Client "R", Session January 24, 2013: Client discusses her career work, and her health. trial

in Integrative Psychotherapy Collection by Caryn Bello, Psy.D.; presented by Caryn Bello, 1974- (Alexandria, VA: Alexander Street, 2015, originally published 2013), 1 page(s)

TRANSCRIPT OF AUDIO FILE:


BEGIN TRANSCRIPT:

CLIENT: God, it’s so . . .

THERAPIST: It’s very, very cold out there today. Your cheeks are rosy.

CLIENT: I need to knit one of those hats that covers the head, everything except for the eyes, because everything is cold.

THERAPIST: Hopefully there won’t be very many days this bad.

CLIENT: So my boyfriend and I finally found a way that we can exercise that, if it’s not this cold out, we can actually stick to. There is this game that’s an augmented reality game, which means that it takes place in the real world. [00:01:00] By adding things virtually, it’s called Ingress. Basically there are two portals. There are two teams and either you go to your own portals to get entry or you go to other portals to take them over all over the world. The portals are virtual, like you only see them on the map. They’re not in real life, but they’re places in real life so you have to actually get up and go to those places.

THERAPIST: So that makes it a fun way to get . . .

CLIENT: Yeah. And we were like yeah, we can totally do this for an hour every day if it’s not this cold out; but right now it is this cold out.

THERAPIST: The prediction is that it will end on Monday.

CLIENT: Oh, good. Taking off my gloves, even for a couple of minutes outside on Tuesday, was the worst idea ever. It wasn’t even that long that I spent doing it and it was like oh, wow. I needed to get back into the car and then I had to sit in the car and wait for the heat to turn into actual heat so my hands didn’t get frostbite. [00:02:11]

THERAPIST: I did see some warnings that in the next couple of days avoid being outside and make sure you don’t have any skin exposed, especially if you’re vulnerable to that kind of thing. In the next couple of days it makes sense that you’re not going to use that, but not all of winter is this bad.

CLIENT: Usually it’s just a few days.

THERAPIST: Well I’m glad you were persistent in looking for something that would be motivating and fit in your lifestyle.

CLIENT: It wasn’t really persistence so much as – I guess Sydney had requested an invite about a month ago because there was a web comment about it. When he got his I was like, “That looks cool. I should try it.” I was like, “Oh, well. I guess I can come along with you on your trips until I get mine.” And then I got mine two days later, so I actually didn’t have to wait a month. [00:03:05] I guess a lot of people, because it was featured in [ ] (inaudible at 00:03:08) and then all the people were like oh, what is this thing, and signed up for it. The first day James spent a few hours walking around the square and stuff just because he wanted to check out lots of things and stuff. It’s really addictive. I guess it’s helping Google figure out better walking directions for things. They can see where you’re walking from Google, so that’s how it’s, even though it’s free, it’s still profitably bound. I don’t really mind giving my information about where I’m walking around to Google and helping with their walking directions. [00:03:56]

THERAPIST: No, it’s actually you can feel like you’re, for a good cause, getting exercise and having fun. It sounds like a win-win for everyone.

CLIENT: I’m really worried about my job that I started. I think I can do the work. It’s a little bit complex.

THERAPIST: So what are you doing?

CLIENT: I’m working and doing data entry. I’m really primarily doing data entry and there might eventually be other projects to work on, but it’s mostly just entering the data. Basically you get a request or you get a quick form and it has stuff filled out. You have to add different things that around practice and you have to add the doctors to the system, so you have to look up their NPI and stuff. Also there are a few different fields like they have an address for where they practice, where the service was rendered, another for their normal address, and then they might even have a third address in the NPI lookup system. I’ll figure it out eventually. [00:05:06] Apparently, it doesn’t matter too much which address you use, as long as it’s one of the correct ones. There are a bunch of different fields and stuff. It’s just like – I don’t know. It feels like the whole place is a little too quiet and people aren’t really talking. I actually brought my sunlamp with me today in my backpack, even though I took the “T” here and I’m taking the “T” out there. I’m hoping it will help. I’m feeling better now than when I woke up this morning. I just felt so bad. I was just like. “I do not want to do this. I do not know if I can do this.”

