TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: This is session 14, final session for transcription. It is Monday, the 28th of January, 2014. Hi, Jessa.
CLIENT: Hi, Debbie.
THERAPIST: So, this is the final session of this chapter of your first experience with REBT therapy. And you’ve done really, really well. But before sharing further thoughts, I would like for us to look at you did with the homework.
CLIENT: Sure.
THERAPIST: Which was – just to refresh – the first was inviting you to think of strategies that you can use when you’re alone, both when you’re in a good space and also if you find yourself relapsing into panic, anxiety, or other unhealthy emotions. [00:01:14]
Then, the second thing was inviting you to organize or prep any questions or comments about the work we’ve done together, about REBT, and so forth.
Thirdly, it was inviting you to reflect and make notes on gains that you have noticed, advantages and changes since you’ve been using REBT. And just a reminder that a main stated goal when we started was for you to reduce – best case would be eliminate – anxiety and panic.
CLIENT: Mm-hmm.
THERAPIST: In the course of sessions, another important goal emerged. [00:02:00] And that was the importance of your increasing your unconditional self-acceptance. And that’s pretty common in the course of many therapies, that you might start out with one goal and then things are revealed and—
CLIENT: (crosstalk at 00:02:20)
THERAPIST: and it then appears that you would benefit from working on additional ones, which you’ve done.
So, then I invited you, as part of that third area of homework, to make notes of changes in yourself, in your thinking, in your behavior since doing the REBT.
And another part of suggested homework from last week: to note any noteworthy revelations which emerged during, or as a result of, our sessions. I remember that, a few times, some may be on the transcripts and some you may have just said as we were saying “hello,” or, “good-bye,” and not recorded. [00:03:10] You have told me that you have noticed changes and whole new understandings and appreciation for REBT which dispelled some serious misconceptions about it – which, by the way, I think that, unfortunately, many other people share because they haven’t been taught it accurately.
CLIENT: Sure, sure, yes.
THERAPIST: I’m interested to hear what you say. And then finally, regarding your homework, to express your goals and intentions regarding your emotional – and other – well-being going forward.
Towards the end of our session tonight, I’m going to give you these pages of information, written by my husband – Albert Ellis – and we worked on them together, on the revision – points here, in written form, for you to keep and you can go over them a million times: about how to maintain and enhance your REBT gains ! [00:04:10] So, we’ll look at that at the end.
So, there is the agenda; over to you.
CLIENT: Okay. Well, first, let me start off by saying that I’m very, I’m very sad that it’s our last session today, but I will survive. [Laughs]
THERAPIST: Indeed.
CLIENT: Okay. I just wanted to let you know.
THERAPIST: Are you sure about that? (Joking)
CLIENT: Yes, I am. I am sure. But I am very, very sad, which – if I remember correctly – is a—that’s an emotion that we can still experience. But it’s not debilitating; I’m just feeling sadness and not letting it get in the way of my—what I’m doing and, in fact, I have a lot of things coming up this week. I’m thinking, obviously, my head is on the surgery that’s coming up on Thursday. But at the same time, I feel it’s all related and it’s bittersweet; it’s bittersweet that our final session—not like I’m saying “good-bye” to you, because – as we’ve mentioned on the tape before – that we do live in close proximity—we’ve seen each other around, I know I’ll see you and wave and things like that. [00:05:10]
THERAPIST: Yes.
CLIENT: But it’s different.
THERAPIST: Plus, as I’ll mention later, it’s fine and it’s on this information page that I’m going to give you that if you do at any point get bogged down—
CLIENT: I can e-mail you or something?
THERAPIST: There’s not a law preventing more sessions ! So—
CLIENT: Oh, oh! okay.
THERAPIST: (crosstalk at 00:05:35) REBT isn’t like a brief taste and then it’s over. But—
CLIENT: Got you, got you.
THERAPIST: it now gives you a chance to see how you go—
CLIENT: Okay.
THERAPIST: practicing it on your own, taking responsibility on your own, for your emotional well-being.
CLIENT: Well, exactly, exactly. And I think that’s—it’s like you get your wings and then you—ooh, I don’t want to say that right now, but—[laughs] My point was that it’s bittersweet. And that I am sad. But, at the same time, I feel like this has been really, really beneficial for me. And I know that I have to—in order to maintain the philosophies, that that’s something that the work that I need to put in. I’m aware of that and I’ll continue to read. I think that’s a really big part—anyway, but going back to the agenda.
So, basically, we had talked about—you asked, originally, what I can do when I’m in these moments of—where the REBT would fit into my life, that’s how I interpreted that first part.
THERAPIST: Well, it was strategies—
CLIENT: Strategies, yeah.
THERAPIST: you can use if you’re alone – both when you’re in a healthy, self-sufficient state—
CLIENT: Or also in . . .
THERAPIST: Or convalescing, because in a few days, you’re having surgery and—
CLIENT: Yes.
THERAPIST: being a very active woman who already, in the past seven months, has been restricted—
CLIENT: Mm-hmm.
THERAPIST: you will be more restricted, but not for seven months. [00:07:02] In any case, it’s a grand adventure and opportunity for you to practice patience—
CLIENT: Yes, it is.
THERAPIST: and reminding yourself it’s temporary, and for the wider good.
CLIENT: Yes.
THERAPIST: For the longer good in your life.
CLIENT: Exactly, exactly. So, what I talked about here, in my homework, is that I said for strategies, that I would do—I would identify the activating event and that I would first—so, I would really try to hone in on what it is. And sometimes I feel like it could be more than one but what I’ve learned to do is prioritize to figure out that there generally tends to be one that might be the one most large.
And so, I would identify that—or there could be more than one. And I can do that, as well. But taking it easy and telling myself what the consequences are after determining what the activating event is or recognizing it. And then here, I said, in the homework where I wrote it down, I just said, “Example: surgery coming up.” So, I just use an activating event. And I don’t know if you’re interested in hearing right now, but I did go over—I did do one full, one complete—what do we call it? [00:08:08]
THERAPIST: ABC self-help form.
CLIENT: ABC, yeah. So, would you like to hear?
THERAPIST: Very quickly, just so we can fit everything else in. Yes, I would.
CLIENT: Sure. I’ll say it quickly, because it came a little bit more naturally this time around. So, I just said—
THERAPIST: Take note of that.
CLIENT: I did, I was very—
THERAPIST: It felt easier to you.
CLIENT: Yeah, yeah.
THERAPIST: Notice that.
CLIENT: It was. It was a great—
THERAPIST: what you just said.
CLIENT: It was a great feeling.
THERAPIST: And the more often you keep reading – as you expressed, as few minutes ago, you intend to do – and practicing it, the more often it will be easier—
CLIENT: And easier.
THERAPIST: Exactly. So, hooray. Anyway, let’s hear it.
CLIENT: So, I’ll just go through it kind of quickly. So I said, “Surgery coming up.” So I said, “Worried, fear of the—” The activating event was that my mother was on the phone and she said that she knows somebody – a brother’s friend of mine – who’s getting the same surgery. And she said, “And he’s going back to work in four days.” Okay. So I thought that was the activating event, because I’m already concerned, right? [00:09:00] The consequences were: worry, fear of unknown, regret before it even happens, anticipatory anxiety, perservation—I don’t know what that is. I have no idea what I wrote—leading to anxiety. Perservation . . . ? I don’t know—leading to anxiety and free-floating unease. That was some of the consequences.
Then I said what I can do is I can write down what I’m brewing over in my head, write down my experience—writing it down – that’s the strategy – helps me to gain clarity and insight and realize how debilitating the anxiety can be. And then I will focus on my irrational beliefs. I’m just reading what I wrote.
THERAPIST: So, this isn’t an ABC exactly.
CLIENT: It is. I was writing the strategies and just throwing—
THERAPIST: Okay. Because what you just said is what you can do. And I haven’t heard the irrational beliefs yet.
CLIENT: Okay, here they are. Sorry. Yes, here they are. Okay, so, I need the surgery to reduce my pain—where are the irrational beliefs? [00:10:01] Oh, no, here it is.
I need the surgery to reduce my pain; otherwise I can’t go on in life as I should.
I’m just going to go through—shall I go through them?
THERAPIST: Quickly, yes.
CLIENT: Okay.
“Others will not approve of my negative attitude and I couldn’t stand that”.
“Comparing myself to this guy going into surgery and telling myself he’s better than me, as he shouldn’t be. And I can’t stand my mother thinking I’m not strong enough to recover as fast as he does”.
THERAPIST: Well done in identifying the irrational beliefs. When I say, “Well done,” – I also mean “Well caught.”
CLIENT: Well caught, right.
I feel angry towards my mom for pushing me back to work when the surgery hasn’t even happened and I can’t stand that feeling.
THERAPIST: But perhaps, “My mother shouldn’t have told me—” is a more helpful way of expressing the irrational belief here.
CLIENT: Ah, got you. Okay.
THERAPIST: Remember: precision is helpful when identifying the irrational beliefs.
CLIENT: Precision, okay. My mother—
THERAPIST: But you’re doing very well.
CLIENT: My mother shouldn’t have told me to go back to work when this other person is or whatever before the surgery hasn’t even happened yet. And I can’t stand that feeling. [00:11:01]
I shouldn’t feel this, as she—I shouldn’t be thinking in this way, as she is expressing herself. And she is just expressing herself. It’s unfair—oh, wait, maybe this is where—hold on, I didn’t organize it for whatever—no, no.
THERAPIST: Which, by the way, is a lesson that the more well-organized your ABCs are, the more clearly the disputing steps can follow.
