TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Come on in. (inaudible).

(Pause): [00:00:11 00:02:17]

CLIENT: Good morning.

THERAPIST: Good morning.

CLIENT: So after last time I looked up "accountable" and "responsible." We'd had that question in between, I don't know if you looked them up also.

THERAPIST: I did not.

CLIENT: Okay, I brought the definitions -

THERAPIST: Great.

CLIENT: because I thought because I thought it was very interesting.

THERAPIST: Great.

CLIENT: So, "responsible" has four definitions, but only three of them are relevant here. The first one is, "liable to be called upon to give satisfaction; answerable." The second is, "willing and able to fulfill one's obligations; reliable." The fourth is, "able to choose for oneself between right and wrong." Kind of interesting.

THERAPIST: Interesting. That's interesting.

CLIENT: So "accountable" has two, only one of which really matters here and that one is, "responsible for giving an account; answerable." So to hold someone accountable is to hold them to at least tell the story of what happened, or answer for it.

THERAPIST: That's interesting. So, how responsibility like looks like the lighter version of it.

CLIENT: Right. At least in that set of definitions.

THERAPIST: Yeah. I like that that's actually how I think about it. Because "responsible" sounds like sort of an idea of a contribution.

CLIENT: Right.

THERAPIST: Accountable is not doesn't have that piece to it of understanding it correctly. It's not quite what your definition actually was but -

CLIENT: They're the ones that were in the dictionary, not particularly mine, but kind of a the one involves discerning something about rightness and wrongness and choosing or being able to choose to do it in addition to having to tell a story about having done it. And the accountable just requires you to say, 'well, this is what happened,' or something like that.

THERAPIST: And it's always after the fact, which is why I thought "responsible" as a contribution because it's while it's happening, or something like that.

CLIENT: Yeah, something like that.

THERAPIST: It's being more of a participant in it versus -

CLIENT: Yeah.

THERAPIST: That really stuck with you.

CLIENT: Yeah. Yeah, well I thought it was an interesting question. It was kind of the theme of a large part of what we talked about last time. It's a you know, what responsibilities do I have, but also, what responsibilities and what accountability does Tanya have and then to what extent should I be holding her accountable or responsible for her actions or thoughts or feelings or what? In general, I come down on like, we have the feelings we have and we have to deal with them somehow. And we're at least accountable for the actions we take. I think responsible, but it's not always clear that responsible is quite right. It seems like emotions can get so overwhelming that willing and able part stops being correct. So -

(Pause): [00:05:47 00:06:20]

CLIENT: Tanya and I had a long conversation on Sunday. It started with her sister calling and talking about her new life plans because she got fired from her job maybe a month ago, now. And now she wants to move to Augusta, Georgia, and be an instructor which she'd probably be quite good at and enjoy. So that is for the good, but Tanya had some questions for her about what her motivations were for doing it and whether it was a good idea and not which was an interesting thing to watch happen. But Tanya was fairly perturbed by the end of the conversation, I think in part, because she felt like neither she nor her sister had a very clear sense of direction in their lives at this point and she felt like they're old and they ought to have something figured out or something like that, which is fine. I certainly understand the sentiment but that progressive of talking about what we're going to do next and Tanya sometime ago a couple of weeks maybe, had suggested that she was happy to go wherever was going to be good for me in the next career step.

(Pause): [00:08:09 00:08:21]

CLIENT: For me a lot of responsibility and in some ways (Pause) anyway, one of the results of the conversation was I don't think she actually feels that way. I think that she really wants to stay here in part because it's familiar and in part because she has this job that like I think she is mostly enjoying. That's a really good thing to have. And I think a larger part because she feels like the therapeutic relationship she has with Chad is effective and long standing. But she still is unable to articulate what she needs or wants or should need or should want, or something like that. She can't quite she does not understand what the word "need" means. I think is actually the problem.

(Pause): [00:09:17 00:09:26]

CLIENT: Which actually doesn't bother me because that's been the case for as long as I've known her. She really does not know what she needs versus what she wants. It's a I think it's a struggle that goes back to her childhood. Her father would like to give them a clothing allotment to buy what they need but the clothing allotment was never enough to buy what they needed or she didn't think it was and so then like I think started a crisis of understanding of the word "need." She also didn't know how to say, "that's not sufficient. I need more than that."

THERAPIST: Were they financially strapped or was the father stingy?

CLIENT: She could never say, 'I need more,' and so I think that she had the sense that they were financially strapped, but her father also didn't like to talk about money at all, ever. So, I don't think she actually knows whether they were financially strapped or not.