THERAPIST: When did you start?

CLIENT: Yesterday.

THERAPIST: Okay. So it’s really new.

CLIENT: It’s really new. I’ll get used to it. I guess a lot of the social interaction – I can do things in my field if they’re by myself without any social interaction and stuff.

THERAPIST: Because you enjoy them. [00:06:01]

CLIENT: Yeah. It’s interesting. So at least I get some mental stimulation there. I can do boring work if I’m surrounded by people. At least they’re talking. Even if they’re not talking to me, talking to each other, then I can easily do mindless things. I when I was working at [Plan on Giving] (ph?) there were some things that were kind of mindless, not that this is completely mindless, but I had a bunch of different things to work on instead of this one task. If I were an actual administrative assistant or something like that I’d have a bunch of tasks. This job has opportunities; it could go on longer than three months if they like me enough. They have opportunities for internal advancement. [00:07:01] I was just so depressed this morning. I’m not even sure if I’m going to make the three months. Also when I found out about the job on Friday, later Friday I got a call, which I still haven’t responded to yet – I guess the first three days since I got the call were not business days – from this other place that I applied to. It was the New Cheshire Whaling Museum. It was only a one-year position, like 15-30 hours a week. It might be paying more because this job is only paying $10 an hour. It’s sort of in my field. It’s more library stuff and just like a lot of MARCed cataloging. I didn’t lie to them. I told them I had experience doing archive stuff and in library school I did more cataloging, but I’ve never actually done it in real life. [00:08:00] I don’t think I’d get the job anyway unless I’m the only one who applied, the only librarian-y person who ,applied because I don’t know if I can actually do them. I guess I could learn to MARC stuff eventually, but it’s a really annoying system with all these fields and stuff. When I had assignments to do things in MARC for library school I hated them. I was like, “Oh, God, will I be working on MARC all the time?” Then, again, I don’t know if I’m already disqualified now because I haven’t called them back yet.

THERAPIST: Well, call them back. See what the real story is.

CLIENT: Okay. Because I made a three-month commitment to this temp position. It’s not like I signed anything, but it is a position that’s supposed to be going on for three months. It’s one thing to leave it early for something permanent. [00:08:59]

THERAPIST: A year is a lot more than three months, though.

CLIENT: True.

THERAPIST: And calling back doesn’t mean that you’re necessarily going, but it gives you information so you’re not making guesses.

CLIENT: Yeah, it’s just hard with the whole like – how would I schedule an interview if I’m working? My normal hours would be 8:30 to 5:00.

THERAPIST: You would have to take a day off for personal reasons or take a half day off for personal reasons.

CLIENT: Which is just a little bit hard because I’m already taking two days off in February for going to New York, which I told them about before they even hired me. I’m just afraid that I’ll get in trouble if I end up leaving before the three-month period.

THERAPIST: Well it’s not ideal, but I think it’s understandable.

CLIENT: Okay.

THERAPIST: Most people that are using temp agencies are looking for some more permanent work, so I think it’s somewhat understood that if you got an offer in your field then it’s likely you would take it. [00:10:07]

CLIENT: Okay.

THERAPIST: But I think it’s one step at a time, you know? Call the people back if you got a call. Find out what it is – if you have some questions about the position or if they want to do a phone interview or bring you in. Let’s see what you’re actually dealing with here.

CLIENT: If it’s a phone interview it would be a lot easier. I could just schedule my lunch break to be such that I’m taking lunch when the phone interview happens and take the call outside; though outside it’s freezing cold so, hopefully, it would be a day when I have the car and can take the call in my car. I don’t know. I guess I could leave a message or call today during my lunch break. Yeah. I don’t want to screw over the place that I am but . . . [00:11:06]

THERAPIST: You also don’t want to miss an opportunity that is more related to your field because that’s your long-term goal.

CLIENT: It is. And it’s just a little bit. I guess I didn’t realize how soul-sucking this would be. I might get used to it. And the thing is I could, at least, listen to the radio.

