TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: How do things stand with you this week?

CLIENT: I spent most of the week at my parents’ place.

THERAPIST: How was that?

CLIENT: It was okay, except towards the end Sydney was going crazy.

THERAPIST: He came with you?

CLIENT: He came with me and I don’t think moving there would be a good solution, however my apartment still drives me crazy. I was panicking as I came back. I mentally somehow got myself not to panic last night and then today it was okay until I was trying to do the dishes and then there was all of a sudden no water pressure and I was not able to do the last few of them. Eventually, I realized if I put on cold water . . .

THERAPIST: It sounds like you ran out of hot water?

CLIENT: I ran out of hot water. There was a little bit left.

THERAPIST: The hot water will replenish, but you probably used up the hot water tank.

CLIENT: Oh, that would explain it. I thought it was just that I was getting really bad water pressure.

THERAPIST: Separate handles for hot and cold? [00:01:05] So it sounds like what happens, and I’m not a plumber by any means, but in my experience you used up the hot water that you had available in the hot water tank. If you have a separate valve for hot and cold, then you ought to have water pressure and you’ll have water. It’s not that you used up water, it’s just that you used up the hot water. And then that takes some time and the water tank will heat the new water available. It just takes a little bit of time. So when you go home today you’ll probably have a full tank of hot water.

CLIENT: That would explain it.

THERAPIST: So when it happens to you for the first time and it’s a new place and you don’t know what the system is like, it can be unsettling.

CLIENT: I was just like how am I going to do my dishes and I have leftover pasta that I can’t eat because I don’t have a microwave and I can’t even eat leftovers. I want to be all good about cooking stuff and productive and thoughtful and I can’t be responsible because I don’t even have a space in my apartment for a microwave. [00:02:08] Then I can’t make leftovers. (crying) I still haven’t conquered my oven yet and I was cleaning it out with oven cleaner first. Sydney said he’d help me with that but it hasn’t happened yet. (crying)

THERAPIST: So when you get really panicked, which it sounds like immediately when something started going wrong or something was unexpected, you started to really panic and it’s much harder to think logically and it’s harder to think creatively and problem solve when you’re panicking.

CLIENT: I just want to be able to deal with my apartment. I tried to distract myself. I tried to find the rainbow wool and I couldn’t find it. I went through like ten of those bins.

THERAPIST: So that’s another frustration on top of already feeling . . . [00:02:58]

CLIENT: I wanted to be able to spin it and now I’m like maybe I have to buy rainbow wool, which seems kind of ridiculous considering I should have all the wool ever. Seriously, I have old stock from my store that I’m not selling right now. I should not have to go out and buy rainbow wool.

THERAPIST: But you can’t find it right now.

CLIENT: I can’t find it. That took forever, getting those in and out, and there were some boxes in the way and it was trapped in the closet. (crying) I need to be able to learn how to calm down and deal with it because I know I’m stuck with this apartment for the next seven months and I don’t know how to deal with it on a day-to-day basis that I can just not feel horrible. I ordered a poster to put in my room because I thought part of it was the room with the wall being so bare, so I’ll put the poster up when it comes. [00:04:09] I don’t know if that will really help.

THERAPIST: It sounds like it will help with one of the issues, but it does sound like the thing with the water doesn’t sound like that’s a new problem. You might have to, if you ever have a big load of dishes to wash again, you know that you might not get through it all with really hot water. The space issue is an ongoing issue and figuring out how to configure your space, how to make the best use of the space that you have so that you can do the things you need to do to take care of yourself, that’s the ongoing problem.

CLIENT: I don’t know what to do.

THERAPIST: Has your mom or dad come to the apartment with you and looked at the space with you? Have they helped you to problem solve that? [00:05:08]

CLIENT: They haven’t helped me problem solve yet. They were going to come up yesterday, but then the forecast made it so she didn’t.

THERAPIST: I wonder if them seeing it with fresh eyes might help you to see if there are ways that you can arrange things or things that you can do to make it a little bit easier to do some of the things your finding difficult.

CLIENT: Maybe.

THERAPIST: I know Sydney has repeatedly said that he doesn’t think it’s a problem and just that, him contradicting you, doesn’t feel helpful. But maybe having a fresh set of eyes help arrange or problem solve might feel helpful.

CLIENT: Maybe. The last time they were up they could only be there for a little bit because dad had a football game to get to. He was watching it with a friend on TV. Maybe if they came back. [00:06:05]

THERAPIST: Would you be open to that?

