TRANSCRIPT OF AUDIO FILE:

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(Background noise)

THERAPIST: Good.

CLIENT: Like clockwork I stayed up late last night, it's great! Things are good, in general...so you can enjoy that...

THERAPIST: It sounds like you almost don't want to enjoy it because you know that its somewhat related to your cycle.

CLIENT: Oh, no no. I guess I've been thinking a lot about continuing sessions every week or every other week as it's been causing me a lot of stress.

THERAPIST: Alright so let's talk about that.

CLIENT: Yeah, yeah. Because I mean of course like last week our car breaks, cost like a 1000 but...

THERAPIST: Mm hm. So it feels like a financial strain? The idea of continuing sessions?

CLIENT: Yeah, well, I mean so last summer I would have paid however much money to come every week, every day and you week by week I can't really decide, I feel like I need to talk about things or not and maybe I'll stop going and then like it'll be a problem but I think I'd like to give it a shot for a little while and see how it goes. [00:01:12]

THERAPIST: Give every other a shot or give not at all a shot?

CLIENT: Just taking a break, I mean I still whenever I stop Zoloft, it still terrifies me and I'd still like to come back to therapy but I don't know, I feel like things are stable right now. At least stable enough that I can handle it. I don't know, maybe you don't agree or do agree?

THERAPIST: You're definitely in a different place than you were when we first started meeting. I think you were really scared, your sleep was completely erratic and extremely frustrating and it seems like that's something's that's been consistently better, you know, here and there. There have been, a week where you've had a couple bad nights in a row, but you haven't had a long stretch where you felt like you couldn't do anything to get yourself to sleep in the way that you described when we first started meeting. That's a real objective and maintained difference from where you were. I think another big shift that I see in you or I guess hear you talk about is kind of how you feel about your relationship. [00:02:32] A big piece of what was so distressing to you was feeling unsure about whether or not you really wanted to be committed to your relationship and did you want to be in a relationship where there were these real big questions of health and not knowing was something that seemed to cause a lot of anxiety and a lot of discomfort in how you viewed yourself and it sounds like that's something you've really figured out for yourself. What you say to me is that you don't question whether or not you want to be with Josh, you'd love to know what's going to happen with his health and you'd love for him to be healthier but the idea of whether or not that impacts whether you want to be in the relationship seems to be something you've kind of figured out for yourself.

CLIENT: I don't know where it even came from, if it came from not sleeping or if it just needed to be resolved and then I could sleep. I don't know, I don't even know what started everything exactly.

THERAPIST: But it feels different?

CLIENT: Yeah I don't go over and over things like "is my life completely wrong?" (laughs) Which is huge, yeah, yeah.

THERAPIST: And it seems like it's been that way for months and months and months. I have to look back in my notes to see when was the last time I wrote that vacillation was something but I mean it seems like you've been pretty solid on that. [00:03:52] So those are two big things that I think prompted you to get yourself in here that don't really cause a lot of stress right now. So are you going to go crazy if you stop therapy? Probably not, I don't think you ever actually were really crazy. I think you felt crazy because you didn't know what was going on in your body and in your head.

CLIENT: I hope things just keep getting better and better just because I was sleeping.

THERAPIST: Not being sleep deprived is a really big difference. Sleep is very, very important.

CLIENT: Yeah, so...

THERAPIST: So it seems taking a trial break makes sense and you're not...I think the big piece in it is figuring out that...how do you know if you want to come back? When would be the right time to come back? And if you decide that you feel better with having contact, how does that not feel like a failure? I don't want you to feel like if you take a break and decide that actually you prefer to be in therapy whether that be every other week or weekly, that it's not a failure on your part to try it out and come back.

CLIENT: I certainly don't feel that way anymore, maybe I did but I mean even just silly things like acknowledging I have anxiety troubles and acknowledging that I'm sensitive to things, you know, whatever...acknowledging what I need. I didn't do that at all last year or whenever it was. So seemingly small things now were like really big things to realize and I guess if I come across something else that I need to have you point out to me or whatever I suppose I know because I'll start losing it or I don't know what will happen exactly. [00:05:52] Stop sleeping or something...