THERAPIST: You will adjust somewhat. If you do this for three months, you will get to know the people a little bit. You will get more familiar with the information that you’re entering so it becomes less confusing. You’ll adjust to the schedule. These are all things that are really new right now. You’re not used to getting up this early on a regular basis anymore. [00:11:54]

CLIENT: Last time that I got up this early on a regular basis, I think, was high school.

THERAPIST: That’s quite a while ago.

CLIENT: Yeah. It’s like ten years ago. I don’t know. I don’t know. It’s my floor that’s depressing. The rest of the building isn’t depressing – at least the parts that I’ve been to in the building. They have a really nice cafeteria and open areas in the bottom and stuff, but the area where I work is all cubicles and they’re all really high cubicles so you don’t actually see anyone else unless you leave your cubicle. I guess it’s good to know that I could put on the radio, but the radio that the person who was training me yesterday had on was like super-conservative radio with Rush Limbaugh. It was just like wow. This is kind of infuriating. [00:13:03]

THERAPIST: If you choose something to listen to that you like, it would be a different feeling.

CLIENT: I was just like oh, my God. Get me something liberal right now because . . . yeah. The guy who’s training me seems to be a nice guy, but that was just like wow. The guy who’s training me today is going to be someone different because the guy who was supposed to train me – he’s the guy who was supposed to train me all along, but yesterday he was out sick. (sighs) I just don’t want to take too many days. Today I guess I’ll just stay later. He said I could either take a shorter day or stay later. Originally I was leaning towards taking a shorter day, but maybe I should just stay later instead. [00:14:04] If I go on that phone interview . . . I mean, they wanted to interview me. Do you think it’s that bad? They called me Friday at like 6:00 PM or something, after business hours, so Saturday and Sunday and Monday were all not business days. Tuesday I was running all the errands. Yesterday was my first day of work, so do you think it’s that bad that I’m calling?

THERAPIST: I would call back today. The sooner the better.

CLIENT: Okay. Maybe I already blew my chance, but I guess I don’t know that.

THERAPIST: You don’t know that so you call today and see what’s up. See whether they want a phone interview or an in-person interview. See what you can do to schedule it, I think, giving yourself the opportunity before you make a decision.

CLIENT: Yeah. Also the whole thing is this is also a very important client to the temp agency so I don’t want to make them look bad, but if I get a job in my field . . . [00:15:08]

THERAPIST: But you are your first priority.

CLIENT: Okay. I guess if I left this for another job I’d be okay with my parents, but it’s sort of like if I left this because it’s soul-sucking and I felt really depressed that would be less okay. My parents would be like, “Oh, you have to work.” Now I sort of feel stuck.

THERAPIST: So the goal is to work. If you can get a job that’s in your field that’s even better, so let’s see what the opportunity is. It could all work out great. They could want you. They might have a flexible start date.

CLIENT: If I could start in three months because it’s a one-year grant, I think though, so the start date might be . . . Either they got it out early so they’d find someone in time for the grant to start, or maybe the grant doesn’t start right away; or maybe they got the grant but they don’t have that much lead time and a lot of things need to be done by a certain time. It’s like you have to show that you’re using the money responsibly. [00:16:20]

THERAPIST: But you don’t know any of this stuff yet, so these are the things you want to find out.

CLIENT: It’s not like Tufts has that much invested in me yet so far. They made me a badge, but I don’t think the badges are that expensive. Day one of training taught me about half of what I need to know and then today I think I’ll know the rest of what I need to know. Two days spent training someone I don’t think would be that expensive, so maybe they won’t be super-duper upset. [00:16:56]

THERAPIST: It’s not personal.

CLIENT: Yeah, it’s like how much am I screwing them over if I leave early?

THERAPIST: Let’s see if that’s the option. But I think you owe it to yourself. It takes a lot of effort to find something in your field and get the application out and you got a bite, so I think you owe it to yourself to follow through with that and see what the next step is.

CLIENT: Would you be saying the same thing if I wasn’t saying that this was soul-sucking and making me depressed?

THERAPIST: Mm-hmm.

CLIENT: Okay.