CLIENT: I would be. I don’t know what else to do. If I can trick myself into thinking the space is bigger then . . .

THERAPIST: More functional. You can’t make the space bigger, but you can make it more functional. I haven’t seen the space, but I would hope that there are ways you can kind of make the best use out of it that you can. And with boxes in the way of things, it doesn’t sound like it’s at that point yet.

CLIENT: Yeah, not so much. The boxes are only in the living room and the closet.

THERAPIST: That makes it hard to get at anything that’s stored in the closet.

CLIENT: I don’t usually use the closets, but that’s true. It is hard to get to things.

THERAPIST: If the boxes weren’t there, maybe you could. [00:07:01] Maybe that closet could become something that’s actually adaptive if there is a way for you to get in and out with things that you need.

CLIENT: I just don’t know when my parents could come up. Maybe next weekend. I don’t know.

THERAPIST: So you said being there was mostly okay but started to drive Sydney crazy. It didn’t feel like a viable alternative anymore?

CLIENT: Yeah.

THERAPIST: Talk me through that. What was good? What was bad?

CLIENT: He was having issues with the whole lack of privacy thing. My parents say if I were to live there they would pick up the basement so I could live in the basement.

THERAPIST: You or you two?

CLIENT: Me. I think Sydney could come over as much as he wanted to. It isn’t a problem. There is the privacy issue, which I guess wouldn’t be an issue because I would live in the basement, but there is also the . . . [00:08:02] Well actually, even then, in the basement the laundry machine is in the basement.

THERAPIST: It wouldn’t be a separate apartment?

CLIENT: Yeah. Also the cat’s litter box is in there so they keep the door closed for that. One of the two cats, I don’t know which one, one of them or maybe even both of them can’t go to the bathroom without a significant amount of light in there, which seems counterintuitive for cats, since they’re supposed to be able to see in really low light. Then having that door open with the light in there is making it harder to sleep. Also, he felt trapped by being in suburbia – not really – even though Stamford is a city. But not having all the public transportation or the ability to go wherever he wanted easily, especially when I have the car because when I have the car he can take the T. [00:09:14] At my parents’ place he can’t really do anything so it makes it really not a viable option. Getting a new apartment would not be a viable option either at this point. Maybe if we moved in a little bit earlier in September I could shave off a little bit of time there.

THERAPIST: But moving is also a big hassle and something that creates a lot of stress for you.

CLIENT: But it would be a temporary, one-time hassle and once it was over, it would be over. It wouldn’t go on for several months like this. I guess it would take some time to pack everything up, but I can get rid of more stuff then it won’t be as bad as the move from the old, old place because at least all the yarn is in containers now. [00:10:13]

THERAPIST: You haven’t fully unpacked.

CLIENT: That, too. I’ve unpacked a lot of stuff. I’ve unpacked the majority of it, but I guess I’m not planning on unpacking any of my books or anything.

THERAPIST: You’re not planning on unpacking them because there is no space for them?

CLIENT: There is space; it just doesn’t seem worth it.

THERAPIST: You haven’t really committed to staying?

CLIENT: My lease is up in August. I just don’t think it would be wise for me to do a one-year lease. I think Sydney and I are going to move in together. But even if we weren’t, I would probably move home or do something else, but I don’t think I can stay here.

THERAPIST: Beyond August.

CLIENT: Yeah, considering how miserable this apartment is making me. [00:11:01] I just don’t know how I misjudged it so much when I viewed it.

THERAPIST: It certainly wasn’t something that you talked about at all. You were excited about it.

CLIENT: But then it was smaller than I thought. I guess I forgot about how small the kitchen was. (sobbing) I want out so much and I don’t know if I should be asking . . . My parents might be able to afford . . . I can’t afford two apartments. I can’t and I don’t know. (crying) I need out. It’s just driving me so crazy. It seems like no matter what, just doing little things is like rearranging the chairs on the Titanic or something. It seems like I’m trying to fix small problems when there is still the big problem of this apartment driving me crazy. [00:12:02]

THERAPIST: The question here is how does an apartment get that much power? The problem with the Titanic was that it was sinking and people can’t breathe underwater. How is it that the size of an apartment gets as much power as a huge sinking boat?

CLIENT: Because I can’t get to my stuff. I can’t even eat. It’s impacting the way I live my life in terms of eating habits and stuff. (crying) It’s because I can’t have a microwave.

