TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: How are you doing?

CLIENT: I’m doing okay. So we went to my parents, first of all, this weekend, and they kind of, like, at one point, they had me come down and talk to me and, basically, it felt like an intervention, like, that they worried about my weight and stuff. And I just sort of like was…I guess felt like they were pushing boundaries. Like because they were saying like I should come home at first, and then it was like I’m not doing that. And they were like, okay, you can say.

THERAPIST: When you say they were concerned about your weight and stuff, what…?

CLIENT: The pre-diabetic thing and the fact that I haven’t been getting any exercise and that I’ve been depressed.

THERAPIST: What feels like the boundary crossing type…?

CLIENT: I guess the suggestion they felt that they needed to completely take care of me and stuff. And I’m, I’m like no, I’m an adult. And you know, they can’t be responsible for my weight. Like I’m the only one who can be responsible for my weight.

[01:11]

THERAPIST: Yet in some ways, you’ve been echoing what they’re saying. You have used those same words in here, that you don’t feel like you can take care of yourself.

CLIENT: Yeah, that’s true.

THERAPIST: I’m not disagreeing with you that it felt like a boundary crossing, but I guess I do want to kind of sort out what’s true for you.

CLIENT: I guess I feel like it should be my call to make and not theirs.

THERAPIST: Is that what they said, that they want to make the decisions or that they’re worried about you?

CLIENT: No, they were like, that sort of went back and then they were like oh no, we don’t actually want you living with us; we’d rather have you living in New Haven. But the fact that they originally proposed me moving back home, like…

THERAPIST: Because they are worried.

CLIENT: Yeah.

THERAPIST: I think their concerns make sense. You’re worried too. I don’t know what the solution is, but you have certainly expressed that you’re worried about your weight and the impact that that could have on diabetes or developing into that. And you’ve also worried about your ability to make good decisions about taking care of yourself; your ability to do that.

CLIENT: I guess. And then they want me to never go out to eat; like only go out to eat once a week. And I’m like that would mean I’d have to cook the rest of the time and I don’t think I can cook that much. You know.

THERAPIST: Yeah.

[02:43]

CLIENT: Like I don’t [inaudible – 02:46] trying to cook in a really tiny kitchen. Having to do the dishes with cold water because the hot water runs out.

THERAPIST: Has that been a repeated problem?

CLIENT: Yeah. Like I…even when I first started out and I can’t get full pressure with the hot water. So maybe there’s just a really small tank and other people are using it. But I have yet to get full pressure with hot water. So…

And I’m like I was planning on going country dancing this week and like starting now that I don’t have work and it’s like why did they have to bring stuff up and make me feel worse? Because that’s what it ended up doing. And now I’m like, okay, I’m not going to talk to them ever again. Or if not ever again, I’m not going to tell them about any weight issues or something I shouldn’t have told them that I was pre-diabetic. I regret it now because they’re just going to use that information against me.

[03:50]

THERAPIST: How are they using it against you?

CLIENT: In their campaign to possibly make me come home.

THERAPIST: Mmm. Yeah. I wonder how we can get you guys on the same team, because in a lot of ways you are. You’re worried about you, they’re worried about you. Your goal is the same. It sounds like your parents want you to be able to make choices that lead to a healthier you, which is also what you’re expressed countless times in here, wanting to be able to make choices that are healthier, but you feel like there are a lot hurdles to doing that. So how can we get them, instead of feeling like it’s a competition, or a battle against each other, how can we get your parents to be something that lower some of those hurdles?

CLIENT: I don’t know. I mean they’re willing to pay for like a gym or something like that, but that’s not going to solve the eating healthily issue, which is…

THERAPIST: No, it’s not going to solve that one, but one of the things we talked about on Wednesday was how difficult the weather has made it to walk and a gym does solve that problem.

CLIENT: Yeah.

THERAPIST: If there’s a gym, that’s sort of convenient to you.

CLIENT: Mm hmm. Yeah.