THERAPIST: Because the ultimate goal is for you to get a job in your field and the temp work fits a number of needs, but this is not in your field. It’s not where you want to end up permanently so the fact that you have something that is related to your field, you have a potential opportunity to your field, I think that is a step on the path, even if it’s not exactly where you want to end up. It’s not archives, it’s not a permanent position. It’s something on your resume that, if you get it and you take it, it’s something that’s in that direction. I think your ultimate goal is to build yourself a career. That’s very understandable. Of course that’s what you want. [00:18:17]

CLIENT: Yeah, and the other thing is if it is a year, even if they’re paying $15 an hour or something, if I did the 30 hours a week because it’s 15-30 hours a week, it sounds like that makes the schedule more flexible and it’s like I might be able to make the same amount of money anyway with less – not that it would take no effort, but at least I would be doing things that are interesting.

THERAPIST: Interesting to you.

CLIENT: Interesting, yeah.

THERAPIST: Sounds like a cool place.

CLIENT: Yeah. I actually went to the museum a lot of times.

THERAPIST: (coughs) Excuse me.

CLIENT: I guess you’re still getting over the flu? [00:19:05]

THERAPIST: I got a sinus infection after I got the flu, so this is from the sinus infection. I’m no longer contagious.

CLIENT: Okay. (chuckles) I used to go there. I have fond memories of the museum.

THERAPIST: That’s nice.

CLIENT: They have a big – I think it was pretty to-scale – model of an old whaling ship that you could go and play on and stuff. It might even be like decades since I’ve been there. I was very little and half of them are hazy memories. [00:19:59]

THERAPIST: But you have memories. That’s really cool to have a little bit of connection.

CLIENT: I know absolutely nothing about nautical history and whaling. I’m usually careful when I write a cover letter or something not to put anything in there that isn’t true. Anytime I exempt some experience, like when I apply for some position with reference and then it’s like, oh, well, yeah. I did reference at this job and the one thing is that I actually only did reference once at that job.

THERAPIST: You highlight what you did.

CLIENT: It did and it was really fun. Telling them that that was one of my favorite things that I did at the job isn’t a lie. I’m pretty sure my cover letter said that I have done unique cataloging with archival collections, illustrating how to use MARC in library school. I never actually said I did MARC at an actual archive somewhere. I guess I could even call the guy back right before I head out to the bus. I could do it from the lobby. [00:21:29]

THERAPIST: Yeah, you’re certainly welcome to use our waiting room. It’s usually semi-private at this early hour.

CLIENT: I just need to get out. The fact that I’m bringing my sunlamp in today . . . I need the sunlamp. At least this job has a flexible schedule. The other thing is once I started doing a few of these things on my own I was getting the hang of it more. [00:22:08]

THERAPIST: I think you will become more comfortable with what you’re doing. Day one can be very overwhelming.

CLIENT: Part of the thing is that they have this huge backlog, so it’s like you work really, really hard and get the backlog done while I’m there. Then maybe it will be less bad that I’m leaving.

THERAPIST: Well before you worry about how bad it is that you’re leaving, let’s see.

CLIENT: Well I might be leaving anyways for my sanity if I’m not leaving for something else.

THERAPIST: Let’s see because you don’t know. Once you get the hang of it, once you get into a flow, you don’t know what it’s going to feel like. Day one and two, I’m sure, are different than day seven and eight. Once you get comfortable with what you’re doing, get comfortable with the routine, it might feel different; so I think before you project what it’s going to be like over time, let’s see what it’s really like and let’s also see what the possible opportunity is with the whaling museum before you jump too far ahead in that process. [00:23:17]

CLIENT: It’s like also a little bit of schlep to get out to Cheshire, but if I only have to work 30 hours a week I can probably time things so I’m not going during rush hour. I guess it’s a reverse-feed anyway, right? Because more people are going . . .

THERAPIST: More people are going . . .

CLIENT: From Cheshire to Rhode Island than the other way. I’m just sort of kicking myself for not calling and leaving a message on Saturday night or Sunday.

THERAPIST: Well I think the next best thing you can do is to leave a message this morning. That’s what’s available to you now.

