TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT 1: Weekend (ph).

THERAPIST: Yeah, no, I'm happy to do so. I mean, this is confusing and scary.

CLIENT 1: Yes.

THERAPIST: And, you know, new because you guys haven't lived together for how many years?

CLIENT 1: Five years? I mean, we've lived together over the summers, but...

CLIENT 2: Yeah.

CLIENT 1: Not for longer than I guess we've (inaudible at 0:00:24). So it'd be about three months?

CLIENT 2: That's right.

THERAPIST: So I want to help you guys, like... a game plan is a little too structured, but just (chuckling) something along those lines.

CLIENT 1: Yeah. Yeah, and I feel like I don't really know what is going to be best. And, you know, I've been thinking, but I don't know. I talked with Chad yesterday about partial programs. [0:01:02] He said he didn't think that one would be the best thing for me right now. You know, most of the kind of skills and coping strategies based once (ph) are pretty focused on containment, and containment isn't something that's, like, a problem for me (chuckling). Like, I contain things pretty well. And so...

CLIENT 2: Until you can't any more.

CLIENT 1: Until I can't any more, yeah.

CLIENT 2: And then at that point containing them harder is probably not the right choice (chuckling).

CLIENT 1: Yeah. But then I just end up feeling guilty about feeling bad. It's counterproductive. So, you know, I think I agree with him on that. But I don't know how else to do this so that it's not all on James. The last couple of days have been better, but...

THERAPIST: What do you think has made them better? [0:02:04]

CLIENT 1: Time, yeah, having a break from work and just... yeah, having some time.

CLIENT 2: You don't think having decided to leave the coffee shop helped?

CLIENT 1: Oh yeah, also that (chuckling).

CLIENT 2: Okay.

CLIENT 1: I did tell the manager I was quitting after... or last night, so that was a huge load off. (inaudible at 0:02:30) going to continue of, what do I do now? And try and find a job, and... that's not management.

THERAPIST: And have you felt that Tanya has been doing better? Has that registered with you?

CLIENT 2: Oh yeah. Even when we saw you last she was doing better than she had been doing when we started this particular strategy. The strategy was on the way out, you know, anyway (ph), in a sense. [0:03:02] She was getting to the point where leaving her alone was not a truly terrible idea.

THERAPIST: Terrifying? Mm-hmm.

CLIENT 2: So, you know, it'd probably been okay for a little longer than... like, it had probably been okay for a little while at the point that we saw you.

CLIENT 1: But then, like...

CLIENT 2: But catching up on that lag...

CLIENT 1: But then Wednesday night was very, very bad also, so it's like, it goes up and down.

THERAPIST: So what does very bad look like?

CLIENT 1: I cry. A lot of it is more internal than external. I think about suicide, I can't stop thinking about it. I go through scenarios and then have to kind of be very firm with myself. You know, if it gets bad enough, I'll call Chad. [0:04:01] Yeah, I get angry about things that I wouldn't ordinarily be angry about.

THERAPIST: Like what? What do you get angry about?

CLIENT 1: I just... I'm just angry about... I just get angry about being here, so, you know, things that James does that would ordinarily be on the mild annoyance scale turn into the towering rage scale. But I also get more afraid to tell James about them or to tell people about what I'm upset about, so I kind of close in a lot. (Pause) [0:04:58] I don't know what it looks like on the outside. I don't want to do anything

CLIENT 2: Well, there's some difficulty in answering, what does it look like when Tanya's very bad (ph)? Because Tanya has a whole range of very bad that, for some percentage, I mean, it all looks the same. So I can't tell how badly she's doing. It looks a lot like, every action takes a whole lot of effort. Her head is always hung. Sad face. When it gets... after some period of time in that range, which could... it's hard to tell how bad anything is in that range, then we do get to crying and to clenching and unclenching and tensing of neck muscles, shaking herself sometimes, which I assume is trying to shake away some of the suicidal thoughts. [0:06:13]

CLIENT 1: Yeah, I have a hard time not self-injuring also (inaudible at 0:06:18).

THERAPIST: Kind of cutting?

CLIENT 1: Yeah. I haven't since I've been in the hospital, but it's hard.

THERAPIST: So, when you guys were living together over the summers, was it this bad? Like, is this the first time the two of you are together where it's this bad? Or is this... you've had this experience before?

CLIENT 1: I mean, the first time I went to the hospital, we were living together. That was a little bit...

CLIENT 2: I still don't think it was this bad.

