TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Hello.

CLIENT: Hello. I was just doing something out there, just thinking about various things, today being the birthday it’s the, kind of look at it New Year’s almost, what have I done in the last few, what have I failed to do, what am I going to do in the coming year that as much as I, because it’s funny, the expectation of having done significant things when you didn’t set out to so they weren’t the things that you set out to do. [00:01:05]

I didn’t set out to do a radio documentation (inaudible at 00:01:11), but it happened. Insignificant, sure, but I think the, I mean it’s funny. I understand how it’s hard to live up to things you don’t lay out, but I also see that there’s a value in the things that I didn’t do. I didn’t drink, and it’s been four years now of sobriety. And though I think the, my fear is that I’ve traded in one access, one delivery mechanism for addiction for another.

THERAPIST: Do you feel like you were addicted to alcohol? [00:02:02]

CLIENT: No, no, but I mean, delivery to the addiction to—

THERAPIST: The thrill-seeking type—

CLIENT: Yeah, the attraction to women’s attention. And not, so that’s what I mean, it’s like with not drinking, it’s not much of a challenge because it’s not-

THERAPIST: But not seeking that thrill of attention would be quite a challenge, and the alcohol is just a way to get that.

CLIENT: Yeah, and now is it going to be a massage, for example, or you know, I’m going to see you, for example, or people on the street, bus, whatever. So I know that, you know, the things that you and I have talked about not denying those things, but trying to find other ways to fulfill them or trying to fill up time and space with things that don’t make me feel bad. [00:03:14]

And I understand that in theory, I do. But I think, I mean I know that I don’t want to live that way, it’s clear to me, but I think it’s hard at times to consistently fill up my time with things that are helpful, things that are healthy, things that don’t make me feel bad. [00:04:04]

When, like today is the day I feel good about who I am and my prospects. Yesterday wasn’t a good day.

THERAPIST: And what’s the difference between yesterday and today?

CLIENT: I don’t know.

THERAPIST: So that just feels innate, like the way you felt yesterday and the way you feel today, there doesn’t seem to be a thing that happened.

CLIENT: Well, yesterday I went out for errands fully intending on trying to get a massage someplace. Now granted, my lower back has been really hurting me lately, and so trying to get some relief with that has been legitimate. [00:05:02]

CLIENT: Whether I go to the gym on Wednesday and exercise and stretch a lot or trying to find some other type, Tylenol, I can’t take ibuprofen, things like that. Yesterday I wanted to get some sort of treatment for it, so I went to one place, and this woman walked on my back, and it felt good. It was a half an hour. I didn’t want to go for an hour because I didn’t want it to be a flip-over, let’s say. And I left there, I felt pretty good. There was another place a few blocks away, I went and tried this other place for a half hour. I go there, it wasn’t a flip-over type thing. When I, when the woman left the room, I masturbated. [00:06:03]

And that, to me, seemed better than the previous time when it was assisted, not assisted, chaperoned. So, you know, it’s the allure of the thrill of the unknown that gets my heart racing.

THERAPIST: So you said it felt better than the previous incident, but did it, what did it, what was it, can you be more, you felt better, but what did you actually feel? Were you okay with that, does that feel somewhat illicit but not quite as illicit as previous, what (inaudible at 00:06:53)

CLIENT: No, I was okay with it.

THERAPIST: You were okay with it.

CLIENT: I was by myself, and I was not being touched in other ways that were, that would have naturally led to that, even though it does, can get me excited. There wasn’t any of that. [00:07:10]

And I don’t know, I just, there’s a switch that goes off after I’ve ejaculated where it’s like, okay, I’m, I mean, those, that need for thrill and sex is now off. I can go about my day whatever I’m trying to do, supposed to do (inaudible at 00:07:53), and so maybe it’s because I—

THERAPIST: Does that feel different than if you were to have sex with your wife, because obviously, there’s a huge chemical component to having orgasm, where there’s, you know, lots of endorphins and chemical reactions that there’s definitely a switch that goes off. Does the switch feel different for you if it’s, you know, having sex with your wife or something like this?