(Pause): [00:10:29 00:10:44]

CLIENT: All of that was intended as a back-story to say that I found during the conversation that I already do hold her accountable for her response to her emotions internally. So you had suggested that actually doing that, like saying that, would be a helpful thing, and in fact, is a helpful thing. I think that in that pair of definitions, "responsible" may be too far at this point, but "accountable" is certainly like it is what I do anyway. So, being explicit about it is a better thing, at least.

(Pause): [00:11:32 00:11:58]

CLIENT: The other upshot of that conversation was that I suggested to her that we need to make in some sense, separate decisions. I need to make a decision about what I want to do a few years from now so that I can make the decision about what I need to do now. Because the next career step bounds the following ones in some fashion. And she needs to decide whether she needs to stay in Andover or not. And then, in essence, needs to decide to what extent she needs this relationship with Chad. We talked about that latter point some, but as a way of putting bounds on it for her, like I think that a reasonable observer looking at the last six or 12 months would say that it would certainly be not a good idea to go to, to stop doing therapy at all for her. And it would certainly be not a good idea to drop down to like once every two weeks for her and so you can kind of back that up to at some point I don't know whether the right answer is to very clearly stay working with Chad but the answer can't fall too far from that. Like, you can't go to someone who is terrible and will only see you once a month. So that already has restricted the range of moves that she should be willing to make in some sense.

THERAPIST: Well, that latter point I mean unless you go somewhere really rural, you'll find people who do analysis some very good ones too.

CLIENT: Okay. Tanya's certainly more skeptical about that than you are and I don't know exactly whom to trust in that circumstance. I tend to trust you but on the other hand I know that Tanya has had a number of therapeutic relationships over the years that have been bad.

THERAPIST: Well, I imagine she's very attached to Chad and probably idealizes him in some ways as a lot of patients do. And so sometimes it's hard to imagine that what you're getting you can get from somebody else or at least get something different, but as valuable and as needed.

CLIENT: And I think there's probably some of that going on in her case. I think there's also the realistic assessment that any other relationship that she was to start would be starting over. Not that she'd lose anything that she has learned or changed about herself, but the history with the therapist is lost.

THERAPIST: Right. And I think that speaks to the attachment part.

CLIENT: Okay. But you don't think that the conversation you and I can have today is different from the one that we could have three months ago?

THERAPIST: Oh yeah, I agree with that.

CLIENT: Okay.

THERAPIST: So you're sort of making the point that it takes time to build.

CLIENT: Yeah. And I think she is I think there is some attachment and I think there is also a like analysis as a long game? It's not a short game. So the initial visits are more investment and less therapy in some ways.

(Pause): [00:16:25 00:16:32]

CLIENT: You don't have to agree. That's okay.

THERAPIST: Yeah. I think that way. I also think that sometimes another clinician can give a fresh perspective, kind of a lateral perspective that, not to diminish the building of the relationship as a relationship in which you feel connected and you feel someone understands you, but surely that piece you don't have with a new person because you just met them. And then you have, they understand you in a particular way that they can offer you things. I'm not sure that at the beginning of the relationship someone can offer you things maybe a different set of things.

(Pause): [00:17:07 00:17:13]

THERAPIST: That's sometimes very useful in its own right.

(Pause): [00:17:19 00:17:45]

CLIENT: That makes sense to me. I don't have any real objection to that. But I sort of I agree with that also.

(Pause): [00:17:55 00:18:06]

CLIENT: In part the (Pause) this seems to be a process of constructing a narrative in addition to understanding what's going on as part of like coming to understand experiences and so when one is forced to constructing a new narrative or retelling the story in a different way, that seems not necessarily a bad thing.

THERAPIST: But it's a loss. It's a loss of a relationship and is a loss of what you guys have come to understand together, even, hopefully that understanding is internalized.

(Pause): [00:18:40 00:19:47]

CLIENT: Yeah, that sounds right. Also, it seems particularly problematic for someone like Tanya who doesn't handle that sort of loss well.

(Pause): [00:20:02 00:20:10]

THERAPIST: Right. There is the issue of her being able to what might feel like a traumatic loss, that what's suffered then, there's not good help elsewhere.

(Pause): [00:20:27 00:21:03]

THERAPIST: You didn't (inaudible).

CLIENT: Well, so they just seem like parts of the same decision about whether she is able to move or not. That they're I agree that they're separate issues but they're tied intimately in the sense that they will happen under the same set of conditions. I guess the other condition it could happen under is Chad leaving. So -

THERAPIST: I think that's fairly unlikely.