CLIENT: No, I did organize it. I did. I just realized, here, I wrote “disputing,” this is not “disputing” yet.
Another irrational belief: “It’s unfair for her to do that and I can’t stand for her pointing out others and comparing myself to others as I shouldn’t be doing”.
Okay. So, now I dispute.
The surgery may or may not be helping the problem, but it may—I just can’t read my own handwriting. But it not be 100%—wait. It’s been difficult because of my arm, by the way—
THERAPIST: Yes, I understand.
CLIENT: with handwriting. So I’ve tried to do—I did the best I could and now I’m having a hard time reading my own writing. It may not be 100% but could be somewhat better, which is better than what I’ve been dealing with all— oh , disputing.
THERAPIST: Disputing is—just think of the word “disputing.” [00:12:03] You’re having an argument. You’re having an argument with the irrational beliefs expressed.
CLIENT: Let me just write this down so that this time, when I do do it on my own—I wrote it down the last time but I just want to get that one more time. Disputing: think of myself as having an argument?
THERAPIST: Yes, with the irrational beliefs. Ask yourself – “Where is it written? Where is the evidence? Does it follow from my preferences?” In other words, just because I would prefer that Mom didn’t have that attitude doesn’t mean that she won’t continue to be that way, and that I can’t stand that. And so on.
So, again, I invite you to go back to the books you have , and seriously study the sections on disputing and the ABC approach.
CLIENT: Okay.
THERAPIST: The section describing disputing is not long and it makes it clear. Disputing has been an area some fogginess, though you are improving.
CLIENT: Okay.
THERAPIST: Clarifying for yourself the difference between disputing and the effective new philosophy will be helpful for you.
THERAPIST: And I’m confident if you do that and keep practicing—
CLIENT: I should be able to—
THERAPIST: You should be able to? [00:13:02]
CLIENT: No, no, no.
THERAPIST: [laughs] There’s a good chance that you will find it easier and easier and clearer.
CLIENT: Okay.
THERAPIST: Okay?
CLIENT: I know you’re trying to just be helpful with that, with the language—
THERAPIST: Correct.
CLIENT: but I just think that it’s—I’m learning, so I understand—
THERAPIST: You are learning.
CLIENT: Okay.
THERAPIST: And you’ve learnt very well already.
CLIENT: Just letting you know.
THERAPIST: All right?
CLIENT: Okay, just letting you know. Okay. So, hold on, let me just go back—now I just lost my—all right, so, rather than go into that now, maybe just say that these were the E’s, because I probably did a similar thing to what I did the week before.
THERAPIST: All right. Let’s quickly hear your E’s, then.
CLIENT: Okay, okay.
THERAPIST: But, again, know that this is something worth practicing. After surgery, when you’re able— read, reflect, apply.
CLIENT: Yeah.
THERAPIST: It will be good for you. When you feel able. And, by the way, you—after the haziness of post-surgery, you’ll benefit from not doing too much. You won’t go to work immediately.
CLIENT: I’ll benefit from not doing much of what?
THERAPIST: Of going to work or any strenuous activities. So, you may have more time—
CLIENT: Time, okay.
THERAPIST: when you’re clearer—
CLIENT: Yeah.
THERAPIST: after the drugs wear off, the surgical drugs.
CLIENT: [chuckles] It’s (crosstalk at 00:14:09).
THERAPIST: So, just saying there will be opportunities for you to study REBT
CLIENT: Absolutely
THERAPIST: in a more relaxed space, without time pressure—
CLIENT: Yes.
THERAPIST: and keep on with it —work and practice, work and practice, work and practice.
CLIENT: I agree. Okay.
THERAPIST: Okay?
CLIENT: So, would you like to hear the disputes, then, or are we going onto another part?
THERAPIST: My understanding from what you told me was that they’re more like effective new philosophies.
CLIENT: That’s what I meant, yeah.
THERAPIST: Quickly, yes, I would.
CLIENT: Okay. Okay. Which is better, (inaudible at 00:14:35) Regarding: “I can’t stand”—oh, I can stand not to be perfect, as nothing in life is—nothing in life ever is, I said.
Others may not approve of how I heal, but I can stand that —I can stand them not agreeing with me taking the time that I think is needed for my recovery. And I don’t have to prove myself to anyone as I don’t—wait—as I don’t need—wait—as I don’t need to do what is right according to anyone else. I don’t know. Remember, when I’m doing this, it was a challenge – to say the least – with the writing, so . . . but I did it and I accept myself despite the bad writing. [chuckles] [00:15:09]
Okay. My mom may compare me to others who she thinks do it better – in terms of healing – but that’s her opinion. It doesn’t make it right or the only idea of—what’s best for me. I will survive even if she thinks I’m lazy and taking advantage of the fact that I can get three months off work. I told her, “Everyone heals differently.” That’s what I said back to her.
Okay. So, anyway, that was not—I was just giving—I guess I didn’t do a whole ABC—when I was doing it, I don’t remember what I was thinking at the time. But when I did it, I was just saying—going over generally what I can do for myself. And I sat down and did this right after it happened, so it was a brief—it wasn’t going—
THERAPIST: Good that you made at least some effort.
CLIENT: through a whole, full thing.
THERAPIST: Which is better than nothing.
CLIENT: I felt it benefited me.
THERAPIST: Well, that was my question.
CLIENT: I felt much better after I did it.
THERAPIST: In what way?
CLIENT: Well, I was able to look at it on paper and to realize that my mother – bless her – is sometimes a little ridiculous. [00:16:02] And that I don’t need to please her—my life does not have to be just to please—it is my life. And I don’t need to—she’s entitled to her opinion. She can have her opinion and it doesn’t have to cause rage. It doesn’t have to create that. That’s me creating that response back to maybe my own personal feelings of how I want to heal. But then, that can encourage when I’m ready and when I feel good enough, I will be able to go back to my duties. And I think it’s a much more rational way of looking at things. Because, unfortunately, through this whole process, I’ve fortunately recognized a lot of irrational beliefs that my own parents have, and so—
THERAPIST: Very fortunately. With awareness, you can really more precisely work on changing your perception of their ideas and how you let them impact you. And with greater awareness of your irrational beliefs, you have the power to keep disputing – challenging – them, as you did in this imperfect – but still effective – ABC application on yourself. [00:17:06]
So my question was: How did you feel differently after you did it?
CLIENT: Calmer.
THERAPIST: Calmer.
CLIENT: Not angry, not—
THERAPIST: Anxious? Or less anxious?
CLIENT: Less anxious.
THERAPIST: Good.
CLIENT: Really—the anxiety piece has been—I’m just having just plain old pre-surgery anxiety. So, I can’t say that it was same old anxiety—but it was a different type of anxiety, if that makes sense. It was just— Not related to this. It wasn’t related to the conversation that I had.
THERAPIST: So, talking about this, you were able to create – on your own, within a few minutes—
CLIENT: Mm-hmm.
THERAPIST: less anger and less anxiety.
CLIENT: Yep, absolutely.
THERAPIST: Well done. Well done.
CLIENT: [exhales] Okay.
THERAPIST: Okay, good.
CLIENT: Going on to the next part, the questions.
THERAPIST: Wait. Wait, wait, wait, wait. So, looking at number one homework, so what strategies can you have on hand. Strategies you can use. One of the issues that came up in our last session was the—
CLIENT: Mm-hmm.
THERAPIST: temporary panic that you felt when you dramatized hearing that your two girlfriends, who you thought would come on X, Y, Z days, may not be able to come then. And you allowed yourself to believe your initial ideas and you then experienced panic. So, before we leave homework number one and go to homework number two – or hearing what you did with two – and this is a preventative. I want to hear your words you’re going to say to yourself, think them, let’s hear your words. So, it can help you not succumb to what appears to be automatic panic.
CLIENT: That rhymes.
THERAPIST: I’m very talented.
CLIENT: [laughs]
THERAPIST: So, if you find you’ve heard some news and your experience is panic – breathless, chest-achy panic. [00:19:18] What can you do in that moment, realistically, to turn the dial right down on that?
CLIENT: Well, what I tell my students: I can stop and think.
THERAPIST: Good.
CLIENT: Stop and think. Don’t just jump. You can take a minute. Unless you’re under the gun, literally, or someone has a knife at you, you might not have time to stop and think then. But in most circumstances in life, we’re given the benefit and the opportunity to be able to stop, take a breath, be like, “Okay. Let me think about this for a minute.” And then make a plan or have a thought or whatever. [00:20:02]
And that’s not to say that the reaction wouldn’t be still more of a heightened reaction, but it could be much less if I give myself that chance to just stop for a minute: thinking it will get resolved, there’s got to be a way. And empower myself is how I look at it, because I think that in the past, some of my tendencies have been because I didn’t feel that there would be a way to resolve it. And that somebody would have to come and—
THERAPIST: Rescue.
CLIENT: rescue me or help me to fix it. And those have been my tendencies. So, I think I now have that awareness. I did it today. I actually had an incident where I did it today. And I didn’t panic—
THERAPIST: Did what today?
CLIENT: Where I had a stop and think moment. And I told my doctor. My actual—PCP. “Hold on a minute.” And he went, “Don’t waste your breath, come down here.” It was a long story; I don’t have to get into it now. But he basically said, “Don’t waste your breath. Come down here right now, come get checked out.” And I said, “No, no.” I said, “Let me just take care of a few things.” [00:21:01] And I went and called the secretary and I said, “I took care of this.” And then I called him back and he went, “Oh.” It’s just funny, too.
