TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Where do we start?

CLIENT: I met with Linda on Tuesday and I was having a bad day. (chuckles) Last time I talked to you Pat had seen an apartment and we were really excited about it.

THERAPIST: Yes, you were convincing her to try to take it. It was right around the corner from you.

CLIENT: Yes. She had applied and had put down a deposit and everything. She flipped out because they ran a credit report on her and it was the kind that hurts your credit or something. She flipped out and was really, really stressed about it. They eventually e-mailed her and said that someone else offered her more money. They didn't say it was her credit.

THERAPIST: But she knows.

CLIENT: I had just happened, maybe it was Monday I don't know. I couldn't handle it. [00:01:01]

THERAPIST: What were you feeling?

CLIENT: So trapped and frustrated with her. I asked her to call them. Before she had the e-mail that it was allegedly that someone had offered them more money, which I know is true. I don't know if they didn't offer it to her because whatever. I asked her to call them and talk to them and she just wouldn't do it. She was just clearly so...

THERAPIST: So you were angry with her.

CLIENT: Yeah. Now I'm talking to Linda and she was asking me about all of this and she was like, "I think that you should not go off Zoloft for a while." Then she spent a while telling me that I should probably see if I could get Pat to go to therapy, (sniggers) which Josh has promised me he'll ask her to do if she doesn't find a place by September 1st because part of the frustration with her is that we don't know what's happening. Either she's happy or depressed or what. Why can't she get herself together? [00:02:09] I can imagine how she could be really upset because she doesn't really show it except [in the confusion] (ph?)

THERAPIST: It sounds like, from what you've shared, she has a very hard time expressing what she's thinking or what's going on with her. Either she can't or won't.

CLIENT: Yeah, so I don't know. Then the other day she came home after visiting a zillion apartments and was asking me all about them and showing me all these pictures of them and telling me all the things that were wrong with them; and I just started to panic. I couldn't handle it.

THERAPIST: "She will never leave," is what's going on in your head.

CLIENT: I was trying to be nice like, "That's fine," about like the tiny kitchen. "That's fine. That one's good." (chuckles) But I can't. Poor Josh. I flipped out to him. It was too exhausting.

THERAPIST: Yeah, trying to manage her stuff and your stuff. [00:03:02]

CLIENT: And I don't know what's come over me. The minute I walk in I feel so stressed out.

THERAPIST: It's a lot of tension.

CLIENT: Josh doesn't hardly get it, but he does get it. I don't know why I feel so irrationally upset.

THERAPIST: I think you're pretty angry. When I say angry, I see you sort of guarding against it.

CLIENT: I'm super angry at her, but it would help if I knew what was going on. I know she's had some really bad things happen even this past year.

THERAPIST: What would it do if you knew what was going on?

CLIENT: I would at least know if she's just trying to take advantage of if she's just really, really upset and distressed with her life. If she doesn't want to leave because I don't know why she doesn't want to leave; or does and is making it so difficult because it's not that difficult. [00:03:59]

THERAPIST: Are you wondering if she's sort of sabotaging her search because she doesn't actually want to find a place to go to?

CLIENT: Yeah, I guess.

THERAPIST: So it feels intentional that she's still with you guys?

CLIENT: Yeah. I guess Josh still does sabotage himself from time to time or often. He's so much like his mom.

THERAPIST: Ahh. In what ways? What are you speaking about?

CLIENT: He's always doing things in a less serious way that are not logical, that the consequence is pretty obviously not what he's planning on despite his actions. (sniggers) I mean everything from taking care of himself to like money. He's gotten so much better about it, but every once in a while (sniggers)...

THERAPIST: So what are you seeing that's frustrating? [00:04:56]

CLIENT: I don't know. Maybe that's what she's doing. Maybe she is sabotaging it.

THERAPIST: When you see it in Josh, do you think it's intentional or with awareness?

CLIENT: No. He does change. Mostly I had to show him like with money, the positive outcome that can happen if you actually took steps that would lead to them, I guess, that makes sense. Like if you spend more than you have, obviously you're going to end up in debt. If you save money you'll build up money. That concept is not something he was familiar with.

THERAPIST: It didn't make sense to him.

CLIENT: It's not that it didn't make sense, he just didn't I don't know. He figured that it would all be fine somehow anyway, regardless of what he did.

