TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Hi, I'll be with you in a second.

[pause to 2:20]

CLIENT: So I continue to do the couples thing with Tanya and Dr. Jannis, and that's-this last session was again mostly good, and then right at the end there was some tough pieces that I'm still-so that was yesterday-still frustrated about them I think. But we're at the point where he wants to do individual sessions also, which is standard and reasonable. So I see him later today. So I feel like I need to talk about these things with you, but I'm also going to talk about some of them with him, so it's not like a... Yeah, it's more that I think it's probably important to talk about them here because I have a lot of feelings about them, and we seem to talk about my feelings here, so. [pause] [3:30]

So I think the most useful context to give starts with Tanya and I had a conversation last Thursday I think. She thought I would be upset about something, I actually don't know what it was, and I'm not sure she remembers what it was either, but you know. The attempt she gave was not doing the dishes. It wasn't specifically that, but something like that. I said, "No, I'm not upset about that at all. I'm still angry with you about this whole big thing, but I'm not angry about that." And so she said, "So what are you angry with me about?" And so I presented that in the context of I feel like she abandoned me. [pause] She'll listen, and then I would let it go there for a while, and then she came back later and said, "I think I need to say this." And she said that she felt like... she said more or less she felt like it was a similar situation to her being raped and then me coming and saying, "You were unfaithful to me. I'm not okay with that." [5:20]

Which I suggested was not a very good analogy, because of the-I feel like it does several things, but it places a very specific burden on how I ought to respond in the situation. If she were raped, there is a very clear defined set of this is how you ought to respond. And then it says, not only is there a way you ought to respond, you have not responded in that way, and you've responded in the exact wrong way, or something like that. So we talked some more. I think that still describes her feelings accurately, and that's fine, but... [long pause] But I guess I feel like the... We've spent a long time, and I have spent a long time, living in this world where her feelings are the thing of supreme importance, or the thing that dictates where our lives go, and that's not... it doesn't seem like that's a way that I can continue to live, it doesn't seem like that's a healthy way to continue to live. So at some point I have to say, "I hear that, but that's not the point." So... The conversation continued from there, and I think it was hard for her, but I think that we-she said too-like the reason I thought it was a good conversation, she felt good about having had it. So that's good. [7:20]

THERAPIST: The conversation after she said-

CLIENT: Mm hm, yeah.

THERAPIST: The conversation you had prior to seeing him.

CLIENT: Yeah, yeah. Yeah. So we talked some about that. You know, it's an hour-long therapy session, I won't try to summarize it or recount it all for you in 45 minutes. But... [long pause] I guess I had a few moments that felt like important realizations during that. One was... I can't quite set up how the question came up, but it was something to the effect of like... I guess the question came up more or less twice, once as like what did Tanya used to be like, and what is it that you need or want. And I... obviously I struggled to answer that second question. You've seen me struggle to answer that one. But I think the important thing that I took away from that is I don't think that's the right question in some sense. It's certainly the right question for me to be asking and trying to answer, but it's not the question for me to be answering to Tanya. Like, "If you could just do these things that would be good enough and everything will be okay." Particularly because I know what that does to her internally having known her for a long time. Like it sets up a checklist for her to fail at, and any time she doesn't do any one of the things exactly right-and so it's like putting the burden of our relationship recovering on me dictating these things must happen and her fulfilling them. But that's not a relationship, that's some sort of... So. I articulated that perhaps less clearly than I did just now, but I did say it then. If you think I'm wrong please yell out, but...

THERAPIST: Think you're wrong about what? [10:10]

CLIENT: What I just said. If you think that's an incorrect description of the...

THERAPIST: Well, I think that's your idea of what a relationship should and shouldn't be, which sounds like that's important, because you ultimately are going to be in it.

CLIENT: Fair enough. [chuckles] [pause] The other key realization was-or articulation-was I feel like the Tanya that I knew is gone, or at least was gone, such that it's as if she did die earlier in the year. Which is a thing that I have avoided saying I think. I don't know if I have articulated that to you at any point. Certainly I think you've gotten that impression, but...

THERAPIST: Mm hm.

CLIENT: I have definitely avoided saying it to Tanya, or in Tanya's presence, because I thought that one of the things that kept her alive when it got bad was the knowledge that she had not killed herself, and so if I feel as if she has already died then I was concerned there might be a lower barrier to her actually killing herself. Which is its own snarl of equivocation, but I think it can be rewritten without using the same word-

THERAPIST: Mm hm.

CLIENT: -and come out coherently. [pause] That was also interesting, because Tanya said that she felt similarly, that she also felt as if the person that she was had died or was gone, and that part of the struggle was like who is she now and what does it all mean. In some sense that's not surprising, but it was interesting to hear that concisely.