CLIENT: I’m just so, so focused on getting things done. Also the whole [ ] (inaudible at 00:24:13) thing is that I had to get retested because when they took the blood test the level came out really, really high; not toxic, but mine came out at like 376 and normal is 100-250 or something. We weren’t sure if it was a fluke or not. Then I had to go back down to 75mg, which is not quite enough. I could take something in between because they have 10mg pills, so I could be at 80 or 85 or 90. I went back last Thursday to get my blood taken and the person who was there first tried in my right hand, which usually they can get it from my right hand because, you know, they can’t get it from my arm. [00:25:10] I always tell them to just go for my hand. She didn’t get it on the first try and then she did it again and said, “Let me try your left hand,” because you can kind of see the veins in my left hand. It looks like there might be something, but my left hand has even worse circulation than my right hand. I was like, “Okay. If you want to.” She tried it a second time and failed. I just called Dr. Barnes and I was like, “Can I please do something else? I do not want to go back and have them fail again.” It’s all about how it affects the heart, so she was like, “Oh, you can go in and get an EKG,” so I did that on Tuesday. I guess maybe by now there would be a result. I got the print-out of the actual EKG scan, but it isn’t translated into . . . [00:26:07]

THERAPIST: Person-speak. (chuckles)

CLIENT: Person-speak. I don’t know if it’s just not having enough Desipramine in me.

THERAPIST: How do you feel?

CLIENT: Yesterday I felt okay, but a little bit tired. I was feeling sad before. I was feeling better when I started eating stuff. When I got out to the bus and got a little [ ] (inaudible at 00:26:43) now I’m feeling sad again. It’s like “work is going to be horrible” or something. It’s not like . . . it would be worse . . . it could be so much worse. I could have a micro-managing boss or something like that, who’s always telling you what to do. I’m not dealing with mean people or anything, I’m just dealing with bored-ness. [00:27:09]

THERAPIST: So what are the up sides? Rather than imagining how horrible the day would be, what’s good about having this temp position?

CLIENT: Well, hopefully, if someone doing the same work as me can listen to the radio, I can assume that I can also listen to the radio, right?

THERAPIST: Sounds reasonable.

CLIENT: Or at least after I’m done being trained. I can listen to podcasts and I’m not dealing with anyone mean. I brought some chocolates with me and having the sunlamp on will also help. At least it’s something that I have to think about doing and not just automatically type everything in and be so completely straightforward that you’re just copying and pasting everything. It does require a little bit of investigation and stuff. I guess those are the up sides. [00:28:16]

THERAPIST: I think trying to focus, when you think about it, letting yourself focus on what the up sides are – you failed to mention a paycheck at the end of the week or at some point.

CLIENT: Yeah, at some point a paycheck. That’s true. It’s not quite enough to live off of. It’s enough to live off of with my part grant because it’s $10 an hour.

THERAPIST: That gives you a little bit of independence, maybe not complete.

CLIENT: I don’t have to feel guilty about buying . . . Now I can finally get a new phone, which I’ve wanted for a while and have had the upgrade ready, but was like I don’t think I can justify this until I get a job. [00:29:02] I can get nice things and also it is a job that is impossible to do from home, which means I don’t do any work when I’m not there. And I don’t have to feel lazy anymore for coming home and just internetting and stuff. I guess that’s also an up side.

THERAPIST: Focusing on those might help you not to feel as sad as when you focus on the down sides of it.

CLIENT: I guess I just sort of was like, “Oh, my God. Maybe I’ve given up any chance of being at the top of my field,” which isn’t true.

THERAPIST: No, especially not if you make that call back today. How has the panic been?

CLIENT: It’s been mostly okay. I’ve had a few episodes, even one over the weekend or something, that after I’d gone in the offer for the temp position, so it wasn’t even like I was – you know. Now I’m panicking about the fact that I’m so worthless because I don’t have a job and I’m spending all my parents’ money. Still I was feeling kind of horrible and wanted to hurt myself. Sydney helped me. It wasn’t triggered by anything. Even Monday, I think it was, I was feeling sad and I didn’t know why. It’s not been happening as often, but I still have it. Now I’m like maybe it’s more depression than panic. [00:31:12]

THERAPIST: Let’s see if the sunlamp helps with that.