THERAPIST: Yeah so those are some objective things you can...obviously if you feel like you get in a pattern where you're not sleeping well and you feel really, really tired...

CLIENT: I'm sure that happens...unless it's clearly some monthly thing it's going to be because I'm laying up at night thinking about something.

THERAPIST: That you need a place to talk about?

CLIENT: Actual somebody...(laughs) Yeah. I think...

THERAPIST: I think if you find yourself noticing that your thoughts are kind of going in loops and you find yourself circling back to the same thoughts that's sometimes a good signal to yourself that you need to get it out there. Therapy's a good place to do that. Get it out of your head.

CLIENT: Last week I tried...I made an effort to make friends and I invited a girl I met out to hot chocolate. This poor girl, she mentioned something about being tired or I don't even remember how it got started and we ended up...I think I overwhelmed her like I do with talk about therapy. She's just had fatigue her whole life and they're kind of trying to figure it out with it being some other stuff.

THERAPIST: What made you feel like you overwhelmed her? [00:07:08]

CLIENT: Well I wasn't quite sure. It was just we didn't really know each other and we ended up having an intense hour of conversation about her OCD and my lack of sleep and I told Josh about it, he was like "Oh my gosh! That was your first time coming out together? That's what you talked about?" I don't know...

THERAPIST: "Maybe I really bombed it?"

CLIENT: Maybe, I'm not sure exactly but anyways I'm trying. Josh has finally come to yoga with me and I think we're going to go on a yoga kick. I'm sorry?

THERAPIST: (inaudible)

CLIENT: It was freezing actually, good and cold.

THERAPIST: (laughs) Maybe that's because you're so used to 95 degrees (ph?)?

CLIENT: Like Saturday morning at 8 a.m. and the studio just opened but we got some passes and it was an amazing teacher who talked about...she kept going up to him and telling him to accept himself and all this stuff. So maybe that will be helpful for both of us to do for a while.

THERAPIST: Awesome!

CLIENT: See if that helps...it's also expensive...[00:08:15] Do yoga therapy for a while...he also found out, well he also stopped one of his drugs that was like an added on drug but it messes with your electrolyte levels and he's been feeling a lot better since then so it's good.

THERAPIST: What did you guys find out about the hypothyroidism?

CLIENT: Nothing yet.

THERAPIST: That's a long time to wait for an answer.

CLIENT: Yeah I don't know, it's questionable whether it was hypothyroidism or just basically elevated potassium levels cause the drug that worked to cause him a lot of trouble.

THERAPIST: I don't either.

CLIENT: But we had sort of a horrifying doctor visit, not horrifying, eye opening in which we found out how they have to go through insurance to prescribe those drugs and how they have to explain why they don't prescribe certain drugs and how you prescribe certain drugs that are better or more expensive or a newer drug so he's putting a lot more research on what he's taking and why he's taking it and what other alternatives there are. It's something I wish they were more upfront about. Once you complain of a symptom then they can put you on the next drug and they probably can't tell you because then you'll think you have the symptom and then complain or something. I don't know.

THERAPIST: Yeah but it feels scary because it feels like his treatment is being guided by insurance rather than by...[00:09:39]

CLIENT: Yeah I mean in one way it's fine because if they don't put him on a beta blocker the insurance will freak out and that's important but I don't know.

THERAPIST: You guys are certainly learning a lot about the medical system and insurance system.

CLIENT: Yeah I mean, I wish it wasn't through like, Goodwill. Someone could just tell us about it, hospital...

THERAPIST: You ever talk to a patient advocate at the hospital?

CLIENT: No.

THERAPIST: I wonder if that would be helpful. I don't know what kinds of information you would get but maybe that would be a more straightforward group to...

CLIENT: That would actually be interesting. I've seen that here before, at school, I also tried to get us into the chronic health conditions group but I was told first of all it was only women and it wasn't for spouses or significant others and it was only for students.

THERAPIST: So all the odds are against Josh huh?

