TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Hi, come on in.

CLIENT: (inaudible) The health insurance so that you'll have because it says that they issued they sent me a check on November 18th for the first one and they never did.

THERAPIST: They never did.

CLIENT: So I don't know if a check date of November 18th means that (inaudible) because that's for the first one. The second one it's like (inaudible) is in there but since they didn't finish that one.

THERAPIST: I see. That's really strange. So when you called and you say they checked and they sent a check to -

CLIENT: No. Well I just called and listened to the they tell you all the different stuff so I didn't talk to anyone but I can ask them again I don't know why.

THERAPIST: Got it. That's really strange.

CLIENT: Well I didn't realize they were supposed to send me the check until (unclear) sent me an e-mail. I don't know.

THERAPIST: Well, I can is your member ID on there do you know? I can have her look into that. Usually they send you a check with an explanation.

CLIENT: Yeah. (inaudible).

THERAPIST: Well thank you. Thank you for doing that.

CLIENT: You're welcome.

THERAPIST: We'll figure it out.

CLIENT: So I realized something I think this weekend when I was on New Jersey this weekend and it was for my grandpa's birthday and I was really concerned about seeing people in my family and thinking that they were going to judge me and all this stuff and I was really uncomfortable about it and when I saw everyone their reaction was more like 'we're really happy to see you and spend time with you. We haven't seen you in so long. It's so great to see you. We're so proud of you and what you're doing in school. It wasn't really what I was expecting and so I think that what I am doing in a lot of different situations, and I think it's so think it's because of stuff that's happened to me in the past, but I think I'm manifesting things about myself onto other people.

So the week before when I was home, too, I ran into this person I went to high school with and I was really standoffish because I hadn't seen them in a long time and my immediate reaction when I see people is I don't want them to see what I look like. I have this really standoffish reaction and then the person I run into is like, 'I'm so glad to see you.' And then they said to me, 'look at you, you're all dressed up,' and so it was not at all what I expected because I think in my head I'm thinking is all they're seeing is sad stuff, like they're out to get me, but and I build it up so much that when I'm actually having interaction with them I'm like really surprised when it doesn't go as badly as I thought it was going to and I'm really feeling that it's all in my head and it's all the way that I am looking at myself because I didn't feel that anyone was reacting negatively to me this weekend when I was at the event but then they sent around pictures afterwards and then I looked at the pictures of myself and thought like I looked terrible and saw all these different flaws and then I thought well they must have seen all this stuff too.

So in the moment I'm thinking oh they're reacting really well to me but then after I interpret the way I thought I looked in these photos, I thought well they all must have seen this too. I look pale and washed out, I have a double chin, my hair is a I saw all of these things and then I thought (unclear) I said, oh everyone else must have been thinking these things too. So then I realized that they may not have been thinking those things it was me thinking those things after I saw these photos and picked myself apart and then decided that they were thinking. [00:04:42]

THERAPIST: I think that's such an important insight.

CLIENT: Yeah.

THERAPIST: Really, such an important insight.

CLIENT: Because and I don't know how to stop thinking that way (crying) about myself because normally I won't look at pictures of myself and I don't let people take pictures of me but I kind of like they were taking group photos and I couldn't really run away so and then I didn't want to open the pictures and look at them but I wanted to see the pictures of everybody else and I also wanted to force myself to look at the pictures because I felt like I needed to look at them like I couldn't avoid it but when I did look at them I didn't I saw good stuff when I looked at everybody else but I didn't see anything good when I looked at myself. And the same thing happened when I was at my friend's wedding in October I thought I looked great and I was having a fun time and then someone took a photo and then showed it and said, 'oh, that's a good photo.' And I saw what I looked like in the picture and it ruined my entire night because then I was like I look so awful and I can't believe that I didn't realize that I looked like this and then my friend a couple of weeks ago sent those pictures from the wedding around and I was like I ruined all of her pictures because I looked so disgusting and so horrible. So seeing like in the moment I might not feel badly about myself, it's when I see pictures of myself that I think that the picture the way that I see myself in the picture is the way I really must look to everyone else and the way I see myself in person when I think I look okay, that's not what I really look like. That's me. I feel like that's me somehow like distorting myself to look better. And then when I see myself in pictures, I think about how fat I look and how terrible I look and then I think that that view is what everybody else sees. So it's weird though because it's not necessarily happening in person if I'm getting ready or something. I may actually think I look okay. I might actually have confidence and then it's when I see a picture and I think I look so bad and I say, 'that's what I must really look like,' and I wonder why I thought that I looked okay. [00:08:20]

THERAPIST: What do you think it is about a picture in particular?

