TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: I’m glad that this will work. (inaudible at [00:00:07]).

CLIENT: So I don’t think I mentioned this last week. Did I talk at all about one of my cousins?

THERAPIST: No, okay.

CLIENT: So one of my cousins, on my dad’s side, my cousin Daniel (sp)—

THERAPIST: Yeah, I know. He was in the hospital with like (inaudible at [00:00:33]).

CLIENT: He had an enlarged heart, he had pneumonia, he had like everything. Yeah, and he like, they kept him for like a couple weeks, which, given that he’s poor and getting on Medicare, is pretty impressive. So that was like, yeah, you actually need to manage your diabetes as opposed to ignoring it, et cetera, et cetera. [00:00:57]

His kidneys have now failed, or are failing, so he’s starting dialysis and needs a kidney (inaudible at [00:01:06]).

THERAPIST: Is that also a consequence of diabetes that’s not well managed?

CLIENT: So he also did a lot of drugs and alcohol and other things, but I think in actuality, not managing his diabetes at all was the problem that is making his kidneys fail. He’s always felt, he’s been convinced for a long time that he’s going to die by the time he’s forty. He’s thirty-nine, so he’s been like, well there’s no point, because I’m just going back and forth, (inaudible at [00:01:46]). So he hasn’t been taking good care of himself, and like I thought that any other hospital was going to do, get him to manage his diabetes, but not really, or damage done. [00:02:04]

THERAPIST: Does he have a trauma history?

CLIENT: Hm?

THERAPIST: Does he have a trauma history?

CLIENT: Like a traumatic event happening to him?

THERAPIST: Sort of. I did ask because of like a (inaudible at [00:02:22]) T-shirt thing? Did you hear about that?

CLIENT: No.

THERAPIST: A ton of people who have advanced trauma, not always, but sometimes have a like foreshortened sense of their future. They just don’t, it can sort of manifest a few different ways, but they say that, like I’m going to die young, would be consistent with that. Not that there aren’t many of us that think that.

CLIENT: Yeah, so his parents fought a lot and like in and out of being married, and so for awhile he went to live with my, with our grandmother. [00:03:09]

I think he lived with her for about a year or so, and we now know he had ADHD, but at the time, you know, whatever. And I think he was five, but didn’t know his like ABCs, and couldn’t really read very well, so my grandmother was like all about budget, and she’d retired at that point, so she’d like sat him down at the table and was like you’re going to learn things. And then she died kind of suddenly. I mean, you know, she was in her sixties, so it’s not completely crazy, but I think she had just retired I think two years before that. [00:04:00]

And had like a lot of plans that she wanted to do too. And when it happened, Daniel wasn’t there, but he remembers coming in and like his mother and my aunt were just sobbing hysterically and freaking out. My grandmother refused to go to the hospital in an ambulance because she was scared of them, yeah, she got driven, and she died. And I mean, Daniel definitely feels like his life would be completely changed in a better way if grandmother had lived, which is kind of true, in a way. When he was a teenager, he, his father’s, it wasn’t my father’s, but his uncle on my cousin’s father’s side of the family introduced him to cocaine and drinking a lot and doing a lot of dumb shit. [00:05:06]

And so he used to fight with his mother to the point of like he, he and his friends would like hide by her house and try to scare her when she walked in. He punched out her car window one time. Yes, and then I mean, he was in jail I think twice. So his mom died young. His mom died, actually I don’t know. I don’t know how old she was. Like I remember when it happened, but she was probably in her forties. And then he saw some things, and then he did a variety of things, including going to jail. [00:05:57]

So yes, his dad is also really fatalistic. Like, because if you ask him, yeah, he never really explains why he knows that he’s going to die. He just kind of knows it. And I think he also feels like having done a shit ton of drugs, and like a serious alcoholic and a bunch of other things that I don’t know, it’s kind of like well it’s too late now. So yeah, I was looking at my phone, because like I, for some reason I, (inaudible at [00:06:51]), I’ve been kind of sucking it down, like talking about it, because it’s very stressful. And then having two good friends with, you know, mothers with cancer is kind of like at least it’s not cancer, I guess. [00:07:14]

So what, but like Saturday or something I was like oh, I think the reason I’ve been incredibly stressed and unable to sleep and just feel really horrible might be that. In fact, it’s almost definitely that. So yeah.