CLIENT: I usually don’t ejaculate when I have sex with my wife. She does, and then for me, it’s just difficult because she’s just really relaxed, and so then I end up usually masturbating then. So I don’t know, there’s something about having sex with my wife which is not, it’s not entirely satisfying because I don’t, I usually know what’s going to happen. [00:09:14]

It’s not good enough.

THERAPIST: There’s not the unknown thrill. Has that been a longstanding pattern?

CLIENT: Yeah. Yeah, it used to be that she was having issues with her medication (inaudible at 00:09:39), whatever, it’s, it would be hard for her to want to have sex, and when she did, she usually (inaudible at 00:09:47) she was waiting for me to be done and so now I feel like there’s at least some understanding about what I’m going through. [00:09:59]

That doesn’t make it any easier for her.

THERAPIST: No, but it sounds like I mean, it’s not really that you’re having difficulty achieving erection or ejaculating, it’s, there does seem to be something in the interaction because it’s not sort of a medication issue.

CLIENT: Yeah, although my, yeah, so I have a hard time figuring out is it that I’m not interested in sex with her, I think that might be it, which is, it’s painful because I’m not being entirely straight with her if I’m, I mean, I can, you know, when I masturbate after having sex with her, it’s next to her, so she knows that I can do that. She knows why I can’t, you know, ejaculating having sex, because it’s you know, she’s just too relaxed. [00:11:05]

And if you get my meaning, but so I mean, the machinery works, but it’s just like I’m not necessarily drawn to that as being, “Oh, this is going to be great because who knows what’s going to happen.” I know what’s going to happen, you know. I know what’s going to happen.

THERAPIST: And it doesn’t feel all that enticing.

CLIENT: Exactly. And I’m sure all sorts of married couples have this issue, you’ll hear.

THERAPIST: When was it different for you with her? [00:12:00]

CLIENT: At least three or four years, but I can’t.

THERAPIST: But given the length of time you’ve been together, that means for lots of years it was very different, right? You’ve been together a long time.

CLIENT: Yeah, yeah.

THERAPIST: That history is just as important as the more recent history.

CLIENT: Yeah. Well, the problem, I think, is that when she was going through her own issues, it wasn’t that it was all that satisfying for me, knowing that it just seemed like I was the one being satisfied.

THERAPIST: Right. Yeah, it feels different to have a sexual partner that’s really interested, engaged, versus having a sexual partner who’s doing, willing to accommodate. It doesn’t feel the same.

CLIENT: Yeah, yeah.

THERAPIST: Physically, emotionally. [00:13:02]

CLIENT: Yeah, and being the one who seems to be the one who’s just kind of accommodating right now is not satisfying, it’s not thrilling, it’s not, and you also feel like you’re letting them down because you’re not doing it maybe as often as they want, and b, when you are doing it, it seems like charity, perhaps. So I don’t know, maybe that’s why these other escapades seem so exciting. But you know yesterday, I Googled, because the Internet is so useful for things like this. [00:14:05]

Addiction to massage, and what it led to was so many discussions about people who go to massage places that are, you know, explicitly, we talked about this, (inaudible at 00:14:21), but this is like places that, where people go every day, or more than once in a day, and they’re getting hand jobs at the end of every one, which is very different than what I was experiencing, so it’s hard to understand where I fit into that spectrum of addiction. Nonetheless, it’s, I don’t know what, I don’t know what to do. [00:15:11]

Because I don’t know how to suggest to my wife that, “Let’s try something different, because this is obviously boring,” you know. How do you say that in so many words. Maybe she’s bored too. But, you know, she’s getting apparently what she wants out of it.

THERAPIST: Well do you know that?

CLIENT: No.

THERAPIST: So I think it is perfectly appropriate to have a conversation with her, and say like, “Listen, it’s not exactly what I want. What do you want? How do we make this something that is maybe more mutually satisfying for both of us?” [00:15:57]

THERAPIST: Find out how happy she is with the status quo. It’s okay for you not to be happy with the status quo. What feels worse for you is not being happy with the status quo and figuring out how to make yourself happy, just sort of by circumventing her in the process, because there’s clearly a sense of guilt around not being able to be straightforward with her, and maybe there are some things that you can be more straightforward with her about, without that causing really undue burden or stress or disappointment.