CLIENT: To me the picture captures the reality of how I look from like every angle and to me a picture is like someone else capturing how they see you and so I feel like the picture is how everybody else sees that's how everybody else sees me, maybe not how I see myself but that's how everybody else must see me because it's like a picture of like someone looking at you. And when I look in the mirror I think I look okay and when I'm looking at like a certain angle and maybe I don't look good from every angle or something but I can't stand to see pictures of myself and I try to not let people take pictures of me and then sometimes and this is only in the past couple of years since I gained weight, it wasn't like that before that but and then I think like also because so many people take it from different angles in relation to me and it shows like all these different all the different flaws I have from all the different vantage points so I guess to me the picture is more I think it's more realistic than what I see and I don't know why but it literally when I see a picture I always think, 'oh that's what the person must have thought of me and I thought I looked good then, but I didn't. This is what I really looked like and this is what they must have been thinking when they were talking with me. And it's only when I see pictures from an event or something that I look back and think, 'oh they really must have been thinking about how fat I was because I look really fat in this picture.'

So I don't know what it's like maybe I would have a little bit of insecurity or be thinking in the back of my mind about what someone thought of me but if I thought I looked okay in the moment it's fine but then it's like afterward once I see the pictures then I know that's what I really looked like and then they must have been thinking all these things about me. So it's just kind of because my boyfriend's mom wrote it and this guy whom she had gone to school with was talking to us and he said his wife was a dietician and he was talking about health and fitness and he was talking about how all these people were obese in America and stuff and I was like, 'he's talking about me. And he's thinking about me and he's saying all this stuff to me because he's thinking about me.' And then I tried to push that out of my head and then I saw pictures of myself from the event afterwards and I was like oh I look so horrible and I have a double chin and I look so bad so he really was saying all that stuff to me.

So it's like once I see a picture it's like it reaffirms what I was already thinking in the back of my mind and to me that's reality and that captures what the situation really was and I just might not have realized how bad I looked. But I've realized that that's really the trigger is seeing a picture of myself that's like because of this wedding I thought I looked great until I saw the picture and then saw all my friends' pictures I look so terrible I can't even believe that they let me be in a picture because everyone else looks skinny and pretty and I look like a pig. I really felt like I ruined her pictures and so but I thought I looked really good leaving the house and going to the wedding. So it wasn't like the whole time I was like I look terrible and stuff, it was just seeing a picture of myself. [00:13:25]

THERAPIST: It's like when literally the lens is turned outward in.

CLIENT: Yeah. But to me it's almost like the camera lens I'm looking through is how other people must see me because it's like another set of eyes other than my own capturing me and that's how everybody must see me. Because when I look at other people in a picture I'm like, 'oh, that's what they look like.' So I just feel like, I almost feel like I have a distortedly, I think of myself too positively when I'm looking in the mirror and the camera is what's real. But I really thought it's only when I see these pictures that's when I start thinking that this other person must be thinking all these things about me. So it's not in the moment and it's not related to interaction with another person, it's everything that I'm finding I'm putting it onto the other people in deciding that. That's what I'm thinking. But I know why I can't avoid having people take pictures of me and I can try to avoid seeing them but it's really hard to when people send you something or whatever. And I don't want to avoid either thing. I mean, because I was looking back over the past couple of years and I don't have a lot of pictures that I'm in at events or different things because I was taking them and didn't want to be in them so it's kind of a shame to me that I don't have these pictures of these memories because I'm avoiding being in them and it's like I don't want to avoid life or these different things because of the way that I see myself.

THERAPIST: It sounds like one of the things that you're describing is really a kind of confusion about what's inside and what's outside and what you feel and what other people feel.

CLIENT: Yeah. Because I know that it's really I know that when I'm picking apart the photos that it's me talking and that it's what I'm feeling. But I don't understand why I'm not why it's only (unclear) when I'm looking at myself in photos because I think that. It seems almost like I'm escaping from saying that I could feel this way so that I'm putting it on other people because I don't want to acknowledge that I feel this way about myself so I'm thinking I'm trying to say that's what everybody else thinks but it's definitely how I feel. I just don't understand why it's like one minute I could just look in the mirror and say, 'okay, that's fine.' And then when I see a picture it's like I'm picking everything apart.

THERAPIST: Do you think it's also part of it that it sorts of exists in real time? It's not a perception it's an actual object, the picture.

CLIENT: Like, you mean that I have a snap of it and I haven't had time to pick it apart or that -

THERAPIST: Maybe it's like when you look at yourself in the mirror that you just have that moment whereas you have a picture it's sort of, it's branded in a sense it's there.