CLIENT 1: I don't know that it was this bad, and it was a little bit anomalous in that I just slept all the time or, like, just lay in bed all the time. [0:06:58] But yeah, I don't think it was...

CLIENT 2: But you weren't taking the Adderall then, right?

CLIENT 1: No, I wasn't. I don't think it was this bad. So probably, yeah, [it's worse now] (ph).

THERAPIST: And it feels that way to you, that this is worse than it's been in the past when you've lived together? Tanya's symptoms?

CLIENT 2: Yeah. Yeah, I think so, I think so. But I think the depression is also worse than it's been in the past in some level because we've been through the point that we were at the last time we lived together. And so now we're almost two years later, and so it's worse in some sense because the key then was that she didn't feel like she had any other options. And so going to the hospital was really helpful because it was another option. [0:08:01] But now we're two years of options further down the road, so it seems worse. It might not be, but it seems worse.

THERAPIST: Yeah.

CLIENT 1: I feel like, even if I'm not... I don't know that the depression is actually worse than it's been, but I'm definitely more suicidal than I've been, and I'm less hopeful about it. Yeah, I have a harder time seeing a future in which I'm not depressed. (Pause)

THERAPIST: Can you see a future with James?

CLIENT 1: Yeah, yeah. I... yeah, I just... I mean, I can imagine myself not being depressed because I've gone through periods of my life when I haven't been depressed. [0:08:57] Mostly... the longest periods were the time that I've been with James, so I sort of know what that looks like. I just don't see how I'm going to get back there or forward to something else that looks vaguely like it. (Pause) Yeah, I mean, I guess I can see a future with James. I just... it looks like... any future that's not pretty much exactly like what's going on now seems contrary to fact. It seems like a fantasy. (Pause) [0:09:57] So, like, talk as though that's going to happen or things are going to be like that at some point or talk about plans for... longer-term plans like having kids down the road, things like that. But it's... yeah, there's a lot of skepticism in the back of my head about... it seems like the important thing is to be talking about it. I don't actually expect any of it to come to pass if that makes sense. This is what I would like to have happen, but...

THERAPIST: Because in the past when you've felt better, you feel like that could never be regained? That will just always stay in the past? [0:10:55]

CLIENT 1: Yeah, yeah. I just feel like things have been so bad for so long, I don't see any way... I don't see how they're going to get better. And I don't have any hopes that they will. (Pause)

THERAPIST: Do you guys talk about this? Is this something that you talk about, or is it... these kinds of conversations, like Tanya expressing this?

CLIENT 1: Not very often.

CLIENT 2: Only when Tanya gets bad because she doesn't want to talk about it in the way she's doing it right now while she's not doing well. I don't know why that is, but that is the observation.

CLIENT 1: I don't want to spoil it when I'm not doing badly. And when I am doing badly it's the only thing I can think about so might as well talk about it. [0:11:59]

CLIENT 2: Yeah, you [have to be feeling] (ph) particularly badly to talk about it, so there's like a range of okay and bad that you don't want to talk about it in.

CLIENT 1: Yeah, I feel like it is... must be disappointing for you and for other people for me not to have hope, so I try not to rain on people's parade, I guess.

THERAPIST: Well, your future is James's future, too, a big piece of it, not all of it.

CLIENT 1: Yeah, sorry about that (chuckling).

CLIENT 2: To be clear, I chose that, so...

CLIENT 1: I know. I wasn't... yeah, it was more an expression of sympathy.

CLIENT 2: Okay. (Laughing) Often it's an actual apology, so... [0:13:00]

THERAPIST: That seemed like an important statement, your saying, I chose this. Is it in some...?

CLIENT 2: It seemed important to me.

THERAPIST: Mm-hmm. Do you feel like that gets lost in Tanya's guilt?

CLIENT 2: Oh yeah, oh yeah. I feel like Tanya... the worse she gets in part, the more she thinks she controls everything in the world and particularly, like, everything in relation to her. And so it seems important to me to assert that, no, I control some of the things also, and I am here because I chose to be. And I'm not going anywhere. But I don't know whether that's the right strategy or not (chuckling), it just is what seems important to do.

THERAPIST: When Tanya is this bad, do you talk about the impact, or do you keep... on you, or do you keep it to yourself? [0:14:01]

CLIENT 2: I almost never talk about the impact on me.

CLIENT 1: I think about the impact on you a lot, though we don't really talk about it.

THERAPIST: With Tanya or with anybody? (Pause)

CLIENT 2: With anybody, I think is the answer to that?