[05:15]

THERAPIST: Is that something that you could let them be helpful with?

CLIENT: I guess. I mean I think I’m going to try the country dancing instead, because it would be more fun that going to the gym.

THERAPIST: Yeah? Okay.

CLIENT: In which case I can let them pay for that.

THERAPIST: Sure. If they’re willing to pay for something to give you more activity and you found something that feels more enticing, that sounds like a good solution.

CLIENT: If I exercise more, can I not have to do the whole eating healthy thing to like will it be enough to lower my weight? Because I can just, right now it feels like eating healthy isn’t really sustainable. Like it requires more…

THERAPIST: More work than you’re willing to do.

CLIENT: Or like the things that they do, and they’re like, oh yeah, you should like never have sweets ever. I mean just give it up. I mean that’s not sustainable. You know, as soon as I lose the weight I’d go back to eating ice cream and stuff.

THERAPIST: That’s too extreme for you.

[06:18]

CLIENT: Yeah.

THERAPIST: Or too extreme for anybody to manage long term.

CLIENT: And it’s just like I guess they’re being really lecturing and like I… [Tearful.]

THERAPIST: So they’re tone makes it really hard to hear the useful parts of their message.

CLIENT: Yeah, and it’s just like you don’t know what’s sustainable for me. Like I know me, myself, you know. I’ve lost weight before. And then as soon as I finish it like, when I was doing Weight Watchers in middle school, high school, like as soon as I stop losing the weight, I stop doing all the measuring the food stuff and you know, not eating junk food and everything not snacking and stuff. And then it all came back over a few years. Like it’s not sustainable.

THERAPIST: Yeah, so something that drastic is not sustainable. Something like giving up sweets.

CLIENT: Yeah, I really don’t want to do that if I don’t have to. Because like if that’s the only reason why I lose weight, like as soon as it goes away, which is when I’m like, maybe if I’m exercising more, I can continue to not have to go to the extreme of like calorie counting and stuff. I don’t know if it will work.

THERAPIST: It sounds like really paying attention to finding what are some of the smaller changes that are more sustainable that you’re willing to make. So, you know, eating out only once a week isn’t…is too extreme for you because the idea of having to cook on the other six days is too much. So where is room between what you you’re doing now and that?

[08:22]

CLIENT: Maybe like trying to eat out like only like three days a week. That’s still a lot.

THERAPIST: How many days a week do you typically eat out now?

CLIENT: At least, almost, every day, for at least one meal. There are many days I be like [inaudible – 08:49].

THERAPIST: So there’s a lot of room to cut down, right. So even just making that two days a week that you cook at home.

CLIENT: Mm hmm.

THERAPIST: There’s a lot of space for a change; making a change from eating out almost every day to eating out one day is huge.

CLIENT: Yeah.

THERAPIST: You don’t have to make quite such a leap.

CLIENT: Yeah, just they were telling me what to do and I…

THERAPIST: Yeah, that doesn’t feel good.

CLIENT: No. [Tearful.] But I didn’t really have a good counter argument at the time. My argument against not eating out is like Sydney won’t like that. It’s like, oh well, we don’t care. You should care about yourself more. Like it took me to later to think wait a second. No. The reason why I’m really against that is because then I’ll have to cook all the time and do all the dishes.

THERAPIST: Yeah, it feels like too much work.

CLIENT: Yeah.

THERAPIST: Which is why they are concerned about you being able to live on your own, because those things feel like too much work, and those are basic necessities.

CLIENT: And now I’m just kicking myself for getting an apartment without a dishwasher. And I think if I had a dishwasher it would be a lot easier and it wouldn’t be as much of a hurdle.

THERAPIST: Yeah. Well it certainly makes dishes easier.

CLIENT: Yeah.

THERAPIST: It doesn’t change the cooking. And it doesn’t really change the prep, the time, which is another hurdle, I think, that we’ve identified is having to go to the grocery store, think ahead about what to make or buy. Having that stuff on hand; that felt like a big challenge.