And not that I need to impress him but there has been some nice impressions that even people that I’ve – in the past – maybe put on pedestals realize that they don’t have all the answers. They don’t know everything.
And he said, “Oh, well, okay. If that’s case,” he said, “thank you for investigating.” He said, “And you’re not alone in this problem,” that had occurred without getting into it, so . . . today. I think, given this – I don’t want to call it “illness,” but it basically is; it has been an illness – has given me opportunities with using REBT, because I’ve been faced with not just everyday bullcrap, what we go through that we can very easily get into daily routines but life’s thrown me a couple of curveballs, in terms of things that have come up.
THERAPIST: Major ones.
CLIENT: Major ones. And I’ve been able to, in certain situations, be able to impress myself [laughs] by saying, “Okay, that was pretty good, Jessa. You have more knowledge and resources than you think.” [00:22:09]
THERAPIST: And the ability to apply what you’ve newly learned – successfully—
CLIENT: Yes.
THERAPIST: much of the time.
CLIENT: Yeah.
THERAPIST: Well done.
CLIENT: So, I was just thinking about that because that did happen today. Instead of having that automatic panic – which could have easily—I could have gone down that road. If I allowed myself.
THERAPIST: Yes, which is the road you used to habitually go down a lot of the time – not all the time, probably, but a lot of the time – without questioning. And, by the way, that is a very common aspect of the human condition, of humans who aren’t working on being more aware and helping themselves. And I’ve said before, at various times: with awareness can come change. If you’re not aware there’s a problem, how—
CLIENT: How are you going to fix it? Right.
THERAPIST: you focus your energy—
CLIENT: They say it in AA, the first thing is—the first step is saying, “I’m an alcoholic,” and then you move on from there. [00:23:05] So . . .
THERAPIST: So, indeed, and what a lot of people do, who have been in the habit of not questioning their thinking, when something happens that’s adverse and they find themselves in fear or panic, there’s kind of literally a [gasps] gasp, a holding of the breath. The body tightens, and so on. And it’s like arrested development. And they carry on regardless. They might find distractions or turn to healthy or unhealthy distractions. And don’t ever look for the root cause, bring it up and out, and eliminate it.
And so a lot of people put a heavy, metal lid on the panic. [00:24:00] They just push it down and not want to investigate further. And that doesn’t prevent them from thinking the—
CLIENT: Denial?
THERAPIST: things—yes, you could call it denial. And that does nothing to prevent us from keeping on doing that for the rest of life. But from now on, you – as long as you intend to – will have the choice – as often as you remember to – to NOT succumb to the ideas and notions that brutally hurt you.
CLIENT: Yes.
THERAPIST: Okay, very good.
CLIENT: [giggles]
THERAPIST: So, that was one. Unless you have anything more to say about homework number one?
CLIENT: No, no.
THERAPIST: No. Good. So, do you feel prepared to handle any debilitating emotion that comes up? And right now, in theory, do you have clear strategies in your head of, “What I can do if and when”?
CLIENT: Most, yes. Not—I mean, I think—I can’t say all the time, but this is the go-to resource that I would use. [00:25:07]
THERAPIST: Sounds good. All right, number two: prep any questions you have—
CLIENT: Yeah.
THERAPIST: Questions for me, about REBT—
CLIENT: Yes.
THERAPIST: about therapy, and any related issues.
CLIENT: Okay, so, I know we’ve addressed this in the past but just being that it’s closer to my surgery, and so, the pain has been completely debilitating on certain days – and at night, especially. So, my question is: REBT related to severe, chronic pain, I feel it has affected me differently when I’m horrific pain and I can’t think as clearly or positively. Do you have suggestions? Or can you elaborate a little bit more on when that pain is gut-wrenching – which, I’m going to use that word because it has been that – suggestions for what to do? Or what to do—how to—do I need to do something differently because of that or . . . when my brain is just overtaken by pain – which, unfortunately, has happened. [00:26:07]
THERAPIST: Well, your brain won’t feel the pain. Your body will feel the pain and your brain registers it and—
CLIENT: Okay.
THERAPIST: you’re indicating that, when you feel that pain—am I right in what I’m about to say? That you are looking at whether just the brain, you suspect, may not cooperate with the—
CLIENT: Exactly, exactly.
THERAPIST: ABCs and the REBT approach? And asking what you can do about the pain?
CLIENT: Exactly.
THERAPIST: Well, first of all, particularly post-surgery – and you’ve indicated you rather trust this particular surgeon doctor—
CLIENT: I do.
THERAPIST: so, that’s certainly a question on a purely biological, physical, neurological level. Ask him, “What do I do about the pain?” Post-surgery.
CLIENT: Oh, oh, oh, okay.
THERAPIST: Okay?
CLIENT: Well, he’ll say, “Take pain medication,” which I’ve talked to him about. [00:27:02]
THERAPIST: Which may be the helpful thing to do. Because if you can get your body to a state where your mind is not so distracted by the pain, then you can more easily – I’m not saying it will be easy, but it will be easier for you—
CLIENT: Mm-hmm.
THERAPIST: to then think about your thinking. So, step one, when the pain is very severe, is to address that. And get advice from someone who knows. In this case, the most appropriate person to ask about post-surgery pain is the doctor.
The second thing I suggest – which I attempted [chuckles] to do with you in a past session – was the relaxation meditation, or progressive body relaxation. Which many, many people practice to lessen their pain.
CLIENT: Okay.
THERAPIST: Relaxation meditation or progressive muscle relaxation. [00:28:02] So, referring to the second one [chuckles] first, the progressive muscle relaxation is simply taking your awareness to every part of your body and just consciously intending, directing, suggesting to that part of you, “Relax. Relax. Relax.”
Then, the first suggestion [chuckles] which I mentioned was relaxation visualization meditation, where you visualize. One popular one for people who are visual is to imagine a soothing color just oozing down from the top of their head and filling every part of the body. And you see it in graphic detail, whatever your color is. It may be a gold color, and a bit of a warm, molten gold and a healing yellow color, and you see it going through. It enters your body from the crown of your head And you see it flowing down through every part of you, just relaxing every cell. And you let your body drop all effort. And it’s a good idea, when you do this, to either lie flat on or your back or, if you’re sitting up, to consciously get in a relaxed posture. Uncross your legs, uncross your arms.
So, a strategy that helps a lot of people—
CLIENT: Mm-hmm.
THERAPIST: when they’re in pain is the visualization or the progressive relaxation and/or both. I mean, you can do each at different times. Find what you respond most successfully to. And it’s a very good idea to do this even when you’re not in pain. It’s a lovely way to go to sleep. Again, imagine – maybe it’s a beautiful sky blue color that enters the top of your head and moves down through every part of you before you go to sleep. [00:30:09] Even when you’re not in pain.
I recommend daily meditation – even if it’s only for a few minutes – in a form that you embrace comfortably every day when possible. And it may not be possible to do it every day, but it’s a good idea to do it as often as you can – even for a few minutes.
CLIENT: Okay.
THERAPIST: There is a great amount of research – scientific research.
CLIENT: Yeah, yeah. Gene expression changes based on meditation.
THERAPIST: So, I recommend making meditation/relaxation a part of your life.
CLIENT: Okay.
THERAPIST: And in response to the question you asked: when in pain, before you’re in pain, and post-surgery, my recommendation would be done in addition to whatever your doctor recommends, because your body will be in some sort of different state after the surgery. [00:31:09]
CLIENT: Sure.
THERAPIST: So, use both—
CLIENT: Okay.
THERAPIST: after surgery. Not medication for the rest of your life. [chuckles]. But meditation – that would be fine.
CLIENT: Sure. Sure, sure, sure.
THERAPIST: Okay. Any other questions, comments?
CLIENT: Oh. Okay, so, let’s see. Okay, how often would you say it is beneficial to document—what did I write here documenting or journaling your thoughts in order to train your brain differently?
THERAPIST: As often as possible. Some people write in a journal every night. If you can do that, all the better.
CLIENT: Okay.
THERAPIST: Whenever possible. By the way, going back to strategies. Dr. Norman Cousins, have you heard of him?
CLIENT: Hm-mmm.
THERAPIST: He was very ill. He wrote, I think, a multimillion—
CLIENT: What’s his name? Dr. what? Norman . . . ?
THERAPIST: Norman Cousins.
CLIENT: Oh, I have heard—Cousins, yeah. I have heard of him. [00:32:00]
THERAPIST: When very very ill, he watched funny movies.
CLIENT: To get rid of pain?
THERAPIST: To distract himself from pain. And he laughed. And it made a huge difference, so—
CLIENT: Okay.
THERAPIST: laughter is a good thing. Which may be harder to do when you’re in pain, but worth striving to do.
CLIENT: I’ve been doing that, yeah, true.
THERAPIST: We’re talking about different degrees of pain. What to do? There’s a relaxation. There’s a meditation. There’s distraction, which could include funny movies, good books, a walk in nature – again, if the pain isn’t too severe. And seek appropriate medication – not instead of the above – in addition to it – for when pain is severe.
CLIENT: Okay. Any suggestions on how to best use REBT when too many thoughts are happening at once and it’s hard to get to the place of relaxing your mind in order to decipher the thoughts and then dispute them, i.e., catastrophizing?
THERAPIST: Mm-hmm. Good on you for asking that question, because that is really pertinent—by the way, not only to you – a lot of people. But in asking that question, you have recognized that that is a tendency of yours. [00:33:00] And we’ve talked about it in some of the sessions in the past.
