TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: How are you?

CLIENT: I’m all right. I had a strange experience when I walked into the pizza restaurant. I wanted to get a coffee drink and I ended up buying these gift cards because you can use them like cash, so I was buying these gift cards, and for twenty-five dollars, I can get a free medium coffee. Okay. And I looked at him, “Oh well, I know you. You’re from, you lived across the hall from me for two years the last time I was living here.” Kind of bizarre because it’s kind of like, cool, I don’t know that many people here. I know like five, that are still here, so for that to happen was very jarring. [00:00:57]

Anyway, I’m all right. I’m just it seems that (pause) I don’t know. (pause) It just seems that I’ve been so busy that even my structured stuff has got to fall by the wayside. [00:01:59]

THERAPIST: Are you happy with what you’ve been busy with?

CLIENT: Yeah. I mean, this, I’m happy to get this stuff done. Again, it’s this website thing, but it just seems to me to be snowballing, just (inaudible at 00:02:22). I’m not really sure everything I’m putting up is accurate, but (inaudible at 00:02:29) is nowhere on it, so I mean—but I got a nice plug from the independent group in Europe plugged my site and (inaudible at 00:02:47), so you know, it’s getting some recognition.

THERAPIST: High praise.

CLIENT: Yeah. So but I’m also trying to figure out what, going from hardly ever working on it to working on it quite a bit, I’m trying to figure out what is the threshold for feeling like I’ve done enough each day? [00:03:18]

But yeah. Aside from that, I’m quite attuned to just how the docket balance, I should say. [00:04:03]

Feeling good about myself and falling into despair.

THERAPIST: Those are pretty wide gaps.

CLIENT: Yeah.

THERAPIST: Maybe I’m not.

CLIENT: Yeah. And well I don’t know. It just seems like it’s—I have to remember just how easy it is for the structure to fall apart without deliberate maintenance.

THERAPIST: Then does no structure equal despair?

CLIENT: It can, often does. And like if I, I went to Vermont this past week and that was fun, and didn’t get to go to the gym, and then on, Tuesday, let’s see. [00:05:07]

THERAPIST: It’s Friday.

CLIENT: I didn’t get to the gym at all this week, and that is something that I can’t help wonder, is this, am I putting so much on that if I don’t go, it’s so damaging to have it (inaudible at 00:05:39). So (pause) [00:06:13]

But I mean, sort of—

THERAPIST: I was just going to ask where you were, and where do you want to be?

CLIENT: I don’t know (inaudible at 00:06:39) despair, but (inaudible at 00:06:43). I don’t know why. [00:06:57]

But I just am, it’s all this terminal (inaudible at 00:07:17). I just don’t like feeling.

THERAPIST: What were you feeling? When you say despair about your marriage, what does that mean?

CLIENT: Well, like I’m lengthening something that’s stretched beyond its nature. [00:08:01]

I mean, I firmly believe that divorce is often a result of relationship failure, but the person’s relationship with themselves reflected or exacerbated through the marriage, but I see this is as my own issues with myself, but it just seems like I have a—really die hard and so despair is about whether or not I can either choose to be true to myself which is following those old habits that aren’t help, but aren’t healthy. [00:09:07]

Or choose who I actually want to be, choose the, choose to steer the course, not let my fears, anxieties and insecurities overtake how I’m going to live or how I’m going to feel about myself. But again, it just seems like such a slippery tightrope that’s about right, my insight I can just fall off.

THERAPIST: So what happened to the steered course this week? [00:09:55]

CLIENT: Well, on Tuesday, I told my wife I was going to the gym, then to the grocery store, and I went to a different massage spa to get a massage, then I went to the grocery store. And that kind of stuff really bothers me because part of it is if I’m willing to allow myself the first incident and not catastrophize it, was that just a little bit too easy that I was able to say, “Okay, I’m going to try a different one and see what happens there?” [00:11:08]

Nothing really happened there at this point, but I could tell, it was the same kind of feel, that they were just waiting for me to say, “Well why don’t we do this?” It was that kind of bizarre. But nonetheless, I didn’t tell my wife that I was going to do that, even though I had intentions of doing that, and—

THERAPIST: What stopped you from telling her?

CLIENT: I think it’s the fact that I don’t feel like my intentions are pure going to those places. [00:11:59]

That I am seeking something out that just might put me in a position where I might be compromised. And that really bothers me because on the one hand, I (inaudible at 00:12:17), and think about it and wonder you know, what would happen if I went back there? And I knew that I was doing the same thing after the first one.