[10:34]

CLIENT: Mm hmm. Yeah. It still does. My kitchen still is not really set up for like buying lots of groceries in advance and having them there. I don’t know; I’m like, maybe I should have [inaudible – 11:05] problems. I guess, I don’t know. Like I don’t know how I could have avoided all this. I don’t, like, you know, living on my own and stuff.

THERAPIST: It doesn’t seem like looking backwards is going to help. Let’s figure out sort of you are here now, making good decisions going forward. You know, you can’t change what’s already happened, but you are in a place, in terms of what you’re eating, what your daily habits are, that isn’t really working for you. So what decisions can we make now to have that be healthier for you; feel better mentally and physically? You don’t have to make the same choices that have been problematic in the past.

CLIENT: I don’t know. Maybe just getting more fruits and vegetables in to my diet. Like ones that I can eat without cooking. I do have lots of [inaudible – 12:20] that I’ve been eating and stuff.

THERAPIST: Yeah, so are you using that to replace something else?

CLIENT: Yeah. I’m trying to at least.

THERAPIST: Okay. That sounds like a really good step.

CLIENT: I thought it really hasn’t done that much yet.

THERAPIST: Yeah, changes are slow. That can be really frustrating.

CLIENT: Yeah. I finished my job on Thursday. So now I actually do have the time to…

THERAPIST: Congratulations.

CLIENT: Thanks. And I did go to music rehearsal last night. So…

THERAPIST: How was that?

CLIENT: It was good. It was really small, because apparently everybody was like out. Yeah, I was panicking right beforehand, but…

[13:06]

THERAPIST: I know it was a big decision to decide whether or not to try it again.

CLIENT: Yeah. But like I think it’s going to be okay.

THERAPIST: Well good for you for giving it a shot and letting yourself test it out. Were they receptive to the fact that you might not be able to go to everything right away?

CLIENT: I didn’t really talk about it that much. That’s how, like, well, we have on the Wiki, usually a document that like lists all the rehearsals for the semester and then people write their name if they’re like not going to be there for that rehearsal. So I told them that I’d be missing a few rehearsals, but I didn’t have the actual dates for those yet. So…yeah.

[13:59]

THERAPIST: But there’s a procedure in place.

CLIENT: Yeah. So I can just do that.

THERAPIST: How was it to sing?

CLIENT: It was okay. Like I don’t know. It was nice. I liked being able to be around people again.

THERAPIST: I’m glad for you.

CLIENT: I guess the other problem that I’ve been having is with Sydney and like feeling empathy when he gets all panicky and like I don’t know. A part of me is afraid that like maybe all my love for him is completely gone. Like I want to stay with him, but I don’t know if it’s my depression or what, but I’m starting to get really scared.

THERAPIST: Scared?

CLIENT: That maybe I shouldn’t be in the relationship.

THERAPIST: What do you feel for him? You said you’re starting to feel afraid that your love for him is gone. What do you feel for him?

CLIENT: I enjoy being around him and stuff, but like I don’t feel that deep passion and I don’t feel like, you know, complete like when he’s upset, I don’t feel like, usually I’m annoyed at him for doing something and, you know, like I don’t rush in to comfort him like I should. Like that’s how I should be feeling. It’s just been so long that like, you know, and like we haven’t a functional sex life for like a year, more than a year. And so I think I like retreated when that happened and I don’t know. Like I know the like warm and fuzzy feelings that like starts off a relationship fades, but I don’t know what love is anymore.

[16:17]

THERAPIST: You guys have been in a challenging position for a really long time.

CLIENT: I’m just afraid that it’s not going to work out.

THERAPIST: What’s kept you together this long?

CLIENT: I don’t know. I guess the fact that we think we’re good for each other. Like each other’s company and are good companions and stuff. Possibly in our shadow or the fact that he really loves me.

THERAPIST: But you’re not sure you really love him?

CLIENT: Yeah.