CLIENT: Yeah.

THERAPIST: An object in itself.

CLIENT: Yeah. And I can go back to it and see the different things because like the pictures from this weekend once I clicked on one and saw -I thought it was really bad, then I clicked on other ones to say was it bad every time? Yep, it was. I see all these things in every single one and so it gave me something to sort of like evaluate or be able to take the time to really look at and then I'm like immediately when I see this stuff I think, 'what can I do?' Can I start drinking Slim-Fast immediately? Immediately my mind goes to, I need a quick fix because I can't see myself like this anymore. Like I can't go through seeing pictures like this again and again and again.

THERAPIST: There's something that feels intolerable?

CLIENT: Yeah, because after seeing the pictures from the wedding that were sent around I just thought, 'this is so terrible. I can't even look at putting myself out there in public like this.' And then it's sort of like died down and then it happened again with these pictures and I thought, 'I can't look like this anymore and I can't do this and I need to find a solution that's immediate so I don't have to look like this anymore.' And then it will go away but then it could happen again. So it's sort of like yeah, like I can't deal with looking at these pictures and knowing that I'm out there in the world looking like this. [00:20:20]

But I know that it's I'm realizing now that a lot of it is me and it's not other people. Other people aren't out to get me and say all this stuff about me. It's stuff that I'm craving, usually after the fact, I think when I'm reflecting on different situations. Because actually, like you were saying, even when you're looking in the mirror or when you're having an interaction with someone you're just having the interaction like there's not a lot of time to think all this stuff in your head, it's only when you sort of look back on it that you can add all of this commentary to it. So when I went back on this weekend I added commentary to what I decided my one aunt was really thinking when she said she hadn't seen me in so long and loved getting to see me. She must have really been thinking, 'look how fat you are. You look so disgusting. Like I added all of this stuff into it afterwards, after I saw the pictures instead of it wasn't really what was happening. But I decided that that's what must have been happening, so I think in a lot of situations I'm like putting a lot of my defenses up because I think someone's going to say all this stuff or be out to get me when really it's me adding this commentary to whatever happened afterwards.

THERAPIST: I started to think about your mom and started to think that there must have been something probably still is something inside of her that she felt so unsettling, or ugly or disturbing that she sort of grafted onto her appearance and also onto your appearance by seeing you guys as almost as twins. It's something like that you are now trying to deal with inside of you and it gets sort of played out on the canvas of your body in your appearance.

CLIENT: Yeah, well she always talks about she always will tell me about issues with her weight and go yo-yo dieting and all kinds of stuff but then this weekend when we were with my aunts she was like, well, those two look so great because they're always working out every time I talk to them they're working out. I don't have time like, she's still, I think, still feeling all that stuff and that's just part of her running commentary of justifying well they look like this and I don't think I look as good as my sisters because of the so that's definitely all there and she probably feels a lot of the same things which I think is because of the way I grew up that I feel those things too, but I mean she's always saying, she'll say, 'I looked at this picture and everyone else looks rested and great and I look like the tired -' like she says like that a lot. So I mean I think it's similar. And there's a lot of like jealousy of other people and she says, well I do all this stuff and so that's why I don't look there's all kinds of stuff. So I mean that's definitely part of it because she definitely says (unclear) about my appearance. Like I know with her it's not really me manifesting it but that's real and she definitely talks about other people's appearance, too, and so I think a lot of it, too, is that well everybody else must be like her and they must go home and have these commentaries about how everybody looks and all this stuff. And so because she does that and that's how I grew up, sometimes I think part of me putting all this stuff in other people's heads or thinking this is what they were thinking is because when we would come home from something, that's what my mom would do and so I just think that automatically that's what everybody else does and that everybody's always going to be critical of you and talking about you but that's I know that that's not the case and I know that people could have gone home and said, 'oh we're really glad we got to see Felicity and we're really happy that we got to spend time with them.' And probably they might not have said anything about my weight but I decided that instead of saying that it was great to see me they said and did you see how fat she got, she must have been avoiding us because she got so fat. So to me that's what they were saying. Because that's what my mom would do when we would get home from a party or something. She would say, look how many less (unclear) this person has. She gained a lot of weight. It's probably because she likes her drinks, or something like there's all kinds of comments made about other people.

THERAPIST: Is there bitterness to her comments?

CLIENT: Yeah.

THERAPIST: It sounds like it. Bitterness.