CLIENT: (Laughs) Well, her Dr. Hoffsteder (sp?) has taken a job, so she is leaving. So that's -

THERAPIST: I know Chad, so that's why I said that.

CLIENT: Okay. (Laughs)

THERAPIST: I'm not saying that in general, but he's not going anywhere.

CLIENT: Okay. (Laughs)

(Pause): [00:21:58 00:22:06]

CLIENT: So anyway, I feel like we're talking about all this and I'm not exactly sure it's something that I really need to talk about. But we're talking about it so -

THERAPIST: Well, part of it is sort of deciding, like understanding your personal goals and your goals as a couple and the extent to which they might conflict and your needs might conflict which certainly is the theme for us.

CLIENT: Yeah. Absolutely. Which is I think the important thing is that I need to make a decision that is separate from what Tanya needs about what I want to do and need to do next. And I just think that's an important thing to do. I'm not exactly sure what I'm going to decide, but one of the important things is that if I make that decision and Tanya decides that she thinks she really does need to stay in Andover, if those two are not those two don't necessarily conflict, like making the decision about what I want to do does not have to be dictated by where she feels she needs to be. Although the final, like, what I do for the next two years might be bounded by that. That doesn't need to be bounded for the larger choices. Does that make sense? I'm not sure I articulated that at all, but -

THERAPIST: I'm not sure I follow you.

CLIENT: Okay. So no matter what I decide I want to do Denver, Andover, the area is fairly well populated with -

THERAPIST: Opportunities?

CLIENT: Yeah. So the decisions really are separate in some way. Like saying I need to stay in Andover can look like it makes the decision of what I do next but it doesn't actually need to. So that's all.

(Pause): [00:24:15 00:24:22]

THERAPIST: Would it be helpful for us to talk about what you'd like to do next? Or does that seem something that you want to is not as important to focus on?

(Pause): [00:24:30 00:24:46]

CLIENT: Well, I don't have anything else, but it seems important to focus on today, and I don't know if it will be helpful because I don't know that I have a clear enough sense of everything to talk usefully. But maybe.

(Pause): [00:25:08 00:25:17]

CLIENT: Is there anything else that is jumping out today as something to talk about?

THERAPIST: Not jumping. I mean certainly I'm thinking about the way you started the session and that this is an ongoing issue for you in terms of understanding Tanya's behavior and also (inaudible).

CLIENT: Yeah.

(Pause): [00:25:47 00:25:57]

THERAPIST: And also relates that what is or isn't under Tanya's control and also what is or isn't under your control. Like does she need to stay here? Or does she want to stay here?

CLIENT: And who should make that decision or, or, analysis? I think that's one she should make. But I could be wrong about that. It's just I think I need to make an assessment of it. But I think that she needs to be I think that that is a place where she needs to take responsibility for her own treatment and that is a way of doing that is deciding who will be treating her.

(Pause): [00:26:51 00:27:00]

CLIENT: The thing that I don't want to happen in our next set of decisions is to like, for them to be governed by Tanya's illness which I think is a separate thing from being governed by Tanya responding to her illness.

THERAPIST: Um hmm [yes].

CLIENT: Okay. I like you agreeing with that because I feel very different today, but I wasn't sure if I was making up some sort of artificial distinction.

THERAPIST: How would the distinction be artificial?

CLIENT: I don't know. If they're the same thing in some way that I'm not recognizing? But I really do think that her saying, 'no, I need treatment for this problem, and this is the treatment that I think I need,' is a different thing from saying like, 'I'm scared to leave because nothing else will work.' Or something like that.

(Pause): [00:27:52 00:28:22]

CLIENT: Yeah, so I guess I feel pretty okay about that. And a little bit less clear about what I'm going to do next, or really how I'm going to choose what I'm going to do next. So maybe it would be helpful to talk about that.

THERAPIST: We have about 15 minutes.

CLIENT: That's good. Okay.

(Pause): [00:28:42 00:29:04]

CLIENT: Have I told you before about my preliminary examination?