[17:00]

THERAPIST: When did you start questioning that?

CLIENT: A few days ago. Like I guess last week. I guess on my birthday when I got really upset, because I came back from therapy and we were going to go out to dinner and like he’d been panicking all day because I guess it was my fault for starting off the day with like getting annoyed with him, like the night before, that it was like staying up all night. And I’m like tomorrow is my birthday. We need to go to sleep. And I was going to sleep and like, and he was still up at like 3:00 a.m. or something. And so that he was panicking later in the day and like I had…and after therapy I came back and ended up getting the car. Like I thought it was like shoveled out enough to be [inaudible – 17:48] and it was just no way and I couldn’t get out and he didn’t help me. And like he wouldn’t, because he was panicking. And at that point I was just like really frustrated and I’m like, okay, well if I break up with you, then I don’t have this problem anymore because it’s your car and I don’t have to do anything.

THERAPIST: You were thinking that or you said that out loud to him?

CLIENT: I was thinking it and then I said it. Which is really cruel.

THERAPIST: I was only asking to understand.

CLIENT: He eventually did come down and help me. Like it felt like I had to go back to the apartment to like get him and the car was like half out and I couldn’t. It was like I can’t leave the car like this. And just the fact that he didn’t come down to help me just…

[18:45]

THERAPIST: Yeah, you felt abandoned.

CLIENT: Yeah, and like it’s my birthday. And then like that night, like I had a glass of water on the night stand that I knocked over onto the bed and like he…I was having trouble falling asleep and like was keeping him up out of spite. I was just so pissed off at him. Then the water. And I’m like, well, if I break up with you, then how then you couldn’t go home and then I could use the other side of the bed. I was just, you know…which also was really really cruel. I mean we didn’t end up breaking up, but then the next day he broke down and we talked and I apologized.

THERAPIST: When you said those things, did you really want to break up with him?

CLIENT: Like I wasn’t panicking and feeling like, oh no, I’m going to lose him. I was thinking that this was a better solution and…

THERAPIST: Because you wanted to end the relationship or because you wanted to use the other side of the bed?

CLIENT: Because I wanted to use the other side of the bed but apparently didn’t care enough about the relationship to think, you know, that I thought it was worth sacrificing in order to use the other side of the bed and/or not have to deal with the car.

[20:02]

THERAPIST: It seems like, you know, making a decision about whether or not you want to end the relationship is a decision you want to make based on whether or not you want to be in the relationship.

CLIENT: I know.

THERAPIST: Rather than using the relationship to solve another problem. And what I’m hearing is, you know, I don’t know whether or not you want to end the relationship. That’s, I think, hat is a big question that you need to figure out. You know, and it’s based more on whether or not you love him than on whether or not there’s an immediate problem. So both of those situations in the past couple of days were immediate problems that, yeah, it would be solved by breaking up with him, but then what happens after that. It’s similar to wanting to kill yourself to end the panic. Yeah, that would work. That would stop the panic. But then it also has a host of other consequences. It ends everything else, too, right. It sounds like similar types of thinking kind of like overly dramatic solutions to an immediate problem. The question of whether or not you want to be in the relationship is an important question. But it’s not about whether or not there’s spilled water on the bed.

CLIENT: No, but the fact that I’ve cared so little about the relationship enough to…

THERAPIST: Do you really care so little about the relationship, or did you care so little about the relationship in that moment?

[21:35]

CLIENT: I guess, possibly. I cared so little in that moment. Still, the fact that I would get there was scary.

THERAPIST: Yeah. And I guess my question is the fact that you’re getting there, is that about the relationship or is that your general thinking?

CLIENT: I don’t know. I mean I haven’t thought of it before today. I guess it could be my general thinking style…

THERAPIST: Applied to a new content area. When I think about your responses to other problems, the line of thinking sounds similar to me, right. Like it’s a similar line of thinking to the kitchen is too small and it’s hard to cook, so I should move to my parent’s house. Right. The big, big changes for a smaller…that does solve a smaller problem, but it’s like a big response to a more contained issue. It’s hard to separate and now you’re thinking about the relationship and it’s hard to separate, well, is this because you’re tending to think about these big solutions to more contained issues, or is it really an indicator about the relationship and the health of the relationship?