CLIENT: Yeah, and that's I mean, I think that's what bothers me the most because I try really hard to un-train myself from seeing all that stuff in other people and to being more like envious of other people and trying to put them down because I'm envious because I think that's what my mom always did. And I don't want to say these negative things and I don't want to think of others in that way but it's really hard to retrain your brain when you grew up with that's just like normal conversation. But I think that the reason she would say that stuff about other people is because she felt stressed out and that she was giving a lot and the other people weren't and she was sort of envious of them.

Or I always thought it's to take attention away from herself, too. I've always felt that she tried to say all this stuff about other people or see all these flaws or be caught up in their drama or have stories about them all the time to take attention off of herself and to having to actually talk about anything to do with herself because she always has these stories about people that I don't even know, they have nothing to do with me. I don't want to hear about them. Like that's not really relevant. I mean that's, too, a way of taking attention away from yourself if you focus on all this stuff about other people. But I think just because she is that way why I just assume that everybody else is and that's what they go home and talk about. [00:28:46]

THERAPIST: Yeah, that sounds like a lot of voices to undo.

CLIENT: Yeah. Well that's I mean I think that's the hardest thing now that I I mean I think it's good that I realize that it's me and probably not the other people, but that being said, it's hard to not think to stop the behavior of thinking all of these things because literally that's when I look at these pictures that's what I see and the immediate thing that pops into my head is not that I'm thinking these things about myself, it's just that that's what everybody else sees. Like that's just it seems like a natural mechanism. I see the picture. I look terrible. That's what everybody else saw. It's even if I know it's me thinking all of this.

THERAPIST: Did your mother's comments ever make you angry?

CLIENT: About other people? They do now. They I used to just play into it and say, 'oh really?' and like because I didn't know any better. To me it was normal conversation to have about other people and if anything, I was doing the same thing. Because that to me was just normal and it probably really wasn't until I met my boyfriend and he would say, 'hey, why are you saying this stuff about -?' that I realized first of all what I was doing and that I realized where it was coming from and now I'm to a point where it makes me very angry and for the past year or two I'm (unclear) 'can't you just focus on the positive?' Can't you but it doesn't work so I think being aware of what's going on has caused me to become angry about the way that she speaks. So that's why I like a lot of the stuff she does now just makes me so mad and it's really hard. Like I feel like the only way to interact with her is to just go along with what she wants because if I let her know that I don't like the way she's being or if I say something, she literally flips out and yells and goes crazy.

So in the beginning of this weekend on Saturday when we first arrived I was sort of being a little standoffish because I just didn't want to deal with her antics and then I went to my grandmother's house with her and then my aunts were there and I heard her telling my aunts that I was like Jekyll and Hyde because when I was with my aunts who, the two that were there, don't live anywhere near New Jersey and were very relaxed people, when I went, those two particular aunts actually they don't speak badly about other people, they don't do any of these other things, and so I'm really happy because I can have normal interactions with them and it's and they're really great interactions and so obviously I'm going to have better conversation with them and I think because I was being really curt to my mom beforehand because she was being really crazy then she went over and said to them, 'it's like Jekyll and Hyde.' Like I heard her saying all this stuff. So in the meanwhile I'm like, she's like that. So it's just hard for me to deal with her because there's so much when I'm talking to her there's nothing but chaos and negative energy like that's all that I feel that I get from her. So it's really hard for me to respond positively to chaos and being negative and I just I can't really deal with it.

But I got really, really angry because, and frustrated, that I can't change it. And sometimes I'm mad about growing up around that has made it so hard for me to change and to see things differently from being immersed in that for so long and I also get worried that in the heat of the moment when I'm not being reflexive enough that I will fall into those behaviors and I'm sure that I still do sometimes, but I don't want to do that. [00:34:42]

But I sort of feel like I just want to stay as far away from it as possible and not when I'm with her too long, that that's when I fall into some of the old habits and different things and being around her for too long also really makes me think that everybody's talking about me because there are so many story lines about so many different people that it's just that you can't help but it's like you can't help but respond to the people that you're around especially if they've always had such a big influence on your life and how you behave. So sometimes when I'm with my family I'm afraid that I'm going to fall back into that. You know, just go with their conversation that they're having about someone else or kind of it's just hard to like be around it and totally shut it out.

THERAPIST: You're describing two things. One is sort of a projection of your own feelings that you've taken in over a long time onto other people and the other like very understandably is a kind of paranoia which was very much inculcated into you like with reason to be paranoid.

