—

CLIENT: Okay.

THERAPIST: instead of thinking of worst-case scenarios and then catastrophizing and then saying to yourself, “I couldn’t stand it,” then you will feel less panic and anxious. I just brought up a movie and you told me you felt anxious at the just the very thought of the actress, Sandra Bullock, in space.

CLIENT: [laughs]

THERAPIST: So—

CLIENT: Well, that’s—I don’t know. Anyway.

THERAPIST: So watch it! Know your tendencies, and watch out for them.Watch your thinking, watch your thinking, watch your thinking.

CLIENT: Okay. Okay. Okay. I get it, I get it, I get it.

THERAPIST: All right. So, homework: unconditional self-acceptance. What did you do? Or not?

CLIENT: [laughs] What’s that mean?: “Or not?” Did you have to add that in?

THERAPIST: No, I didn’t have to. I chose to.

CLIENT: [laughs] Well, if it helps any, I have a picture that was brought to me from Arizona from—

THERAPIST: Hang on, is this a yes or a no? What is the answer to my question?

CLIENT: Yeah, I’m telling you what I did.

THERAPIST: Oh. Oh, oh!

CLIENT: Allow me to tell you what I did. There was a picture that was brought to me—because I mentioned this—or maybe I didn’t—about the thing we talked about my doing sessions ago, to get a childhood picture of myself. I think we mentioned it on—

THERAPIST: You mean a photo?

CLIENT: A photo.

THERAPIST: Yes.

CLIENT: I said “picture,” yeah, photo. So, I did get the picture. And it’s sitting up in my apartment here.

THERAPIST: Photo.

CLIENT: Photo. And what I did was I actually – it’s going to sound quite strange but I feel like if Al were here, he would say that it doesn’t really matter—who cares, right?

THERAPIST: Well, he’s not here. He’s a little dead, but I’m here.

CLIENT: No, I don’t. Well, I literally caressed the picture of myself and held it like—and said, “It’s okay,” and gave myself loving kindness.

THERAPIST: When?

CLIENT: Last night, last night.

THERAPIST: When?

CLIENT: When last night?

THERAPIST: At what point, what part of last night? What was going on?

CLIENT: Oh. Well, it was after I had catastrophized about this whole not having somebody to be here. And then I spoke with – the Rabbi’s wife – who I’ve been—I’ve gone to her classes before and we had a consultation because of X, Y, and Z. And so I spoke to her on the phone and we were talking about different, really, just nice thoughts and spiritual thoughts.

And when I got off the phone with her, interestingly enough, my cat was kind enough to jump up on the closet thing where the picture is, where the picture lies. [00:39:11] And during the phone conversation the cat literally pushed—hit the picture down. So, I wouldn’t have even thought to tell her that story unless my cat hadn’t done that action. So, when that happened, then it reminded me that the picture was up there.

So, I shared the story with her. And when I got off the phone, I was just raging with—not “raging,” that’s the wrong word. I was just filled – I don’t know where I got “raging” from – with lots of emotion from our conversation and my earlier catastrophizing. And so I said, “Jessa, you’re going to be kind to yourself.”

And so by doing that, I literally picked up the picture as if it was a baby. And said I will be kind to me in the way I would treat my students. And I looked at the picture. And then I even did this weird thing that was kind of cool. But I looked at it pretending it wasn’t me, because it doesn’t look like how I look now. And so I looked at it. Really looked. And I actually said, to the picture, “You are so innocent. You have absolutely no concept of what happened when you were little and you couldn’t have been responsible.”

And so I took away some of the guilt and the early self-criticism that I did so much because, unfortunately, that was just the circumstances, that I was constantly criticized. And so I looked at the picture and I said, “You didn’t know any different.” And it was me. I was talking to me.

So then I did this whole thing where I—by the way, not even thinking that I was doing my homework. I honestly forgot that that was the part of it, because I know you said just be compassionate. And by doing that, I said, “Okay, well, then I don’t have to do any written work and that’s being compassionate enough.” And just maybe, on a very subconscious level, picked up the picture and really just cradled myself, in a sense. And said, “It’s going to be okay,” and, “Stop thinking the worst,” and, “Don’t constantly beat yourself up because it’s not so bad and things are going to work out.” [00:41:07]

THERAPIST: And then how did you feel?

CLIENT: I felt much better. It was calmer afterwards.

THERAPIST: See? See?