THERAPIST: What do you do with that? (Pause) [0:15:00]

CLIENT 2: I go for walks, I read books, I watch some television shows. It's sort of a... I do things that occupy some part of me so that I can deal with it in some other part of me. Yeah. Then I hope for a better time. (Pause)

THERAPIST: Do you feel that that's enough for you?

CLIENT 2: Well, certainly almost no one else seems to think it's enough for me, but yeah, most of the time I do (chuckling). [0:15:58] (Laughing)

THERAPIST: Well, I'm interested in what other people think, but people aren't you (chuckling). It's... when you're thinking about what someone else needs, it's easy to project what you yourself need, so that might be a projection of other people... you know, people projecting what they need more than what you need. And so it's important to clarify what is helpful to you.

CLIENT 2: Right. (Pause) It is enough when it doesn't last for too long, so I can't go for three weeks straight with it being really bad. It just... there's no way to deal with that much of it being bad. But it's never that constant, so it isn't a problem most of the time. [0:16:59] But the beginning of this week was really rough, and I'm still recovering. Exhausting, so...

THERAPIST: Mm-hmm. (Pause) You know, outside of being with Tanya and also feeling... like, taking care of her, are there...? It sounds like not at the beginning of the week, but in general are there other things that you...? Do you feel like sort of the time and space to be able to do other things, your work, whatever else is important, walks (chuckling, clearing throat)?

CLIENT 2: Sure (ph).

THERAPIST: Do you feel like this is sort of consuming, or do you feel that there's sort of other spaces and times for you to do the things you like or need to do? [0:17:55]

CLIENT 2: Yeah, no. Most of the time there is other space and time. Even this week I got some work done, but between doing work and helping Tanya, dealing with Tanya, or whatever you want to call it, no, there's not been a lot of time. But it's not consuming all the time.

THERAPIST: Mm-hmm. (Pause) When you first met, were you depressed, Tanya?

CLIENT 1: I was moderately depressed when we first met, I mean, when we first started dating. But we were both pretty depressed. And for more situational reasons we were both just having a tough time in school, yeah, having a kind of, I guess, loss of faith in the educational system, which was... [0:18:59]

CLIENT 2: Loss of faith, round one.

CLIENT 1: (Chuckling) Yes. And, you know, the educational system has been pretty important for both of us in our lives. And I kind of got better in the first year that we were dating and was really good up until, yeah... I guess, that fall was when it started to get bad again, but so... that was, like, almost five years in which I was...

THERAPIST: Yeah, it sounds like a long time because you guys have been together a while.

CLIENT 1: Yeah. So really most of our relationship, I think, I'd not been terribly depressed. Like, I've had hard weeks and hard months but nothing like this. [0:19:54] And yeah, he says he chose this, and part of me thinks, but he didn't know what he was getting into. And I know that that's part of what happens when you get married, you don't know what you're getting into definitionally. But it... yeah, it still is hard.

THERAPIST: Was 2010 when you moved to Denver?

CLIENT 1: Yes. I guess the fall of 2009 really.

CLIENT 2: Yeah, I think that's a better beginning date.

CLIENT 1: The semester that I was applying for schools or applying to PhD programs and planning a wedding and incidentally that spring had to have surgery because I had cancer. That was, like, the most minor thing, the cancer part? Was like a distraction from everything else. That was fine (laughing).

THERAPIST: Cancer's so common these days in women, it's striking.

CLIENT 1: Yeah, as soon as...

THERAPIST: I'm sure that there's some studies on that, but I can't believe how many people, women in particular, I hear have cancer. [0:20:58]

CLIENT 1: Yeah, as soon as they found the goiter, it was like everybody I talked to was like, yeah, that happened to me. And I didn't have it...

THERAPIST: Not to normalize...

CLIENT 1: It was just... I just had thyroiditis, but yeah, it really didn't feel like that big of a deal.

CLIENT 2: Yeah, the numbers of thyroiditis of some kind or another in women are, like, one in six or something ridiculous like that...

THERAPIST: Wow.

CLIENT 2: So yeah, I think you're... I might have the wrong number, but you're exactly right (chuckling) that it's really common.

CLIENT 1: But so... yeah, so that fall was rough, and then things got a little better in the spring and the next year. And then it went down again in 2010 I guess. So I think part of it was the move to Denver. I think part of it was the move to Brown. I don't know exactly what it was.