CLIENT: But I don’t know.

[23:23]

THERAPIST: So let’s think about it. I mean removed from, there’s no immediate crisis right now, like a car or being stuck or birthday plans being canceled. So this is sort of a time to really explore what the relationship means to you and what you feel for him.

CLIENT: And how much, like what does stuff feel like? How do I know?

THERAPIST: What does it feel…does it feel different than before?

CLIENT: It’s just it happened so gradually that I don’t know. [Tearful.] The very beginning, I was all really excited to like, you know, there was this wonderful new guy and we’re going to do all these fun things together and he’s, you know, we get along really well.

THERAPIST: Are those things still true?

CLIENT: We get along when we’re not fighting. Like he’s…

THERAPIST: How often is that? What’s the ratio of getting along well to fighting?

CLIENT: We fight at least a couple of times a week. And then just all of his panic and inability to deal with life just makes it so much harder. And then I feel like sometimes I’ve depending on him when I shouldn’t be. And then he doesn’t follow through. And like, you know. Or he creates problems for me. Even like last night, like he had a salad while I was at rehersal and like he never did the dishes from it. And then he didn’t do the dishes again today. And then I was like, I don’t want to have like all the dishes in the sink after everyone’s…I ended up going out to eat. But I had been planning on having, making pasta for lunch, but I was like I can’t do this until the dishes are done, and you know, which meant that either he couldn’t do the dishes and he was panicking and then it was like I was going to have to do his dishes like [inaudible – 25:25] and then. Just feels, you know, but I’m not like, oh, this is like, you know, he’s doing really badly. I’m going to do the dishes for him because I care about him so much. Like it just feels like hassle rather than…

[25:39]

THERAPIST: You’re somewhat resentful.

CLIENT: Yeah, rather than just wanting to help him and stuff. And I can’t [inaudible – 25:49].

THERAPIST: You know, resentment is really not healthy in a relationship. And it’s something I’ve heard you talk about quite a bit, feeling resentful of plans that aren’t followed through on or feeling dependent upon him to go do something or get the boxes unpacked, or eat.

CLIENT: I don’t know how to make the resentment go away. I want it to go away. Maybe I’m just destroying everything in this relationship. It’s all my fault for getting so resentful about everything and I won’t be able to fix it. [Tearful.] Because I have a poisonous personality and I can make everything horrible. [Tearful.]

THERAPIST: I’m sorry. Where did that come from?

CLIENT: It’s the fact that we fight so much and it’s my fault, usually, for getting resentful at him for like not being able to do something. And so it’s just like really bad and toxic. And I’m the toxic one. [Crying.]

[27:07]

THERAPIST: How does it become all one’s person’s responsibility? You’re the toxic one?

CLIENT: Because he’s the one who’s panicking and I should be like empathetic to him.

THERAPIST: You both panic.

CLIENT: Yeah, but…

THERAPIST: You come in every week telling me that you’ve panicked.

CLIENT: Yeah, well, the difference is when I panic; I can still get things done. I can do dishes while I panic. I can pack while I panic. I can get dressed while I panic. I can go to work and work while I panic. He can’t do anything when he panics. He just stays in bed.

THERAPIST: So that makes you toxic?

CLIENT: No, but then like he panics and it’s always like when he has to do something and then I get mad at him for panicking. And that’s not good.

THERAPIST: Yeah, you feel disappointed.

CLIENT: But I shouldn’t get mad at him because the panic is just the way he is.

[28:03]

THERAPIST: It’s really hard not to have a response when you feel continually disappointed or thwarted in some way.

CLIENT: Yes.