CLIENT: And interestingly enough, I had a student today who came in and was like, “I hate myself. I’m the worst.” I never saw that much of the kid in the past and still he came in and he said, “I’m so bad and I hate my life and I don’t mean anything to anybody and I’m a loser and I’m stupid,” he kept going on and on. And because I did this exercise with myself last night, it was much more available to me that having compassion for yourself is so crucial.

And so when I was speaking with this young boy today, I specifically said to him, “You are not having any self-compassion.” I said, “And you are worthwhile, just being you”. And it was easier to do with him, for me, because he is a child. So I like to say to children – as I mentioned one other time before – that, “You’re only nine years old. What did you do to get this beating?”

And so, we went over it. And he looked out the window. And he actually, in those few minutes, perked up. [00:42:03] I mean, he went on and on for—

THERAPIST: I want to hear more about you, though Jessa. But fantastic that you helped him.

CLIENT: Well, I used it, and so, that was the homework.

THERAPIST: Fantastic. Well done.

CLIENT: What do you want to hear more about? I mean, I basically slept with myself last night. [laughs] No, I’m just kidding. [laughs] No, but I was—I put music on, I talked to the picture. I think I got a lot of benefit out of that picture. So, now I get why you wanted me to have the picture and that watching a video of me was not sufficient, of just watching myself run around. Because that’s not the same thing, you’re not a still. And so, you’re not talking to a video, you’re looking at a photo. And that was, I think, the benefit that I got from having some power-that-be get that photo to me, because I really didn’t do anything to get it.

THERAPIST: Okay.

CLIENT: Anyway.

THERAPIST: Good. All right. Did you do anything else in the last few days towards that unconditional self-acceptance, in addition? [00:43:07]

CLIENT: Yes, yes, yes. Yes, yes, yes, I did. Today there was the—the principal had sent me an e-mail that said that there wasn’t going to be, now, somebody that was covering for while I was out, which I’d been working so, so, so hard to get that for the other students, so that they have a replacement for me when I am away, a replacement in place. And she said that there wasn’t necessarily going to be anybody there. And my go-to, my tendency is to not fight something like that and to just react that I must have done something wrong because I didn’t prepare enough.

And instead, I marched downstairs and – after the end of the school day – and she said, “You got my e-mail, right?” And I said, “Yes, I did.” And I said, “And it is not right.” I was not catastrophizing in the least. I said, “These children need to have somebody here,” I said, “because it is important that the work that I do, that they get that.” [00:44:06] I said, “Would you leave students without a teacher—if a teacher wasn’t here, in the building, because they were leaving on maternity leave or sick, would you leave a classroom without a teacher?” I said, “That is the same thing that’s happening by them not getting a replacement for me.”

And my principal, who’s a very tough personality turned to me and she went, “I agree.” And I said, “So, I will make phone calls from my hospital bed if I have to, to ensure that there is somebody in this building, taking care of the children.” And I stamped my foot and I think she probably didn’t know what do with me because that’s not my—my tendency is—

THERAPIST: You mean it hasn’t been your tendency.

CLIENT: Well, it hasn’t been my tendency, yeah. So, I think it was a surprise—she turned around and was like, “Okay.”

But the reason that that relates to unconditional self-acceptance is that I wasn’t blaming myself that that crap happened. In fact, I said, “Those people are lazy.” And I did say something that probably was not nice but I didn’t say anything about anybody in particular, I just said what I said—and she went, “You’re right.” [00:45:02] And I said, “Well, somebody needs to get their butt over here and start helping the kids. Otherwise, I’m going to have to make phone calls and do something about it.”

And I felt that I was feeling life isn’t horrible; this is just a really crappy situation. And I didn’t catastrophize it and make it into a huge thing. But I just said, “This really sucks right now, because now it’s left on my hands that I have to have the responsibility when, in all actuality, somebody else really could be doing this right now.”

So, without catastrophizing about it and, of course, feeling that it was a problem – because there are problems that do come up throughout the day, and that’s life – I said, “We’ll figure something out and it’s the not the worst-case scenario. And if the kids do go without a guidance for a couple of weeks? Okay. They’ll write me letters, I’ll write to them, and we’ll figure it out. And they will survive.”

THERAPIST: And after thinking those very healthy thoughts, what was your feeling?

CLIENT: Empowered. And more secure within myself, not as questioning of things. [00:46:05] Because I unearthed the real issue. If I had kept that to myself when I saw her e-mail that said we might not—I could have used that as the opportunity to then go, “Oh, Jessa, you didn’t do enough. Why are you taking this leave? You don’t, you shouldn’t …”

THERAPIST: Self-downing.

