TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: …than you anticipated.

CLIENT: Sydney and I were out for lunch and he started panicking. And the plan had been for him to drive back and drop me off at therapy, so I had to drive all the way back to drop him off since he was so panicky that even if I had dropped him off at the subway that wouldn’t have worked for him and I’d come back through the Square. So that’s why I thought I was going to be late because I wasn’t sure how long that drive would take.

THERAPIST: Well I appreciate the heads up and glad you’re here.

CLIENT: Thanks.

THERAPIST: Take (ph) a couple deep breaths. I mean, it sounds like you ran from your parking spot.

CLIENT: Yeah. It wasn’t that bad.

THERAPIST: Or walked fast.

CLIENT: Yeah. And also I chose to walk up the stairs. That’s probably why.

THERAPIST: That’s a healthy choice. [00:00:49]

CLIENT: Yeah. So I finally ended up going dancing two out of the three nights last week because Monday after therapy I hit a really bad pot hole and it gave me a flat tire. And the tires were all worn down anyways so I was like, “Okay. I’ll replace them all.” And then waiting for all that work to be done ended up – like I had a little bit of time I could have gone to dancing but it would have required missing dinner and I was just so worn out I’m like, “Screw it.”

THERAPIST: Yeah. But you went twice.

CLIENT: But I went Wednesday and Thursday.

THERAPIST: How was it?

CLIENT: It was good. I realized I actually forgot a lot about dancing and so felt a little bit self-conscious about my lack of dancing skills, but yeah. It was good. The other problem with dancing is just it’s like kind of awkward asking people to dance or waiting for them to ask you to dance. [00:02:09]

THERAPIST: Right. It’s partnered. So did you do dancing both nights?

CLIENT: Well, Wednesday was swing and Thursday was Contra. Monday is also Contra because the swing dancing is once a week (inaudible at 00:02:21) for free. But I think it’s definitely helping.

THERAPIST: Helping in what way?

CLIENT: In like, my mental health.

THERAPIST: Okay. Hoping that the activity would sort of serve that purpose as well as helping you kind of expend some calories for the week.

CLIENT: Yeah. And I think I’m getting a little bit better about walking and stuff.

THERAPIST: This weekend was a little less brutally cold.

CLIENT: Yeah. Well, when I danced on Wednesday—well, even after the first dance my legs started hurting and I sort of did maybe every two out of three dances and then I walked back to the car. And it took forever for me to get back to the car because I was walking so slowly because my legs had hurt so much and I realized when I got to my car that I had forgotten my hat. I could go back and try to get it but it would have been really really painful to do that walk again and by the time I got back everything would have been over anyways and I might not have been able to get into the room. [00:03:31]

So the fact that I wasn’t really that bothered by losing my hat, even though it was one that I knitted myself. The fact that I was fine with that is a good sign that my mental health is improving. So now I’m just making myself a new hat instead.

THERAPIST: Have you called to see if maybe it was there?

CLIENT: I e-mailed the person who organized the dance, who never got back to me, and I also e-mailed my friend at Stanford, like asked if the student center had a lost and found and she wasn’t sure. There’s apparently a police office in the basement but apparently it’s not open that often and I don’t know if they would handle lost and found or what. So it seems like it might be a little more effort than it’s worth.

THERAPIST: Well, I’m glad to see that you’re able to sort of put it in perspective and problem-solve it and move on. [00:04:24]

CLIENT: Yeah. I mean I was going to have to knit a new hat anyways because that one wasn’t going to last more than one winter.

THERAPIST: So it made it almost the whole season.

CLIENT: Yeah. I mean, I had it for like five years or something (ph).

THERAPIST: Oh, wow. So lots of seasons.

CLIENT: Basically, last winter my scarves were all wearing away and this year it’s the hat. And it’s not like it’ll be cold for that much longer.

THERAPIST: Hopefully not. And you have the skills to make another one.

CLIENT: Yeah. So, I’m feeling better. I mean, I think just not having the job. So it probably was the commute that was doing…

THERAPIST: Yeah. The commute was difficult for you.

CLIENT: Yeah. Now I still need to find a new job and I did apply to two jobs last week.

THERAPIST: Good for you. [00:05:21]

CLIENT: Yeah. I’m worried I won’t have much of a chance because I’m sort of over-qualified for both of them. One of them I was way more over-qualified for than the other and the one I liked better was the one that I was less over-qualified for.

THERAPIST: What were these opportunities?

CLIENT: They were both at Yale. One was an assistant and that was the one that I think—I forget if that was the one I was over-qualified for more or not. Like one of them was part-time, like 17.5 hours a week and the other one was full time and that one was helping with running the reading room and stuff like that. Definitely something I’m capable of doing. I don’t know whether or not they’ll write me back since it’s Yale and sometimes they never get back to you ever. Or only at the very end, like several months later to tell you that you didn’t get the job. So, I’m not expecting too much from it. [00:06:23]

THERAPIST: But I think it’s a good sign that you felt motivated enough to apply because you had felt really panicky and really stuck the last few times I had seen you.

CLIENT: And I even did it from my house.

THERAPIST: Wow.

CLIENT: I’ve been in the apartment for the past week and I’m no longer freaking out about how small my apartment is and stuff. So it wasn’t the apartment.

THERAPIST: It sounds like you’re feeling much more upbeat.