So, conscious focus is what can be done. Focus, intending to watch your mind and be master of it rather than succumb to its whims and habits. It takes discipline, which you’ve demonstrated that you have. And intention, which you’ve demonstrated that you have.
CLIENT: Mm-hmm.
THERAPIST: And then, increasing the habit of thinking about your thinking, of being aware. I may have mentioned it before that Al used to say, “As far as we know, many animals think. But as far as we know, humans may be—”
CLIENT: [That’s most animals]
THERAPIST: “the only ones who can think about their thinking.”
CLIENT: Right, right. [00:34:01]
THERAPIST: Even think about thinking about their thinking !
THERAPIST: And research has shown that people who meditate every day find it easier in their daily wakeful life—
CLIENT: Right.
THERAPIST: to be more mindful and focused on one thing at a time. So, I would say, as a preventative, it would be very beneficial to you to meditate each day.
CLIENT: Okay.
THERAPIST: To increase, enjoy and have that core of inner peacefulness and stability as much as possible.
CLIENT: Mm-hmm.
THERAPIST: And, also, intend every day to watch your thinking. Have that intention. And intend to just say, “Stop!” when you are thinking in unhelpful ways as you might tell your students to do, at times – not necessarily when they’re thinking too many thoughts but when they’re thinking unhelpful thoughts.
But now I’m suggesting you do that either when you’re thinking unhelpful thoughts—pause and think about—and also remind yourself: FOCUS. Think: “Wow, look, I’m thinking about this, this, this,” “Hang on!” say to yourself: “Just one thing at a time”. And it’s a matter of conscious choice and discipline. You can do it. If you choose to do so.
CLIENT: Okay.
THERAPIST: A possible reason that you won’t is—I don’t want to use the word ”laziness” which sounds like a bit of a—
CLIENT: Hm-mmm.
THERAPIST: critical word here, but your just not doing it due to that or...
CLIENT: No, I think it would be laziness.
THERAPIST: Or Forgetfulness.
CLIENT: Forgetfulness or—
THERAPIST: Not intending strongly enough to do it. Insufficient dedication to the task.
CLIENT: Right, yeah. I try to steer away from the word “laziness,” because I don’t—I think it’s that—it’s more helpful being kind.
THERAPIST: Alright, so, kindly be firm with your mind when it’s on a trip in nine different directions in one millisecond. And firmly and kindly and firmly say, for example, “Stop. Okay. I’m going to think about this now. I’m going to do this now. Look, I’m writing a note about it so I don’t forget. At 6:00 p.m., I’ll come back to that issue.” [00:36:09]
CLIENT: Okay.
THERAPIST: And you’re just lovingly firm. Anything else?
CLIENT: [chuckles] On questions, no. That was—
THERAPIST: All right.
CLIENT: you know my tendencies to ask a lot of questions, so I just kept it brief.
THERAPIST: All right. But if there’s some pressing question -
CLIENT: No, no, no, because I think—I mean, I had one other question, and I said—
THERAPIST: Yes?
CLIENT: and I went back and forth in terms of asking this, but I am just curious – and if you have an answer to this or some thought to it—not a definite answer, but a thought. I’m just curious: people that—if someone in their life hasn’t done REBT, if they haven’t been trained—do you know what I’m going to ask ?
THERAPIST: I’m not sure. I suspect I might.
CLIENT: Okay. Okay. If they haven’t been trained, how is that they can still—that they’ve developed and become this very healthy—because there are healthy people out there that have not done REBT. [00:37:03]
So, I guess my question is: those people that I look to and maybe modeled or said—I can even think of just friends that I’ve had, over the years, or coworkers that are very—just are healthy thinkers. You could tell, just in their daily way of life that they are. If they didn’t have REBT, how do you suspect that they got to that place of just thinking in that way but yet not ever being trained?
THERAPIST: Well, REBT doesn’t have the monopoly on wisdom. It does express it very clearly.
CLIENT: I understand, okay.
THERAPIST: My husband had a gift for that.
CLIENT: Okay, got you.
THERAPIST: And so, it sounds like the people you’re asking about are bright and wise. They may have also read things and selected the goodies that were healthy to think about and/or apply.
CLIENT: Yeah, that.
THERAPIST: And maybe they also had healthy models in their lives. Maybe they don’t use the REBT terms and language, but they practice the principles: that is what you’re indicating.
CLIENT: That makes sense, yep. [00:38:00]
THERAPIST: Buddhism has many similar principles within it as REBT. So, there may be other approaches that they have studied or consciously embraced and they use the principles in those that are akin to REBT ones. If it works, wonderful. The goal is to enjoy this life.
CLIENT: Life, yeah.
THERAPIST: This life, that passes so quickly. To enjoy it.
CLIENT: Exactly. Okay. That was my other question.
THERAPIST: Okay, all right. So, then, homework number three: make notes of gains you have made using REBT.
CLIENT: Okay, so, I just wrote a few things so I could share. I just said: I am more lighthearted, more easy-going about some of life’s circumstances. I’m more able to go with the flow. I’m not catastrophizing as much as I did—I don’t catastrophize as much as I did in the past. I’m able to stop and think a little more. I’m able to dissect my thoughts, dispute them more thoroughly, and gain more clarity. [00:39:02] I have lessened my expectations so that when something good happens, I’m more grateful. I’m a little neurotic. [laughs] I’m okay with still continuing to work on my neurotic behaviors or tendencies, because I have a choice. I’m more—hold on, what did I write here? I’m more . . . gosh, I really do love my own handwriting. And it’s funny, when I’m writing these days about myself, it’s more compassionate, I guess? More unconditional acceptance.
THERAPIST: That’ll do it.
CLIENT: Okay. I think that’s what I wrote. More compassionate, yeah.
THERAPIST: If you didn’t already write it, write it now !
CLIENT: Yeah, exactly.
THERAPIST: Good.
CLIENT: With myself, I’m happier and slightly more ease. I feel more optimistic, just about life—
THERAPIST: That’s pretty major progress, wouldn’t you say?
CLIENT: In general. Yeah.
THERAPIST: After only 14 sessions.
CLIENT: I think so, yeah.
THERAPIST: That’s big. Really.
CLIENT: I think so, yeah.
THERAPIST: To your credit.
CLIENT: Yeah.
THERAPIST: Not more enthusiastic about that?
CLIENT: I’ve modified my expectations. I’m a little less hesitant to express my feelings without worrying over what the other person’s response will be later. [00:40:01] I have more unconditional self-acceptance, more unconditional other acceptance. I understand the human limitation. And I’m less quick to put someone on a pedestal, recognizing that they’re just a fallible human – just like myself. And I’m less inclined to anger.
I feel like I’m going to cry.
THERAPIST: You can let yourself cry Jessa. It sounds like it wouldn’t be crying with deep sadness.
CLIENT: No, no, just the emotion – and I feel appreciation and just the whole process and journey.
THERAPIST: Success in important ways.
CLIENT: Yeah.
THERAPIST: And it’s an ongoing story.
CLIENT: It’s ongoing. [chuckles] It’s ongoing, but I really feel grateful that I’ve been able to get to this place in such—I mean, even just before, I was taking a shower before our session, and I stopped myself and I said, “You know, Jessa, even if you aren’t feeling—” I had this thought in my head. I didn’t catastrophize, I said, to myself—no going to somebody else, for them to fix me maybe like I would have done in the past, “Well, what happens if . . . ?” I said, “Jessa, you may not feel 100% after the surgery. And, chances are, you probably—”
THERAPIST: You probably won’t. [00:41:06]
CLIENT: I probably won’t exactly.
THERAPIST: By the way.
CLIENT: No, no. I know that. I know that. I wanted to say—
THERAPIST: Just for a while, for a while.
CLIENT: I know that. And I had this conversation with myself. I said, “You’re having your neck worked on.” I said, “You’re having nerves touched. You’re having a lot of trauma to the body.” Surgery is some type of trauma to the body.
THERAPIST: Intrusion.
CLIENT: I said, “But the hopeful thing is that the body has this amazing ability to heal. And that when you start getting a pain or a feeling or an ache or an, ‘Oh my God,’ or a this or a that, in time, things will get better. And that you have something to look forward to. But this surgery is the first step.”
And this was my little conversation that I had with myself in the shower, able to calm myself down – which was a beautiful thing, because I think that in the past, I would have said, “I want to get off the table and start doing jumping jacks.”
And I think that my mother’s wish is that by pushing me back to work after four days, that was her hope and I’m much more realistic. [00:42:01] And so, I felt that I was able to take what she said and use it in a positive way to say, “That’s her wish, but my reality says that it’s not going to be like that, but that, in time, I will be given the gift of getting better,” because otherwise I wouldn’t be doing the surgery. And that if something doesn’t go exactly as planned, it’s not a catastrophe.
THERAPIST: Not at all. And by the way, not in time are you going to be given the gift of—what did you say?
CLIENT: Healing.
THERAPIST: The surgery is part of the gift of healing. The healing begins there.
CLIENT: Let me write that down.
THERAPIST: The healing has begun. Don’t you wait for it to begin. The healing has begun. And you are helping it.
CLIENT: Okay. [cries] I’m just emotional right now.
THERAPIST: There’s no law against tears that I know of, so—
CLIENT: [laughs]
THERAPIST: feel free to cry.
CLIENT: No, no law.
THERAPIST: Those tears are not attached to sadness or depression, it appears.
CLIENT: No.
THERAPIST: So let them nourish your experience.
CLIENT: I don’t feel depressed (crosstalk at 00:43:06).
THERAPIST: No, I can see. I think you’re touched by the progress you’ve made, and your awareness and the revelations.