THERAPIST: I wonder what it was that you were seeking in going to this new one? So you didn’t go back to the same place where you knew what might happen. You also didn’t go back to the place that’s tried and true and you knew what wouldn’t happen, so I wonder what it was? What were you really doing?

CLIENT: Well, I think I was trying to play the innocent. [00:13:01]

“Oh I didn’t know that was going to happen, oh, I was in the moment.” Because I think that’s what used to happen when I drank.

THERAPIST: To yourself?

CLIENT: Yeah.

THERAPIST: You were saying that to yourself?

CLIENT: It was something that I would say. That was my justification. But, you know, I mean, I don’t even feel comfortable telling you about this, honestly. It’s—

THERAPIST: What are you afraid of in telling me?

CLIENT: That I, that I seem to have this problem. Twice makes it a problem. And I, you know, it’s not like I’m, it’s not like I’m afraid to tell you about a problem, but I don’t know if I really want to admit that this is a problem. [00:14:03]

I can tell, and I guess I was thinking a couple days about this, you know, when I get hooked on something, I look forward to it. And the idea that, I don’t think I was ever on (inaudible at 00:14:20), but I think I was excited about the next time I was going to drink because I was in a state where things might happen.

THERAPIST: And the flirtation with that was exciting.

CLIENT: Yeah. And you know, I just, I’m putting myself in these places that apparently I want to be in, because I think about them. [00:15:01]

And dwell on them and yet, I know it’s not helpful ultimately, in the short term. So to say I’ve got an addictive personality, I don’t know, that’s just too easy, but it seems like, and I’m also, I heed what you’re saying about what is it that is fulfilling, what is satisfying about this, and I try to think about, you know, what would happen if my wife were to (inaudible at 00:15:59) [00:16:02]

That just doesn’t excite me. I don’t know why.

THERAPIST: It doesn’t have that sort of illicit thrill in the same way that a fantasy about me does, or one of these massage places. You know, I think part of what feels exciting about it is that it’s somewhat illicit.

CLIENT: Yeah, yeah.

THERAPIST: Drinking may have felt the same way, or what could happen when you were drinking.

CLIENT: Yeah. I mean, it’s the same excitement I get before I come to see you as I go. (inaudible at 00:17:05) [00:17:05]

And steal glances at her, things like that, and get my body worked over, you know, in so many ways. I get to go drinking and I get to let loose and not have to be responsible for my actions, not to be responsible for ogling you because it’s natural. It’s what’s to be expected. And yet, I don’t know if the solution is to just say, “Okay, I’m going to deny alcohol and not touch it.” That seems to have taken care of that outlet. [00:18:09]

THERAPIST: But the rush that you seek or the freedom from responsibility that you seek or, you know, the excitement that you’re seeking, that doesn’t go away, the need for those things.

CLIENT: Exactly.

THERAPIST: Just got placed onto something else.

CLIENT: Yeah. So that’s what I have.

THERAPIST: So the need for something exciting and thrilling, that’s totally normal and not harmful in any way. [00:18:59]

But seeking it through things that make you feel guilty later or ashamed, that, and that’s the harmful piece is the fact that the momentary satisfaction is met with a much longer lingering feeling of guilt and shame.

CLIENT: That’s true. It seems like those desires of illicit (inaudible at 00:19:59) [00:19:59]

Seem to be amplified when my idea of what it means to take care of myself is not happening.

THERAPIST: That’s a different way of taking care of yourself, I guess, so you have lots of different needs for self-care. When you let the other ones go unfulfilled, that one kind of gets bigger.

CLIENT: Yeah. And self-legitimates and kind of blocks out the idea of the other ones that aren’t being met. [00:20:58]

THERAPIST: Is there anything that feels thrilling or good in the same way that’s not illicit?

CLIENT: I don’t know. I don’t walk into the gym like I walk into the massage places. I mean, it’s like, this is going to suck, yeah. [00:22:00]

I mean, I think that’s the same for everybody. Well, maybe not, but so—

THERAPIST: You walk into the gym thinking it’s going to suck?

CLIENT: Yeah, oh yeah. You don’t?

THERAPIST: No. I think maybe we should find a form of exercise that you enjoy more. It’s hard, and you know, I say that honestly because the exercise is obviously good for you, right? We know that it’s good for anxiety, we know that it’s good for fighting depression, it’s like good cardiovascular, even though it has a lot of good things. But if you honestly go in there thinking it’s going to suck and you hate it, it’s really hard to keep that up. And so, not that you should never, ever go to the gym again, sometimes it might be the only way, but if there’s other ways, and the thing that works about exercise is not that it happens in a gym. The things that works about exercise in all those ways is that you get an elevated heart rate for twenty minutes or more and like all those good things happen. [00:23:05]

So maybe you’ll define avenues that are easier to sustain that give you some of the same benefit.