CLIENT: Yeah, I mean, and I don’t, I don’t mean to become too graphic or—

THERAPIST: You can be open. [00:17:02]

CLIENT: You know, she knows there’s a certain position that I like, but she does not want to do it because she feels it is degrading to women, that it’s uncomfortable, and that those two things should be enough for me to not want to do it. I understand that. It doesn’t mean that I don’t want to do it.

THERAPIST: Right.

CLIENT: And it’s (inaudible at 00:17:38) you know illegal, I mean, it’s just, you know, but—

THERAPIST: But it’s not comfortable for her, on two levels.

CLIENT: Yeah. And so I don’t, you know, I don’t pursue it, obviously. [00:18:00]

So—

THERAPIST: And so then the conversation becomes about, I mean, are there other things that aren’t sort of beyond her boundaries that would be more satisfying than what’s happening now? Right? So there are certain things that she said are, you know, everyone has their limits in what feels comfortable and what doesn’t feel comfortable, and you want to be respectful, obviously, but that doesn’t mean that there’s maybe not room for something else than what’s happening now that might meet those needs more closely or at least be different because you’re experimenting with something new or something that’s not part of the sort of, you know, typical fare right now. [00:19:03]

And I wonder if she would be open to sort of having those kinds of conversations with you and maybe exploring a little bit like what’s something different that we haven’t done that might be okay? (pause) [00:20:00]

(pause continues)

CLIENT: The other thing I was trying to figure out is, you know, how do, how do I, how do we, (inaudible at 00:20:40), how do we find, you know, and this doesn’t even need to be sexual, find things that provide the thrill of the unknown, and I don’t know how we can do that. [00:21:04]

But—

THERAPIST: When was the last time you guys explored something new together? Or sought out a new experience?

CLIENT: Well we went out to Provincetown last week.

THERAPIST: Okay. How was that?

CLIENT: It was good, except for all the other tourists, you had to walk three, four aside down the narrow sidewalks which was infuriating, but—

THERAPIST: But were you infuriated together?

CLIENT: Yes.

THERAPIST: That’s a bonding moment.

CLIENT: Yes.

THERAPIST: Did you enjoy being with her?

CLIENT: Yes, I did. [00:22:00]

Yeah, I mean, there are those things. I understand they, how they can be appealing, but those things, for both (inaudible at 00:22:21) just myself, are hard to compete with the heart rates and thrills that I get when I’m in here or when I’m on my stomach, you know. And I’m just not sure what the best way forward is. [00:23:09]

THERAPIST: Do you ever have the heart-racing feelings with her?

CLIENT: No. And I don’t know that I would expect to at this point in the relationship. That’s not to say that it’s not worth having or anything like that.

THERAPIST: Well, that’s not new. [00:24:00]

CLIENT: Yeah. It isn’t, and it can’t be expected to hold the same appeal as it did seventeen years ago or whatever.

THERAPIST: But you, but I think you can expect to feel fulfilled, so maybe the question to explore is whether or not, can you feel fulfilled without that in a relationship or do you need to find a way to experience that alongside her if not triggered by her, right? So sort of that, the newness and that sort of titillation of not knowing is something that comes with new experiences, and she’s not new to you, but you guys could seek out new things together so that you can experience that feeling with her, if you need that. [00:25:03]

Maybe you don’t need, necessarily need to have that in your relationship with her.

CLIENT: Doesn’t every couple need that?

THERAPIST: I don’t know. I think you need, you need to feel satisfied. What you need to feel satisfied might not be the same in every, for everybody.

CLIENT: I understand that and, you know, I do imagine that as being part of my present, in the present, or in the future, and long-term future, and that is part of how I imagine things moving forward. [00:25:56]

But, and I guess, I just wonder to what extent the thrill provides. I mean obviously, the thrill is, does not offset the damage, the feeling of badness.

THERAPIST: Not the way you’re getting fulfilled now.

CLIENT: Exactly, and I have to think where I’m going with this. [00:26:53]

I guess I just don’t know if, how the desire for these particular needs or desire for these feelings is related to my own feeling of deficiency, you know, or my history, all those things, baggage. I mean, I know that the desire to feel these things is a well-worn groove. Alcohol is for someone else, this is for me, and you know, the shot in the bar for someone else might be, you know, a lingering glance from some stranger on a bus. [00:28:02]

And I get that that’s not in and of itself, a bad thing, but I’m not sure I understand how to categorize it or balance it with the other parts of my life.