THERAPIST: You seem kind of (inaudible at [00:07:48]).

CLIENT: Yeah, it’s so, it’s really frustrating that I really thought that last year he was going to, it seemed like he was going to like do things. [00:08:10]

His girlfriend Marianne (sp), who’s really amazing, they’ve been together for quite awhile, she’s really helped him like, I don’t know, stay away from bad influences and try to, he has horrible anger management problems, just horrible. And she’s been helping him like with that, and some other things, and so she actually got him into the hospital by saying, I will break up with you and leave the house right now if you don’t go. But it’s definitely the week of back and forth thing. So I don’t know, like I didn’t realize that he hadn’t whatever gotten off or done anything. [00:09:00]

And yeah, I mean it’s like there’s so many things like he has kind of trashed his body in various ways, but I do find it kind of overwhelming that not taking care, like not, the diabetes is probably, the cocaine does hurt, but the diabetes is probably the rest of him. And like I don’t know. Like all the, like out of all the ridiculous things he’s done in his life, I’m kind of like diabetes? Wow. And—

THERAPIST: Like there’s something about his activity around managing the diabetes that is like matters more than anything else? [00:10:14]

CLIENT: Yeah, because he’s very, he’s really hot-tempered, and he like tends to pursue things, I guess, vigorously for lack of a better word, like, so it’s weird that he’s just not doing anything. I mean, he, when he was in prison the last time, he got his GED, which, you know, is impressive. And apparently he was the person that other prisoners went to if they were having math problems, which was, I had no idea. [00:11:02]

I hate math. But I mean, (inaudible at [00:11:09]) used to think about how, when one of his, one of his big regrets is that his mother died before he stopped being a horrible person towards her, so he never really got a chance to apologize. I mean, he did, like he apologized to other family members, like he had like, been horrible to. And not surprisingly, so I guess it was whatever it is for drugs. He had done the, you know, step of asking for, or trying to make amends, asking for forgiveness, and (inaudible at [00:11:59]) for my Aunt Sam. [00:11:59]

And he was really angry because she said, you know, I forgive you, like I forgive you, but I’m not going to forget that. And he could not, I don’t, I mean, I think A, he didn’t understand, like he didn’t really seem to get what she was saying, and also, not surprising, he’s like, “But I apologized.” I’m like yeah. And also like a lot of my dad’s family is, so my grandmother and, my grandfather died, like at like sixty. He, I think he had a heart attack, and then my grandmother died. Aunt Vivienne died really young. [00:13:01]

Like I don’t think she even hit forty. And then my Uncle Jim was the youngest of all of them, and he, you know, got cancer recently, and then my Aunt Sam was in the middle. But—

THERAPIST: (inaudible at [00:13:17])

CLIENT: Yeah. I guess I, kind of like, with the other, I don’t know, like cancers have like, well it’s out of the blue, like there’s nothing that they could have done, really. And then my grandmother and grandfather, you know, they had bad health, but again, like a heart attack. Especially if you’re scared to be in an ambulance, like nothing’s going to happen. [00:13:58]

And actually, I don’t really know why Vivienne died so young. We didn’t really talk about it. Maybe my parents told me, but they just, so sometimes I wonder, like I know she had diabetes, I know she had high blood pressure like everyone in the family, and I don’t like, I’m like, did she have heart disease? Did she, was it diabetes-related? But I don’t know. And like one of the things that’s gotten me very stressed is so I offered to get tested to see about donating a kidney because I just totally would do that. [00:15:02]

But weight cutoffs are really common. And technically I’m too fat to donate bone marrow, but I lied on the bone marrow registry because I was annoyed.

THERAPIST: Lied about your weight, you mean? Or—

CLIENT: Well, I called and asked about the policy, and they’re like well, they actually said if you’re over this BMI, you’re obviously not healthy enough to donate. And I was like well, but can I write you a doctor’s note? They’re like, “No.” Like okay. I’m like, so that concerns me. Having one kidney’s not great either. [00:15:56]

But also, I don’t know, like I’m worried that when I talked to him, you know, it’s hard. Like I talked to him the day after he found out about the dialysis, and I talked to him again. Actually, I talked to his girlfriend like a week later.

THERAPIST: How often do you generally talk to him?