CLIENT: You think so?

THERAPIST: I hope so.

CLIENT: Well this is the way it’s always been for me.

THERAPIST: Like snowshoeing, bike riding.

CLIENT: Yeah, sure. I don’t know. I mean—

THERAPIST: Ice skating?

CLIENT: Yeah, I’ll have to think about it. [00:23:59]

But to answer your question, the illicit tools are hard to match as far as I can tell, as far as I can (inaudible at 00:24:20).

THERAPIST: What’s your earliest memory of enjoying something that felt illicit?

CLIENT: It was, I have a lot of early memories, but it was when I was with my sister and I was like twelve, eleven or twelve years old. That was a thrill.

THERAPIST: When did it feel bad? When did the thrill of what happened with your sister turn negative? [00:25:01]

CLIENT: Probably when my dad, when she ran away accused my dad of sexual abuse.

THERAPIST: What was that time like?

CLIENT: Maybe months.

THERAPIST: It feels like a really long time in the life of a twelve-year-old.

CLIENT: Yeah. Yeah, you know, (inaudible at 00:25:40), but I guess I’m not sure why you’re asking.

THERAPIST: Well I think those first connections of strong feeling are pretty ingrained. I mean, our emotional responses, that thrill is an instinctual response. [00:26:12]

It’s a pretty deep-seated response, and so the first times of having those kinds of responses to a situation become pretty ingrained, so you know, what you’re going to have your strongest responses to are going to be things that mimic that in some way.

CLIENT: Great.

THERAPIST: Not immutable, but it does form a basis, for, you know, what you’re going to respond to.

CLIENT: Yeah, so someone else might be like a first reaction is playing with fire.

THERAPIST: Yeah, and that was a really thrilling, watching fire come to life and having a really kind of thrilling moment with that could be, yeah, it could be. And then you have your choice between becoming a pyromaniac or to become a firefighter. [00:27:16]

Or, you know, some sort of chemist that makes fabulous things using heat and flame, who knows. So you know, it’s not that having had that experience and a strong physical response to it does not set you on one path and you have no choice about it, but I think it is important to be aware of what informs your reactions to things and then like you said, then you steer the ship. But if you’re trying to steer the ship in a way that has absolutely nothing to do with what you naturally respond to, it’s going to be a lot harder to continually follow a course that feels kind of meaningless to you. [00:27:58]

Now can you force yourself to go to the gym and work out? Yes, if it feels like drudgery every single time, how many times are you really going to do that? How long are you going to sustain that?

CLIENT: It’s been two months almost, now.

THERAPIST: But imagine if you found something that actually corresponded better.

CLIENT: That I can do.

THERAPIST: Like becoming a race car driver. You might get a thrill from that.

CLIENT: Oh my God. I feel like I already am one, driving around Providence.

THERAPIST: Spoken like a true Midwesterner.

CLIENT: I know, these people are crazy.

THERAPIST: Oh, so they say.

CLIENT: I don’t know, you know, it’s hard to say. Perhaps, so what you’re saying is that the need for the thrill likely won’t go away, but the thrill, how it’s met, can be, you know, modified. [00:29:08]

THERAPIST: Yeah, I think that yes, we can find, I would like to think that we could find a way to feel that thrill in a way that is more adaptive for you. So I guess, yeah. I’m not going to say modify what gets you that response, but find the thing that feels acceptable to you that gets that response.

CLIENT: Okay. Is that, I have nowhere to start. I don’t even know where to start.

THERAPIST: Well what else, what else has bordered on feeling good like that, that didn’t also feel shaming at the same time?

CLIENT: That’s a tough one. It is hard for me to think of one where I was not also very scared. Sailing, for example. Thrilling, but also some anxiety that I have.

THERAPIST: Anxiety, but was there shame?

CLIENT: No.

THERAPIST: Or guilt? [00:31:08]

CLIENT: No.

THERAPIST: So anxiety’s okay.

CLIENT: Well, it’s not saying this is going to suck, but it is, “Oh my God, I’m going to fall off the boat.”

THERAPIST: Right, yes. Well that’s part of what the thrill is, right? That there’s some danger there that, and there’s a different finding the boundary of what level of danger is acceptable, right? You know, that differs for people, you know? Some people free climb, other people would never do that. The different level of accepting, you know, how much risk are you willing to accept here?