CLIENT: I liked what you said, “The surgery is the gift,” to what?
THERAPIST: Of healing. You said, “I can wait for the gift of healing.” Meaning – after the surgery. It’s already begun. You’ve made a decision. The surgery is going to bring you healing, that’s the first physical step of the healing process. You’ve already started. Now, with this healthy way of thinking, Jessa, you will be creating fewer of those harmful chemicals in the body – adrenaline and others you can read about – that can inhibit or retard healing.
CLIENT: [laughs]
THERAPIST: By keeping your thinking healthy, that will affect your physical healing, as well.
CLIENT: Exactly.
THERAPIST: Chemically.
CLIENT: Exactly. [00:44:00] I think that’s more important, truthfully. I think it is more, in my experience, it is.
THERAPIST: Yes, if you have free hours, do research on the—
CLIENT: Oh, oh that’s on it.
THERAPIST: on the mind-body connection.
CLIENT: And [inaudible] is a good example of that.
THERAPIST: Yes, you might go on “Dancing with the Stars.”
CLIENT: [laughs]
THERAPIST: I’ll watch you if so. Yes. Okay, that was a very marvelous revelation that you had in the shower. You “should” (joking) have more showers!
CLIENT: I love that shower, I love—
THERAPIST: Did you hear what I said? I said “should,” why didn’t you catch me? You “should” have caught me !!!
CLIENT: I was thinking about how much I love showers.
THERAPIST: [laughs]
CLIENT: I’m not allowed, by the doctor’s orders, to shower for five days after my surgery. So, I got baby wipes so that’ll suffice but I might smell a little.
THERAPIST: If your cats want to leave home due to the stench, I’ll cat-sit them.
CLIENT: [laughs]
THERAPIST: They’ll meouw: “She stinks. I can’t live with her anymore.” All right, great. Okay, so, next …Back to homework you did -
We are talking about gains you’ve made using REBT. Any additional ones there?
CLIENT: No, that was what I wrote.
THERAPIST: That was that, then. Make notes of – this is part two of homework three – changes—which you’ve somewhat answered, maybe you put them all together.
CLIENT: I put it all together, yeah.
THERAPIST: Changes in you, particularly with regard to anxiety, which was the emotion mentioned in session one as the main one – anxiety, panic – that you wanted to change, eliminate, and reduce. So, you have touched on it already this session, but do you want to, again, just verbalize – briefly—
CLIENT: Sure.
THERAPIST: the progress you feel regarding your tendency, in the past, to create quick anxiety and severe panic? And you have mentioned it today, but . . .
CLIENT: Yeah, I think I’m good. Unless there’s something you want me to share, but I think it’s—
THERAPIST: So, during the weeks of using and working on applying REBT, you’ve succeeded in lessening it.
CLIENT: Lessening it. [00:46:04]
THERAPIST: And are you comfortable that you have the ability to keep working on it?
CLIENT: Absolutely, absolutely. I see, now, that it’s a lot—that anxiety is—there’s situations that happen and then there’s what we choose to do with those situations, our minds. And how powerful—
THERAPIST: And how we think. We can choose the way we think.
CLIENT: that is and that we can definitely create—there are situations that can, just by themselves, create some anxiety and then it’s our choice.
THERAPIST: No, no, no! Situations don’t create anxiety.
CLIENT: Oh, well, I guess I meant that if someone—I’m thinking more extreme again, there I go. [chuckles] But either way, it’s something that we have choice, in order to . . .
THERAPIST: Choice about what?
CLIENT: Of what we tell ourselves.
THERAPIST: Exactly. That’s the bottom line.
CLIENT: It’s that inner dialogue in terms of how we handle situations.
THERAPIST: So, you already shared with me you find yourself doing—creating it less—
CLIENT: Yes, I’m anxious less.
THERAPIST: and attending to the thoughts more.
CLIENT: Yes.
THERAPIST: Keep it up, would be my encouragement. All right. And then, next homework again, you may have already bundled this together, part three of homework—
CLIENT: I did.
THERAPIST: three was any noteworthy revelations. You shared the one you had in the shower—
CLIENT: I have something else, now.
THERAPIST: Which emerged during or as a result of our sessions, yes?
CLIENT: I actually did, just as part of revelation, I was on the airplane in—gosh, when was this, that I went to—I was with Madeline, where did—we were flying in the summertime. So, there was a book that I’d had, some spiritual—I’m very much into that, a lot of that spiritual type of stuff. And so, one of the things that it said was to write down all the things that you’re not and then the negative patterns that come with it, and then all of the things that you are. That was what had been said by the book. [00:48:00] And it’s just funny, because I found it. Things I wrote. As you can see, it was from the airplane, because it’s on one of those—
THERAPIST: Vomit bags !
CLIENT: Bags you use if you get sick. [laughs]
THERAPIST: I hope it’s empty right now !
CLIENT: [laughs] That’s funny. Well, I didn’t have any paper, so, I had to get creative. So, anyway, I just wanted to share this because I just thought it was interesting that it was so extreme to say all the—in that, to say all the things you’re not. And I’m looking at it now very differently, but I was so steadfast when I was writing it at the time. Can I share, if I may? Because this was back in August, so it’s only a few months ago.
THERAPIST: Before we started working.
CLIENT: Before we started working together. So, I wrote all the things I’m not. I’m not—this is what I told myself: I’m not patient. I’m not calm. I’m not organized. I’m critical of myself, so I’m not kind to myself, basically. And I’m not decisive, so I’m therefore indecisive.
And all the things I am, I said: I’m sensitive. I’m kind. I’m funny. I’m creative. I’m good with children, pets, and understanding others.
So, again, it said, “Negative patterns that being that way creates.” [00:49:04] And I wrote underneath, where all the things I’m not, I said, “This creates me to, then, focus more on my weight in a negative way. To control, to have negative thinking or not thinking clearly, to eat my feelings” – oh my gosh, I haven’t done that. That’s good, I don’t do that – and to worry.
I’m just looking back at this and thinking of so many things that have changed and I wasn’t aware—
THERAPIST: That you have changed.
CLIENT: That I have changed. And then the positive, they said that what you put in them was a positive substitution replacing the negative of what you could do. And I said, eat healthy—but, again, I was just writing it down. I wasn’t doing anything, I was just writing what I could do.
So, I wrote, “Eat healthy and enjoy the food.” Interestingly enough, without knowing that I had written this, I have changed my diet in the past—since the REBT work I do started. Completely, I’ve taken out chemicals. I’ve taken out processed food. [00:50:01] I eat natural, all healthy, drink just water and tea and that’s it. Before, I was having diet peach Snapples, which have aspartame and all of that kind of stuff and “crap,” I’d say. So, I’ve changed that.
“Live in the moment and let things be.” That was one of the positive substitutions. I feel like I’ve definitely been able to do a lot more of that.
“Changing the thought,” that was a positive substitution. At that time, I was not allowing myself to do that. I just was wishful but wasn’t doing it.
And then, this other one, here, was, “Take deep breaths,” which, again, is something I’ve been working on.
So, in a way, it was REBT in some way, without realizing it. But not taking it to that next level. It was without disputing the thoughts, without that piece of it. So, I wrote it on a vomit bag ! and wasn’t really sure what I was going to do with it after. And now, I’ve been able to use REBT to make those changes I wrote about, so . . .
THERAPIST: Well, that’s . . .
CLIENT: That’s a revelation .
THERAPIST: Yes.
CLIENT: Because that was in August. And I can remember where I was, in my head, in the frame of mind that I couldn’t get out of things. That I didn’t have hope—I felt stuck. Clearly, I have this upcoming surgery. I have been in physical pain, I have—but I’ve made a lot of decisions. And I put “indecisive” there and I don’t think that is the same now.
THERAPIST: You can rip that sick bag up now, if you choose, if you want to.
CLIENT: I like to remind myself of where I was at different points—
THERAPIST: That’s interesting.
CLIENT: because it’s still me. It’s not—
THERAPIST: What is still you?
CLIENT: Well, even though I might have changed my thought patterns or different ways or things, that was – at one point or another – that still came from me. So, it’s nice—
THERAPIST: In the past.
CLIENT: Yeah, so it’s nice to be—
THERAPIST: It’s what you did. Past tense.
CLIENT: I like to be able to—I like reflecting, at times, for my own—just to look back and say, “Look how far you’ve come,” so . . .
THERAPIST: Okay, Good, good. Any other . . .
CLIENT: Revelations?
THERAPIST: Mm-hmm.
CLIENT: Yes. One that I think is interesting and I did kind of say it in here: it is that I do not put people on pedestals now. I see people now for—which, in a way, it’s interesting because I—in the past, I would have put the surgeon on such a pedestal. And yes, I mean, he’s good and I’ve heard he’s good but I’m not doing that as much. And, in fact [chuckles] it’s had a little bit of a negative effect, because I’m like, “Oh, crap. He’s a human.” [laughs] “He’s not a superhero” [laughs] But also knowing that—
THERAPIST: “I want the Lord operating on me.”
CLIENT: Exactly, exactly, exactly. But I’ve realized that I don’t do that as much because I realized that we’re fallible. And so, with that said, I said, “He is an expert in his field.” And I’ve been able to remind myself that, yes, he’s not perfect. He is a human. Who knows what he’s like as a husband? Who know—I don’t care. He’s trained and this is what he does. And so, let’s hope he has a good day. [laughs]
But I’ve taken down some people off of that pedestal I put them on, and just said, “This is who they are.” And that they might do things very well but that’s not who they are. Nobody’s perfect, and I think that’s been, in certain ways, a huge realization for me, a huge revelation for me. Because I tended to put my parents on this pedestal. And them coming off of the pedestal has been enlightening, in addition to—there were times where it was disappointing to have that realization that, “Wait a second. You don’t have the answers that I thought you did?”