CLIENT: I don’t, like I talk to him a couple times a year. I just don’t, I hate talking with him. And he’s funny in that both he and his mother would, they love to ask questions, but never want to answer questions, so he’s always asking questions about what I’m doing, and my life, but if I ask and he’s like, “That’s really personal.” I’m like oh, like including things like just everything, just like Daniel, if you’re going to ask me twenty questions, I get to ask you twenty questions. [00:17:03]

THERAPIST: And did you hear back about donating a kidney, or you still haven’t heard?

CLIENT: So they’re not at that, they’re not at that stage yet.

THERAPIST: I see.

CLIENT: For a second, I’m like, it sounds like probably mid-April, end of April the doctor will be able to say something useful about like how to get tested, where, I’m assuming living in Manchester I could find someplace to do something, I don’t know.

THERAPIST: Is he in Columbus?

CLIENT: He’s in Cincinnati.

THERAPIST: Cincinnati, okay. Somewhere, conceptually.

CLIENT: And also, I’m just like, yeah, he hasn’t like use for, he doesn’t have a lot of money, his girlfriend makes some money, but like he’s going to have to go on disability. [00:18:05]

And he’s frustrated that’s not enough. He’s going to have to deal with all the Medicare paperwork, Medicaid or whatever, which the hospital, fortunately, has some people on staff to help.

THERAPIST: Oh good.

CLIENT: Which is good, because that stuff is hellacious. But it’s one of those things where I’m like being a black male in Cincinnati, or in Indiana is like, let’s knock thirty years off your life expectancy, or put you in jail.

THERAPIST: Or both.

CLIENT: Or both, yeah. And it’s just, and like that’s just, like there’s nothing I can do about that. He doesn’t want to move, and not like it would help, but like it’s hard to just try thinking, like school to prison pipeline. [00:19:13]

Environmental reasons, everything, which aren’t really, they don’t know how I feel about it.

THERAPIST: No, I’m sure they don’t. (inaudible at [00:19:33])

CLIENT: Yeah, because that makes me feel fatalistic, just like well, you were kind of screwed from the start, but and also like, I don’t know, I got caught up for a little while thinking about the logistics of how that would work, like would I have to go to Cincinnati for a month, do you know what I mean? [00:20:00]

And I hate Cincinnati. It’s kind of horrible in many ways. And my, so my dad and my Aunt Frances (sp) are the two siblings who like made it the most, I guess. And my brother and I have probably, (inaudible at [00:20:48]), one of my, one of my cousins Layla, she, I think she got a PhD. She may have just got a Masters. But it’s always awkward being the like, why can’t you be like Karen and Will? [00:21:08]

Because they know that, I confirm that like they’re hard to (inaudible at [00:21:13]). I’m just like, and for a long time, like Daniel, he’s definitely expressed resentment. I don’t know, kind of like, like towards my parents, towards that, I don’t know. He’s like, “Well you had it so easy.” I mean, so his thing is sort of, he feels like my brother and I, and then also my dad to an extent, like we had it easy, like our parents handed it to us, like you know, handed us whatever. [00:22:03]

And it’s not there because his parents weren’t supportive, and at times he very much, he very much seems to feel like I don’t know, like he was cheated out of something. I, like a better life, or something. I mean, he also like, he also blames his uncles and cousins who introduced him to like drugs and alcohol. And then he also blames his mom, blames his dad sometimes. [00:23:03]

THERAPIST: So it’s a pattern of blame?

CLIENT: A lot of blaming.

THERAPIST: I think I’d have grievances, but (inaudible at [00:23:08]).

CLIENT: Yeah. And he, it’s one of those things where I’m like, “Well, I don’t think, yeah your parents had some problems.” But so when we were kids, his parents had a nicer house than my parents did, and his, I think his dad actually made possibly as much as, like a, salary comparable to my dad. He worked for Pepsi, a regional sales manager, whatever, whatever. And his mom worked too, so like they had money, and various things happened. ‘[00:23:08]

You know, like I know that he was encouraged to go to school, but when he started terrorizing his mom, she didn’t any more. I think like yeah, at some point she threw him out of the house because he was terrifying her. And so he went to live with his father. But it’s also this weird thing where he’s like, he’ll sometimes say like, “Well you know, Karen, you and Will never had, like you’ve never had any problems or any difficulties.” And I’m like, “Well, it’s true I’ve never been in jail. I do not have three children accidentally, but certainly other horrible things have happened.” And, like, you know like— [00:25:05]

THERAPIST: Sure, yeah, I can recall some of them.