But there’s a difference between, I think, the kind of straightforward risk and then that sort of tantalizing sexual risk where the risk is, “I hope I don’t get found out.” That’s different than “I hope I don’t fall off the boat,” because there’s not the shame. Falling off the boat, and, you know, maybe drowning, there’s no shame in that. There’s a lot of fear. [00:32:07]

CLIENT: You can’t be shameful when you’re dead.

THERAPIST: But there’s not that fear of what will people think, people will think I’m a horrible person. That’s shaming, and I think carrying around shame is damaging to you. You know, fear for your physical safety, it’s actually that’s a survival instinct. That’s not bad for you.

CLIENT: Yeah. So is a common narrative, for lack of a better word, among people who do not look for those sorts of things to resort to affairs and whatever? [00:33:00]

THERAPIST: I don’t know, to be honest. I don’t know that there’s a sort of gathered research on who does what why. You know, I think there’s lots of reasons that people end up having affairs, you know, thinking about what your narrative is and what would make sense in your story, you know, it seems like that’s what you’re afraid of, that you know, if you didn’t curtail this somehow, is that where it would go? [00:34:01]

You know, if you look at it in a broader sense, that’s probably true. You know, people who are dissatisfied in some way seek satisfaction in lots of ways and one of them might be an affair.

CLIENT: I was tired when I came in. This is just draining. Not raining, draining.

THERAPIST: Draining.

CLIENT: Yes. [00:35:05]

THERAPIST: What is it that, what do you think feels so draining about it?

CLIENT: Processing it, or considering the different alternatives, fighting the urges or the tendencies to resort to what I think is just me. It’s hard to resist those thoughts.

THERAPIST: What if you thought of yourself as a thrill-seeker instead of as someone who, I don’t know how you think of yourself, actually. [00:36:00]

Whether, what is the label that you’re using?

CLIENT: Creep.

THERAPIST: Ah, so thrill-seeker seems better.

CLIENT: Yeah. It is an interpretation. I’ve just never thought of myself as the type to skydive or whatever.

THERAPIST: Have you tried it?

CLIENT: No. I didn’t.

THERAPIST: Not that particular one?

CLIENT: Skydiving? (inaudible at 00:36:49).

THERAPIST: I’m going to not say.

CLIENT: Really? Bungee jumping? For the record, it is bungee jumping. Are you crazy? Wow. Where?

THERAPIST: You didn’t even answer the question, Bryce.

CLIENT: That’s all right. Where was it? I mean, was it like over a river?

THERAPIST: Amazing the fantasies that you’re actually fulfilling right now, without me giving any information. I’m not going to answer your questions, and I’ll tell you why. Because if I were to give you a list of things I’ve done or not done, then it gives value to some things versus other things or it gives you comparisons to make, and I don’t want you to do that. I want you to find your path.

CLIENT: Sure. No, understood. I don’t know that I would necessarily honor bungee jumping or dishonor it.

THERAPIST: But I don’t want to give you the impression that I’m voting for you to do certain things or not other.

CLIENT: Yes, yes, yes. I mean, I think it’s got to be something that I feel comfortable doing.

THERAPIST: Yeah.

CLIENT: And as much as I like you, I don’t run out and say, “This is what Dr. Keller (inaudible at 00:38:10). [00:38:10]

But—

THERAPIST: And what might get, I guess what I really want you to do is sort of find, is there something that would feel good to you after that might also give you that same sense? And it doesn’t necessarily need to be something that’s physically dangerous. You know, some people get a thrill from learning how to cook something new, and we need to figure out what feels good for you both in the moment and after, what’s going to satisfy that need to have that feeling of like, “Oh, I can’t believe I’m doing this.” [00:38:59]

Without, “I can’t believe I just did that.”

CLIENT: Yeah. So if I felt as though my inability, I know it’s an inability because I’ve demonstrated it for years, decades. If my inability to adhere to structure, to alerts that are from all those things actually denies me the satisfaction that those things normally hold [00:40:02]

What would you recommend?

THERAPIST: Motivation. We only really do things when we are sufficiently motivated to do them, and we are much better motivated by some sort of positive reinforcement, getting something good, because we’ve done something, than anything else.

And for whatever reason, even though we have tons of research to show that people do things, other beings do things because they get something good they want from it, so somehow we continually try to motivate ourselves to do things by chastising ourselves, which is negative reinforcement, taking away something good, right? I’m going to deny myself this thing because I didn’t do whatever I was supposed to do. It doesn’t work as well. If you really want yourself to do something, you give yourself a nice reward when you’re done. [00:41:03]

And not yelling at yourself when you do something that you don’t like or fail to do something.