THERAPIST: (inaudible)

CLIENT: So, in Ohio they're saying after in about your third year there is a preliminary examination after which you become a doctoral candidate and then there' a final exam that the thesis defends but that one is really pro forma. It's the prelim that really determines whether you are going to continue or not. And you can fail that and then retake it up until they tell you no, just go away. And it's not uncommon for them to say, 'well, you didn't pass it this time but do this other thing and it will be okay.' So it's really it is a hurdle that allows them to weed out people they really don't want. For the most part, it's a hurdle that they're putting you through, more as a hazing ritual than anything else. Because it's just a like an initiation or something without some of the more pleasant parts of initiation like being accepted afterwards. So, my first several years at Ohio were just like horrifically unsuccessful in some ways like I was working very hard but there are some pieces like I was picking the wrong things to work on and try and actually that's the large pieces. There was a set of problems that I was working on that I would get started and there would be some sort of problem, like they wouldn't work, so I would keep working to try and understand why a particular reaction would not work when we expected it to work, which is fine but is very time consuming and particularly for the systems I was working on. Like most of the normal methods that we would use are not applicable, so the most sensible thing to do would have been like drop that project and move on to other things that are interesting, be more productive. That's not what I did.

THERAPIST: Why not?

CLIENT: I didn't realize at the time it was the most sensible thing to do. I didn't have a very clear sense of what was important in the field or what I should be working on. And stuff like that was work I had essentially two projects and I wanted to work on one of them and I wanted to work on the other one less, but it was the one my advisor had been running for a while and so it felt to me like the one he cared about more. I don't think that's actually the case, in retrospect, but I felt like I needed to hammer out some of those details, in a sense to fulfill my obligations to him, I think. Which, there's the thing.

(Pause): [00:31:58 00:32:06]

CLIENT: I did end up eventually answering the question of why none of those reactions work. So that was cool, but I at the time I did that I was like two years into it and that didn't feel like success. That just even though it actually is a success of moderate magnitude, something interesting for the field that wasn't really well known. And so about the same time and this is the reason I started telling you all this about the same time we had a professor who was coming up for tenure and I thought and still think he's brilliant. He was working on incredibly difficult problems that were kind of at the cutting edge of several fields, sort of an intersection of several fields dealing fundamental studies that were oriented towards enabling like larger discoveries a few years down the road. And he was actually making very little progress on this and doing quite well in it, but it was slow work.

So he was denied tenure about a month before my preliminary examination. So I had this very real sense of like, if this person who is brilliant, maybe doesn't have great social skills, but really is brilliant and doing excellent work, can't get tenure at a major university, then what chance do I have particularly in the light of he's actually being successful like he was publishing papers in good journals and on covers of important journals. The relevant metrics were there. He had funding from everyone. It turns out that there were internal personal grudges caused him to not get tenure and that's wholly inappropriate and the university did a review and said, yeah, no, he should not have been denied tenure.' And whoever was in charge said, 'yeah, well that's what happened anyway.'

I ended up my preliminary examination turned out to be like absolutely a breeze. It was just a nice conversation with several people who were interested in hearing about what I'd been doing. So it was nice. But I was fairly convinced going into it that I was going to fail. So there was not a pleasant the lead up was not a pleasant experience.

(Pause): [00:34:50 00:35:01]

CLIENT: I think the larger point there is that for a number of years I have thought like, 'why would I choose to be a part of that system where someone like this guy is just tossed out after six years for not any particularly good reason?' Now I tend to get along with people better than he does so the particular issue is probably not relevant but I think he's probably a better biomechanic than I am, so in an idealized view of the academy, he should be granted tenure. There is no so there is a clear mismatch between the idealized view and the actual view.

(Pause): [00:36:03 00:36:17] CLIENT: By coincidence it was not long after that that I started sitting on committees literally by coincidence because I didn't actually want to sit on any of them when I started. I got elected to do it after asking people not to vote for me. Then once that started it sort of snowballed into sort of liking doing it and I could tell the story that I didn't want to do it in the first place but I had been asked to do it so I would do it. That turned into sitting on a lot of committees and seeking to make that particular department a better place for students just like it did for faculty because there are a lot of unhealthy things. So in some sense, the fundamental question that I have been seeking to cope with for a long time is, 'why would I want to be a part of an environment like that that is -

(Pause): [00:37:16 00:37:28]

CLIENT: That is constructed largely of people who make it through a series of hurdles, imposing those hurdles on younger versions of themselves in the sort of argument that, well, you have to make it through these things in order to be good enough,' when it's not particularly clear that the hurdles are oriented in any way towards actually selecting for the things that the academy should be selecting for. I think this is a large reason that, particularly in biomechanics, that women are dramatically under-represented. Some of the departments are just not very nice and many of the women I have known have less patience for that sort of crap, so they just (inaudible). But I think what we end up doing is selecting for a set of like driven, but not necessarily very nice people who can get the job done. And so I don't think that's a good thing because I actually do think the university system has some valuable some very valuable things. I think it is both a storage and transmission place for much of the knowledge of the human race and I think that's a good thing.