THERAPIST: Did you not... was it the move... like, just sort of the transition adjustment, or was it Brown itself that you didn't like? [0:21:59]

CLIENT 1: A lot of it is Brown itself. I just... there was not a supportive community there in the way that there was at William & Mary. I didn't feel like anybody on the faculty was rooting for me in the way that they were at William & Mary. I had a really hard time getting any time with my advisor. And he's very nice, and I'm sure he actually cares. But he doesn't really care enough to do his job very well? And so it's hard for me to... you know, I think he regrets not doing his job better, but somehow it doesn't really make that much of a difference. Yeah. (Pause) And I think to some degree a lot of my kind of habits of study and perfectionism and just ways of being were going to crack at some point, and that's just the time that they cracked. [0:23:10] I haven't... yeah, every semester, as long as I remember, there was always a point in which I didn't think I was going to make it through the semester. I was convinced I was going to fail out, and they were... everyone was going to be terribly disappointed with me. And I just dealt with it by keeping my head down and pulling all-nighters when I needed to and doing what I could. And everything always worked out. (inaudible at 023:37) most people don't do that (chuckling). Or, you know, even if most people do do that, it's not necessarily the healthiest way to approach your work life, so... yeah.

THERAPIST: Do you guys share in your, sort of, sentiments about your... sort of the educational...? Let me be more specific. [0:24:03] In what little we've talked about it so far, it seems like you both feel a sense of disillusionment.

CLIENT 1: Very much so, yeah.

CLIENT 2: Mm-hmm.

THERAPIST: And that you share that disillusionment.

CLIENT 2: That's right.

CLIENT 1: Yeah. I'd be like... I sort of feel like I came up with a whole lot of enthusiasm and a whole lot of talent and a whole lot of energy, and I sort of feel like that all got exploited. And... yeah. (Pause)

CLIENT 2: Yeah, and I feel less exploited and more wasted.

THERAPIST: Hmm.

CLIENT 1: Yeah.

CLIENT 2: Just like, I came in similarly, but it hasn't been put to any use or directed or assisted in any way. It was very much as an undergraduate, eventually. But it took several years. [0:25:00]

CLIENT 1: And a professor who was pretty off the beaten track in some ways.

CLIENT 2: (Chuckling) Yes.

CLIENT 1: Like, there aren't that many Dr. Felwood's out there.

CLIENT 2: No, no.

CLIENT 1: Yeah.

CLIENT 2: So... so yeah, we share a lot of the disillusionment pieces.

CLIENT 1: I think it looked different for each of us.

CLIENT 2: Yeah. Tanya didn't have any specific advisors or faculty members that... with whom she was really close, in a sense, up until William & Mary, where she had several. And that was a wonderful thing. I had the one and Tanya, so... as an undergraduate. That was also a really wonderful thing, but those are it in a sense, so...

CLIENT 1: Yeah. You know, my teachers in high school were really wonderful, really great, and I was very close to them. [0:25:59] But in a sense I feel like they kind of set me up in some, I guess, of their idea of what it's like to go to college, is you go and the world of knowledge opens up to you. And that just didn't really happen (chuckling). Or it was like I went, and I was like, oh, there's all of this... so much more to know than I knew was out there and sort of felt like the academic community was shutting me off from it instead of helping me into it.

CLIENT 2: Yeah, sort of saying, well, yeah, we have that knowledge, but you have to get through these other hurdles first.

CLIENT 1: Yeah. You should jump through some hoops for about six years, and then we'll let you in. Yeah.

THERAPIST: Like being denied access?

CLIENT 1: Yeah, being treated as though I wasn't really capable of rational thought, or... in my mind at least. [0:26:56] Having professors say, I'm going to teach you critical thinking, at the beginning of the class, and just like, don't even, don't even talk to me (laughing). Like...

CLIENT 2: But there are a large number of students who just really eat that up, and so they... those professors get very popular and keep...

CLIENT 1: Well, and I, yeah, can see where that's coming from also because I'm in some ways very intellectually insecure and in some ways very arrogant. And so the cocky side of me that knows that I'm very good and very smart says, you know, just teach the class. Don't tell me that you're going to teach me how to think because I know how to think as a matter of fact. The side of me that likes authority or, yeah, finds authority cowing says, oh yes, I will... I don't know. [0:28:03] (Pause) Yeah, and then now, kind of... I don't know whether this is phase two or phase three or what, but at Brown it's like it's all there, and I know how to do it. But it's very hard, and it's not necessarily intellectually hard, it's just a lot of work to learn these things. And, you know, you need support, and you need a community. You need an advisor who has your back. And...