CLIENT: Yeah. (laughs)

THERAPIST: That's too bad, I'm sorry that it was...I didn't realize it was gendered.

CLIENT: I think it's ended up being that way.

THERAPIST: Yeah and a lot of times groups are offered you don't know who's going to be interested and you try to form a group that has a good fit to the other...it wasn't a good fit cause I guess he's not a spouse it doesn't work anyway. [00:11:03]

CLIENT: Yeah and I'd probably have to be on the plan and a spouse.

THERAPIST: Too many complications.

CLIENT: Yeah, we're trying still.

THERAPIST: Yeah it sounds like you are and you know I encourage you to look into that type of group, see if one of the local hospitals, even if it's not where he gets his treatment but check (inaudible), check what's on the red line. (inaudible), (inaudible), you know? If any of these places might offer some sort of support group if he would go or if there's something for partners.

CLIENT: I'm excited, if nothing else, the yoga place has therapeutic yoga in which they focus on a health condition every week.

THERAPIST: Nice. That's a good step.

CLIENT: Yeah, it's something. Something to do...

THERAPIST: And that's okay with his doctor to do yoga?

CLIENT: The doctor is so happy.

THERAPIST: Good.

CLIENT: He's not biking basically. Yeah, the doctor's really happy and I think it's cause of we started calling the doctor's a lot when he has questions which is good. It's not something he used to do before. He would just figure it out on his own.

THERAPIST: Reaching out and asking for help, even if you can figure it out on your own that doesn't mean necessarily you have to, it's okay to reach out for support and let somebody else do some of the legwork. [00:12:28] Or reduce the legwork...

CLIENT: It stressed me out a lot sometimes when he would tell me "I don't feel good, oh I took two of these last night because my heart rate was really high." I'm like "What are you doing? Call the doctor or something." He would do things like that all the time, now he calls them.

THERAPIST: Good.

CLIENT: Sometimes after the fact but at least he's calling.

THERAPIST: Yeah. It sounds like a safer way to navigate.

CLIENT: Well I told him to call the doctor about this one supplement he was taking that he thought made him feel bad and then the doctor...he never called the doctor and the doctor ended up when he asked him about it telling him that there's no way it could work orally, it was totally...crap and so points for me for...First of all it wasn't making him feel bad, it was in his head or something else and that he should call the doctor.

THERAPIST: Mm hm. He's starting to see some of this.

CLIENT: Yeah so it was a good thing.

THERAPIST: I'm glad to hear that. (pause) It sounds like it's a very evident pattern and so there would be a way to kind of take some of the edge off so the highs aren't as high and the lows aren't as low.

CLIENT: It's really hard to remember objectively like was it as bad last month or the month before?

THERAPIST: But you know that even if you can't compare from one month to the next, the best way for you to do that is to start using that number scale. Ten is the worst I've ever felt, one is the best or whichever way you'd like to do it and just mark down a number for a day. [00:14:25] It's a subjective scale but if you use it enough you get a sense of what's your seven, what's your eight, and then you can see from month to month what the swing is, how high are you when you're feeling good, how low are you when you're feeling bad and you can also see from month to month if your rating yourself similarly?

CLIENT: That's a good idea.

THERAPIST: People do tend to...if you get used to rating your mood everyday people do tend to get good at making their own gauge comparable to anybody else's one to ten but you'll start to find some consistency for yourself and that will give you some data on is it the same month to month, do you have a good month, bad month, are you following the same pattern?

CLIENT: It's frustrating I really don't know what I can do besides try to be healthy I guess.

THERAPIST: It's important to be healthy and I also think trying to be accepting of there is going to be some swaying and if this is it you want to advocate for yourself and figure out if there's something you can do but I know you couldn't talk to (inaudible) about it, talk to your doctor about it, nobody seems to want to...No one seems to think that they can do anything from a medical standpoint. [00:15:45]

CLIENT: Yeah I mean I still want to sort of join more things, meet more people, and a lot of things I want to join are teens or sports things and I'm still kind of afraid of doing that.

THERAPIST: What are you afraid of?