THERAPIST: Without forethought or planning? [00:05:58]

CLIENT: I guess. As much as I would like to go off Zoloft, maybe not until she's gone. (sighs) I can't really take it anymore. (sniggers) I'm dreading this weekend because I just feel so tense at home.

THERAPIST: It feels out of your control, how to change your environment because you can't make her leave so what can you do to decrease the tension for yourself?

CLIENT: I've been dragging myself into a better place piece by piece, even just going on these bike rides I've been going on; but it doesn't last very long. I'm exhausted. I think I'll do it, so I do it and I feel better; but then I get back home again.

THERAPIST: It ends. The bike ride ends. [00:07:01]

CLIENT: Yeah.

THERAPIST: So I know when I saw you last you were a little nervous about having committed yourself to a ride with other people and you weren't sure how it was going to go. How did that go?

CLIENT: It was fun.

THERAPIST: Good for you.

CLIENT: And then I went again on Tuesday and it was fine, but we went with a beginning group of four and we went with a less-beginning group this time. We actually rode a decent ride and then I couldn't sleep because I was really worked up. I drank so much water.

THERAPIST: What do you mean by "worked up?"

CLIENT: I don't know. Anxious. I was really anxious.

THERAPIST: Happy? Happy worked up?

CLIENT: The poor people who rode back with me I was just... so happy. But it was 9:00 by the time we got back and then I went to bed about an hour later and just couldn't do it, so it was frustrating. I tried. That also makes me feel trapped. I know right before you probably shouldn't exercise. It's on the list of all the sleep things. [00:08:07]

THERAPIST: But also you don't want to avoid things that are good for you. You can't necessarily plan a ride to be ending at 7:00.

CLIENT: A lot of people I know, when they exercise they sleep better. That doesn't always happen.

THERAPIST: I think it's a combination of the exercise and part of the exhilaration you feel which comes out in your chattiness and wanting to talk with people. I think you're somewhat starved for that kind of interaction, so being able to have that with other people where it's less problematic than with your boyfriend's mom it's not just the exercise. It's also the social piece.

CLIENT: Oh, yeah. I wouldn't have had a good bike ride by myself. Totally. So I'll keep going. [00:08:59]

THERAPIST: And maybe some of the newness of it will wear off and it can continue to be good without necessarily having that almost hyper effect for you. Or maybe we need to figure out a way to kind of help you come down from this so you can experience the high but not have it interrupt sleep quite so much.

CLIENT: Josh's thyroid problem has been getting worse in a way. He hasn't been feeling good and he's really worried that he's worse and then he got a blood test the other day. He's been on thyroid drugs for months and months and it's barely helped in the blood tests, and now he needs to go to an endocrinologist, more doctors and everything.

THERAPIST: It's very frustrating.

CLIENT: So the other day I came home to that and then he's all upset I came home from the bike ride and he's sad. So I come home to that and then I also feel guilty and sad and then I try to go to sleep. [00:10:02]

THERAPIST: That's a really tough combination.

CLIENT: It is a tough combination. I've told him that it's really difficult for me when he said that, but you're allowed to be sad.

THERAPIST: It's a really hard dynamic because he would love to be able to participate with you, but he can't so you're sad for him and you feel guilty about being able to enjoy something that he can't. Also it seems like you're somewhat blocked from being able to process it. If you could come home and talk about how great it was, that would probably help you come down from the experience and put it away so that you can relax and go to sleep. Because it's so hard for him to see you be able to enjoy something that's off limits for him, you've sort of missed that opportunity to process it and talk about it and kind of wrap it up. [00:10:58]

CLIENT: It's kind of ridiculous how long I need to calm down and vent it sometimes. Even the other night when we came home from the movies it was so hot we went to the movies and then Pat immediately started talking to us about apartments for like an hour, like 10:00. And then I had a terrible time going to sleep.

THERAPIST: How long does it take you to recover from that?

CLIENT: An hour. I had just gotten a new book, which is not helping. It's a book, Lean In, for my book club. It's way too much to think about so that's even making this worse.

THERAPIST: Whatever happened to fiction?

CLIENT: I thought it would be a good thing to read at night.

THERAPIST: It's very provocative, I think.

CLIENT: It is really too provocative.