THERAPIST: Good family.

CLIENT 1: Yeah, yeah.

THERAPIST: Extended relatives.

CLIENT 2: Yeah.

CLIENT 1: And I just...

THERAPIST: Point person.

CLIENT 1: Yeah, I don't feel like my department really offers that to any of the students. [0:28:59] And part of that is because the administration has decided that my field is not relevant. Despite the fact that Brown had one of the top programs in the country for 50 years, they're not hiring new faculty members, and all the faculty are aging out. And so there are fewer and fewer people trying to deal with the students. And its' just... nobody cares about Numerology (sp?), nobody thinks it's worth investing in. I can sort of sympathize, but why am I here if they're not going to teach me? (Pause)

THERAPIST: Well, (clearing throat) you certainly want to feel that what you pursue and what you offer has value, right?

CLIENT 1: Yeah. [0:29:58]

THERAPIST: And feeling that it's devalued or has no value is a terrible feeling.

CLIENT 1: Well, I'm pretty used to feeling like it's not very valuable to anybody other than me and a couple of other crazy people. But yes (laughing). Yeah. Yeah, I guess... yeah, in some ways I'm used to feeling like the things that I'm most passionate about nobody else really thinks are important. But in other ways it's still very hard.

CLIENT 2: You know, this was a problem for us years ago because I couldn't understand why she would... Tanya's very bright, I couldn't understand why she'd want to study some of these things, and...

CLIENT 1: We had some big fights over that.

CLIENT 2: (Chuckling) It's been years since we had one of those fights, but it was just a question of, like...

CLIENT 1: Well, we kind of put them to rest and, you know, talked through it eventually.

CLIENT 2: Yeah.

CLIENT 1: Round ten (laughing). [0:30:59]

CLIENT 2: (Laughing) But there was a real question of, why would you want to do this? What good is it going to do anyone? But I don't have that question any longer.

CLIENT 1: That's right, because my answer's not nearly as clear.

CLIENT 2: Right.

THERAPIST: What was...? You don't have the question because it was answered?

CLIENT 2: Yeah, yeah.

THERAPIST: What was the answer?

CLIENT 2: I don't remember. (Laughing) But it was answered. I think it had to do with, you know, some combination of pursuit of knowledge and some combination of teaching people. And in a sense it doesn't matter what field you're teaching them in. There are lots of things that people learn, there are lots of things that are interesting... that humans have found interesting. And so teaching them in any vein of that is a good and important thing.

CLIENT 1: I think there was also a component to it where you didn't understand why... how I could work in a field so much of whose work is pretty terrible... [0:31:57]

CLIENT 2: Oh yeah, I probably did have that question.

CLIENT 1: This, and, you know, were judging me harshly for thinking... for feeling as though I wasn't discerning enough to recognize that shoddy work is shoddy work, and me kind of saying, well, yeah, a lot of it's pretty bad, but it's sort of what we have to go on. And I take everything with a grain of salt, like, the bad work, I do recognize it as not very good even if I don't throw it out entirely because it's sort of all there is. And that's just how you do history in some ways, like, your data are very limited. Is that about right?

CLIENT 2: Yeah, that's right. And, going back through time, the younger I get, the more absolutist I get about truth and the more I believe that we can access absolute truth. So that's...

CLIENT 1: You know, that...

CLIENT 2: Really doesn't work in graduate school (laughing).

CLIENT 1: Being a scholar (crosstalk) (laughing). [0:32:58] Well, it ought to teach you the error of that fast. Doesn't teach a lot of people, but they do bad work, so...

THERAPIST: You guys, especially you, Tanya, brighten up when you talk about this. It's clearly something that you think about and share...

CLIENT 1: Yeah.

THERAPIST: Are passionate about and had a lot of thought in it, about it.

CLIENT 1: Yeah, it's really hard to be leaving (ph). It's really, really hard. Yeah. It's really hard to feel like I'm not good enough to do it or like I can't make it work.

THERAPIST: But that's not what you said a moment ago. It seemed like... I'm not... I'm sure that's a piece of it, not being good enough, but you also talked about not really wanting what they have to offer and not feeling like it's what you need. [0:33:57]

CLIENT 1: Yeah, yeah. I mean, the actual reasons are much more centered around not having the support that I need and, yeah, not finding... yeah, are much more around that. But it still feels like I'm not good enough. It feels like if I were... it feels like what they have should be what I need.

THERAPIST: Do you feel like you tend to sort of turn disappointment inward?