CLIENT: Well I'm afraid of not being able to sleep cause we're meeting really early in the morning and I mean things like that used to, like I have to wake up early to go meet these people, six a.m. or seven a.m., the bike team, that used to keep me and I used to not sleep. I haven't tried that in a long time...

THERAPIST: So you don't know if it's still...?

CLIENT: Like even just...I mean it might be fun now. It used to be.

THERAPIST: You're afraid to test it out?

CLIENT: (laughs) Yeah and then having a commitment with something that's athletic. I mean like yoga doesn't matter how you feel, you can go and it's fine.

THERAPIST: Non-competitive sport?

CLIENT: It's not...yeah.

THERAPIST: What if you found another non...are there any noncompetitive group sports?

CLIENT: Even like...at Josh's bike shop there's a triathlon bike club but they meet at like six a.m. and I mean it's not competitive they just meet and train to do triathlons in the summer. [00:16:58] It still requires a lot of energy.

THERAPIST: You don't feel like you can count on yourself to consistently have it?

CLIENT: Yeah I'm afraid to try. I guess but I suppose there's nothing wrong with just giving it a shot.

THERAPIST: Yeah, I mean you can give it a shot, see what happens and if it doesn't work for you right now that's okay.

CLIENT: I'd have to come back and talk to you because I would feel like a huge failure having to wake up to do something fun, caused me not to sleep. I'm still really traumatized by last January, exactly a year ago was the bike team kick off meeting, it was on a Friday night, I got really excited and then I remember I walked home and my heart was pounding and I couldn't chill out. I did a meditation tape or something and I couldn't sleep and I quit the bike team the next day.

THERAPIST: Hmm.

CLIENT: And sunk into like lying on the couch for like three months, dragging myself through school so like that was the beginning of like the worst time.

THERAPIST: Yeah and I know you don't want to repeat that. Hearing you say that you would feel like a huge failure if you tried something and it didn't go well, that worries me a little bit. [00:18:20] It's such an extreme labeling of yourself based on a few experiences.

CLIENT: Well that's where I want to get back to someday, like to be able to...I mean I used to wake up and meet friends and run the beach as the sun was rising.

THERAPIST: Sounds awesome.

CLIENT: That's what I hold as like the perfect day.

THERAPIST: Mm hm.

CLIENT: I would like to be able to do that again someday but maybe I should just wait a whole other year? Relax and some things. I don't know but my mom's trying to get me to go to a meeting with her, I thought of trying a knitting club.

THERAPIST: You don't want that to be your thing? So you may be able to do that, like it be that you're sleeping is secure enough now that your able to schedule something like meeting people for an early morning run or bike or whatever the training thing is that day and it works. It also might be that that's something you can do seven out of ten times but that three of those planned days aren't going to go the way you expect them to. That doesn't mean you're a failure and jumping to having some experiences that don't go the way you hope or planned and leaping to "I'm a failure," that's a really big leap. [00:19:49]

CLIENT: Well I mean in things like that if I'm not in a good place it puts tension on my relationship to wake up and biking at 6 a.m. because Josh starts getting...as much as we talk about it and as much as he supports me I just know, we've talked about...

THERAPIST: That he wishes he could go too?

CLIENT: And that's fine and I can console him and we can go to dinner and be happy and all fine but if I'm like at all exhausted or frustrated it's just too much. So I guess that's the other part of it. Which continues to get better as Josh becomes less, I don't know, frustrated with trying to get back to his old life, figure out a new life. I don't know.

THERAPIST: So part of it is how much energy do you have to be supportive to him while you also try to make changes in how you feel about yourself when you see, you kind of take a risk and figure out what you are capable of right now?

CLIENT: It's an enormous balancing act on everything. (pause) [00:21:07]

THERAPIST: There's something called the Winter Project, are you familiar with it?

CLIENT: Huh uh.

THERAPIST: I don't know a ton about it but I see it on Facebook (laughs). It's an exercise group of some sort, you should Google it. It's some sort of group where people meet early morning and do different kinds of led activities. One day it's a run, one day its stadium stairs, one day its push-ups in the mud but it's almost like a balance between what I hear you talking about, like joining a specific group and doing a specific training and not challenging...feeling afraid to challenge yourself in any way because this group is going to go on and do whatever their Thursday morning project is regardless of whether you show up for it.