THERAPIST: It may not be what you need in your life right now. [00:11:53]

CLIENT: My parents asked me to drive them to the airport the other day and I had just read a chapter about how women are asked to do things and men are not asked as much. If men say no, there's no stigma attached, but for a woman there is because women are supposed to be helping. I had this bizarre discussion with Josh over gender issues. It took me a long time to stop thinking about it.

THERAPIST: You said it's crazy how long it takes you to come down from these things. An hour is not necessarily an insane amount of time to need to wind down your day and prepare yourself for sleep. Lean In is all over the New York best seller list and it's what everybody in the world is talking about and every news outlet is talking about it. It's not crazy that it's kind of provocative for you. It's provoking an entire nation.

CLIENT: I guess another part of Josh's thyroid thing is that, not only has he always been able to fall asleep, he now falls asleep in the middle of a provocative conversation. (laughs)

THERAPIST: Right. Because he really can't sustain energy; but that's not your goal. [00:13:04]

CLIENT: I guess the good thing is that I'm not hiding out completely.

THERAPIST: You just don't have a place to put this stuff.

CLIENT: Yeah, that's actually a good way to put it, I guess.

THERAPIST: So you're reading the book for book club. Have you had a chance to discuss it with your book club?

CLIENT: Actually the book club is supposed to meet on Tuesday and I might go to the bike ride instead. I was also supposed to go to a concert with my friends that I had planned a long time ago when I was panicking about having no friends and nothing to do. I just tried to get out of it today, actually, because this morning I woke up and I was pretty...

THERAPIST: Double booked?

CLIENT: Yeah. I don't know. A concert just sounds really exhausting, taking a lot of energy. The last time I went to a concert it took me two days to recover because if I come home late I won't sleep more. If I have one drink then I'll sleep even less and feel terrible. [00:14:14]

THERAPIST: What did Linda have to say about I know you'd asked me about the reaction you're having to alcohol. Did she comment on that?

CLIENT: I asked her about nausea and she said if it was not all the time and actually this week I don't feel nauseous at all so it must be the pill.

THERAPIST: Okay, so it can't be the medication if it's off and on like that, since you take your Zoloft every day.

CLIENT: Maybe I should go off the pill. I don't know. The last time I tried to stop all medication didn't really go well, so I don't know. [00:14:55]

THERAPIST: Well you can try stopping one med without the other med.

CLIENT: Yeah. I wish I'd been keeping better track.

THERAPIST: You always have an opportunity. You can stay on the pill for another cycle and pay attention to what you're feeling when you're nauseous, when you're anxious and see if it has any correlation to where you are in your cycle.

CLIENT: Yep. This morning I woke up feeling really terrible.

THERAPIST: Terrible sad? Angry? Sick?

CLIENT: I woke up at 5:30 or five-ish and immediately started thinking how today is going to be terrible and I was going to be exhausted all day and not be able to do anything.

THERAPIST: So I take it you woke up with a lot of dread.

CLIENT: Yeah. And I woke up thinking about I have a lot of stuff to do at school right now and I was thinking about Pat. It was too much. I don't know why I woke up with all of this. [00:16:00]

THERAPIST: How does that compare to other mornings when you wake up? Is that typical for you?

CLIENT: No. This week has been particularly like that, though. I wake up at 5:00 or 5:30 and then I usually go google I googled "waking up early" and it said like "you could be depressed or maybe you're stressed out from not sleeping and thinking." I don't know. There was something about being worried about sleeping causing you to also have other... Then Josh and I went to the gym and I felt so much better and I've been having a good day.

THERAPIST: There's certainly a lot of negative anticipation which I know in the past you've sort of looked at what are your thoughts and what types of things are you predicting and making assumptions about. Your pattern when you were looking at that was to make assumptions about things going pretty catastrophically, which leads to a lot of anxiety usually. [00:17:14] There's not always evidence to support what you're predicting, so trying to take what you're thinking and asking yourself like, "Is there another possible outcome? Maybe the day won't go like this," and kind of forcing yourself to come up with some alternatives. That's something that I know we were working on in the past and it sounds like it might be useful to put into practice again.

CLIENT: Yeah. Yep. I spent a whole week waking up super early and it just feels really abnormal, like I can't do anything. (sniggers) Especially after Tuesday after this bike ride where I was so happy and then couldn't sleep. It's like everything I do is going to backfire. [00:18:09]

THERAPIST: Even the things that you do that make you happy impact your sleep. I wonder if that's necessarily backfiring. You got something positive out of it and you got something negative out of it, but it wasn't all bad. It doesn't make the whole thing bad.