THERAPIST: I can certainly see why it feels bad on both ends for you to be angry when he’s hurting in some way. But I also feel that it’s unfair to say that you’re poisonous or toxic because of a response that you’re having that seems pretty normal.

CLIENT: But then he gets like really sad when I’m mad at him and it just makes it worse.

THERAPIST: Yes, he does get really upset when you’re angry. It is a really negative cycle that you feel let down, you get angry, he gets angry for you being angry.

CLIENT: I’m not really angry for me being angry. Usually, he just gets really sad and panics for me being angry. And then wants me to comfort him and then I get really annoyed.

THERAPIST: And you can’t be comforting.

[29:16]

CLIENT: And I actually would like hug him and stuff if he asked for it, but like it’s really hard to be honest. Especially when it’s like…

THERAPIST: Do you remember how it got like this?

CLIENT: I don’t.

THERAPIST: Because I don’t remember it being like this when you first got together and this cycle of being sad and feeling like empathy was being solicited vs. natural.

CLIENT: I mean it’s been this way for a while.

THERAPIST: Mm hmm.

CLIENT: Is it something I can fix?

THERAPIST: I don’t know. I don’t know that it’s necessarily your problem to fix. It can’t be…a relationship pattern can’t be all one person’s fault. You both bear responsibility for the reactions that you both have and the behaviors that you have in response to one another. It can’t be all your responsibility or all his. And dealing with illness in a relationship is a really challenging thing. And he’s had very chronic illness.

CLIENT: That’s true. But still, I feel like I could be a better girlfriend and I’m not.

[30:51]

THERAPIST: What would you need to be a better girlfriend? What would make it possible for you to be a better girlfriend?

CLIENT: I guess if I felt better about him taking care of his mental health. Like because if he ended up…I mean I guess it was because we had the fight on Wednesday, but like he had an appointment on Thursday with his psychiatrist that he ended up missing. And his psychiatrist is really hard to get a hold of and like reschedule with and like this is like the second appointment in a row that he had missed.

THERAPIST: So it doesn’t really feel like he’s doing his part?

CLIENT: And it was my fault for getting in to a fight with him.

THERAPIST: No, it’s not. That’s where it’s unfair responsibility. You’re not in control of his choices, good or bad.

CLIENT: But I made him too upset to go to the…

THERAPIST: No. That’s unfair. You can’t; you can’t be given responsibility for how he responds to things, or the choices that he makes. He has to have responsibility for that in the same way that you have to take responsibility for your choices. So when you say something like, “Well, I can’t eat…I can’t cook dinner because he did this.” That’s placing unfair responsibility on him. That’s you making a choice based on, you know, something else. And to say that you’re not responsible for him missing his session. He’s the one that didn’t go. That’s him being responsible for missing his session. He may be upset about something that happened, but his choice is to say, “I’m upset. I’m not going.”

[32:32]

CLIENT: But he didn’t, I guess it didn’t feel like a choice for him because he was panicking and he couldn’t stop the panic.

THERAPIST: And you could stop his panic?

CLIENT: Well, I could have made it not happen in the first place by not getting in to that fight with him.

THERAPIST: That’s an unfair burden.

CLIENT: When he gets in to a fight, it takes a long time for him to recover.

THERAPIST: I understand that.

CLIENT: Like the next day.

THERAPIST: It’s just too much of a burden to place on another person to say they’re responsible for your mental health. I can’t stop your panic. You can’t stop his. If I could stop, if somebody could stop another person’s panic, they would just fix it. But it’s not that easy.

CLIENT: But people can induce other people’s panic. If they’re already tending towards panicking.

THERAPIST: There may be just as we kind of think about what your triggers and how to avoid triggers for panic, and what are some things that you can maybe intercede; we talk about those things. And you’re right. There are…having a fight with you, for sure, is going to be something that makes him more susceptible to panicking. It might be a trigger for a panic attack. But it’s not your sole responsibility to avoid those things. He has to also take responsibility in the same way that I ask you to take responsibility for taking care of your health in thinking about thinking in ways that are adaptive for you and avoiding thought patterns that elicit more panic. But he can’t control your thoughts. You have to control them. And you can’t control all of the situations that might create an argument.