(Pause): [00:38:52 00:39:10]

CLIENT: Yeah, so I guess I've talked for a long time but I'm not really sure that I've gotten anywhere in saying something.

(Pause): [00:39:14 00:39:22]

CLIENT: So for a while the solution I thought made sense was to teach at a primarily undergraduate university or college where they actually care about teaching the students and all that, but more recently I have been I guess two points have been important. One is that I think that I might not find teaching general biomechanics fulfilling for the next 30 years. And that would be a large portion of the responsibilities of an instructor at an undergraduate university. The other is that my friend, Franco, suggested that given that I am a person who is going to work to make whatever place that I'm in, better it's not necessarily reasonable to say, 'well, that place is broken, I shouldn't go there.' It seems like a decent insight.

THERAPIST: They might need you.

CLIENT: Yeah.

THERAPIST: But not at the cost of your own unhappiness.

CLIENT: Right.

(Pause): [00:40:30 00:40:40]

CLIENT: (Unclear) the cost.

THERAPIST: Oh, but that's been an ongoing theme in your life right now.

(Pause): [00:40:47 00:41:09]

CLIENT: Yeah, and one of the particularly difficult things in my life right now has been in some sense, like it's not clear what that cost has been worth. Like, we've talked about you know, she's alive but it's a fairly low bar. It's not exactly the case that she's happy. So what are we gaining here? Neither of us is particularly happy. That's painting it more grim than it actually is because it's less and less of the case over time and I think she is finding some fulfillment in this job that she's doing. So that's good. I mostly find fulfillment in the work that I'm doing. I think that in most things I've ever done, you know, it goes up and down from day to day and is still like how enjoyable any individual task is, but on the whole I would say I am finding the work that I'm doing, fulfilling.

(Pause): [00:42:15 00:42:26]

CLIENT: Fulfilling it is somewhat difficult but that's part of being fulfilling is it being challenging. So I guess I want to keep doing it in some capacity.

(Pause): [00:42:39 00:42:49]

THERAPIST: I would say this is a general rule for everybody. I think for you, this might be a particular challenge that there'll be disappointments in whatever job you take. There will be things that are far from ideal.

(Pause): [00:43:00 00:43:06]

THERAPIST: That will hopefully not outweigh the satisfaction you get from the work.

(Pause): [00:43:09 00:43:23]

THERAPIST: I hear a lot about people's work as well as I do about a lot of things and I'm not part of that work system it's me. But when I think about when I hear about people's work places I often think about kindergarten.

CLIENT: (Laughs) In what way?

THERAPIST: People can get very regressed in any sort of system that they're deeply involved in. Not always, and certainly there's a broad variety of systems, but there is definitely a (clear) and a lot of time there and so there are familial elements, simply from the intensity of interaction in time and people can get very regressed so that things are decisions are made based on who likes who, who's been mean to who, you know things get very petty.

CLIENT: I see.

THERAPIST: Again, I'm not characterizing this as the entirety of a workplace. Some workplaces are better than others but certainly it's been my observation.

(Pause): [00:44:18 00:44:25]

CLIENT: Do you work for yourself to avoid that?

THERAPIST: Not actively. Not actively.

(Pause): [00:44:31 00:44:36]

THERAPIST: I think that given that I can do what I can do on my own, I feel like there's a certain efficiency of what I can do. I always think of the workplace as on one level, very inefficient because of all these dynamics, being caught up in all these dynamics. It's hard to then be focused on a goal. So in that sense I feel like being on my own in this workplace makes (client laughing) as an employee makes me more productive in that sense.

(Pause): [00:45:06 00:45:13]

THERAPIST: But not all professions you have that opportunity and there are certainly downsides to it, too. People can also elevate each other. It's not only regressive but it can be.

CLIENT: Right.

(Pause): [00:45:26 00:45:29]

THERAPIST: Like with this faculty member. People didn't like him. He was a disliked kid on the school grounds and he doesn't get to play kickball he's not going to be chosen.

CLIENT: That's about right.

THERAPIST: And it's not -

CLIENT: It's really not what you'd hoped from your university system, I don't think.

THERAPIST: Yeah, I guess my whole overall point is that it's probably more of a problem than anyone would like.

CLIENT: (Laughs)

THERAPIST: And certainly what you would like. You want people who aspire to much more than that.

CLIENT: Yeah, I really do. Because like they can do much more than that.

(Pause): [00:46:10 00:46:34]

THERAPIST: Well, on that note we need to stop. I will see you next week.

CLIENT: All right. Thank you.

THERAPIST: Take care.

CLIENT: You too.

THERAPIST: Bye-bye.

END TRANSCRIPT