THERAPIST: Because of what tends to give you that sensation of excitement, because it tends to be something, you know, an interaction with a woman, and sexualized, it feels like it interferes in a way that, you know, some other behavior might not, because it’s relationship-based.

CLIENT: Yeah, yeah. And would I want my wife to know this was happening? Certainly not. [00:29:01]

And I think that’s probably.

THERAPIST: I think that’s the biggest piece that gets in the way for you.

CLIENT: Yeah, I mean, if I were single, I think there’d be a different thing altogether.

THERAPIST: Yeah, you wouldn’t feel guilty, but you feel like a betrayal.

CLIENT: Exactly.

THERAPIST: Having your needs met when you feel like it’s somehow a betrayal to someone else.

CLIENT: Yeah.

THERAPIST: And the way it stands now, it does. It feels like it’s in competition.

CLIENT: Yeah. So, this might seem like a really basic question, but what, I mean, I understand I can’t just shut that off and say, “I’m not going to look at other people.” [00:29:59]

And I know on a day like today when I’m feeling good more or less, I can look at somebody and say, “They’re an attractive person.” That’s great.

THERAPIST: And not say anything back.

c / Yeah. And that’s when certain needs are being met. I’m feeling good about myself. But I went to the gym for an hour on Wednesday, and I woke up yesterday and played guitar for half an hour, so some of those things were being met, and yet there I went. [00:31:04]

And granted, you know, my, I feel like my motives were driven by my lower back which is poorly regarded right now, but would I have told Julie that I was going to do that?

THERAPIST: You wouldn’t have told her that you were going to get a massage or you wouldn’t have told her that you masturbated after?

CLIENT: Either. Certainly not the latter.

THERAPIST: Why not the first? [00:32:05]

CLIENT: Well, when we were living in Harvard, last time we were here, it was right then that this massage place that was being shut down because of illicit activities and sex, basically. And so she remembers that, and when I told her that I was going to this place that was down the street, you know, and try it out, she’s like, “Well, what kind of place is it?” So I know she’s suspicious of places, and I understand.

THERAPIST: Suspicious of places or suspicious of you?

CLIENT: Of places, I think, and I don’t know if I can say, “Well whenever I get a lower back problem then I get a massage.” [00:33:04]

THERAPIST: If you were going to the PT and getting a massage, would that be different?

CLIENT: I think so, and I think it would also be different if—

THERAPIST: Would that hold an allure for you? Like would you, if it could be replaced or is there something—

CLIENT: I don’t know. I mean, I don’t know.

THERAPIST: It would take the thrill out of it.

CLIENT: It might, it might not. I mean, I think it depends on who’s doing it. If you were doing it, it probably would make it thrilling. If it were some colleague next door, it probably wouldn’t. Nothing against him. [00:33:59]

But, you know, that’s, I think, the attention, the touch. Those things are, and you know, I’ve actually even thought about that, that need, and if it could be met at home, and I’m not convinced that it could be.

THERAPIST: What makes you doubt that?

CLIENT: Well my wife doesn’t like massage at all, and when I talk about massage with her, the fact that she doesn’t like it suggests that she probably doesn’t know how to, how it might be enjoyed. But who knows? I don’t know. [00:34:59]

(pause)

CLIENT: So I think, you know, those days when I said, “You know, I’m going to go down to the place that I trust and get a massage because my lower back’s—”. “Okay.” When I do that, when I tell her where I’m going and she knows what I’m doing, I can enjoy myself, I don’t feel like I’m sneaking around. [00:36:09]

I don’t feel like I have to, you know, prepare a story about where I’m going, what I’ve been doing, but I think it’s not just a matter of telling her that I’m going to the place down the street versus not telling her that I’m going to one of those places on Yelp, I’m just not entirely convinced that my selection process is entirely true. [00:36:58]

THERAPIST: Yeah, because it does, it sounds like there’s a little bit of questioning sort of what if, what might happen? And so part of yourself wants to leave that wiggle room, and it’s, and you’re not always going to the place you trust down the street, or you know exactly what you’re getting. It’s almost that part of you wants, there are times when there’s a piece of you that wants to seek out what might happen if there was a little gray area.