CLIENT: Oh yeah.

THERAPIST: Yet you could also show up for it if it was a day where you felt like you want to do it and it would be that sort of group mentality that it sounds like you're interested in. So I have no idea if it's something that is close...meets close enough to you to do it or not, I know it's somewhere in the city but it might be something worth Googling as sort of an in between committing to a particular group and shying away from challenging yourself to do an organized activity. [00:22:33]

CLIENT: I will say (inaudible) people doing an activity is fun. I did something actually, just last night, with the graduate woman in engineering which was fun. I also want to get away from Harvard.

THERAPIST: Yeah.

CLIENT: I miss being around people who have normal lives, who work, who have families, who have other things going on besides just school. Sometimes I feel like I'm really the only one and I know it's not true but...

THERAPIST: Yeah, but it's easy to feel that way when you are surrounded by other graduate students all of the time.

CLIENT: Yeah. I don't know, maybe I just haven't found the right people.

THERAPIST: But your experience is somewhat different from many of your peers. Living with your boyfriend, having a boyfriend with a major health condition, living with your boyfriend's mother. These are things that are really different in a lot of what your peers are doing and you have another peer group that's outside of school but you don't have that much contact with them so talking to other young adults that have a more varied lifestyle might be, you know, kind of grounding. [00:23:50] To see some of your old life kind of reflected back in ways that just don't reflect back the life that you're actually living right now.

CLIENT: Yeah I don't know if I'm just creating this or if it's just something that the whole grad school lifestyle...I don't know.

THERAPIST: I don't think you're creating it, I think there is...it's a pretty homogeneous group and it's not all of the world. (pause)

CLIENT: And see last year a lot of this sort of thing led to, besides Josh, extreme stress over whether I had made a terrible decision. Not just the fact that I couldn't find friends but like the whole lifestyle seemed contrary to what was working for me.

THERAPIST: Made your decision in coming to school?

CLIENT: Yeah, now it's fun and rewarding but...

THERAPIST: What led you to want to come to school? What went into the decision to go to grad school?

CLIENT: I'd always wanted to do research but I've always like to try out some different things and so in undergrad I did lots of different research and like a bunch of random, different things and finished a set of applications as a senior and I was really overwhelmed by the options so I decided to do consulting because it's kind of perfect for me and it was. You do something in a field that's really broad, like environmental science but you get to try out projects in a variety of different things. [00:25:22] Until then I found that I really liked this particular subject and then after my first year I almost applied to grad school. I was like "No, this is fun, I want to keep doing it." And then the second year and then the third year and I really do want to go deeper into this and research, at least I thought I did. I think that I would've probably felt like a failure if I'd never went back to grad school, if I go back as myself right now I don't know if I would've chosen this exact path, maybe, it is a unique opportunity that I'll be...you know? It's really rewarding but I wish I'd known myself better at the time when I chose this so...I don't know. Too many options. (pause)

THERAPIST: Where do you see yourself being in five years?

CLIENT: In five years I mean, hopefully doing a post doc somewhere. Fun...except that when I choose the next thing I'll think a whole lot more about where I'm going to be and when I'm there I guess. Coming here too seemed like it would be really great and help my family, nothing really bad could happen, I just handled it so badly. [00:26:42] Or tried to handle it without any help. I don't even know anymore exactly what went wrong...a lot of things.

THERAPIST: Trying to do everything by yourself?

CLIENT: If I think too much about it I start blaming Josh again, which is terrible because it's not his fault but he was certainly the cause of it for me...a lot of it.

THERAPIST: I think yes there are certain events that were triggered by him but there is just a whole lot of different things that happened at once.

CLIENT: When I first started not sleeping when I was quitting my job, that's still so embarrassing to me that I couldn't handle it and if I had to do that again and its caused me the same amount of stress it would be really difficult to choose from my own mental health to not hide things. I think I told you about when I first stopped sleeping when I was quitting my job and had just moved in with Josh, I was really stressed about money, them letting me go...early. I don't know.