CLIENT: Self-downing, as opposed to, “There are options here. This is just an unfortunate situation: that I do have an ailment that I need to take care of.” I could sit there and beat the crap out of myself over the fact that I have an ailment. Well, how is that going to help me heal? It’s not.

THERAPIST: So, Well done Jessa. Wonderful. I urge you to use the vigor that you just expressed, that you used to do what you did, to continue to keep yourself calm, to address a situation, and prevent any disabling emotions such as guilt or shame or fear of not having approval of those people, as you voiced your opinion. [00:47:03] Well done!

CLIENT: [laughs]

THERAPIST: So, that same vigor expressed with the woman at work you can apply to yourself in the situation you mentioned at the start of our session, “Well, if my preferred people can’t help me, I can get on the phone from my hospital and help myself.” So, you were better at doing it in the school situation than you were on yourself last night. But—

CLIENT: Well, I did say I would reach out to someone in the city. I just got nervous about finances because I thought they were going to cost a fortune. But I did say, “There must be somebody in the city,” because I did look up to go on disability and there are lots of options. So—

THERAPIST: Indeed.

CLIENT: I was just emotional reaction.

THERAPIST: Indeed.

CLIENT: At that point. And so once you get to—

THERAPIST: You created the emotions that you experienced at that point. And some of them were constricting. And yet, I didn’t get any sense that you felt those emotions when you were at the school, sticking up for the children, the other kids. [00:48:00] “The other kids” meaning the vulnerable part of Jessa’s kid side.

CLIENT: Yes.

THERAPIST: So, you are doing extremely well. Simply giving you the objective feedback that your tendency, up to this point, has been to be more efficient using REBT for the school kids than for yourself in a situation where you feel understandably vulnerable because you will physically be vulnerable after surgery, for a time.

CLIENT: Temporary.

THERAPIST: Temporary, absolutely. Well – rephrase. I don’t want to say “absolutely,” but in all probability. [chuckles] Huge. The point is, Jessa, painting a picture that, number one, magnificent progress you are making. So, great progress. You looked at the photo last night. You addressed that. But it took the cat knocking the photo over! Never mind.

CLIENT: Right, right. Yeah, right.

THERAPIST: Whereas, at school, you jumped into action.

CLIENT: That hasn’t been my tendency, so that was just today.

THERAPIST: Correct, correct.

CLIENT: So . . .

THERAPIST: So, you’re doing very well.

CLIENT: I’m going to jump into action with myself, too, if I’m jumping into action in that circumstance with them, there’s now reason that I can’t do it with myself.

THERAPIST: Correct. And you did it with yourself. But it was a little slower. The cat helped ! Just pointing that out. The REBT is fairly new to you. You’re doing very, very well.

CLIENT: [laughs] I’m just laughing about something else. I was picturing the monkey on the—

THERAPIST: Okay, we can come back to that later.

CLIENT: Okay.

THERAPIST: By the way, humor is healing, is it not? [00:50:03]

CLIENT: Yeah, and you can laugh about yourself.

THERAPIST: Yes. You probably won’t get locked away.

CLIENT: No! I’ve done it before—

THERAPIST: If you’re sitting alone, giggling to yourself.

CLIENT: you’ve done that, right? Like when you’re sitting on a bus or something and you have a thought in your mind and then you just start cracking up because it—something happened and—anyway, I just—I’ve done that before!

THERAPIST: So, I’m very glad that you like the image of seeing the monkey! if your friends can’t look after you and the city can’t provide a visiting nurse, you can call the Zoo and say, “Which little chimpie is available?” It’s good that you’ve got this humorous perspective. It helps, does it not?

CLIENT: It does.

THERAPIST: Very good. So, when we first—

CLIENT: Oh, one little thought. One just little, tiny, tiny, tiny, tiny, tiny thought. I know that we—I’ve expressed how much physical pain I’ve been in and it’s really, really (inaudible at 00:50:58) so I want to give myself a compliment because I think that—I know this work is so much harder when you’re in chronic, physical, effing pain every minute. Literally, I know that it’s got to be harder. There’s no question about it.

And so, because I’m challenged with that every day, and so I feel like I’ve—I want to give myself a compliment in the sense that not only have I been able to apply a lot of the practices throughout my daily life but I’ve been able to do it with being in this enormous amount of physical pain.