THERAPIST: You can’t or nobody could?

CLIENT: I don’t know if anyone could. Maybe. Maybe if I put it on top of the frig, but then I wouldn’t really be able to reach it. Someone taller than me might be able to reach a microwave.

THERAPIST: I guess I didn’t mean specifically the microwave, but you can’t make a meal in that kitchen or nobody possibly can make a meal? [00:13:05]

CLIENT: I can make a meal, but I can’t make leftovers. So that means I have to cook something new each time. We made pasta last night and there is leftover pasta and I can’t do anything with the leftover pasta.

THERAPIST: You can’t heat it in boiling water?

CLIENT: Wouldn’t that overcook it?

THERAPIST: You leave it in long enough to get hot. What did people do before there were microwaves?

CLIENT: They didn’t eat leftovers or they ate cold food.

THERAPIST: They heated them up in other ways. Part of this is rather than resigning yourself to an uncomfortable fate, getting creative. If you want to heat up leftover pasta, it’s going to take longer than a microwave, right? A microwave is super easy. You press a minute, start, the food is warm.

CLIENT: Plus you have to do more dishes then if you have to rewash the pot. [00:14:01]

THERAPIST: Yes. So it’s not the easiest way; but rather than letting yourself be trapped in an impossible situation, you have to create something different. So yeah, if you want to heat up leftover pasta you can do that without the sauce on it. Save it without sauce. Boil some water. Leave the pasta in there long enough to get warm – you’re not recooking it; you’re just reheating it – and drain it. It’s going to take a little bit longer, but you can still have it. You don’t need to be denied.

CLIENT: The other solution was to bring it to work where I do have a microwave.

THERAPIST: Sure. Then you can have leftovers for lunch. That’s another way. That way it’s a way to get two meals out of something without necessarily the extra work. [00:14:58] Part of having your parents look at the space or taking to me about it or looking at it through Sydney’s perspective – because the apartment is not driving him crazy, and yet he has another apartment to go to. [00:15:09] It’s not the lease that he signed. But if we can think how somebody else would respond to it who isn’t feeling as emotionally upset about it, looking at it as a practical challenge rather than an emotional sentence – because it sounds to me like you feel like this apartment is a death sentence.

CLIENT: It kind of feels it is. (crying) It makes me so sad on a regular basis and I just can’t keep on being this sad all the time. (sobbing)

THERAPIST: I agree. You cannot live this sad. The piece of the equation that we want to change is how you feel; and if you can’t change the apartment, then we need to change something else, which is how you respond to the apartment. That’s the only piece it sounds like you have a lot of control over because if living with your parents now sounds like it’s not a viable option, then we have to find a way for staying in this apartment until August not to be such a death sentence. [00:16:12]

CLIENT: The only thing I can think of is not being in my apartment as often.

THERAPIST: So taking some breaks from it might be a good tool.

CLIENT: I wanted to go to Sydney’s place last night and we were going to, but then he was like “why don’t we just go tomorrow?” (sobbing) Then this all happened and I was stuck.

THERAPIST: I think your response is probably on two things. One was that you were in the apartment that you don’t like. But also that it doesn’t feel like your choice. You wanted to go to Sydney’s place and he said no.

CLIENT: He said yes, but later.

THERAPIST: So he said yes, but later. So two things happened: You lost control. You didn’t get control of when. He got control of when and you felt unhappy in the apartment. [00:17:01] That control piece, feeling trapped in the apartment, feeling very dependent upon Sydney’s permission to do things, his ability to do things with you, both of those things have an effect on how you feel. (pause)

CLIENT: (crying) Just calm down and not have to go crazy over it like a normal person should be calm. (sobbing)

THERAPIST: You’re having a really intense reaction to this move.

CLIENT: I’ve been there a month now and it hasn’t gotten any better.

THERAPIST: No, it hasn’t. [00:18:02]

CLIENT: Even though I have unpacked some things and now I have a table. It doesn’t end. (crying) It never ends and I just want to move on and make it all go away. (sobbing) Maybe I should live with my parents anyway even though it doesn’t seem like it would be viable with Sydney. Maybe I should break up with Sydney so I can live with my parents and then I can live with my parents and I won’t be in the apartment anymore and I won’t have to deal with it.

THERAPIST: Can you live with your parents without breaking up with him?

CLIENT: Maybe. I don’t know. I would see him less often.