CLIENT: I guess. Yeah. (pause)

THERAPIST: When we're starting to look at things for all of their components, then the bike ride was good because you got a lot of exercise and it was good because you got that social connection and it made you really excited. So there are three good things and one bad thing.

CLIENT: I really wish that I could stop thinking so much about sleeping. It's better, certainly, than when I really wasn't sleeping.

THERAPIST: Absolutely.

CLIENT: I wish I could stop thinking about how I feel all the time, but it doesn't help also to have a boyfriend who's constantly...

THERAPIST: Doing a lot of analyzing. [00:19:06]

CLIENT: Yeah. Which he kind of has to.

THERAPIST: He has to be very aware of his symptoms, but you don't.

CLIENT: No. It makes it hard to stop thinking about it, I guess, especially since he has no energy, too. It kills my energy also.

THERAPIST: How does his energy impact yours?

CLIENT: We go out to dinner once a week. If I'm feeling really excited to be out and put on a nice outfit, if it gets to be like 8:00 or 9:00 he's just can't keep himself together. He's just exhausted and then I feel sad that he's not feeling well.

THERAPIST: It ends your night and you feel like he brings you along...

CLIENT: And it makes me worried about him and he feels upset. I don't know. [00:20:11]

THERAPIST: Does it help to know, like when he got this blood work back and you know why he's so...

CLIENT: It does really help, actually, because he's been on this medication for so long that I wouldn't have expected it.

THERAPIST: You expect that he was actually having higher levels, but he's not.

CLIENT: He is much happier, too. It put him in a much better mood than he was before.

THERAPIST: It's frustrating that it's not having the desired impact, but it's also good to know that there's good reason for him to be this tired. He's so really hyper-thyroid.

CLIENT: Actually it will help a lot because I was kind of pushing him a little because I was thinking that maybe he was focusing too much. When he feels bad in any way he assumes that his heart is in the final part. [00:20:59]

THERAPIST: But this is not necessarily.

CLIENT: Sometimes I try to say, "Just go do it anyway. Try it anyway." Sometimes it's true. It works. I talked him into doing a lot of exercising the other day and he felt better, so maybe he was just feeling bad in a normal person way.

THERAPIST: It's a little tricky.

CLIENT: But then, inevitably, something like this happens where there isn't a real explanation, then I feel guilty for having been frustrated with him. The friend who I'd canceled on in the concert for next week, today I ended up telling her about all of this and, again, the reaction I got from her was just, "Oh, my gosh." She just didn't know what to say.

THERAPIST: What was that like for you to have her not know what to say?

CLIENT: I also felt really bad because she's sort of sad right now because she's not over her ex-boyfriend and she's feeling sort of lonely and sad. I'm afraid I'm going to tell her these things and I don't want to discount her boyfriend cheated on her and did some really mean things to her. Of course she should feel really depressed. We don't seem to be able to connect, I guess, when either of us talks. [00:22:15]

THERAPIST: So you have some things you feel upset about and she has some things she's upset about, but you feel like sharing yours somehow discounts hers?

CLIENT: I don't know. I just don't get it. Maybe we just aren't meant to be good friends, I guess. We just have to sit next to each other. I don't get that she feels better when I talk to her and vice versa. (chuckles)

THERAPIST: So you don't feel better when she talks to you, either?

CLIENT: Yeah.

THERAPIST: I wonder what blocks you guys from really being able to support one another rather than feel like you're just talking at each other.

CLIENT: (chuckles) I don't know. [00:23:00]

THERAPIST: Have you ever asked her what she's hoping for in sharing with you?

CLIENT: No.

THERAPIST: What do you want? What would you like?

CLIENT: That's a good idea.

THERAPIST: What would you say if she asked that of you? Not that she's going to miraculously know to ask, but just for practice. What would you like?

CLIENT: I guess I want her to understand when I do something like cancel a concert. This morning I sent her an e-mail, not just because I have this bike ride that I want to go to, but that I've been feeling so exhausted that the thoughts of going to a Beyoncé concert I feel like someone should be really pumped to go see Beyoncé. It's a big concert, expensive ticket. I don't really want to go. It's just making me stressed and exhausted. It was a little bit of a heavy e-mail and I sent it to her at like 6:00 AM or something. [00:23:58]

THERAPIST: So you wanted her to really understand?