THERAPIST: Mm, hm hm. [12:45]

CLIENT: So those were I felt like good things, and those are just some of the good things. And so now we're in the last like five minutes of the session, and he suggested that was an interesting fantasy, that Tanya had died. Which... So for me, not trained in what the appropriate language is in the therapeutic circumstance, that word has a moderately broad range of meanings, but it tends to indicate something that one desires or wishes for. I don't really think it's accurate to say that I wish Tanya were dead, or desire her death, and so I found that suggestion upsetting. I did press him on whether he intended those pieces to the meaning, and he said no, that's not how he uses that word. But then he didn't give a concise definition of how he does use the word, he kind of... yeah, he did not give a concise definition. Which means I have nothing to replace the definition I normally hear it with with. So I just... So that's one piece, that I'm upset with this idea that this is something that I wanted or willed. It's not the case. [pause] [15:00]

Then shortly after he suggested that that was not the only way to experience what had happened, and that other people might have experienced it differently, and that it's interesting that that was how we experienced it. And I don't... can't pick out the timeframe, but the next thing that I remember clearly was him sort of looking at me directly and saying, "I think it's a function of your depression." Which... I'm pretty sure this is not what he was trying to say. But that sequence, what I hear is, "You could have just experienced this differently and your life would be better. And if you weren't depressed maybe you would have experienced this differently and things would have been okay." Which even if causality worked in that way with people I think reverses the order of cause and effect in this circumstance, so. I don't think I experienced Tanya wanting to kill herself because I was depressed, I think that the driver is in the other direction. So anyway, I think it's not very important to get at what he meant, particularly in this room, but I think that me being upset about feeling like that was he was saying was probably something he would be interested in.

THERAPIST: Well, I'm interested in it all. So what about that in particular that made you think she would be interested in this? [17:00]

CLIENT: [laughs] We had a conversation last time where we had talked about, "Gee, you don't take what I say as a recommendation," but you might say, "Well, it's interesting that you would respond in this way."

THERAPIST: Mm hm.

CLIENT: So in that sense I thought you would be interested in this is the response I have with this specific thing. So that was a story I had to tell. Now I've told it, so I don't know what else to say.

THERAPIST: Yeah, there's so many different types of ways we could go around thinking about what happened, but you clearly were distressed at the end it seems like.

CLIENT: Yeah. Yeah, that's right. [18:00]

THERAPIST: And distressed because you felt sort of misunderstood or mischaracterized. I mean, almost blamed. I mean, it sounds like there's a blame part to it.

CLIENT: Yeah, I felt blamed or accused, yeah. I really don't think that was the intent, but that's what happened anyway.

THERAPIST: And you were being blamed for how you experience it, interpret it, what happened?

CLIENT: Yeah, I think that's right. Or for the particular effect that the... yeah, I think for the effects that the... in my experience has had on me and perhaps on my relationship with Tanya. [pause]

THERAPIST: Hm. [pause] [19:30]

CLIENT: And I feel like another way to phrase it would be like, "Why can't you just be happy she's back?" Or something like that. [pause]

THERAPIST: Well, in that way whatever the-I mean, this, you're describing a particular kind of agenda, but feeling that there's an agenda. Like changing the way you feel about it is an agenda, rather than understanding how you're feeling.

CLIENT: Hm. [pause] Yeah, that's really interesting. Yeah, that rings true. [pause] You know, on the other hand, aren't we there to change something about the way we're-Tanya and I are coexisting or something? But yeah. [long pause] Just thinking about, you know, one of the unsettling things about it has been the contrast with our sessions in a sense. And then that is a clear way of articulating a contrast I think, is that... [pause] ...is that that felt like a particular scene of how one ought to do things, and you are very careful to-or for the most part refraining from making any [all out? 22:33] statements, even when asked directly. "What ought I to do here?" You'd say something like, "That's a good question." [23:00]

Which itself is a weird thing, right, because I do actually want advice and help, but it has several times been helpful in the sense that you-"that's a good question" isn't a way of saying there is no answer to that. That is not a thing you can get right and wrong, that is a thing you figure out how to do and you do it, but it's not a... If that makes sense.

THERAPIST: Mm hm.

CLIENT: I feel like now I'm describing some piece of your method to you, which is a weird place to be sitting, but.

THERAPIST: I hear it more as you're describing your experience.

CLIENT: [laughs]

THERAPIST: That it's your reflection on how I think about things.

CLIENT: [laughs] Yeah that's right. [24:00]

THERAPIST: You're feeling very unsettled about several things that I imagine are related, so that's what I'm thinking about now, how they're related.

CLIENT: Mm.