THERAPIST: Yes.

CLIENT: But I don’t know. It does seem like I should be able to take care of myself, but it’s hard to do with the apartment. I don’t feel like I have the space to take care of myself. I don’t know how someone lived in this apartment for two years and didn’t go crazy. [00:19:01]

THERAPIST: So the person who lived there with you stayed two years?

CLIENT: I think he lived there maybe less than that. Maybe he stayed there one year, but he stayed a while. Maybe he ate a lot of take-out. I don’t remember him having a microwave. Maybe he did. Maybe it was in the living room area instead of the kitchen area.

THERAPIST: It’s possible.

CLIENT: I guess if I could find a stand to put something on maybe I could get a microwave in there.

THERAPIST: Even just a tray table, if that would make it feel more manageable to you.

CLIENT: Yeah. (pause)

THERAPIST: Have you talked to your psychiatrist in the past couple of weeks?

CLIENT: No. I’m seeing her on the 21st. I probably should. I don’t know. I wonder if that new med is a problem. [00:19:59]

THERAPIST: Certainly you’ve now had several weeks of very intense emotions. You’ve been feeling very defeated, very hopeless, really panicky for a couple of weeks now. We can trace the trigger to moving into this apartment, which was such a disappointment to you, but you haven’t accommodated to that and I think that’s something that you want to talk to the psychiatrist about because we’re working to problem solve, but you’re having a hard time doing that. It’s hard to get out of the thought loops that are intensifying your response. (pause) [00:21:01]

CLIENT: I just don’t know what else I can do with the drugs. (crying)

THERAPIST: I don’t know the answer to that either, which is why I wondered if you had been able to consult with your psychiatrist.

CLIENT: I can try calling her. I just don’t know. The drugs seem kind of hopeless, too, because there are only so many things you can do. I can’t take anything that affects the serotonin.

THERAPIST: You have certainly had much reduced symptoms compared to what’s going on now in the past. That might not be a drug issue. [00:22:03] Maybe there is; maybe there isn’t some adjustment that can be made. It’s certainly worth checking into because it sounds like some of the problem-solving stuff you’ve been trying to use in trying to think in a more creative, flexible way is really hard for you to do and it’s having minimal effect. You want all those pieces working together. You want the flexible thoughts working to help you, the meds working to help you.

CLIENT: Maybe this apartment is just so livable and maybe anyone would say that, you know? Maybe I really am in the worst apartment ever. I guess it’s not the worst apartment ever because I saw worse apartments. [00:23:00]

THERAPIST: And people are renting them. You had a really hard time getting an apartment.

CLIENT: Sometimes I thought I would have someone look over my lease, but I could see about breaking it maybe. Maybe I would even find a new one, but something else would have to be for a year or something and I don’t think I could find another – maybe if I found a sublet or something like that and subletted mine. It seems like it would be another temporary move for another one. It just seems so not worth it.

THERAPIST: How were things feeling for you when you were out of the apartment?

CLIENT: A lot better, although right now today I’ve been feeling tense. I brought my laptop with me because I thought I was going to work on cover letter stuff, except I feel completely not up to that now. [00:24:04]

THERAPIST: What changed?

CLIENT: I don’t know. I guess everything today is sort of feeling like in a haze and I’m having trouble seeing. I don’t know.

THERAPIST: You’re having trouble seeing?

CLIENT: A little bit. Things were a little bit blurry for a while. I don’t know what’s going on. (crying) I can’t explain it. It wasn’t for that long. Of course, I still have the weight of the laptop that I’m carrying even though I don’t think I’m going to get anything out of it. I carried it for nothing and I guess I feel frustrated with that.

THERAPIST: What would you need to put yourself in a frame of mind where you could write a cover letter, rather than giving up? [00:25:04]

CLIENT: Leave my stuff over at Sydney’s place and be staying there and not be staying at my place. I really do think I need to be not staying at my place and being there and having my stuff still there is a huge part of the panic. It doesn’t make sense, but I think that’s it.

THERAPIST: No, it doesn’t. (pause)

CLIENT: I just need to calm down and relax by not being at my place, and then I could write one. Maybe. Knowing I’m going back to my place is hanging over my head.