CLIENT: Absolutely. Very well said. And that’s, to me, what’s I think, bothers me.

THERAPIST: Yeah, because you’re not sure you want your intentions to be pure.

CLIENT: Especially when I know how I’m feeling that day, and what I’m seeking out. I’m seeking out—

THERAPIST: Right, and you don’t think you can get that from her, right, so if you’re having a day where you felt a little down about yourself, it’s something, you’re not sure you really, that she ever could give you that thrill and help feel, help you to feel like you’re kind of being built back up? [00:38:17]

Or if you want her for that role, even if she could?

CLIENT: Yeah. Yeah, I hadn’t thought it would matter, but right now it’s the (inaudible at 00:38:36) think it’s the profession.

THERAPIST: (inaudible at 00:38:57)?

CLIENT: (inaudible at 00:39.00).

THERAPIST: How come? [00:39:01]

CLIENT: I don’t know. Here or there, and it’s a well-worn path.

THERAPIST: And I wonder why you chose it right then? Right after you sort of, well right after I posed those two choices of whether it could be fulfilled by her or whether you want it to be? That’s when you went away.

CLIENT: Yeah. I mean, I don’t know that it’s, I don’t, not being an expert in marriage.

THERAPIST: Nobody is. [00:39:58]

CLIENT: I’m not, I don’t know how people, you know, you hear all the time about accessories and toys and things that make those things more exciting as a means of, you know, supplanting the boredom or whatever, so yeah. I get it that this is not something unique in a marriage, but, and this is also not necessarily just my responsibility. I understand that too. You know, she’s getting her needs satisfied as far as I can tell, when it happens, but how far is she willing to go to let my needs be satisfied? [00:41:01]

Does she even know what my needs are?

THERAPIST: How true. These are really good questions and conversations to have. How else would you know? How open are you guys to talking about that stuff?

CLIENT: Not very. I think it’s, you know, I think in the past when she’s wanted to address it with me, I felt that okay, she’s not happy with it, I’m doing something wrong, I feel bad. Can (inaudible at 00:41:36) for just a second?

THERAPIST: What’s going on?

CLIENT: It looks like not really, you’re fine, actually fine, sorry, just you had like a depression.

THERAPIST: Oh, I thought you were (inaudible at 00:41:59) my hair.

CLIENT: On the other side, but anyway. [00:42:01]

You’re fine. And so I felt yeah, that this is a problem, I get sensitive, I get defensive. You know, but that was a long time ago, and that was when I was reaching climax and she was not and this was also the time when she was on the pills and so on and so forth. You know, not enough foreplay and things like that. And these days, there’s hardly any foreplay and it’s not like I’m the one who’s cutting it off.

THERAPIST: Right.

CLIENT: And so I mean, it would be ridiculous for either of us, but especially her, to admit that there’s, or to deny that there’s not a problem. [00:43:00]

THERAPIST: I think first you need to decide whether or not you really want to address it in the relationship. It does seem like there’s a problem. There’s clearly a problem. You’re not feeling satisfied and you’re seeking some sort of sexual satisfaction out of the relationship, which was not part of your agreement with her. So that’s an issue. Deciding if you want to address the issue in the relationship means you have to actually talk about it with her. It doesn’t mean you need to be ready to have full disclosure about everything that you’re missing and everything that has been, you know, that you’ve been seeking out, but nothing’s going to change in the relationship unless you guys start talking about it and getting past that barrier of being able to say, well, like, “I’m not totally happy. Can we start talking about ways to explore other stuff so that we can both be happy in each other?” That’s, nothing in a relationship changes unless you actually talk about them. [00:44:04]

And it sounds like some of the stuff might be independent of her and just, you know, stuff that you’re working out and is related to earlier experiences in your life, but that’s not, that’s not all of it. You know, it’s not all happening in a vacuum.

CLIENT: Yeah. That’s a conversation I’m not exactly ready to have.

THERAPIST: I can understand that.

CLIENT: I’m not going to tell her about how I’m meeting those other things. [00:44:57]

THERAPIST: But that doesn’t preclude you from her, from telling her that you’d be maybe interested in trying something new.