[34:35]

CLIENT: I could have not been a bitch about it. I could have just been like, okay, I’m going to sleep on the wet [inaudible – 34:38]. And then I ended up putting a towel underneath me and doing that. I shouldn’t have like told him that I wanted to break up with him and send him out so I could have the other side of the bed.

THERAPIST: Yeah, so you could have chosen other solutions to the problem.

CLIENT: So therefore it was my fault he panicked.

THERAPIST: It’s taking it a little bit too far. You could have said the same thing and he could have not panicked. Would everybody have had a panic attack in that situation? You both play a role. You can’t have…I’m not saying that you have no responsibility; I’m saying that you don’t have all of the responsibility.

[35:22]

CLIENT: Okay.

THERAPIST: You both share responsibility for the pattern in the relationship and how you impact one another. I don’t know. I’m not completely convinced. I still think it’s my fault. Even if it wasn’t, I mean he still missed the appointment and there was nothing I could do about it at that point. And…he was panicking and then he wanted like…and I was at work and I was doing something. I didn’t say something until like another 15 minutes and then it was like too late for him to leave, so I couldn’t try to calm him down over talking on the Internet. And so I don’t know if me trying to calm him down would have made it so he could have gone to the appointment, but he didn’t go and it just bothers me so much.

THERAPIST: Well, you’re angry for not going. Does that fit?

CLIENT: Yeah. Then he told himself that I was angry at him for it and I was like, oh, you’re making it all about you. But like I’ve been dealing with the consequences of his panic for the past two years. That’s really exhausting. I think he needs a new psychiatrist who actually will get [inaudible – 37:15] and stuff and that would be even more panic inducing for him having to find a new psychiatrist while being this upset. But…

[37:31]

THERAPIST: What would be best for you? What do you think would be healthy for you in this situation?

CLIENT: Possibly getting out of the situation, but I don’t know.

THERAPIST: Well, let’s weigh the pros and cons. What would be…what do you think would be healthier about being on your own?

CLIENT: Oh, I wouldn’t be responsible for his panicking and every decision I make whether or not to do something would be all on me.

THERAPIST: Okay. That would be sort of a relief in some ways not to be responsible for him and able to make decisions just based on you. Are there any other pros?

CLIENT: I’m not sure. Well, possibly being able to find someone else so I can like actually have a sex life with them and stuff and not have to deal with their panic because they’re actually emotionally healthy. I feel like in order for that to happen, I’d have to lose a lot of weight first and so it’s going to require being on my own for some time because I don’t think any guy would date me the way that I look right now.

THERAPIST: So what would be the con of breaking up with Sydney?

CLIENT: I’d be really hurt and he’d be really hurt. I’d miss him and I wouldn’t have him around and wouldn’t have him to give me hugs and keep me company and all that.

[39:20]

THERAPIST: Would you miss him or would you miss having someone to give you hugs?

CLIENT: I think I’d miss him. Like I don’t know that I’d find someone as good as him. Like or as good for me as him and like…you know. We get along really well and I’m like we have the same interests and I like having him around. I don’t like his mental health issues and they’ve just gone on for so long that I’m just wearing out all my patience. I don’t want to break up with him.

THERAPIST: So you just said you don’t want to break up with him. How sure are you?

CLIENT: Pretty sure. I’m just afraid that I will never get better, though.

THERAPIST: Well, if it doesn’t get better, do you want to still be dating him? Or is the you’re sure you don’t want to break up with him based on if things changed?

CLIENT: I guess I still would want to be dating him even if it doesn’t get better. It would just be more draining.

THERAPIST: And so this sounds like a well thought out decision. This is how you think about it. Not in the heat of the moment or trying to solve an immediate crisis by giving yourself time to really imagine what you want long term, longer term.