CLIENT: Yeah, and it’s also sort of like an argument that I can’t win.

THERAPIST: Right. But it actually feels like he’s sort of working pretty hard there to defend himself.

CLIENT: Yeah.

THERAPIST: And you need a way of sort of externalizing it.

CLIENT: Yeah. I mean, part of the thing is like I do feel a certain amount of guilt or discomfort with like, yeah, I have succeeded like better than he has, but, you know, I don’t know. It’s also a little unfair to me what he thinks are the things that make my parents, gave my brother and I. [00:26:04]

Because sometimes it seems like material goods, and sometimes it seems like he means emotional support or good parenting, and sometimes it just is unclear. Like I guess like sometimes it’s kind of like, “Well your parents are classy, and mine weren’t,” which I don’t think is true, but yeah. It’s just really, I don’t know. [00:27:05]

THERAPIST: Like a lot of his life is incredibly sad, and unfortunate.

CLIENT: Yeah, like he made a series of horrible decisions and for the last like, I don’t know, eight, nine years like that, he’s been doing a lot better, like the last time he was in prison he was like, “Wait, fuck this.”

THERAPIST: Yeah. Is that when he got his GED?

CLIENT: So the second felony, and third felony you’re in jail for like—so he’s like, “I don’t want to be in prison for—”

THERAPIST: Yeah, that’s true.

CLIENT: And the last time he was in prison, he also like asked for his family members to pay his child support for his daughter. [00:27:05]

When he was in jail, because he couldn’t. So yeah, like he started a sort of small business of like doing like yard, lawn work sort of things because he can’t work, like it’s really hard for him to work for a person, like.

THERAPIST: Taking (inaudible at [00:28:31]).

CLIENT: Like taking orders, or he just woke up. He’s no longer physically, like thankfully, he will no longer punch you, but he’s just a really tall, big guy who will yell and get in your face, and might punch the wall. So I kind of see why people get freaked out. [00:28:58]

Like it’s scary. And I kind of think that lately, he’s been doing things that are really positive, like not doing drugs anymore. And he had a hard time, he was trying to sort of build a better relationship with his daughter. And actually, recently, his daughter’s mother claimed that she never got any child support when he was in jail, and sued him for the actual support, and Daniel (sp) was furious about it. And then my relatives said no one had thought to do like documentation of it, of giving her money. So she claims that she never received any of the money that she was given. [00:29:59]

And there was a problem with his daughter because he was so mad at his daughter’s mother, and his daughter recently was like, “Look, I know my mom lied. I know that you had people send her money when you were in jail. I get it. But you need to let it go so we can talk to each other.” Good job, kid, by kid I mean eighteen. And he’s going to go to her high school graduation, and she got straight As, and she’s going to go to cosmetology school, which is great. He also has surprise twin sons, which the mother just didn’t tell him. And so he’s been trying to do something with them. So it’s like you know, good things, positive things. [00:30:55]

Not drinking too much, whatever. And now I’m like well, this really sucks. Like this is, I don’t know, I guess it feels like now taking a turn towards tragedy again.

THERAPIST: I see, where it had been sort of like a change of trajectory towards more positive stuff, like he was on the way up.

CLIENT: Yeah, like it really was like we had a (inaudible at [00:31:37]) long conversations about one of my other cousins had said that (inaudible at [00:31:44]), you know, it was like a waste, like he just wasted his life, whatever. And I was talking to Daniel, like I was actually proud of him for making all these changes, and that he’d gotten his GED was really amazing, because they’re hard to get, and you know, so we had this type of long conversation where I was like, “No, like I’m really proud of you. You have done such great things.” [00:32:07]

And I don’t want to be cheesy about it, but we’re proud of you. So like I’m still proud of him, but I’m also like, “Oh my God, why aren’t you taking care of your diabetes?” You need a kidney transplant. Like it’s a lot.

THERAPIST: Yeah.

CLIENT: And, you know, I don’t want to talk about to Jamie (sp) because she’ll give me a medical consult and I don’t want that. And I don’t know. I’m just finding it hard to talk about.