THERAPIST: Because there's something that's hap-there's some good things that are happening, or things that feel good about the couples therapy, and there are things that don't feel good. And I'm trying to sort of pick out if there is a relationship between other things in your marriage that don't feel good in your experience. That's sort of how-I don't have any ideas yet, but that's how I'm thinking about things.

CLIENT: Thanks for sharing. [pause] Certainly constructing the story the way I did there appears to be a connection between my rejecting Tanya's particular analogy and my resistance to the particular description in the last session. I don't... [long pause] Yeah. And I guess there's... I'm not sure that that's all there is, but there's certainly a piece to both of them that's sort of like: this is a bad thing that happened to me and I'm dealing with it in this way and that's all there is. [long pause, one minute] [27:00]

THERAPIST: I'm... Well, before, what were you just thinking?

CLIENT: I was just circling the problem, I didn't have a... trying to... looking for the connection and trying to figure out whether what I just said was a sufficient description. I don't think it is, but I don't have a... I don't have a more yet, so.

THERAPIST: You had said that the conversation after Tanya made that analogy went well, or better. What did you guys talk about? [27:30]

CLIENT: [long pause, 30 seconds] So we talked some about what had actually happened. [long pause, 40 seconds] It's strange, I don't actually remember the conversation that clearly. [long pause, 40 seconds] We talked some about... what it's meant for her to be ill in this particular way. That if it were cancer it would be one thing, but it's different in terms of not having this obvious in some sense external thing that can be removed and dealt with together. [pause]

She sort of tried on some other analogies, like if she had been abducted for six months would I feel angry in the same way. Which is really an interesting one. And I feel like those don't... those analogies are good, but they're sort of not-I guess I'm going to bleed over into our Monday conversation also, but I feel it's more like she abducted herself for six months, and so there's both the... So like if she had abducted my sister for six months, I would still love my sister, but I would be angry with her. But you've got to collapse those into one person, that's kind of how I feel. So. [pause] [31:30]

THERAPIST: Do you think she understood that analogy?

CLIENT: Yeah. Yeah. I don't think it's one she finds particularly helpful, because her response was just that they're the same person. Like the person that you love and the person that you are angry with are not extricable, they just are the same person. And sometimes I feel like that's a helpful [model, as she says? 31:47], but most of the time I don't. So that's... You know, that's troubling in one sense, but it's... [pause] I don't know. I like true things better than false things, so if that's the way it is, that's the way it is.

THERAPIST: I'm sorry, the way it is? What's-

CLIENT: If that is how she experiences it, and if that is the way it actually is working for her to the best of her understanding then... Now, whether that's true in some more factual sense I don't have any access to, so... [pause] It's certainly more true of my experience that they... they inhabit the same body, but they are maybe not exactly the same person. But it's also not the case that they're unrelated people, so that's... You know, like who is she right now? Well, she's Tanya while she's depressed is kind of the person that she is right now, but she's not Tanya while she's really, really depressed and very suicidal. So I guess it's not that helpful in some ways, but.

THERAPIST: Do you think she's worried about her depression, and then the tendency for it to be so severe, what the impact of your relationship [going] forward could be? Not on-you and your relationship. [34:00]

CLIENT: I'm sorry, say that again.

THERAPIST: Both on you and the relationship.

CLIENT: Yes. Well, that was an interesting feature of our Thursday conversation. She said that she was not really concerned about the future of our relationship. She didn't know how we were going to be okay, but she was just very sure that we were going to be okay. [pause] I told her that I hoped she could understand how I might feel that that certainty had been taken from me.

THERAPIST: Did she feel that in part because she doesn't feel she can ever-she'll ever go back to that period again?

CLIENT: No. I think she hopes she won't go back to that, but she's certainly not willing to say she won't. So I think that there's at least part of her that thinks she might. [long pause, 40 seconds]

THERAPIST: This is a really sort of tough question as I think about formulating it, but I think accurate in terms of what you might think. Do you think she wonders whether you might actually just want to be with someone who's not mired down by this level of mental health difficulties? That you might want a different kind of life than that? [36:15]

CLIENT: I don't know. [pause]

THERAPIST: Do you wonder that?

CLIENT: Do I wonder if I want to be-

THERAPIST: Do you wonder if you could have a different life with someone who is not mired by so much, you know-

CLIENT: No, I don'tNo. [pause] Isn't that description one of the two endpoints on the map of if I'm okay? Or I will be okay in one of these two ways? I feel like that's one of the two endpoints. So no, I don't wonder if that's possible. I mean, you sort of said these are the two endpoints. Yes, that's clearly true. Like that just rang true. So yeah.

THERAPIST: Well, I guess yes, and then you do-I meant wonder, meaning wonder in that sense, think about what that-

CLIENT: Oh I see, do I think about it. Yes. Yeah, absolutely.

THERAPIST: NotRight.