That’s been also a huge revelation. I think probably the biggest is that I’m one, like all of us, a struggling human being, at times. Just having life challenges that we have to deal with that—or we don’t have to, but we choose to deal with them because we want to go on and enjoy our lives. But I have challenges like others. And that I’m not alone. My challenges might look different, but I’m not the only one. And just because I have physical pain, there are people that have emotional pain. Thank God that I don’t have that much emotional pain.
THERAPIST: When you work on changing your anxiety and panic.
CLIENT: Yeah. But I mean, just from life.
THERAPIST: Yes.
CLIENT: I feel blessed in a lot of ways.
THERAPIST: And that attitude of gratitude – ugh, I sounded so cliché-ish then – but truly, daily reminders of what you’ve got to be grateful for is hugely beneficial.
CLIENT: I went to the dentist today. He said, “You have beautiful teeth.” And I said, “That was the best thing you could have told me today.” I said, ‘Thank you so much,” because I went thinking I was going to need a crown. But I said to myself, “Jessa, you don’t know for sure.” And I went in and he said, “No, I think your tooth just needs to be shaved down.”
And it was another example of—I could have catastrophized that I had this dentist appointment because my tooth was killing me, which it has been. And it was much better than I thought—I walked out of there relieved.
THERAPIST: Probably wasn’t “killing you”.
CLIENT: Oh, it was really—it was pretty painful.
THERAPIST: Did the tooth come out of your mouth and strangle you?
CLIENT: Oh.
THERAPIST: [laughs]
CLIENT: My own tooth? No.
THERAPIST: Yes, I understand. I’m just being unsuccessfully funny. Or not.
CLIENT: [laughs]
THERAPIST: Right, so, remembering each day what you’re grateful for is a key component to healthy emotions, and a happier life. A key component.
CLIENT: Right, right.
THERAPIST: I think I’ve shared with you, at one time or another, that my parents went through five years of hell – literally – in concentration camps during the Second World War, and survived, made it to Australia to start new lives. And I feel grateful and blessed because my environment was not one of trauma and bitterness and, “How could this have happened to us?” Every day, in one way or another, I saw my mother or father or both just happy – very often. Grateful for this new life they had.
CLIENT: Oh my goodness.
THERAPIST: They survived hell. And had a new safe home. And children. And Australia is a great country to live in. So, gratitude enriches every moment and prevents a maintenance of trauma symptoms, if there have severe past circumstances.
So, that you feel gratitude is a very good thing. Any other revelations?
CLIENT: [sighs] Oh, that I’m not—that I haven’t—my tendency has been that I’ve been very unkind to myself. And that I haven’t really treated—not intentionally, not realizing it, not knowing, not—
THERAPIST: Not being aware.
CLIENT: not knowing that that was how I was treating myself. And so, I think that going forward that just to stop and to think and I think that, truthfully, I think is the first step, because if I’m not being kind to myself, then I wouldn’t give myself the opportunity to think differently because it goes hand in hand. I think it’s giving myself that gift to not—and rather than beating the crap out of myself, which I—which anybody could do if they allowed themselves, so . . .
THERAPIST: Which you used to do a lot more in the past, I believe.
CLIENT: Yeah, absolutely.
THERAPIST: I saw that in my early sessions with you. I witnessed it quite often in those early sessions.
CLIENT: It was much worse, yeah.
THERAPIST: And I have noticed the change, to your credit. So, that’s wonderful. Now Jessa, can you say a few words on the next homework piece, because this has come up before, here or there.
CLIENT: Mm-hmm.
THERAPIST: You studied psychology. You went through a long period of psychoanalysis. You studied REBT. You thought you knew what REBT was. And then, you have shared with me – without specific details – that, wow, you didn’t realize REBT was the way it really is, as we have practiced it. So, could you briefly share what you now realize on that.
CLIENT: Sure, sure.
THERAPIST: Share about what you now see REBT is and how your—and/or what your misconceptions were.
CLIENT: Absolutely, absolutely.
THERAPIST: And how you now see they were false.
CLIENT: Sure.
THERAPIST: How they were false.
CLIENT: Sure. I went to graduate school in counseling, as you had mentioned, but we did specifically learn the different—each different type of therapy. I just remember REBT – I believe, I believe it was called CBT when we learned it, cognitive behavioral therapy, because that was how I—and that’s why I kept saying that, over and over. Because I don’t know if it was taught that way in school, I’m just telling you what I know. And it may have been REBT but they focused, for whatever reason, more on using that terminology.
And so my belief about it was that—my past belief about REBT is that there was not a whole lot of compassion – I’m just telling you what I thought – for the client’s issues, whatever they brought to the table and that if they were dealing with whatever they were dealing with – X, Y, and Z – that the belief that their ways of thinking would be able to change just based on changing their thinking was really strictly how REBT worked.
That was my understanding of it, not thinking that—and yes, I understand now that REBT doesn’t sit and have you go over, each week, when you go in, what your childhood woes were, all—and I see, now, that—I do see that the benefit to not doing that, because you could—anybody could do that at any point. But I also see that REBT has a place for it. Because I think, in the very beginning of our sessions – and I know we were limited, I’m not seeing you on a—for—I haven’t even seen you more than just 12, 13, whatever sessions—
THERAPIST: Fourteen.
CLIENT: This is today, 14 sessions, but I do remember that, in the very beginning, you got to know me and we dissected where—or understood where the self-criticism came from. And I felt, the whole time that we were working that when I kept going back to that place, you still had compassion as my therapist. And you knew – you might not have expressed this to me, to feel badly for me – but I think you—but you had a sense of, “That’s probably where that came from with her.” And that the language that—and that my parents were unaware when they did it. And that it was of no fault of theirs, but just that—
THERAPIST: Their behavior may have been contributing, but they weren’t intending harm.
CLIENT: Well, they weren’t intending harm. Exactly. It wasn’t meant to hurt. I just think that that was—they didn’t know, really, any different. So, regardless of that, I think you got that as somebody working with me, that when I would go back and—
THERAPIST: So, you felt empathy.
CLIENT: I felt that you were empathic with me.
THERAPIST: Because one misconception I often hear about REBT is empathy is low on the list, and I feel that’s a huge misconception.
CLIENT: It is.
THERAPIST: Do you think that in the light of your experience?
CLIENT: Absolutely. I agree that you can do both. I think of what—another misconception, though, is that a lot of people don’t think that you can be empathic and also push people to do good things at the same time—simultaneously.
THERAPIST: So, what was your experience with that?
CLIENT: That I was more empowered after each session. That I would feel, “I can do this.” Because really, at the end of the day, for children it might look slightly different because they can be more helpless. In certain situations, they might need an adult. I don’t expect a child to walk up and—
THERAPIST: We’re talking about you now.
CLIENT: Well, I’m talking about—the reason—
THERAPIST: Your misconceptions.
CLIENT: Well, the reason I’m saying that is because I think there is—because I work with children, I think that there is—I’ve taken REBT and just maybe bent it more to work with children. But in my understanding of it is that you can mix compassion and empathy but also empower someone so that it can benefit them double-time, that they don’t have to be helpless. I think it can create a learned helplessness when all you have is just compassion and empathy. I’m not saying that about other therapies, I’m just talking strictly about REBT is that it’s you can combine those two.
And I think that one thing that I would like to maybe share, just in—is that I think with REBT that maybe, just a suggestion, I think that there is maybe—it’s decided in me, but if this is how it works, anyway, I don’t know. But it’s decided between the therapist and the client in terms of what—or maybe it’s in the therapist’s best judgment to see how much trauma, maybe, the client has. And for that therapist to intelligently make that decision that they might not be able to push so much with certain things in the beginning, for whatever reason.
THERAPIST: Well, actually, that is taught and recommended in REBT training.
CLIENT: Okay.
THERAPIST: That is the way I teach it, and the way my husband taught it and others who practice what they were trained if they were trained by my husband or people he had trained and trusted. And that is that each individual is an individual and you gauge what might be most helpful based on their tendencies and issues – and don’t just apply a same-size-fits-all formula.
Now, you and I, we’ve laughed a lot in sessions. And I’ve expressed more humorously, more of the time with you, than I might with many of my other clients, simply because initially, I noticed your response. It seemed to enhance the session and your receptivity and seemed helpful for changing your perspective and seeing things more realistically and for your doing less catastrophizing and so on.
But with another client, in particular, let’s say they were relaying a traumatic event to me. I would not use humor about that. Unless and until I felt there were appropriate moments for the good of that client – then I would.
CLIENT: Right, right.
THERAPIST: Until I felt—
CLIENT: They were ready.
THERAPIST: and assessed that they were in a healthier place—
CLIENT: Mine was .
THERAPIST: and that it would serve them. So, humor isn’t used randomly.
CLIENT: Right.
THERAPIST: An effective REBT therapist does the best they can, being fallible, but intends to do the best they can to do what’s most appropriate for the client’s good. Not to be magnificent REBT practitioners but to be appropriate REBT practitioners in relation to who they’re working with. To help them to help themselves as well as possible.
Now you shared, indeed, you know that my husband was notorious for, at times, using strong language and being forceful. You have implied and at times said that I’m quite direct, at times. I can be forceful.
CLIENT: But it’s a more directive type of therapy.