THERAPIST: It’s really upsetting.

CLIENT: Yeah. [00:32:59]

THERAPIST: It’s really bothering you a lot.

CLIENT: Yeah, and it’s just like—

THERAPIST: My sense is like is it something because of what’s happening to him? Sort of reflect in a depressing way about the world he lived in?

CLIENT: Yeah, and my other fear is that I won’t be able to donate a kidney because of my weight, and—

THERAPIST: It probably doesn’t make you feel any better about any of that.

CLIENT: Right, it’s infuriating, and it’s one of those things where I’m like, would I attempt to voluntarily lose weight which I don’t think would work for that purpose, and then like, like I don’t know. It just brings up like that spectre of would you try to lose weight for medical reasons? And my basic answer is no. [00:33:56]

THERAPIST: Right. I imagine, maybe I’m wrong, but that might be because you’re angry and don’t buy into why you have to in the first place, or is it different?

CLIENT: Well, it’s sort of a couple things. It’s like most of the time what is happening is that for whoever’s sake you need to lose weight is assuming that I’m very sedentary, that I eat lots of fast food, that I eat, like I assume gross lean cuisine or I drink diet soda. Like they assume—

THERAPIST: They don’t really know.

CLIENT: Yeah, I’m like no—

THERAPIST: Actually, you live quite a healthy way.

CLIENT: Yeah, and also like while these are like medical conditions that like are affected by weight, they’re just like, “Lose weight.” And also dieting almost always fails. It’s one of those big depressing like 80 percent of people who diet gain it back. [00:35:11]

And like to be really sort of blunt, like if I had to lose 50 pounds to donate a kidney, I wouldn’t give a shit like if I gained it back.

THERAPIST: Right.

CLIENT: Like I don’t care. But I actually don’t know that it’s, I could.

THERAPIST: Lose it.

CLIENT: Yeah.

THERAPIST: Which might not work.

CLIENT: Yeah, that’s the thing. It’s like it just might not work, and it’s, it’s yeah, like I don’t know. My father’s sister is (inaudible at [00:35:53]), like off and on all their lives.

THERAPIST: Yeah.

CLIENT: And I’m like, and just, you know, it’s like weight loss doesn’t, like it’s really hard to lose weight, it’s really hard to keep it off. I don’t enjoy the things that you have to do to try to like drop weight. [00:36:17]

Especially since they often don’t do anything except make me cranky and miserable, and I don’t like, like you know, much harsher things to say to myself than obsess over calorie counts. And, a coworker of mine, I just found out, which I think also ties into this, is, she just had weight loss surgery.

THERAPIST: Bariatric surgery?

CLIENT: Yeah. So, and she didn’t really tell anyone, so this is a (inaudible at [00:36:58]) worker but who’s overweight. She’s fat. [00:37:02]

She’s probably fatter than me, like, and so anyway, there was a whole thing where no one told me that she was going out for surgery because everyone in their office space knew but even though I’m not there a lot, no one—

THERAPIST: I see.

CLIENT: It’s like pisses me off, which also set me off into a tizzy. But the reason, the reason that she told me was pretty much because I’m also fat. She’s like, “Well you know how,” she’s like, “You know how it is,” like I went to the doctor, and I don’t want to have diabetes, I don’t want to blah, blah, blah, so I decided to do this. And I’m just like, like I didn’t say anything negative. [00:37:59]

What the fuck?

THERAPIST: Yeah, she just had it done.

CLIENT: Well, and also, yeah, like she did it, she has control of her own body. It was like a new bariatric procedure was going, but she looks like a wreck because right now she can’t really eat anything. So the way they mostly work, it’s just horrifying, is so—

THERAPIST: Makes a like whole, like pulling the way out of your stomach so small that you can’t eat very much, right?

CLIENT: This particular kind basically kind of smushes half your stomach, or blocks it off or something. So you can only eat a very small amount of food, and you just start eating only a very small amount of very soft food. [00:39:01]

And then it’s like you can start (inaudible at [00:39:01]) with crunches, and you have to be very aware of like nutritional content, because you are eating a half cup of food.

THERAPIST: Right, you could be malnourished, right, very easily.