THERAPIST: So being able to focus, having some control over where you can focus your thoughts – because it seems like what’s happening, no matter what you’re talking about, the place where you turn your thoughts to is “I hate my place; I need to be out of there and nothing will be okay unless I’m out of my place.” [00:26:12] It’s like that’s the train that your thoughts want to go on and being able to turn and take control and say, “This is what I’m focusing on right now. Yes, I acknowledge that I hate my place. I don’t want to live there anymore. I want to be out, but that’s not where I’m going to focus right now. Right now I’m focusing on reading the requirements for this job and crafting a cover letter that addresses how I fit.” So it’s not pretending that you like your place or that it’s okay, but it’s not allowing that to be the only thing that takes up the focus.

CLIENT: Okay. I just don’t think I can do that right now. (pause) [00:27:00] I don’t.

THERAPIST: I believe you. I believe that you feel like you can’t.

CLIENT: I want to. I brought my laptop. I’m also just feeling like lugging around too much stuff isn’t helping. Maybe if I just brought my laptop or had emptied my backpack of all the things that I normally carry around because I carry around all my meds in my backpack because then I bring it to my place or to Sydney’s place or to my parents’ place.

THERAPIST: Without having to repack.

CLIENT: Yeah.

THERAPIST: So it seems like the thread here and the pattern that I hear in your thoughts is that you feel like you need to have things the way that you ideally would want them in order to be able to be effective at anything. In order to be able to work, you need to not be frustrated by what you’re carrying around. You need to not dislike your place. This belief that you need to have things be the way that you want things in order to be able to do something is really getting in your way because a lot of the time things aren’t the way that we want them. [00:28:09] They might not even be close to the way we want them, but yet we still have to find a way to function.

CLIENT: But I don’t think those people are living in apartments that make them miserable.

THERAPIST: No, a large part of the population is homeless.

CLIENT: Okay, but then they’re not getting stuff done if they are homeless.

THERAPIST: They might be getting a lot of stuff done. It’s not a comparison. Some people have it worse than you; some people have it easier than you. The comparison game doesn’t help you. This is your reality. Your reality is that you have an apartment that you don’t like. Your choice is are you going to allow that reality that you don’t like your apartment, that it’s challenging in many ways, are you going to let that force you into living the next however many months like this? [00:28:59] Or are you going to face some of the challenges that are there and be functional anyway? We could list a whole host of people who are living in more challenging circumstances and a whole host of people that are living in much less challenging circumstances, but that’s not going to change what’s happening for you. The only thing that’s going to change what’s happening for you is if we can find a way for you to respond to your challenges in a way that helps you rather than further traps you in them. It seems like this past month you’ve been really trapped. You’ve said a couple of things today that have potential to get you sort of untrapped – thinking about being able to stay with your parents sometimes and not others is a way of having that escape you so desperately want. Even bringing your laptop with you today was a great way of thinking “here is a way of getting out of the apartment and work on something I need to do.” [00:30:02] It is challenging, having to lug around all the stuff.

CLIENT: That, plus I have no clue what to write in the cover letter. If I had a clue what to write in the cover letter, maybe it would be easier to get over the other challenges.

THERAPIST: I’m sure it would, but you’ve written other cover letters. You’ve written lots of cover letters. You’ve done this before and you can do it again.

CLIENT: But I’m kind of out of practice. (pause)

THERAPIST: What do you expect of yourself?

CLIENT: I don’t know. I expect myself to curl up in a little ball and cry for the rest of the day possibly. (sobbing)

THERAPIST: Then that’s probably what’s going to happen. You’ll probably meet your own expectation.

CLIENT: I don’t know. [00:30:59] Maybe I can get something done. If I can just go over to Sydney’s place I think it would help.

THERAPIST: Can you do that?

CLIENT: That’s on Sydney. I can’t really go to his place without him and I guess I could, but that would be weird.

THERAPIST: Would he be supportive?

CLIENT: I don’t know. I think he wants to get out, but he didn’t really get to sleep until really, really late last night so I let him sleep in so we’d have this time.

THERAPIST: So so much of what happens to you in your day is about Sydney.

CLIENT: Yeah.

THERAPIST: I think I’d feel frustrated by that.

CLIENT: Yeah. I am frustrated that I just couldn’t get over to his place like I wanted to. (crying) Also, when I was trying to go to sleep he wanted to use the computer and told me, eventually, that he would go to the living room and use the computer there. [00:32:07] He was using it on the bed next to me and the light was making it really hard for me to go to bed.

THERAPIST: So you’re also tired.

CLIENT: A little, I guess. Maybe that’s why I’m having trouble seeing. Whatever. I am tired. Maybe I should take a nap or something.