CLIENT: If she asked me that question I would say, "Please understand." I would want her to understand and be okay with me doing stuff like that. I don't know if she can be. Maybe it's not okay to her. I don't know. Maybe she thinks she's got a ton of stuff, too.

THERAPIST: And maybe she does. Your stuff doesn't have to negate her stuff.

CLIENT: I don't know. I don't know.

THERAPIST: It seems like you're making somehow comparisons or competitions not competition, really, but that there's not room for both of you to have the feelings and reactions you're having to your individual lives.

CLIENT: I don't know. I don't know what's going on with the two of us. (pause) I still need to find some other people. [00:25:04]

THERAPIST: Yeah, where it's a little bit easier and it doesn't feel like you have to hide what's going on with you in order to respect what's going on with her. You don't know if that vibe comes from her or if that's something that's going on in your head, but it does feel like there's this sort of barrier between the two of you really connecting.

CLIENT: Yeah. I don't know. She's like the closest person to me.

THERAPIST: Did she respond to your e-mail? You haven't heard back from her?

CLIENT: I didn't hear back from her by the time I got to school because it was still kind of early. Then I brought it up and it was like she sort of didn't really respond, but she said she felt bad and she'd try to find someone else to go. [00:26:02] Then she told me that she was having a rough time and I told her about yeah, I don't know why I'm not giving her what she needs and she's not giving me what I need.

THERAPIST: Yeah, because the way you describe it it sounds like a pretty good and open interaction, but it didn't feel that way for you.

CLIENT: No, it feels really uncomfortable.

THERAPIST: Can you name what is the discomfort? What's the vibe?

CLIENT: It almost feels like too much was said or something. She was talking about all of these dreams she was having about her ex-boyfriend and I was like, "Oh, my gosh. You're obviously not over him." And then she just lost it and started crying and went to the bathroom. It was too much, I guess. [00:27:02]

THERAPIST: It doesn't sound like you said anything horrible.

CLIENT: For some reason it's really, really difficult to be with her and some of the other people in my lab socially. I don't know why; it's just really hard. But like this morning when I canceled the concert, I immediately just started worrying that I was going to be stuck at home forever in my apartment with Josh's mom.

THERAPIST: How did you get to "forever?"

CLIENT: (sighs) I don't know. I'm already in the forever state, I guess. It seems like every once in a while I feel like things are getting better. Josh is feeling better, his mom is going to move out or I had a good time with some friends or something, and then more things happen that make that one thing seem like not nearly enough. Then I start feeling like it's going to be like that forever. [00:28:02]

THERAPIST: And when do you start getting really anxious during that thought process?

CLIENT: It's really early in the morning and I didn't sleep; that's just kind of when I get it.

THERAPIST: You get to the "forever" pretty immediately?

CLIENT: Yeah, I guess so.

THERAPIST: So let's see if you can spin the conversation in your head a different way. How could you describe what happened differently to yourself so that it doesn't become "forever."

CLIENT: I don't know. A lot of it is really up to Josh. I've been waiting for Josh to be more of himself it feels like forever.

THERAPIST: How long has it been? [00:28:57]

CLIENT: The first six months we were together, it was great. Things sort of fell apart, not like in our relationship health-wise, my sleep-wise so in two and a half years.

THERAPIST: Which is a long time.

CLIENT: Which is a long time.

THERAPIST: But not forever.

CLIENT: Not forever.

THERAPIST: So even just making yourself be more objective and saying to yourself, "I've been waiting for things with Josh to work out health-wise two and a half years." That's very honest. Obviously, you're not going to be ecstatic about that, but does it feel different for you to hear "I've been waiting for things to work out with Josh health-wise for two and a half years?" How does that compare to "I've been waiting for things with Josh to work out forever?"

CLIENT: Immediately after that thought is "maybe I should just stop doing this." I don't know. It doesn't really help because I keep wondering if it would be easier to just stop doing all of this. No more mother; no more Josh. But then right now I'd be left with a sort of I mean school is fine, but there's nothing else to hold onto right now. Well, I guess my parents. So then I'm left with my parents and school.

THERAPIST: What do you need to hold onto? What do you want to hold onto?