CLIENT: Yes, and so she looks exhausted, her skin was horrible. I mean, she looked sick and terrible. And that, and like she made that decision not because she’s currently having medical problems, but because she’s sort of bought into if you’re fat, you’re going to die.

THERAPIST: I see.

CLIENT: There’s this like sort of joke. [00:40:00]

I don’t know if that acceptance, people have been trying friends where a lot of times someone will say like, “That woman was so fat, she was like 300 pounds,” and that’s the like 300 or that’s like the sort of like, “Oh my God.”

THERAPIST: I see.

CLIENT: And so—

THERAPIST: Flashing lights, cutoff.

CLIENT: Yeah, so one of my friends who’s like, “Oh yeah, I’m def that size.” He’s over 300 pounds. And so several people were just like, “Yep, I’m def fatty. I’m going to die of that right now.” And I feel like my coworker kind of believed it. Like she doesn’t, you know, she said, “Well I don’t want to have diabetes.” And I’m like, yes, but.

THERAPIST: Right, so like similarly, really depressing.

CLIENT: Yeah.

THERAPIST: About like the culture with that. [00:41:07]

CLIENT: Yeah, and like my concerns about being too fat to donate an organ combine with her doing like very edgy surgery. It’s just like I don’t know. It makes me not want to eat. Like which is weird, but well also (inaudible at [00:41:38]) makes me not want to eat, but I don’t know. It just makes me stressed thinking about it.

THERAPIST: I’m confused.

CLIENT: So it’s hard to, so the way that one of the ways that dieting plays out (inaudible at [00:42:02]), especially never quits her social groups, is everyone talks about diets. [00:42:07]

And there’s the newest diets and this or that, and everyone assumes you’re on a diet, were just on a diet, or going to be on a diet. And—

THERAPIST: If not all three.

CLIENT: What?

THERAPIST: If not all three of them.

CLIENT: Yeah. At any moment, so that I find horrible and try to sort of cut off, and also (inaudible at [00:42:32]) people who are doing, it’s like dieting thing, they’re talking about, “Oh, I can’t have that full, I can’t have a whole donut, I can’t just pig out on whatever.” And usually I’m like, “Well, fuck you. I’m going to whatever.”

THERAPIST: And create opportunities too, like, you know like so many things, we’re like, “Oh my God, I’m so hungry, I could eat half a sandwich.”

CLIENT: Yeah. And (inaudible at [00:42:58]). Like sometimes my reaction is to be like, “Fuck you. I’m having the biggest salad in the universe.” And sometimes I’m like, “Fuck you, I’m going to have a burger and fries,” like you know. [00:43:08]

And like she’s going to get, it’s just like she looks so sick, she’s going to get all this praise for losing weight, and bariatric surgery isn’t even necessarily, because you, if you want, it is possible to sort of just re-stretch your stomach out.

THERAPIST: I see.

CLIENT: Or just not lose as much weight as you hoped, so you can have bariatric surgery and still be fat.

THERAPIST: I see.

CLIENT: Just not as fat. So there is that. And then I feel like well, but what if my weight was like the only thing keeping me from doing this? Would like, would like, someone, would people like judge me for not trying to diet? Like it’s—dieting is so expected and so assumed. Like that’s what we want to do, and that it’s just a thing you can do, and if you don’t, you’re lazy. I feel like if that was, if that was the thing, and I’m like building it up, you know, think weight would be the only thing. But it makes me feel like it was a judgment of like why couldn’t you lose, you know, like twenty pounds.

THERAPIST: I see. [00:45:00]

CLIENT: To save someone’s life, or whatever. And I’m just like, “But it’s not like that, and fuck.” Like I don’t know.

THERAPIST: It’s kind of an emotional minefield.

CLIENT: Yeah. Amazingly, my mom did not get on me about being diabetic.

THERAPIST: Good.

CLIENT: I was really shocked. She actually was relatively calm, all things considered, especially considering that she’d also had decided like five or six years ago that my dad was going to need to go on dialysis at any moment, which wasn’t true.

THERAPIST: Right.

CLIENT: Yeah.

THERAPIST: We should stop. [00:45:58]

(inaudible at [00:46:01])

CLIENT: Thank you. I think I’ll be talking about it for awhile.

THERAPIST: Sorry.

CLIENT: That’s okay.

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