THERAPIST: Maybe you should go to bed early. Sleep on the schedule that makes sense to you.

CLIENT: But early, like I want to go to bed now, I think. I don’t think I could go to bed now because that would make my schedule really messed up. [00:33:04]

THERAPIST: It’s probably best for you to go to bed at a normal bedtime so that you can get good, consolidated sleep at night and then be on schedule for the day. Sometimes taking a short nap is really useful, but I think having a regular pattern is actually most useful to you.

CLIENT: It’s just been so hard to get sleep lately because I’ve been waking up a zillion times to go to the bathroom and I’ve talked to the doctor about this issue and stuff but it hasn’t been fixed yet. I wake up and feel like I have to go even when I don’t and then I’m just sitting there and not being able to go back to sleep.

THERAPIST: I didn’t know about that. That’s been going on for a while?

CLIENT: Yeah, to varying degrees. [00:34:01] It used to be just getting up once in the middle of the night, but last night it was maybe five or six times.

THERAPIST: Is that happening during the day as well or only at night?

CLIENT: Only at night. I may have to go to the bathroom a little bit more often during the day, but not like that. No. I don’t know why. Last night and the night before was really bad.

THERAPIST: But you’ve talked to the doctor about it and they couldn’t figure out what’s going on?

CLIENT: Yeah. Originally we thought it was the UTI, but then they gave me antibiotics and it hasn’t gone away. They think it’s the whole being pre-diabetic. It might be that. Other than losing weight, there is nothing I can do about it immediately, so I’m just forced to get less sleep.

THERAPIST: So you’re getting interrupted sleep. [00:34:58] Being sleep deprived, which can be a function of how many hours your sleeping, but also how restful that sleep is, gives you less of the tolerance for things that are frustrating. It also tends to have people have more intensity in their emotions and react stronger to things. So also knowing that you’ve been having this ongoing problem for the past couple of months starts to explain part of why you’re having such a hard time accommodating to this change and the stressor of your apartment.

CLIENT: Except that there’s nothing that I can do about it and there’s nothing I can do about it. (sobbing)

THERAPIST: Sometimes understanding why you’re feeling the way you’re feeling. If it makes sense that you’re responding more strongly because there is some ongoing sleep deprivation, then we need to understand that the response is not just due to the apartment, but a combination of things – the apartment and a lowered ability to deal with any kind of frustration or crisis or disappointment. [00:36:10] All that you’re going to have a stronger response to, so we need to think about that because then maybe changing something about the apartment or even where you live is not going to have as much as an impact as you’re imagining it will. Sometimes when you think about “well, I’ll just move to another apartment,” what if that’s not the magic cure? What if you’re going to find something else to be upset about? Obviously, staying in touch with your doctors to see if there is something that you can do about this, but also if you know that your sleep is going to be interrupted, that makes it even more important to be able to get to bed at a reasonable hour.

CLIENT: I have been getting to bed at a reasonable hour most of the time. [00:36:59]

THERAPIST: And that’s great.

CLIENT: It’s just the staying in bed part. When I can, I try to build in extra sleep there.

THERAPIST: That sounds like a good response.

CLIENT: It just hasn’t been working the way I wanted to. Last night and the night before it was so awful.

THERAPIST: So two nights in a row it’s been really awful.

CLIENT: Yeah. (pause) And right now I have my period, so that doesn’t help either.

THERAPIST: That makes it a particularly difficult day.

CLIENT: I just want the day to be over and I just want to go to sleep because then I don’t have to deal with anything. (crying) The thing is, I’m usually fine when I’m at work. I’m far enough away from everything. It doesn’t matter about my apartment anymore. [00:38:03]

THERAPIST: It feels good to be out and being productive. I wonder if it would also feel good to be out and doing things that are not – the work is one great place. What about when you’re out and doing something –running an errand or have you taken any walks?

CLIENT: I walked to get to the station to get here, so a 20-minute walk.

THERAPIST: How does that feel?

CLIENT: I don’t know. I didn’t feel sleep deprived.

THERAPIST: You were carrying a lot of stuff. There’s a difference between talking a walk, lugging your stuff, and taking a walk for exercise where you might not bring such heavy things.

CLIENT: Yeah, that’s true.

THERAPIST: It might feel a little bit more freeing if you were taking a walk and just carrying your keys and your phone, but not all this other stuff.