CLIENT: I don't know. Something that's enjoyable other than school. School's not enough nearly. It doesn't feel like a life, just school. It's the same things that made me move out with my mother for a week, but then nothing changed during that week. Sometimes I think there just wasn't enough time. [00:31:08]

THERAPIST: What were you hoping would change yourself? Your thoughts? Your sleep? What were you hoping would change?

CLIENT: I was hoping I'd be able to sleep.

THERAPIST: And would that change the question? If you hadn't been waking early this week, does that get rid of the "should I just stop doing this?"

CLIENT: Yeah, because if I can sleep and I'm happy, I love Josh. If he can't bike with me all the time, it's fine. Everything is great. So, yeah, it would definitely. I wonder what's wrong with me. Is it because of him? I was sure it wasn't, but I still wonder if I'd be okay if I was on my own without other stuff to worry about. It's a really sad thing to think about, too, because then nothing bad can ever happen to me else. [00:32:04]

THERAPIST: So it's interesting to keep the question to be about what it's really about because it doesn't sound like you're really questioning whether or not you want to be with Josh, you're questioning whether or not you can be healthy and regulate your sleep to a place where you're comfortable with Josh. You need to keep the question about what it's really about. You're not really questioning your relationship with him, you're really questioning your sleep.

CLIENT: Yeah, definitely. And my ability to be in a good, happy mood, I guess. Yeah. That was a big jump or a big step when I moved out of my parents' and decided that I wasn't going to [...] (inaudible at 00:32:54) blame him. I didn't always feel like that. I was really angry at him. [00:33:02]

THERAPIST: And you've let go of a lot of that, but there's still that piece that questions "can I do what I need to do to keep myself healthy and maintain the relationship?" I think that's where we want our focus to be. What do you need to do to stay healthy in the relationship rather than questioning the relationship, because that causes you a lot of stress? Does that sit right with you or am I pushing things on you?

CLIENT: No, that's totally right. (chuckles) Most of my stress right now is coming from his mom, not from his health, but his health is just another bit.

THERAPIST: It's always there.

CLIENT: The fact that I have so much stress with his mom makes it worse.

THERAPIST: Yeah, because lots of energy goes to sitting with the uncertainty of his health and managing the symptoms and that only leaves so much other energy left over for coping with things like his mom or sleep deprivation. [00:34:13]

CLIENT: Yep.

THERAPIST: Have you been doing I know we used to do a lot of relaxation and muscle stuff in here. Have you kept that up at home?

CLIENT: No, I haven't, partially because I don't feel so tense, but I must be a little if I'm not sleeping.

THERAPIST: If you're waking up early there's something going on there. It might be a good idea to get back into that practice.

CLIENT: I don't know why I haven't been because I certainly get tenser at night. (pause)

THERAPIST: Would you like to use some time in here to do that today?

CLIENT: Sure. (chuckles)

THERAPIST: So let's double-check appointments and stuff like that so that we don't have to go into planning mode after relaxation mode, and then we will spend some time doing that. [00:35:01] You can remind yourself to do it. Thank you. I don't think we scheduled for August.

CLIENT: We didn't.

THERAPIST: Next week I'm away and I think you're away, too.

CLIENT: The week after.

THERAPIST: I'm away the week of the 29th; you're away next week; so I think we're looking at the week of August 5th and I have a 2:30 on Monday, the 5th, or a 3:30 or a 4:30 on the 6th. There are a bunch of times on Friday, the 9th as well. Pick what works for you.

CLIENT: The 6th will be great. What times did you say? [00:36:01]

THERAPIST: I have 3:30 or 4:30 or I could do a 5:10 again if you want.

CLIENT: Yeah, that's okay oh, wait. Tuesday, the 6th. I forgot I'm supposed to pick up something for my parents. You said you had an earlier one?

THERAPIST: I do. I have a 3:30 or a 4:30 and I also have a time on Monday.

CLIENT: Let's do 3:30.

THERAPIST: Okay. If you like that time I can keep that consistent on Tuesdays in August; or if there's a time that's better we can pick a different time. [00:36:54]

CLIENT: I'm gone on a field trip the 20th to the 31st, so actually that would just leave the 6th and 13th.

THERAPIST: Okay, so you want to do the 3:30 on the 13th?

CLIENT: Yes.

THERAPIST: You're gone until the 31st you said? Do you want to pick a September time now, since you're not going to be around? Does your schedule change?