So, my point is that I can’t wait and I look forward to having an even better frame of reference without the physical pain. And just being able to think a little bit clearer when I’m not so focused on that – the thought of that. Because I feel like I have gotten so much stronger, just mentally, that just thinking, “Wait a second, you’re at this place and you’re so much stronger mentally but look how crappy you feel physically.”

And so, just a note to recognize that, that that has been—and I did read a portion, when I first started REBT, that it is harder with people that suffer from chronic pain to do REBT. [00:52:04] So, you can’t hide that from me because I saw it in the book. [laughs]

THERAPIST: Why would I hide it from you?

CLIENT: No, because I questioned, in the beginning, is this a little harder because—when the pain takes over. And I know you validated that, but—

THERAPIST: Yes. Harder. But harder doesn’t mean too hard. It means you might require greater self-motivation to push yourself to do it. And you have done that. Very often.

CLIENT: That’s right.

THERAPIST: And just the fact that you are acknowledging yourself for your effort and progress. I don’t know that I would have heard you do that when we first started the work.

CLIENT: Mm-hmm. I agree.

THERAPIST: You were far more apologetic and self-effacing and even more apologetic and said things like “Oh, I don’t know if I should say this.” And you seem much more at ease at acknowledging the very fine progress that you are making in very difficult circumstances. Your intense physical pain.[00:53:12] So, well done, yet again Jessa – Well done.

CLIENT: Thank you, [laughs] Debbie.

THERAPIST: Yay!

CLIENT: You’re so funny.

THERAPIST: You’re doing very well.

CLIENT: [Thank you].

THERAPIST: Indeed. After the surgery, and don’t forget why you are having it. You’re not doing the surgery because it’s going to make your hair a nicer shade of whatever shade it is. You’re having it to improve your life and physical well-being, and to get rid of the cause of your physical pain.

THERAPIST: So, you know the outcome . . . will bring great relief.

CLIENT: [sighs]

THERAPIST: And if you’ve been able to laugh and make progress in your emotional experiences during this time of physical pain, yes, it will in all likelihood be easier.

All right. So, in a few minutes, we’re going to finish up. When we first greeted each other, before sitting down to start the therapy session, you mentioned something to me that perhaps you want to comment on now. And then we’re going to finish this session for tonight.

A few sessions ago—and I’m not sure, again, whether we recorded it or whether it was part of a conversation prior to or after our session, where you may have offered some chocolate to me and I said, “Thank you very much, but no thank you.” [00:55:07] And you said, “Well, what will I do with them?” And I suggested giving it to a homeless person.

CLIENT: Uh-huh.

THERAPIST: You brought up that, “Oh, I’d be afraid to give it to a homeless person.” And so, this evening you shared with me that you’d given a book to a homeless person.

CLIENT: Yeah, yeah.

THERAPIST: So, that sounds like progress, as well.

CLIENT: Yeah, I found this book, and there’s this woman that reads. She’s homeless but she reads every day, outside, by the church. It was something that I noticed, just in passing. I happened to notice that she has a different book in her hand every day and she sits right by the church. And she never smiles, from what I’ve seen. She just always has this very hardened—I don’t want to say “homeless looking” look on her face, but it really is “I don’t have a home” look. [00:56:03] It’s just not a revived, refreshed look and I’d never seen her smile.

And so, when I got a book from work the other day – because we have a little rack with different books and stuff that we can take – and I said, “Oh, I’m going to be having surgery and I’ll probably have time to read.” And I saw this book called “Bossypants” by Tina Fey and I just picked it up. And I put it in my bag.

And interestingly enough, later that afternoon, I walked outside of work – of school – and I saw this particular woman was sitting on the stoop. And we (you and I) had discussed that, maybe when the tape is off, we had said that she reads. I maybe said it after and that I felt it would be more valuable to give her a book than to give her food, just because it was more thoughtful, I felt. It was more applicable—

THERAPIST: More personal.

CLIENT: It was more personal. So, needless to say, I realized as I saw her that, “Wait, I just got this book,” and I wasn’t really attached to it in any way. [00:57:00] I didn’t really feel like I needed to read it, but it looked interesting. And so I literally just took it out of my bag and – without even really thinking – I just handed it to her. And walked right up and handed it to her. And she gave me a huge smile. And then that was it. And I literally was like, “I thought you might want to read this,” and handed it to her.