THERAPIST: Right. It is. And yet, there have been times with you when I have chosen to pull back and be gentler.
Other times, I’ve been more direct and in your face.
CLIENT: Right, right.
THERAPIST: And, fortunately, it seems that I wasn’t too much off track. And I say that just judging by the results, by your progress.
CLIENT: Exactly.
THERAPIST: and your receptivity.
CLIENT: Exactly.
THERAPIST: My husband, who was known by some as being so intense and so strong and some called him rather curmudgeonly at times, despite those impressions – he adjusted his manner and style for the best good for the client. His goal, with regard to the strength and forcefulness of his character, was to shift rigid thinking. When he worked with people who were in a place of deeper suffering, he would modify. I would, without hesitation, say he was brilliant as a therapist, and at practicing what he preached. Not only because he created REBT. There have been some people who created a theory and were not excellent at practicing it, but Albert Ellis did both. And so, yes, there’s modification seen in a skillful REBT therapist’s work.
CLIENT: Right.
THERAPIST: They don’t blindly just stick to the book and stick to the theory and they—
CLIENT: Well, that would be rigid. [laughs]
THERAPIST: That would be very rigid – anti-REBT ! Okay, so, any other misconceptions about REBT that have been broken as a result of our work and your work?
CLIENT: Any other misconceptions, is that what you said?
THERAPIST: Myths that you believed before actually applying REBT?
CLIENT: It’s interesting because, I mean, I still feel—I’ve learned different types of therapy and what came out of it is that I think that therapy is therapy. I mean, I just want to say there’s different types. But I do feel that one of the things that has come out of my knowledge is that of just reading about different therapies, learning different therapies is that a huge piece of it – and this isn’t really a misconception but it’s – well, and in a way, it is – is that there is still much focus on the relationship between client and therapist. And I think that that’s standard for all therapies. But I maybe was excluding REBT from that, originally.
But I feel like my relationship—that they say that sometimes the healing is just in the relationship, even as a piece of it. Not as the whole thing, but just that being—somebody helping you. I feel like you’ve been—as my REBT therapist, you’ve been there every week to really help me work on my life. And I think that’s—it’s like a cheerleader. It’s somebody there, rooting for you.
And so, I think that applies to REBT, as well, which maybe before, it didn’t in my mind. If I envisioned what REBT would look like, I don’t know if I would have thought that as much. I might have thought it was a little bit more robotic, as opposed to including impact from the relationship itself.
And focusing on the fact that, like any type of therapy, that there’s a relationship that’s involved in it. And that there are two people that are working and one is trying to help the other but that the other could help the other—all of that. I think that was maybe a little bit of a misconception that it didn’t take into account the two people involved as much as I thought.
But we didn’t focus on it as much—or maybe I should just say that we didn’t—we focused on it and I never really went that route, for one reason or another. And I’m at a place in my life, now, where I think if a client chooses that type of therapy, then that’s what they’re ready for. Not every therapy works for every client. So I just think that that’s something that the client would want to talk to the therapist about to consider, if that’s something that they think—I just think some people have to be ready for therapy in general, let alone—
THERAPIST: It certainly works better when a client chooses to help themselves than when they are kicked into the session, kicking and screaming. [laughs] And there are people who do therapy because they are court-mandated, and for legal reasons
CLIENT: Exactly—
THERAPIST: Yes, with regard to the client-therapist relationship, certainly REBT appreciates the helpfulness of that healthy, encouraging relationship. But with its goal of empowering the client, the REBT therapist will watch that the client doesn’t make themselves think or feel that they’re dependent on the therapist over the long-term.
CLIENT: Yeah, yeah.
THERAPIST: That they will have to always depend on the therapist for their improvement – that idea is discouraged.
CLIENT: Well, that makes sense.
THERAPIST: Certainly – the therapist is there ongoingly if helpful to help with maintenance of gains. For help after relapses. And that comes from caring about the client.
CLIENT: Exactly. Yeah. Yeah.
THERAPIST: All right, very good. So, we’re at the final point of the homework. And then I’ll say a few things to finish off. Express your goals, Jessa, and intentions regarding your emotional well-being going forward.
CLIENT: Well, I think that my goals are to continue to be the very spiritual person that I enjoy being and include REBT—
THERAPIST: You mean, enjoying the spiritual beliefs that you have?
CLIENT: Enjoying the spiritual beliefs that I have, yeah.
THERAPIST: That’s a more precise way of putting it.
CLIENT: Okay. To continue to enjoy—yeah, that makes sense. To continue to enjoy the spiritual beliefs but adding now what I know with REBT to that. I feel I’ve been doing that all along, so I want to continue to do that and see how—it’s funny, and I’ll just add this on, because I think it’s important.
I read the Bible. I read my prayer book. I read it almost ritually. And it’s so funny, because I’ll read it and see REBT principles in the Bible! In certain places. And it amazes me because it talks about unconditional God—I don’t want to put religion—this isn’t about religion, but what I’m saying is from my own personal experience, is that because I’m somebody who I don’t want to call “religious,” per se, but I do have a faith in God and I do believe in that. And so I’ve been reading different things. And it does make me chuckle a little bit when I see that it talks about this loving—all-knowing, loving God who just is there and loves you unconditionally.
So, it’s just funny when I’ve been reading the prayer book that now I have my knowledge of REBT and I want to continue to put those things in action for—to have a better life, to have a happier life, and to feel more at ease and to have better relationships and enjoy people and myself.
And I think just reading more—I’m speaking about future. Just reading as much as I can to have as much knowledge, because sometimes I read and then I forget, like we all do. I go back to the book that you had given me at the start of therapy. And one of my future goals, once I’ll be a little more settled in after my surgery and stuff, when I’m sitting there and have more things—more time on my hands and not working full-time is to be able to, now, after doing the 14 sessions, to look back at the REBT books and read them with a different mindset. To be like, “Oh, right,” and have a little bit more—even more epiphanies, because I feel like those can keep happening as I read more.
So, to be able to give myself that gift to look—to read but with a different frame of mind, frame of reference. So, reading, yeah. Reading, reading. And then doing journaling. Knowing that it’ll be difficult for me to write for the first couple weeks, so with that, I can record. There’s other ways for me to—I’ll find a way. If I really want to do it and I really want to keep at it, there’s—I don’t have to restrict myself to just writing or typing or anything like that. But there’s got to be other—I won’t have a tape recorder like “Long Island Medium” [laughs] but I can—no, she uses her recorder. I watch “Long Island Medium” but anyway. So, that there are other ways that I can do it if I really want to. And that it’s a gift.
THERAPIST: Do you really want to?
CLIENT: Yeah, absolutely. Absolutely.
THERAPIST: Good, then you will.
CLIENT: Oh, and one last thing is to look back at my journal from the very, very beginning sessions, when I was having such—just to realize how far I’ve come and that I can continue to—that I can always—there’s always room for growth, that’s . . .
THERAPIST: If you’re alive and kicking, there usually is. You mentioned, a few minutes ago, reading about the unconditional love of God and how that nourishes you. And I just want to add, even though there was perhaps an implication, but it may be a really healthy part of your stated intentions to continue to work on having—giving that unconditional love and—
CLIENT: To myself, yeah.
THERAPIST: giving unconditional self-acceptance to yourself.
CLIENT: Well, yeah. Absolutely.
THERAPIST: Not only in your belief system of God giving it to you – not instead of , but in addition to giving that to yourself. Excellent, very good. Wow.
Okay, so, what I’d like to give you now are these pages, as I said at the beginning, that my husband wrote and then we revised them: How to Maintain and Enhance Your REBT Gains. And you know, interestingly – and again, to your credit – a number of things you have said you intend to do are what we recommend here. And so, I’m leaving this with you and this is one of the things you can read and reread and reread, especially if there’s any degree of relapse or you’re self-torturing. [chuckles] Reminding you, and this reminds you that with anything – including REBT – to maintain gains takes ongoing work and practice, work and practice, work and practice.
CLIENT: [sighs]
THERAPIST: All right, so, first of all, it is important to accept that it is human nature to – at times plateau, seem to stop progress, sometimes to backslide. So, it is helpful, and important, to accept that possibility – not that certainty – and then these words you can read give you steps of how to maintain your improvement.
First of all, when you find any falling back, pinpoint precisely thoughts, feelings, and irrational beliefs.
And then secondly, to keep thinking rational beliefs consciously and intentionally, and repeating coping statements such as: “I don’t need my mother’s approval, even though I’d like it.” “I can stand what I don’t like, I just don’t like it.” And make those rational thoughts – even when there isn’t some adverse circumstance – part of your mental conversation with yourself or to yourself.
Keep looking for and discovering and disputing and challenging the irrational beliefs, and forcefully and persistently disputing them. Keep risking – in a healthy way, no unhealthy risks – but risking doing some of the things you fear irrationally in order to prove to yourself that those ideas were irrational and totally without foundation. Just like my husband was afraid of talking to women, and yet pushed himself to do – uncomfortably – what he wanted to get comfortable at doing. And he pushed himself and believe me, he got comfortable with talking to women [chuckles], so that’s what that’s about.
Now, try to see clearly on a daily basis, if possible, the difference between the healthy negative emotions and the unhealthy ones. We started off this session, pretty much, with you saying, “I feel sad.” But you acknowledged it’s not unhealthy to feel sad—
CLIENT: Hm-mmm.