CLIENT: I think it will because I even feel better having it on. It’s not supposed to help right away.

THERAPIST: Sometimes knowing that you’re doing something to combat it helps, though.

CLIENT: Yeah. The sunlamp should help. I really wish that New Haven was built with a lot of tunnels between buildings that you can walk through and that I could walk and not freeze to death. There is a gym in the building. I don’t know if I’m allowed to use it if I’m only a temp worker.

THERAPIST: It’s something to ask about.

CLIENT: Yeah, because I guess if I . . . Somewhere I have an iPod and somewhere if I download the podcasts that I like . . . [00:32:15]

THERAPIST: Somewhere you could listen.

CLIENT: I could do that while I’m – because I don’t mind walking on the treadmill for a half hour or something.

THERAPIST: Maybe that’s something to ask today, find out if there’s that perk. That would certainly come in handy on these really, really cold days.

CLIENT: Even walking from the bus and from the bus to here was very horrible.

THERAPIST: Yeah, that’s enough. I don’t think you want to plan extra time on days like this when it’s 0°.

CLIENT: So it’s supposed to be this cold until Monday?

THERAPIST: It’s not supposed to get above freezing until Monday. I’m not sure if there’s going to be an upward trend. Obviously at 8:00 in the morning it’s worse than at noon. [00:33:12]

CLIENT: I don’t feel the 30° weather. Even Tuesday, when I went to get the EKG done, I had sneakers on because it wasn’t really snowy. It’s fine, I could wear sneakers. Then I went outside and it was like that was the worst idea. So after that I was like, “I’m wearing snow boots.”

THERAPIST: Yesterday was windy, too. That makes it feel worse.

CLIENT: PSG was saying I should dress up, especially for the first few days. At first, my boss, who interviewed me, said the entire month of January is casual; and they have casual Friday. I was like, “Okay, I think that means if I dress nicely and wear winter snow boots it should be okay.” Afterwards I was like, “There’s no way I’m going there in regular shoes. I’m wearing snow boots.” [00:34:14] I brought nicer shoes to change into and then I just didn’t change into them. Today I didn’t bother bringing them, especially because this is so heavy. I think I’ll feel better if I make that phone call.

THERAPIST: Good.

CLIENT: It would look better on my resume, even if it’s part time. My parents said they’d still help me out with stuff. It’s making more than $10 an hour. If I make the equivalent amount of money with less hours of work, that’s better. If I get the experience in my field, then that’s also good.

THERAPIST: That really counts for something. Why don’t we stop five minutes early and give you those five minutes to make the phone call? And then you’ll have that done and you’ll be able to move onto what the next step is. Let’s schedule a time. I can do the same time next week. I’m going to be in next Thursday as well, if this seems to work. If something changes, you’ll let me know? Then you can figure out a time that works more consistently.

CLIENT: Then I’d have more [ ] (inaudible at 00:35:41) to figure out how my job is or whether or not I get the other job.

THERAPIST: Right. All right. I’ll see you next week. Feel free to use the waiting room to make your phone call.

END TRANSCRIPT

1
Abstract / Summary: Client discusses her career work, and her health.
Field of Interest: Counseling & Therapy
Publisher: Alexander Street Press
Content Type: Counseling session
Format: Text
Original Publication Date: 2013
Page Count: 1
Page Range: 1-1
Publication Year: 2015
Publisher: Alexander Street
Place Published / Released: Alexandria, VA
Subject: Counseling & Therapy; Psychology & Counseling; Health Sciences; Theoretical Approaches to Counseling; Work; Physical issues; Teoria do Aconselhamento; Teorías del Asesoramiento; Health care; Occupations; Work behavior; Behaviorism; Psychodynamic Theory; Cognitivism; Anxiety; Relaxation strategies; Integrative psychotherapy
Presenting Condition: Anxiety
Clinician: Caryn Bello, 1974-
Keywords and Translated Subjects: Teoria do Aconselhamento; Teorías del Asesoramiento
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