And of course, now, I look every day to see if she’s reading it. I’m looking, I’m like—because I can see—I’m not staring at her but I can walk by and see the corner and know. And it’s funny, because I was saying to my girlfriend earlier tonight, about the situation and what happened. And she said, “Oh, good, she’ll be malnourished with good books.” And it was really cute.

And I said, “You know, I keep looking to see if she’s reading it yet.” And my very rational girlfriend said, “Maybe she hasn’t finished her other books yet.” [laughs]

THERAPIST: Anyway, the point for here is you did something that, in the past, you might have been afraid to do. [00:58:01]

CLIENT: Yeah. Yes, yeah.

THERAPIST: So, really, what’s been a common theme of our time in this session has been some observation of how far you’ve come in just weeks, in a very few months of applying REBT principles. So, that’s very encouraging. And, again, as you pointed out a few minutes ago, at times, you’ve been applying it under severe difficulty, in terms of your physical pain. So, well done.

I have some suggestions for homework between now and our next session. And then we’ll finish for tonight. Any other comments or questions from you to me?

CLIENT: No, uh-uh. [00:59:01] I was going to say something but I forgot. It’s not important. I just talk a lot. [laughs]

THERAPIST: All right, so I have some suggestions for homework. Here’s paper and pen for you to write them down.

CLIENT: Oh, it’s actually very, very hard for me to write right now.

THERAPIST: Oh.

CLIENT: If you wouldn’t mind helping me with my arm? I can barely raise it today.

THERAPIST: Okay.

CLIENT: So . . .

THERAPIST: No problem at all. So, let me tell you my suggestions. And tell me if they feel do-able to you or not, in all honesty. Because our next session will be our final session for this chapter of therapy. You’ll be off, soon after, for surgery and I’ll be off to India, spreading the REBT gospel of Saint Albert and the wannabe Saint Debbie!!!

CLIENT: [laughs]

THERAPIST: [chuckles] So, the next session will be our final session for now.

So, here are my suggestions. Tell me how doable you think they are.

The first suggestion is for you to write down – and by the way, this comes from what we did tonight in our first part of this session – write down strategies for how you would cope if you are left alone. I don’t mean floating in space and I don’t mean every other human in the world is dead. I mean for a few days, if there’s no one around you here.

CLIENT: Post-surgery, not regular?

THERAPIST: Both. Regular and post-surgery.

CLIENT: Okay.

THERAPIST: Strategies for coping.

CLIENT: You’re going to write this down, right? Because otherwise, I’ll forget.

THERAPIST: I will write this down for you, mm-hmm. Doable?

CLIENT: Uh-huh!

THERAPIST: You’ll do it? Okay.

Then, secondly, because it will be our final session for this chapter of our therapy, prepare any questions that you have for me about REBT or you. Any relevant questions. Do-able?

CLIENT: Mm-hmm.

THERAPIST: And I’m inviting you to think about it, because we want to use that last session very well. You may have fresh questions at the time, but prepare. Yes?

CLIENT: Mm-hmm

THERAPIST: Then, thirdly, I invite you to make a note of the gains that you’ve noticed through REBT. Now, a lot of tonight’s session included that. But do it again. And with some thought, you may come up with other changes you have made in recent weeks. And I remind you that the main issue you identified that you wanted to work on – right at the beginning – was anxiety. So, fourthly, reflect on how you’ve been in that regard.

CLIENT: Okay.

THERAPIST: And particularly how you’ve been handling it differently, if you have, than you were handling anxiety prior to REBT.

I also invite you to note changes that you’ve observed in yourself. Again, some came up tonight, but do it again.

Changes – this is another part of the homework, fifth part – to note changes in your impression and knowledge about REBT, because you had some misconceptions about it when we started out. So, let’s hear your now awareness of it. Revelations that came from and after sessions. [01:03:01]

And finally, sixth part of homework, come up with your goals and intentions going forward, after our final session next week.

So, is there any of that homework you feel is not doable or too much?

CLIENT: Not doable or too much . . . no, I don’t think that—I think the only thing that may be a challenge is the writing, just because of what I said I am dealing with in my arm.

THERAPIST: So, will you find a way to overcome that challenge?

CLIENT: Yeah.

THERAPIST: I believe you will.

CLIENT: Okay.

THERAPIST: All right. Anything else?

CLIENT: No, I think we’re about done.

THERAPIST: Well done.

CLIENT: Okay.

THERAPIST: Well done, well done.

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