THERAPIST: given that there’s been an experience that has been enhancing for you that, in its current form, is coming to an end. Doesn’t mean forever and ever, but for now. So, you already did that. Keep doing that. Clearly seeing the difference between—
CLIENT: And I have memories, too. That’s another thing that I think is important to acknowledge is that we’re given that gift that when I’m in a moment, I can think back to one of our sessions and—
THERAPIST: remember what was helpful
CLIENT: Yeah.
THERAPIST: in our session. Or in many or all of our sessions, see?
CLIENT: [chuckles]
THERAPIST: Keep reminding yourself you are capable of changing the unhelpful thinking. Avoid self-defeating procrastination, that’s a helpful thing. Now, again, I’m not saying do all this within four days of surgery. [chuckles]
CLIENT: Oh, self-defeating, putting things off and then feeling—and then beating yourself up that you put it off, is that what that self-defeating procrastination is?
THERAPIST: Yes.
CLIENT: Okay.
THERAPIST: So, that’s not helpful, is it?
CLIENT: No.
THERAPIST: And have the attitude – which I think you might already have – of “it’s a challenge”. “It’s an adventure to maintain my emotional health and well-being.” And from that, by the way, comes the pleasure to people in the profession that you’re in, that I’m in, of, when appropriate, sharing REBT with others we care about – whether it’s our clients – in your case, students – people in our world, family and friends. You’ve shared with me a number of times how you’re already sharing some of the principles with your students and—
CLIENT: Yeah.
THERAPIST: how some of your students have gotten an e-mail about you.
CLIENT: They have, I know. It’s cute.
THERAPIST: And you shared with me – possibly not during the session but on my way out of the session, when we weren’t recording—
CLIENT: Mm-hmm.
THERAPIST: or when—before we started, that you were thinking of writing a book applying REBT for children. And you’re very musical and I have proposed that you could think about writing songs that the kiddies could sing to with those REBT principles in the lyrics !
CLIENT: Yeah.
THERAPIST: “I am not what I do.” “I cannot be a failure.” “I am not a failure, I just may fail at things.” And, “I have worth, just because I’m alive, etc” All of those messages in lingo that children can understand—
CLIENT: Exactly.
THERAPIST: and benefit from. Remember the main insights of REBT, I’m not going to read them you, they’re all here in these notes. When you can – if possible – be with healthy-thinking people. Hang out with good company.
CLIENT: Yes.
THERAPIST: even if they haven’t studied REBT formulae—
CLIENT: No, no, no, no, yeah. I feel blessed with that because I have a lot of healthy friendships.
THERAPIST: Yes, but note that it doesn’t mean necessarily ending friendships with people who aren’t like that, but view to them more objectively. In an earlier session, you talked about one of your friends who acts like a drama queen and he was catastrophizing and you bought it. You bought the nonsense he was saying until we discussed it. So, I’m not saying get him out of your life because he catastrophizes, there are other qualities he has which you enjoy, but I am recommending that you don’t absorb his unhelpful ideas. And, in time, maybe you’ll be helping him with your healthier thinking and ways.
CLIENT: Right.
THERAPIST: And here, it’s written, you practice using REBT with some of your friends and relatives when you can.
So, then you see here, there’s a whole section here how to deal with backsliding. It is helpful and very important to accept the possibility – not the inevitability but the possibility – that it’s highly common for many people to do that.
CLIENT: [laughs]
THERAPIST: And so, if or when you do—
CLIENT: It’s like a diet. Like when people start a diet—
THERAPIST: Yes.
CLIENT: and then they have to remind themselves—and then they can maybe have a binge—
THERAPIST: Yeah.
CLIENT: or whatever, but then they remind themselves to eat healthy the next day. I feel like it’s the same here.
THERAPIST: Exactly.
CLIENT: The same type of philosophy.
THERAPIST: Indeed, indeed.
CLIENT: I’m not saying, every day I’m going to apply those REBT philosophies—
THERAPIST: You aren’t.
CLIENT: so, because that wouldn’t be human. But then the next day, you say—
THERAPIST: No, it would be human, but it might be unrealistic for this human. Maybe.
CLIENT: Oh.
THERAPIST: It would be very rigorous, wouldn’t it? And stringent. But not impossible.
CLIENT: It is important to not get complacent, but if you don’t practice it each day—to not take it as failure and say, “Oh, that’s it. I’m not successful at REBT because I have one day that—”
THERAPIST: Exactly.
CLIENT: like last week, when I catastrophized about my friends not being able to be here. I could have easily said, “I failed at REBT.” But I went back the next day and applied REBT principles and philosophies – and even later that night. It doesn’t have to the next day.
THERAPIST: Exactly. Also, with that kind of comparison to dieting, some people find the longer they eat healthy food, they no longer feel deprived of what they’ve stopped. In fact, they—
CLIENT: The body gets used to it.
THERAPIST: no longer want it.
CLIENT: Right. It’s—
THERAPIST: In fact, what they want more than gooey, trickly corn syrup—
CLIENT: Is healthy, good food.
THERAPIST: might be healthy honey. Yes.
CLIENT: Right, right.
THERAPIST: And so, they indeed keep on eating in healthy ways, not out of an attitude “This is what I should do for my health,” but out of relaxed preference.
CLIENT: Exactly.
THERAPIST: It’s a new way—
CLIENT: Yeah.
THERAPIST: of being, so—
CLIENT: Yeah, no, that makes sense.
THERAPIST: you know, that’s a good comparison with dieting. So, it just reminds you, in terms of how to deal with backsliding. Just pick yourself up, go back to the ABCs and dispute and keep watchful, keep aware.
And finally, in this literature here for you to read and benefit from: this part describes how to generalize from working on one emotional problem to working on others. So, we’ve largely—
CLIENT: Wait, so I missed—how to work on one emotional problem to working on others?
THERAPIST: How to generalize from working on one emotional problem to working on others. In other words, our main focus a lot of the time has been panic, anxiety, lack of unconditional self-acceptance, sometimes anger and rage.
CLIENT: [laughs]
THERAPIST: We haven’t so much—
CLIENT: I’m going to write that down.
THERAPIST: talked about—well, you’re going to keep this.
CLIENT: No, what you just said.
THERAPIST: Oh.
CLIENT: I don’t know why I want to. Okay, I’m listening.
THERAPIST: So let’s say there was a day of intense jealousy, which isn’t something we’ve looked at.
CLIENT: Okay.
THERAPIST: Or intense depression, which isn’t something we’ve looked at.
CLIENT: Okay.
THERAPIST: Same principles can be applied.
CLIENT: Okay.
THERAPIST: And that’s what this is saying. Yes, you don’t have to study any technique on jealousy – the techniques you are familiar with apply.
CLIENT: Uh-huh. I understand what you’re saying, okay.
THERAPIST: All right. And then, this reminds you
CLIENT: So, this applies to almost all—
THERAPIST: Unhealthy—
CLIENT: unhealthy—
THERAPIST: debilitating—
CLIENT: emotions list.
THERAPIST: You see that? And it points out, here, I think this is—
CLIENT: Grief, as well?
THERAPIST: Well, there’s healthy grief and unhealthy grief, which is akin to depression.
CLIENT: Mm-hmm, that’s true.
THERAPIST: REBT doesn’t recommend not grieving after recent loss. But three years later, it no longer may be healthy grief, it’s—
CLIENT: Yep. Debilitating.
THERAPIST: possibly depression. Depression. And this handout reminds you, when you read it, of some of the main irrational beliefs and what they lead to. So, for example, “Because I’m not doing as well as I must, I’m incompetent, worthless individual.” That was a belief you had in the past. And that leads to self-downing. “Since I’m not approved of, it’s awful, it’s terrible,” – that is awfulizing. “Because others aren’t treating me the way they should,” “Because my mother isn’t being encouraging and she’s telling me I should be up and at it in four days after surgery, then that’s really rotten. She’s rotten, acting in a rotten way,” – that is damnation. [01:25:14] That’s not helpful for you. That’s not UOA, unconditional love and acceptance. It is “I can’t standitis,” and overgeneralizing.
So, these notes I give you are very useful to read and reread.
CLIENT: Okay.
THERAPIST: Reading about how to maintain your gains, because—
CLIENT: Got you.
THERAPIST: that’s how you’re going to maintain them, partly. Reading and reminding yourself and reminding yourself and, when helpful, reading. [chuckles] And taking action !
And remember: Watch the “shoulds”, keep on setting healthy goals and purposes in life, and on the gift of life goes.
So, in a few days, you continue your physical healing process by the next step of having an extremely competent surgeon work on correcting what’s organically, biologically wrong. And then you have some enforced downtime. And after a few hazy days, you’ll gently come up and you will give yourself – I trust and hope – the time that your body requires for maximum healing. And then you’ll gradually do more and more physically, minus the pain. And so many things to be grateful for and look forward to. You’ve done marvelous work. Which is the evidence that you can continue to do so. And it may even be less effort when you’re not in this physical pain.
CLIENT: [sighs]
THERAPIST: And even if it’s not less effort, you’ve proven that even when you are in pain, you can still make progress. So, on you go. Well done and—
CLIENT: Thank you, Debbie, so much.
THERAPIST: Of course, if there’s a relapse and you require more sessions, you can have more. But in the meantime, you have the strategies to work on yourself. So—
CLIENT: Thank you so much. I’m very grateful and—
THERAPIST: Well done. Well done.
CLIENT: I feel like a new woman. [laughs]
THERAPIST: Well, in some ways, you are. And you created that. So—
CLIENT: [laughs]
THERAPIST: Onwards, onwards ! Well done Jessa.
CLIENT: You’re so funny. Thank you.
END TRANSCRIPT