THERAPIST: So it's interesting because I think it's not that you couldn't handle quitting your job, it's that you couldn't handle the thoughts that you created in your head surrounding that.

CLIENT: I couldn't handle keeping it a secret. Going to work and...

THERAPIST: And living a lie?

CLIENT: And living a lie. [00:28:12] For a year...

THERAPIST: That's a really hard thing to do, most people can't handle that.

CLIENT: Yeah (laughs) I couldn't handle that and I couldn't handle...

THERAPIST: In addition to the transition to moving in with your boyfriend?

CLIENT: Right and planning a cross country move and secret while I was still working with him. It seemed at the time, reasonable.

THERAPIST: Maybe your expectations of yourself were similar? That you could do all those things with no outlet and no support or little support?

CLIENT: Well and I would tell people about it, I would tell my parents about it and they would say "Just tell your company." I'd be like "Well no, what if they let me go?" They had let go a few people my age level who were gone like one day and I was terrified but you know it would have been fine. The world wouldn't have ended. I just thought I needed to relax more.

THERAPIST: Those are good things to keep in mind. That if things don't go the way you initially planned, it'll be okay and the world won't end.

CLIENT: But it feels like it will at the time. Like watching my friend who just moved to Washington trying to figure stuff out and objectively watching her do these things that are I'm sure terrifying to her, it's not terrifying to me to watch them, I mean, nothing bad can happen but it's hard being her, the way she talks to me she can't see that or I don't think that she's going to cause herself problems like I did but I can imagine how terrifying it is for her. [00:29:45]

THERAPIST: Yeah.

CLIENT: But I can see how it's not.

THERAPIST: And those are things that I think you can hang on to, not as easily as looking at somebody else but being able to have that alternate perspective is when we worked on that cognitive modification stuff, looking at your thoughts and trying to come up with a more sort of temperate view of what you're facing. Those are things that you can hang on to a little bit to take the edge off of anxiety and fear when you're facing a decision like that or a transition.

CLIENT: Yeah, I guess for at least five years, I shouldn't have anything horrible, no horrible decisions to make, I hope...I hope not. (pause)

THERAPIST: Well what would you think to a plan of like scheduling a session like a month out to give you a chance to try it on your own, see what happens, and then it doesn't have to be your decision about whether or not to come back in, you'll sort of have something scheduled to check in, see how it went and then we can sort of like re-assess from there? That way it's not so much your responsibility to decide whether or not you need it or want it.

CLIENT: Yeah, let's do that, for sure.

THERAPIST: Okay, so let's pick a date for that and lets spend some time today practicing relaxation so you can remember how to do that.

CLIENT: I don't even know what I've said today. [00:31:18] (laughs)

THERAPIST: Do you want me to play it back for you?

CLIENT: (laughs) (pause) And I did get those things from my insurance, I got one last week, they don't send them often.

THERAPIST: Okay.

CLIENT: There was a lot on it (laughs). I'll give you this...

THERAPIST: Oh, thank you. So what about like end of the month, on the 26th? Or do you want to do the first week of March? Do a few weeks? (pause)

CLIENT: Let's do...would March 5th be okay?

THERAPIST: March 5th? Yeah, exactly a month.

CLIENT: It actually is, to the 5th. (pause) And I really don't have much going on so if you wanted to give this slot out to someone for a week and then maybe I could take another slot of something.

THERAPIST: Well that's...the 5th is yours because we scheduled it.

CLIENT: Okay. [00:32:41]

THERAPIST: The other spots are going to be up for grabs but if you should know that if you feel like...if something's going on, if you feel like your anxiety is increasing or if you have difficulty sleeping or for whatever reason you feel like you want to come back in and have a session before the 5th, don't hesitate to call me or e-mail me and ask for a session. We'll find a space.

CLIENT: Okay.

THERAPIST:...To put you in there. I don't want you to feel like you are somehow barred from the room. Anything else you want to check in about or review before we do some relaxation?