CLIENT: Yeah, there is huge paranoia. There's so much stress that goes with that paranoia like thinking about how other people are perceiving you all the time is really, really stressful and so and I think that I have made progress with that like just being able to casually like go in front of people and talk and different things is big for me because normally I would be so worried about what everybody was thinking so in certain scenarios and certain situations I think I am getting better. Like it's not happening as often but in other situations or especially with the pictures it can get really, really bad and then it takes away from enjoying whatever you're doing. Like the whole wedding thing. I was really having fun at this wedding and it literally, seeing this picture, just ruined my entire night and I just had to leave because I couldn't have fun anymore because I thought to myself this is what I look like. And I cannot be walking around like this anymore. Like I have to leave. So it's so stressful and so horrible that I can ruin a whole lot of different situations for me both being paranoid about what the other people think and also just feeling so disgusted with myself as this really it's a feeling of disgust. Like I can't even see anything positive.

THERAPIST: Do you feel that that's how that you mother felt that way toward you?

CLIENT: I feel like her feelings towards me were more that she wanted me to be better than what she thought she was. And so I think when she saw me and really I get so mad because looking back I really was never overweight as a kid or teenager it makes me really mad that she thought I was because like scientifically, medically, I wasn't. It makes me really angry. But when she would say that I was gaining weight or that I was overweight and then tell me stories about her weight problems as a teenager, I think in her mind it was more like I don't want you to go through what I went through so I'm going to help you do all these things so you don't go through that so you're a better version or better than what I was and you don't have to go through all that. So I think I feel that was and is her intention but by doing the things she did and continues to do she's made it worse. So I think when she sees me she sees me having similar struggles to what she went through and she doesn't want me to have those so she's trying to say and do all of these things to help but it's making the situation worse. So I'm not sure that she looks at me and just I don't think that she looks at me the same way that I look at myself but I think she feels like she needs to help me because she doesn't want me to have all these issues. And then she told me also this weekend that she looked at all of the photos of me from when I was 19 until now and she thinks that the reason I have gained so much weight is because of birth control. So knowing that she is looking at pictures of me and analyzing me from when I was 19 until now is just really not a great feeling to know. I mean I do enough of that to myself so it's not really a good feeling to know that someone is looking back on photos of you and trying to say like, where did she go wrong?' And how could she have gained all this weight and what did she do?

THERAPIST: Birth control. And then she comes up with birth control.

CLIENT: Yes.

THERAPIST: Is there a meaning behind that or do you feel that there is some meaning?

CLIENT: Well I went on birth control when I was like 17 but she found out about it when I was 19.

THERAPIST: I see.

CLIENT: So maybe that was so horrific to her because she's very religious that she remembered that and she's blaming everything on that. That's my only thought. Because I do remember that she found it or something like that and went crazy. So that may be so traumatic in her mind that she may have associated it with that but the fact that she's trying to go back and figure out where I went wrong I do enough of that to myself.

THERAPIST: She's obsessed. She's obsessed.

CLIENT: Yeah and she doesn't do that stuff to my sister at all. And my sister is pretty thin but isn't as thin as she was when she was 19 either. And so she's not doing that to her. She not going through her pictures and trying to figure it out and so and she just said it like at random like she says stuff randomly. So she was showing me photo albums that she made for my grandfather and that's what she said.

THERAPIST: So there's no prelude. It's just something that's on her mind somehow.

CLIENT: Yeah.

THERAPIST: Felicity, we're going to need to stop for today. So the next two Wednesdays are Christmas and New Year's.

CLIENT: Oh yeah.

THERAPIST: I'm going to be here other days so if you wanted to find another time to meet I'd be happy to do so.

CLIENT: Christmas week we're going to be in Pennsylvania but the week after it might be (unclear).

THERAPIST: Okay.

CLIENT: Another time. I actually have I'm training at work. I have my schedule for that week, too. So I could e-mail you with what works for me that week.

THERAPIST: And then I put in the schedule where you discussed starting in January.

CLIENT: Starting like the first week, the first full week in January.

THERAPIST: Okay, great.

CLIENT: Okay. Thank you.

THERAPIST: Sure.

CLIENT: Yeah, let me know if you need me to do anything else with the insurance.

THERAPIST: I'll have -

CLIENT: I should have like that has like what they're going to reimburse.

THERAPIST: Usually that comes with the check. That rarely comes by itself.

CLIENT: Well no this is from online. It didn't come in the mail. I went online and printed it out.

THERAPIST: It says the 18th. That means they should have sent it out. The check date is the 18th. Would you mind calling them? I could have your (unclear) -

CLIENT: Okay and just say where.

THERAPIST: That you never got it. Yeah. Thank you so much.

CLIENT: Thank you.

THERAPIST: Okay. Good-bye.

END TRANSCRIPT