[41:47]

CLIENT: I think we’d be good together in the long term. It’s just that this is a really hard, rough patch for both of us and like we’ve both been having crazy mental health issues.

THERAPIST: Is there…are they related in any way, do you think?

CLIENT: You mean mine and his?

THERAPIST: Mm hmm.

CLIENT: Maybe. I mean I think mine was also stemming from the getting worn out by the commute and being burnt out like because I felt so much better when I finished my job, even though now I’m unemployed. And I was like, you know, I started music again and I’m planning on going dancing tonight, which is something I couldn’t be doing if I had my job. So.

THERAPIST: So I wonder when those things are back in place and you’re able to take advantage of them, if you will start to feel better. Because certainly this has been, you know, the past couple of months for you have been the worst in terms of the severity of your panic and depression that I’ve ever seen in you.

CLIENT: It hasn’t been this bad since sophomore year when I first got depressed and wasn’t on medication.

THERAPIST: Yeah, I think that’s important to pay attention to, sort of, you know, what is it…if it’s something going on in your life, you know. Is it the commute? Is there impact of his health on your health, your health on his health?

[43:30]

CLIENT: Yeah.

THERAPIST: You don’t want to have a negative impact on one another. That’s not healthy in your relationship. I don’t know if that’s part of the dynamic. It could be. Certainly, it has gotten worse in the past few months, but I think if we look further back, it’s also gotten worse…it wasn’t, it’s not just the past couple of months.

CLIENT: No.

THERAPIST: This is the most severe, but if you look back a year ago, you were in a very different place.

CLIENT: Yeah. I think our mental health is impacting each other and I’m trying to like get out of arguments faster and like not have them, and be more comforting.

THERAPIST: Well, one thing, maybe, to look at that you have more control over is you can’t control…I don’t think that you can control whether he has a panic attack or is panicking.

CLIENT: I know.

THERAPIST: I do think that one thing you have more control over is the impact that his panic has on you. So one of the things that make you really resentful is when your plans are changed or limited by what he feels capable of doing. And if you can try to separate those, so not making yourself dependent…not making it dependent on whether he can follow through on something for you to go do something. And you want to get up and leave the house and get out, not feeling like you have to wait for him to be ready.

CLIENT: Uh huh.

THERAPIST: If he can’t be ready at the time that you planned, then go on your own. It’s not the same experience as having done something with him, but it might be a little bit less limiting and that might help with the resentment that you feel. If you don’t feel like all of your choices are tied to him, some of the resentment that you feel might come down a bit. And if you can give that a go, maybe that will help decrease the sort of the negative cycle that you guys are in; that more resentful you feel, the less empathic you can be to him. The more he limits you, the more resentful you feel. So you see how it goes around?

CLIENT: Uh huh. That means he doesn’t like it when I feel like, you know, his panic is tied to what I can do.

THERAPIST: He doesn’t like that either?

CLIENT: He doesn’t like it either.

THERAPIST: So what, maybe you can untie that a little bit. You can be independent.

[46:14]

CLIENT: Yeah.

THERAPIST: And it might not be your wish, but it might be better than being resentful.

CLIENT: Yeah. I think I need to like get in tuned to a group or something like that. I asked today about there is something, you know, last night about volunteering…

THERAPIST: Oh you did.

CLIENT: I haven’t heard back yet. So I don’t know if it’ll take her a few days or if she’s waiting because the answer is no or something.

THERAPIST: Well, let’s see what the answer is before you guess. It sounds like you’ve taken a couple of really good steps to get yourself more involved with other things that would be enjoyable. Yeah. Going back to music. I hope you will go take advantage of the dancing tonight. See what you get back in response about that e-mail you just sent. Those are all really healthy steps, I think. So let’s see…let’s see if those take hold.

CLIENT: Okay.

THERAPIST: Why don’t we wrap up there for today. We’re on for our regular time next week?

CLIENT: Yep.

THERAPIST: I’ll see you next week.

[END OF AUDIO.]

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