CLIENT: Not wonder if it's possible. No, I feel like it's very possible. [pause] With the sort of note that... you know, everyone has some issues. So it's not like... It's not particularly helpful to idealize that endpoint, in some sense. [38:00]

THERAPIST: Mm hm.

CLIENT: But yeah. [pause]

THERAPIST: But you don't knowAnd of course this is like we're not even talking about how Tanya thinks, we're actually talking about how you think Tanya thinks. Which actually is important, I'm not missing that distinction. And in part that's where my questions are coming from.

CLIENT: Sure.

THERAPIST: Not because I want to know how Tanya thinks, I want to know how you think about how Tanya thinks. But so you're not sure-

CLIENT: Which is probably easier to get at if you just ask me what Tanya thinks, but.

THERAPIST: It is. But I'm making that distinction.

CLIENT: Yeah, no, I appreciate that.

THERAPIST: I'm not just trying to get factual information about Tanya.

CLIENT: [laughs]

THERAPIST: I'm trying to get an understanding of how you understand Tanya, which I feel is an important distinction.

CLIENT: Yes.

THERAPIST: So do youSo you're not sure if she thinks about that. Or if she wonders about that for you.

CLIENT: So can you rephrase the whole question, only because the wonder part I got wrong in answering in answering it for myself, so.

THERAPIST: That you could or would want a life with someone who does not have this degree-this seriousness of mental health problems.

CLIENT: Do I think she thinks about that?

THERAPIST: Yes.

CLIENT: Okay. [pause] You know, so my sort of gut answer is no, but that seems a little bit absurd. So if forced to think about it I think it... Yeah, I don't know, I don't know. [pause] Yeah, forced to think about it, I guess I would expect that it has crossed her mind. [pause] Probably not, but... [pause] Well, again, she's said she felt very sure of things being okay with us, so... it can't be a large concern of hers I don't think.

THERAPIST: Yeah, I feel like... I don't know why I'm focusing on this in particular-I mean, it's obviously a big issue-but it seems like that's what's unspoken in your relationship. [41:00]

CLIENT: Hm.

THERAPIST: Because we're going to be okay is like as if you don't have other options. Or wonder about other options. Not even in the concrete, like maybe-you know. But like just in the-like in-yeah.

CLIENT: Hm.

THERAPIST: And if you feel that's not something she understands that would be I think a really important conversation to have, because maybe she doesn't. Or maybe there's a lot that she-you know, that you guys haven't talked about that you could talk about. Yeah. You're making assumptions she isn't thinking about things that she is thinking about, which is also helpful to know.

CLIENT: [pause] So I'm reluctant to have that conversation. [pause]

THERAPIST: Let me-actually, as you're saying that, let me back up for a minute. Because even as I'm thinking about it, it sounded more prescriptive or even a suggestion that I didn't mean it to be.

CLIENT: Okay.

THERAPIST: Maybe. I mean, you know, I guess in some ways it could happen. And should it happen? I don't know. But from just sort of the issue of like thinking about-that this is something that seems so obvious and yet is not articulated, and that's important somehow.

CLIENT: Yeah, well-

THERAPIST: Not that it should be articulated, but that it's not is interesting. [43:15]

CLIENT: Yeah, so I can tell you why I am unwilling to articulate it. And that is that particularly when it's bad she has said several times that she hasn't killed herself because she can't bear the thought of doing that to me. So... [pause] I don't think that's a particularly healthy dynamic, but... And I don't know whether I really believe that that's the thing that keeps her alive, or has kept her alive. But... [pause] I feel like the risk is very high in those moments, and taking away a thing that may have been helping is not something I want to do.

THERAPIST: Mm hm. Well, certainly. And even as I-let me-like because we're going to need to stop in a moment-

CLIENT: Okay.

THERAPIST: -I wanted to make very clear. Even as I've said, and I want to definitely backtrack, so it's not quite what I meant, I'm sort of formulating as I'm thinking. I do think it's more interesting that it's sort of-not that you guys don't openly talk about it, but that somehow it seems so obvious and yet is not-like it's sort of-

CLIENT: It's not even a piece of the conversation. [45:00]

THERAPIST: It's not a piece of it. And I'm not saying so make it a piece of it. And obviously there are certain practical reasons-well, practical, which go far beyond the practical why not-but that that's so unarticulated is just-is striking in a couple-I mean, there's sort of practical reasons why it's not, but there's something about that that I can't really put my finger on, I'm just-you know, I'm just sort of pointing it out as-sort of putting it on the table and sort of, "Well, I don't know what to do with that right now."

CLIENT: Okay.

THERAPIST: We do need to stop for today, but I will see you next week, okay?

CLIENT: Okay.

THERAPIST: Okay, take care.

CLIENT: Buh bye.

THERAPIST: Okay, buh bye.

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