CLIENT: You’re absolutely right. I think that’s where, presenting that in and of itself should be enough as a start of a conversation. But you know, as I said at the beginning, this thing, this new year, and lately I’ve been thinking just about the amount of power, influence, control I have over my life, and it appears I have some influence to live the way I want to live. [00:45:59]

And as I was leaving that first place yesterday, the first massage place, and I was putting on my shoes and I said to myself, in a very loud voice, “Why do you want to go someplace where it could possibly make you feel really bad? Why do you want to do that? Why don’t you just go home? Why don’t you just, you’re feeling better, why don’t you just go back? You’re feeling better, why don’t you just go home?”

And I’ve heard that same voice say something after I’ve had three pieces of pizza, “You really don’t need this. Why don’t you just put it away? Why don’t you just not eat this? Why don’t you just, you know (inaudible at 00:46:48),” and I ignore that voice eight times out of ten. And this is not new to me, of course I know that. But you know, it begs the question, do I have control? [00:47:03]

Am I willing to take control? And you know, why do I not listen to that voice? Nine times out of ten, but not ten, it’s right.

THERAPIST: It also sounds really judgmental. One of the first things they teach us when we work with the clients is try to not ask questions that start with “why,” because why sets off defensiveness, and all of the questions you asked yourself started with, “Why are you going to go someplace else where it might make you feel bad? Why are you going to have that third piece of pizza when you don’t really need it?” And the response we feel defensive is, “Because I want to so fuck you.” So to retraining, of course you have some control. [00:48:03]

CLIENT: This is (inaudible at 00:48:04), happy birthday.

THERAPIST: Oh, that’s nice. You have a lot of siblings, you must get a lot of those a day.

CLIENT: Yes.

THERAPIST: Retraining yourself to prompt yourself to make choices in the direction that you want, so that instead of saying, “Why are you going to go someplace where you might end up feeling badly after?” asking “I wonder how I could, I wonder what I could do next that I would feel good about?” You might end up making the same choice, you might end up making a different choice, but being able to talk to yourself in a way that elicits less defensiveness and prompts you to actually make choices for the longer-term, right? I mean, because what you’re really struggling against is impulsivity, right? It’s the classic, you know, you put the marshmallow in front of the kid and you see how, who can resist the marshmallow the longest. [00:48:58]

Being able to prompt yourself in that situation to be able to say, “That might taste really good right now, but it would feel better later.” And the way they do that test is they say to the kids, you put a marshmallow in front of the kid, say, “You can have this now, or if you wait until I come back, you can have two.” Some kids grab it right away, little impulse control, no ability to delay the gratification for later for a better reward. You know in your adult brain that the better reward is actually feeling good about yourself. When you feel good about yourself it lasts longer, but it sometimes takes longer to get there, you have to delay the earlier gratification in order to get the longer-standing one.

But setting up the situation so that you’re more likely to make that choice is a lot about how you talk to yourself, and critiquing, judging, speaking to yourself harshly, telling yourself you’re bad, none of that actually sets us up to be able to delay instant gratification. You want something good to offset all that negativity. [00:49:59]

CLIENT: Yeah, absolutely. Well, and I think the question is, the voices, “You don’t need that piece of pizza.” And my response is—

THERAPIST: Well I want it.

CLIENT: Well that, and, “Well, I can’t change. Who do you think you are? This is beyond my control.”

THERAPIST: Well whose voice is that? Who was that before it was you?

CLIENT: Well, the voice that says, I don’t know, I mean, I think it’s me.

THERAPIST: My guess is it’s somebody before you. You learn how to talk to yourself from someone.

CLIENT: Well (inaudible at 00:50:53) by next time.

THERAPIST: Yeah, well you can think about everything. Feel free to think about it before you come back.

CLIENT: I’ll have plenty of opportunity, I’m sure. Well thank you for meeting me earlier.

THERAPIST: Oh, you’re welcome. I’m sorry I couldn’t move it more, but—

CLIENT: No, it’s fine.

THERAPIST: Back to back.

CLIENT: I was unsure how easy it would be to find a parking spot, and it was easier than I imagined, so—

THERAPIST: Yeah, I mean, if I had another opening, I would have slipped you into it, but -

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