CLIENT: I don't know if it will, actually, but we could just go for the 3rd.

THERAPIST: Okay, let's go for 3:30 on the 3rd and if you need to change it, that's fine. At least we sort of have it in my book.

CLIENT: So the 6th, 13th and the 3rd.

THERAPIST: Congratulations on being the first person to schedule for September. All right. Let's see if you remember how to do this. I'll lead you through it. You're going to close your eyes and let yourself get as comfortable as you can. My eyes are closed, too, so don't worry about your dress. Then just sort of let yourself relax into a pace of breathing that feels comfortable. [00:38:11] You're going to work at your own rhythm, working with your breath. Whenever you're ready to inhale you're going to inhale and squeeze your eyes tightly shut, noticing where that brings tension. And then when you're ready to exhale you're going to relax your eyes, letting them stay gently closed. Then you're going to repeat that as you next inhale, squeezing your eyes tightly shut then relaxing as you exhale, letting them stay gently closed with no tension. On your next breath in you're going to clench your teeth tightly together, noticing where that brings tension to your jaw. [00:39:03]

And when you're ready to exhale you're going to relax your jaw, letting your teeth come slightly apart, repeating the clenching as you inhale. Releasing as you exhale. On your next breath in you're going to drop your head forward, chin towards your chest. As you exhale let your head float up to a neutral position, inhaling and bowing your head forward. Exhale and let your head float up. Inhaling and shrugging your shoulders up toward your ears, noticing where that brings tension to your neck, your shoulders, your back. Exhaling, letting your shoulders drop all the way down. Inhaling and squeezing your shoulders up. Exhaling letting them drop all the way down, releasing the tension. [00:40:08]

On your next breath in you're going to bend your elbows, bringing your hands towards your shoulders, noticing the tension this brings to your biceps. When you exhale your hands fall down, releasing the tension in your arms. Inhaling and bending; exhaling and releasing. Inhaling and squeezing tight fists this time, releasing the tension in your forearms and your fingers. Exhaling and releasing, letting the tension drain out of your fingertips. Inhale and clench those fists. Release when you're ready to exhale. [00:40:51]

On your next breath in you're going to squeeze your belly button in toward your spine, tightening your abdominal wall; exhaling and releasing, letting your belly be soft. Let yourself take a full, deep breath. Repeating that cycle when you're ready to inhale squeezing your belly button tightly toward your spine, releasing those muscles you exhale, letting yourself take a full, deep breath in and out. On your next breath in you're going to squeeze your knees together, noticing the tension this brings to your thighs. As you exhale let your legs come apart naturally. Inhaling, squeezing; exhaling and release. [00:41:56]

On your next breath in you're going to straighten your legs and lift your feet up off the floor, noticing where this brings tension to your thighs, your quadriceps, your hips. As you exhale let your feet fall to the floor. Let the floor absorb the weight of your legs. Repeating this lifting as you inhale, letting your legs drop as you exhale. Inhaling and flexing your feet, pulling your toes back toward you, noticing the tension in your shins. Exhale and let your toes drop, letting your feet and ankles relax. Inhale and flex; exhale and release. Reversing this motion pointing your toes down with your next inhale, noticing tension in your calves and ankles. Exhale and release. [00:42:57]

Inhale and press those toes down pointing your feet. As you exhale, release. Continue to breathe at a comfortable pace. On your next inhale just scan your body, noticing places where tension has refused to leave or crept back in. As you exhale imagine yourself letting go of that remaining tension. You can repeat that process as many times as you need to, scanning as you inhale, releasing as you exhale. You can use the process to release the muscle tension. You can also let yourself use it to release any thoughts that are stuck in your head, noticing the thoughts that are there without judgment, letting go of them as you breathe, knowing that important thoughts can come back to you. [00:44:01]

Continuing to keep your breath at a relaxed and comfortable pace, allow yourself to come back to the room when you're ready, hanging onto the relaxation. How was that? I know it's been a while.

CLIENT: It was good.

THERAPIST: Where was it hard? Where was it easy?

CLIENT: I don't know. I think I feel good. I'm not really sure. (chuckles)

THERAPIST: Okay. Let yourself play with that again. You can try it at night to help yourself relax or you can try it in the morning if you wake up with those feelings of dread and just play with it and see what you feel. I will see you in a couple of weeks.

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