CLIENT 1: Yes.

THERAPIST: Mm-hmm.

CLIENT 1: Yeah, I find it very hard to be disappointed in other people. It's much easier to be disappointed in myself, weirdly (chuckling).

THERAPIST: Yeah, well, among the other things that's interesting, it sort of maybe goes back to something that you said, James. It's like, you're disappointed in other people. You don't really have much control. They are who they are. You're disappointed in yourself, you can at least keep the fantasy of control even though (chuckling) we have our limitations, too. [0:35:00] But maybe that sort of speaks to something you were saying, James, before, about your choosing to be here, Tanya isn't making you.

CLIENT 1: Oh yeah. It's sort of, I see that going on in myself, but it doesn't necessarily help me not do it. (Pause)

CLIENT 2: There's also that piece where Tanya was talking about, the two parts of her in the class, where the professor says I'm going to teach you how to think critically. There's kind of the part that says, well, be quiet, and the part of you that says, of course, tell me. There's this sense in which that first part has recognized entirely that the whole system is just off-kilter somehow, and walking away is a very reasonable thing to do and the appropriate choice here. And the other part is saying, well, that just clearly means you're not good enough, and you're [failing out] (ph).

THERAPIST: Mm-hmm.

CLIENT 1: Mm-hmm. [0:36:01]

CLIENT 2: So I don't know if that's a correct description or what, but...

CLIENT 1: Yeah, yeah. (Pause)

CLIENT 2: It's certainly why most of the students that I know in Illinois who really want to quit don't quit, because they... it would mean that second part, would mean saying you're a failure.

THERAPIST: Where are you in your studies, are you nearing the end or...?

CLIENT 2: Yeah, I've finished four years, so... I guess almost four and a half now, so somewhere near the end. In chemistry the average is 5.2 or something years.

THERAPIST: So you have 0.7 left?

CLIENT 2: (Chuckling) The average doesn't say too much about any specific case, but...

THERAPIST: (Crosstalk) Mean, median, and mode, that's what reflects the actual picture, right? [0:37:05]

CLIENT 2: (Laughing) It reflects the distribution but still doesn't tell you too much about any specific case.

THERAPIST: That's true, that's true. Are you sort of on your way with your dissertation?

CLIENT 2: My advisor wants me out, be done in a year more or less. But it's a little more up in the air, because I'm here, than it was before I came here. So it's to the point where just getting it done seems like the best course of action, even if I don't entirely believe in the system. So...

THERAPIST: Do you feel like, you know, assuming Tanya is... will be doing better, that this works for you, doing your... finishing your degree remotely?

CLIENT 2: Yeah, yeah. I do a whole lot of bench work, or I did. But there's a lot of relevant work that can be done more or less well. [0:38:05] And so it's a field that's going to be more and more important as time goes on because there are more and more computers. And it gets harder and harder to publish without saying, well, the theory also says this should work, even though we observe it worked. So learning the theoretical aspects is a good career move in a sense also. And it's certainly something that can be done from here.

CLIENT 1: Yeah, and it's not going to take away your jobs to be adding that to your skill set.

CLIENT 2: Right.

CLIENT 1: So that you'll be able to be do both. Yeah.

CLIENT 2: Right. It's like adding... it's like getting to add another skill while doing it from here, so yeah, it should work.

THERAPIST: Mm-hmm. That's helpful to know in terms of just sort of the structure and context of your relationship going forward, that it's not the plan to make sure Tanya's okay and then go back... [0:39:02]

CLIENT 2: Right, okay, yeah, no, that's not the plan.

THERAPIST: That this is what...

CLIENT 2: We've done that. That didn't work out.

CLIENT 1: Yeah, we're ready to be done with long distance, I think.

THERAPIST: Mm-hmm.

CLIENT 2: Yeah.

THERAPIST: In addition to the sort of very rich sort of academic and intellectual connection, are there other things that sort of are... that you share in terms of things that are meaningful to you?

CLIENT 1: Well, having a shared religious life I think is very important to us? But we're not quite clear on how to do that. We're still working on that. You know, I found a church here that I really like a lot. I think James really likes how well they've... how much they've been taking care of me? [0:39:54] But I think, yeah, our... we both come from more or less religious backgrounds, but I... we're both only tentatively...we I guess only tentatively construe ourselves as religious, and it's really important to me to be in a faith community? And so I really like being a religious even though I don't necessarily believe anything that they believe (chuckling). But that's the nice thing about being religious, they are okay with that. You know, if you show up, you belong there. But...