CLIENT: No.

THERAPIST: Alright so we'll do a good, long, deep breathing relaxation so you can carry that with you and I'll see you on the 5th. So close your eyes, let yourself find a relaxed pace of breathing, taking full inhalations, allow yourself to fully exhale, without any pressure. As you take that full, deep breath let yourself scan your body, noticing what it feels like, noticing places that might feel tight or uncomfortable and letting go of that tension as you exhale. [00:34:23] Repeating that process, you can be aware of where you're holding on to tension and where you can relax. Also using your breath to take notice of what's going on in your head, acknowledging the thoughts that are there and as you exhale let them go knowing that the important thoughts can come back to you. You're now letting your head be empty or letting it be filled with what's going on in the present around you. Letting go of thoughts about the past to the future, letting yourself be right now. Using your breath to guide your pace, whenever you feel ready to inhale, squeeze your eyes tightly shut, noticing where that brings tension and when you're ready to exhale relax your eyes letting them be gently closed. Repeating that process by squeezing your eyes tightly shut as you inhale. [00:35:56] Relaxing them as you exhale and the next breath in your going to clench your teeth together and then as you exhale let your jaw drop, let your teeth come apart, notice how that feels different. Inhaling and clenching, exhaling and releasing. The next breath in your going to drop your chin down towards your chest and as you exhale let your head float up to a neutral position, inhaling and bowing your head forward, exhaling and releasing. On your next breath in you're going to let your head drop to one side, ear to your same shoulder and as you exhale let your head float up to a neutral position, inhaling and dropping your ear to the other shoulder, exhaling letting your head float up, tension drains down out of your neck. Next inhale shrug your shoulders towards your ears and as you exhale let them drop and the tension go. Inhale and shrug, exhale and release. [00:37:32] The next breath in you're going to bend your elbows, bringing your hands towards your shoulders, as you exhale let your arms drop, muscles relax, inhaling and bending, noticing where that brings tension to your biceps, exhale and release when your hands fall down. On the next breath in your going to squeeze your hands into tight fists, clenching as hard as you can, noticing where that brings all the tension. Exhale and release, inhale and squeeze your hands into tight fists, exhale and release. On the next breath in your going to squeeze your belly button in towards your spine, noticing what that feels like and as you exhale let your belly relax, soft and full. On the next breath in your going to tighten your belly again and relaxing as you exhale, let yourself take a full deep breath. [00:38:45] On your next inhale you're going to squeeze your knees together, tightening your thighs and as you get ready to exhale let your legs relax, letting your knees come apart, repeating that process as you inhale and squeeze, exhale and release. On the next inhale you're going to straighten your legs bringing your feet up off the floor, noticing where this brings tension and when you're ready to exhale, let your feet drop all the way down, relaxing your legs. Inhale and lift, when you're ready to exhale let your legs drop. On your next breath in your going to flex your feet, bringing your toes back towards you up off the floor, noticing the tension in your lower legs, when you're ready to exhale let your feet relax and your toes come back down. Repeating that process by flexing your feet as you inhale and relaxing as you exhale. [00:40:13] On your next breath in your going to point your toes down toward the floor, noticing tension in your ankles and calves, when you're ready to exhale you're going to let your heels drop and your legs relax. Inhaling and pointing those toes, exhale and release. On your next inhale you're going to scan your whole body, noticing places where tension has refused to leave or crept back in, let yourself let go of that tension as you breath out, letting your body relax into the chair, still using your breath to help you notice what's going on in your head, the thoughts that have crept in or refused to leave, acknowledge that they are there. As you exhale let them blow away, letting your mind be empty, letting your mind only be aware of what's right in the moment. Let yourself memorize what it feels like to be more relaxed, what it feels like for your mind to be just in this moment knowing you can come back to this space anytime you need to by taking a full, deep breath. [00:41:46] Let yourself hold on to this feeling and slowly come back to the room at your own pace. So carry that with you and I'm going to see you on the 5th or call me if you want to come in sooner.

CLIENT: And at 3:30?

THERAPIST: 3:30 is okay.

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