CLIENT: Yeah, I should try that. [00:39:04]

THERAPIST: You talked about needing to get out and needing to have a break; and getting out permanently – whether by moving or staying with your parents is one thing – but something you can definitely do is giving yourself frequent breaks by just taking a 15-minute walk. Even on a cold day you can go out for 15 minutes or get a change of scenery someplace to give yourself less dramatic breaks, but a break nonetheless from the space.

CLIENT: The problem is there aren’t really any coffee stores nearby that I could easily.

THERAPIST: You don’t necessarily have to walk to a place. I know that’s what you prefer.

CLIENT: If I wanted to go somewhere else to get work done.

THERAPIST: But sometimes just going on a walk around for a little bit is enough to give you some perspective. [00:40:06]

CLIENT: But then I’d come back and I’m back in my apartment.

THERAPIST: Yes, you do. It’s a break. It’s not a permanent solution; it’s a break. It’s not the ideal thing. It’s not the ideal solution that you want, but that doesn’t mean it’s worthless. If there is one trick that you could take away from today’s session it would be not to discard something that has a little bit of use just because it’s not the perfect solution. I know you want that perfect solution. I think it makes all the bad stress go away. I don’t think we’re going to come by that, but you probably can take advantage of things that give you some belief. I would love for you to not throw those out because they’re not total relief. [00:41:00] That’s the flip side of not allowing yourself to do something because it’s not idea. You can do stuff even when it’s not ideal and you can take advantage of a little bit of relief, even though it’s not total relief. (pause)

CLIENT: I’m still feeling really tense, though.

THERAPIST: You’re in an intense spot.

CLIENT: I just want it to go away [ ] (inaudible at 00:41:44). (crying) (pause) I’ve been discouraged so much. [00:42:04]

THERAPIST: Do you feel like it’s to the level where you need to go to the hospital?

CLIENT: Probably not.

THERAPIST: If it gets to that place, do you know who to call? What’s the closest hospital?

CLIENT: I’m not sure. The closest hospital with a mental ward or area might be the New Haven hospital.

THERAPIST: And I think knowing what your plan of action is if you feel like it is so intense that you can’t keep yourself safe. That’s the important thing being safe to yourself, that you’re not going to hurt yourself as your means of escape. [00:43:11] If you feel like you are going to do that then know who you’re going to call. It can be either one of those hospitals – calling the ER, letting them know, and having Sydney take you there.

CLIENT: Can I have an ambulance pick me up?

THERAPIST: You can.

CLIENT: I think it would be covered by my insurance. It might be a little bit expensive, but if I can’t get myself there or Sydney can’t get me there.

THERAPIST: If Sydney can drive you, that’s fine, as long as you’re with somebody; but if not, then yes, call an ambulance.

CLIENT: I don’t think it will get to that point.

THERAPIST: I just wanted to make sure that you have a plan if it does. [00:44:00] When we talked last week you said to just skip next week because I’m not in on Monday. I do still have spots during the week if you want to come in. What do you feel would be best?

CLIENT: What do you have during the week? It might require me staying somewhere.

THERAPIST: Tuesday, the 18th, I have a 10:30 spot, an 11:30 spot; and Wednesday, the 19th, I have a 5:30. Friday, the 21st, I have a 2:30.

CLIENT: The Friday wouldn’t work because that’s the same time as my psychiatrist; it’s at 3:00.

THERAPIST: Would the Tuesday or Wednesday work? [00:45:04]

CLIENT: Yeah. I think the Wednesday would. I was considering taking my birthday off of work anyway. That Wednesday is my birthday, so yeah.

THERAPIST: Would that be okay to come and see me at 5:30?

CLIENT: Yeah.

THERAPIST: Okay, let’s do that. It does seem like you’re having such a hard time that skipping doesn’t seem like the most prudent thing.

CLIENT: No, it doesn’t. (pause) 5:30 PM you said?

THERAPIST: Yes. At that time of night the doors downstairs get locked. There is a keypad right by the door and you’re going to want to input into that keypad #4125.

CLIENT: I need to write that down somewhere. Do you have a card or something? (pause)

THERAPIST: That’s the code to open the door. The stairwells are unlocked. But if you want to use the elevator, you want to get into the elevator and then there is a keypad separate from the regular floor numbers and you just hit #7032# and then hit 2. If you have any trouble, just call my cell – the number you always have and I will come meet you at the door. I’ll see you next Wednesday then.

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