THERAPIST: It's a nice philosophy.

CLIENT 1: Yeah, I like it. But I think that, you know, James doesn't necessarily find what he needs in the church services in the same way that I do, and so...

CLIENT 2: They sing all the wrong songs. I don't know any of them (chuckling).

CLIENT 1: Oh, [I think they] (ph) sing all the right songs. It's nice, but I understand. It just sucks to go some place where you don't know the music. It's just hard, yeah. [0:41:02]

CLIENT 2: Right. But no, I... we've gone to a number of churches together, and this is the one I like the best out of the ones we've gone to together, so...

CLIENT 1: Oh really?

CLIENT 2: Yeah, yeah.

CLIENT 1: Good.

CLIENT 2: I guess I have not mentioned that to you (crosstalk).

CLIENT 1: No, but I'm glad.

CLIENT 2: It's hard to remember, [I imagine] (ph) everything (chuckling), so...

CLIENT 1: I mean, I know that's not saying very much, but it's something.

CLIENT 2: It's something (chuckling).

CLIENT 1: Yeah.

CLIENT 2: You know, I guess I've become resigned to not necessarily finding all of my spiritual needs met in a church that we go to. It's not going to happen, so... it can meet some of them going here, and that's a good thing.

THERAPIST: Okay. Sounds like maybe your experience in academia as well, some needs met, some not.

CLIENT 1: Yeah.

CLIENT 2: That's right, yeah.

THERAPIST: Mm-hmm.

CLIENT 2: [And so you] (ph) work to figure out what to do with that and take what you can get, I guess, figure out how to find what you need elsewhere, but... [0:42:02]

THERAPIST: It's a hard lesson learned, especially in, well, both realms of thinking. You take one of them, the academic realm, it's exciting and inspiring and... yeah. And so to see its limitations. And then, as you were saying I think two sessions ago, James, the kind of day-to-day potential grind of being an academic where, you know, the job of learning can sort of fall pretty low down on the ladder, is... can be really disappointing.

CLIENT 2: Yeah.

CLIENT 1: Yeah. So I know we're about to run out of time...

THERAPIST: Yeah.

CLIENT 1: And I'd really like to talk about specific plans for, like, what do we do? Because I... yeah, I think you are absolutely right, that this just not ever being apart is just going to drive us both nuts. [0:42:55]

THERAPIST: So let me actually clarify, so I thought that that had changed [at the later meeting] (ph). Is that not changed?

CLIENT 2: I mean...

CLIENT 1: More or less. I mean... but it's de facto, we've kind of been spending all our time together because I haven't left the house. But I went to work, and I think James has kind of stopped checking up on me as much, yeah.

THERAPIST: No, it seems like spending a lot of time together more or less out of choice is different than your feeling like you need to be on watch.

CLIENT 2: Yeah, that's right. That's correct. I guess I'm not quite sure what you need, whether... I feel like we need a plan moving forward for, what do we do if it gets really bad?

THERAPIST: Mm-hmm.

CLIENT 1: Yeah.

CLIENT 2: Because, if going to a partial program isn't the answer and going to the hospital isn't the answer and me watching you isn't the answer, there needs to be an answer.

CLIENT 1: What do we do before it's time to go to the hospital?

CLIENT 2: Yeah, yeah. And I'm not sure if you're asking for the same thing or something different.

CLIENT 1: Yeah, something like that.

THERAPIST: Well, I can... you now, and this might sort of be a work in progress for us to think about. [0:43:57] It seems like too sort of optimistic, but it seems like there's at least a brief period where you're sort of out of the worst of it, but to then just... I mean, this goes in cycles. So I imagine you unfortunately will go back into it for at least some time. And so it's really up to you and Chad to decide what's best for you. I mean, I'm way going to rely on your judgment in terms of the different treatment options. My sort of... sort of the part of the elephant I'm looking at is the two of you and making sure that you don't end up in this sort of lopsided dynamic where you end up feeling kind of like this anxious caretaker and that you in a sense serve as the partial program (chuckling) for kind of making sure Tanya's safe. And I think that that's where the recommendation came from, or the suggestion, that that would not be a good dynamic. And I mean fortunately you're... you know, this is not like... you haven't developed this over many years where you're trying to break it. You're at the beginning of it, and it's... you know, of sort of how to manage your profound suffering. [0:45:03] That's a good thing, so you can create a structure rather than having to undo a structure that's really detrimental to both of you. And so that's part of my job. And I'm very sort of clear, my patient is not Tanya.