CLIENT: Yeah, I’ve done lots of that.

THERAPIST: It doesn’t work. Prison time. It doesn’t work, right? This is what we do. We do something we don’t like, we put you in prison. How often do those people end up back there? It doesn’t teach. It doesn’t motivate positive behavior.

CLIENT: Yeah.

THERAPIST: It’s like feeling guilty after doesn’t stop you from doing something you didn’t want to do, because that sort of punishment, or negative reinforcement in its truest sense, doesn’t work. [00:41:58]

CLIENT: Yeah, I see that clearly after this. I know we have to end soon, but I’m just feeling like the idea that I can go through my day, any day, without seeking the approval, the validation, of someone who’s approval or validation really doesn’t matter to me [00:43:11]

It’s like on the train yesterday, I saw this beautiful woman, and it was, I was determined to have her notice me. I kept looking. I kept looking, but you know, and throughout, I thought to myself, “Why is this person me? Does it mean something if somebody who I think is attractive thinks I’m attractive? Does it mean something to me? Why does it mean something to me? Is it really going to, you know, sustain me until the next beautiful woman I see? Is Dr. Lowry’s approval of me going to help me become a better patient, a better human being, whatever?” [00:44:15]

A different human being, healthier human being? I mean, it’s really hard for me to believe that is it going to be the story of my life? That is frustrating. I mean, as much as I enjoy those thrills, it’s also frustrating that I seem to be addicted to them.

THERAPIST: You feel a lot more self-sufficient if your own sense of self meant so much.

CLIENT: Yeah. If my own achievements, my own whatever have the weight that those of the glances to, should those glances even happen? [00:45:17]

You know, that’s—

THERAPIST: And when they don’t, that leaves you right now feeling very lacking, because your own sense of “I’m good just as I am,” just isn’t there.

CLIENT: No, and what I’m not entirely sure about is what do I need to have in my life in order to say, is it the job? Is it going to do physical activity three or four times a week? Is it losing weight? Is it finishing a song, is it doing this stupid website? It’s not stupid, it’s really important, but it’s going into retirement, but so what is it that I need in my life for me to say yes, and tomorrow I’m going to measure my achievements by the achievements I made yesterday. [00:46:20]

Not against somebody else or tomorrow I’m going to focus on what’s going on inside of me and not what’s going on inside of this office or train or whatever. No, I don’t.

THERAPIST: Just as something to think about, the difference between the external stuff, job, website, how often you work out, weight, job title, whatever, and your value as a human being.

CLIENT: Oh, don’t get me wrong. I’m sorry, I should actually clarify that. [00:47:02]

What do I need in my life as a means of sustaining positive attitudes, not so much I’ve got a job, but what the job gives me, in terms of you know, production or whatever. Does that?

THERAPIST: It does, except I still feel that the positive self-regard is more stable when it comes from what you are, you know, the phrase human being versus human doing, so the human being is like that’s your value as a human, as a human, I don’t want to say being again, but I guess human person versus all the things that a human being does in getting their worth based on what you do. [00:48:04]

You want your internal sense of confidence to be mostly, you know, I think it’s hard to say totally based, but mostly based on just who you are as a person, not what, not all those things that your person can do. You’re trying to build confidence from the outside in?

CLIENT: No, I guess what I mean is, like the job, for example, does it give me the structure I need to be the person that I am as opposed to absence of which allows me large amounts of free time in which I—

THERAPIST: You have to make a whole lot more choices.

CLIENT: Yeah. I mean, so those things that are, what do I need in my life to basically distract me, for lack of a better word? But I know what you’re saying, and I struggle with being as I am. What is, you know, not those things that make me something, but the person that I am.

THERAPIST: Yeah, but when you think of yourself as a creep, it’s hard to feel good about that.

CLIENT: Yeah. (inaudible at 00:49:29)

THERAPIST: We want to start to change that, change the way you think of yourself so you can feel differently so you can go do different things.

CLIENT: Yeah, yeah. It’s just hard when someone thinks getting up on the same time and not feeling like I’m being a very good husband, not feeling like I’m being a very good this, or friend, or whatever. [00:50:11]

So what, then, is the person that I am being, what is that? Is it something to not really feel good about, you know? I know we’ve got to stop, but do you have a pen?

THERAPIST: Of course.

CLIENT: Thank you.

THERAPIST: You’re welcome.

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