CLIENT 1: Yes.

THERAPIST: My patient is your relationship.

CLIENT 1: Yes. I appreciate that.

THERAPIST: And I'm very clear... and each of you, too, that your relationship. And so my sort of making Tanya the patient would be just a replication (chuckling) of the difficulties that you could be facing in your marriage. So I'm very sort of aware of that. And I don't think... you know, I don't have any immediate... I mean, if you were for the last week spending every moment with Tanya because you were worried about her, I'd be more feeling like it's urgent that we have a plan before you leave. Unless you feel that way. I mean, I want to make sure that I'm being attentive to what you need.

CLIENT 1: I don't know. [0:45:55]

CLIENT 2: I feel like Tanya really needs a plan. I am not... I don't...

CLIENT 1: I mean, I'm okay with a plan...

CLIENT 2: Chad doesn't seem to be getting it, but...

CLIENT 1: Yeah, I'm okay with a plan just being, I call Chad if it gets really bad. If that's the plan, it's good. I just... I feel like I am... yeah, I just feel like I don't really know what I'm supposed to be doing. Yeah.

THERAPIST: So it doesn't feel like enough of a plan for you?

CLIENT 2: For me?

THERAPIST: Yeah, because you're saying... I mean, because you don't want the default plan to be like, oh my God, I don't know what to do (chuckling).

CLIENT 2: Yeah, no, I really don't want that to be the plan (chuckling). Calling Chad is obviously a part of the plan, and, if that's enough, that's fine. But it doesn't seem sometimes that that's enough. And I don't... I'm not really sure what's going on right now, so I don't know what I should say or not say.

CLIENT 1: I just feel like I... I feel like you're saying, you will know what you need, and I really don't, I really, really don't! [0:47:01]

THERAPIST: Well, I'm not actually suggesting that you will know what you need.

CLIENT 1: Yeah?

THERAPIST: What I am suggesting is that I feel like I want to be sort of protective of your work with Chad and figuring that out...

CLIENT 1: Absolutely. Yeah.

THERAPIST: And not sort of... I guess what I'm saying is, my focus is more what the two of you need.

CLIENT 1: Of course.

THERAPIST: And that's not to say that I'm not interested in what you need, too (crosstalk).

CLIENT 1: Oh no, no. I really appreciate you being very clear about your focus and, like, what we're working on and that it is about our relationship. I really appreciate that. Just at this moment, I feel like, you know, I keep talking to Chad and not coming up with... not having a clear plan. And I feel like I'm pretty okay with the plan just being, call Chad if it gets that bad, like, that's okay. But, like, James needs more of a plan than that. And so I'm trying to do that, but I don't know how...

CLIENT 2: Okay, so... okay, I see. So the space that I need covered is that space where you call Chad and then you say to me, don't leave me alone. [0:48:02]

CLIENT 1: Mmm. Yeah.

CLIENT 2: Right? Because what that says to me is that calling Chad has not been enough. That's the space that I need covered. That's the only space that I think I need covered.

THERAPIST: That's an important space. I really... this is so... I (crosstalk).

CLIENT 1: No, I know it, I know it.

CLIENT 2: That's okay, that's okay, I'm sorry.

THERAPIST: I feel... no, no, no, don't apologize. I don't like to leave you guys hanging. I mean, is Wednesday a plan and then if something shifts you call me sooner?

CLIENT 1: Yeah.

CLIENT 2: Yeah.

THERAPIST: Because I really take seriously what you're saying, James, and so, you know, I want to think about it. I have a couple... yeah, let me think about it, and... but I take that very seriously. And let's address that loophole (chuckling), you know?

CLIENT 2: Okay.

THERAPIST: I mean, that's really important.

CLIENT 2: Is that okay?

CLIENT 1: Yeah.

THERAPIST: Is that okay?

CLIENT 2: Okay.

THERAPIST: And let me just... so the time I have on Wednesday is... what is it? 10:45. Does that work as a regular time, 10:45?

CLIENT 2: Right. Yes, that's great.

CLIENT 1: Yeah.

THERAPIST: Perfect. Okay. [0:49:04]

CLIENT 2: Thank you for seeing us today.

CLIENT 1: Yeah, thank you.

THERAPIST: Absolutely, absolutely. Okay, you take care.

CLIENT 2: See you...

THERAPIST: See you Wednesday.

CLIENT 2: Wednesday, Wednesday.

END TRANSCRIPT