CLIENT: Yeah. (pause)

THERAPIST: So how are you managing in your apartment? If you’re spending more time there this past week.

CLIENT: (inaudible at 00:07:07) We’re still eating out a lot of the time just because we don’t have the energy to cook and do dishes all the time, which isn’t great but it is what it is. I’ve still been putting off doing things like laundry and stuff until the last minute, but I feel able to do it.

THERAPIST: So it feels less like you can’t and more like you don’t want to right now.

CLIENT: Yeah. Or I don’t have time today. I’ve been making it out of the house almost every day. (Pause)

THERAPIST: I’m glad to hear that things feel better.

CLIENT: Sort of heard that if I do get a job my social life will disappear again and I won’t be able to continue dancing and (inaudible at 00:08:01) I’m not going to apply to anything with an unreasonable commute.

THERAPIST: Well, (inaudible at 00:08:06) down the commute certainly would make it more possible to fit work and something social in the evening. Especially a part-time position. Maybe there would be some days you would feel too taxed, but it would give you time on other days. It seems like that’s kind of a bridge to cross when you get interviews and offers.

CLIENT: Yeah. Which might not be for a really long time.

THERAPIST: Yeah. You don’t know what’s going to come of these positions.

CLIENT: And I’ve got a (inaudible at 00:08:37) volunteering at the zoo again.

THERAPIST: Doing (ph) what?

CLIENT: I’d e-mailed last week and it took her a couple days to get back to me and first she was like, “I’m not sure.” Her assistant had been out sick and she was also hiring a new student worker, so she had a bunch of other things to do and wasn’t sure that there would be time and space for me to volunteer. And then I think it was even the next day that she wrote me back and was like, “Oh, you actually know how to do the (inaudible at 00:09:07) programing thing. How about working on this project?” And I was like, “Oh, that sounds awesome.” So I need to e-mail her and figure out what day of the week I’m going to be working, but I might be starting as early as this week.

THERAPIST: Wow. So how much time is that commitment for?

CLIENT: I think it’s going to be—if it’s anything like the previous times I’ve volunteered there like one day a week for a four hour block or something like that.

THERAPIST: Okay. So pretty minimal, but it does keep you connected and gives you another project of experience.

CLIENT: And it won’t leave the gap on my resume. So yeah, that’s a (ph) big thing.

THERAPIST: Well, it sounds like you’ve taken some really good steps, Georgia.

CLIENT: Yeah. Just still not living as up to the healthy eating as much as I might like to.

THERAPIST: Okay. It sounds like you’ve got some momentum going here by taking some good healthy steps. Maybe not specifically focused on the eating, but some other ways of taking care of yourself. I think being able to get some applications out there, being able to make the contact about volunteering, being able to get out and go dancing again, and you reach back out to a community that you enjoy being a part of. Those are all really good ways of taking care of yourself because you are more than just calories in calories out. Taking care of your mental health and your emotional well-being is important too. [00:10:38]

So now that you’ve got some momentum going, and doing those things it sounds like is reinforcing because you enjoyed the dancing and you got a good response from the person at the zoo. So maybe that will give you some motivation to make another kind of healthy choice.

CLIENT: I guess with the food I’m just doing it in small steps because my parents were sort of ridiculous with that. They wanted me to cut out all soda. Well, not just soda. Soda I could cut out, but they didn’t even want me to drink juice, and I’m like, “Juice has fruits in it and I know it has calories in it, but I’m not going to only drink water.”

THERAPIST: Well it sounds like your parents’ expectation was coming from a good place. They’re concerned about you, but it feels too extreme for you. Too controlling. [00:11:33]

CLIENT: Like okay. I can understand not having real ice cream, but they didn’t even want me to be eating the Weight Watchers low calorie ice cream bars. And I’m just like, “No.(Chuckles) I am not giving up all sweets like you guys do.”

THERAPIST: Is that what they do?

CLIENT: Well, they’ve given up all pastries and cookies and cakes. Once a week they’ll have, lunch with everybody else. They’ll have (inaudible at 00:12:02) ice cream, which is made of soy or something like that. Or possibly coconut milk. Other times for dessert they’ll just have clementines or pistachio nuts or something like that. They don’t eat sweets now and I’m just like, “I’m not doing that.”

THERAPIST: That doesn’t fit for you. And certainly making a move toward heathier eating doesn’t need to be quite so extreme. It doesn’t need to be under their rule. I can see you reacting to them kind of wanting to step in—in a couple of ways.

One, it feels like an unrealistic expectation, but also when you talked about it last week, just having them kind of step in and express their concern and give you some ideas without crossing a boundary. What you decide to do needs to be your decision. We can certainly talk about options in here, but anything you choose to do really needs to be your choice or it’s not going to be something you’ll stick with if you feel like it’s somebody imposing something on you. [00:13:07]

CLIENT: Yeah. And what I’m trying to do is maybe every other time that I would be getting soda, not get soda so I won’t be having soda half as much as I would be.

THERAPIST: When you get a soda, what size do you usually get?

CLIENT: Like, it’s at a restaurant so it’ll be like a can of soda or sometimes it’s a 20 oz. bottle and sometimes a glass.

THERAPIST: I mean, one way of cutting back is sort of making things smaller, serving sizes. But that’s hard to…

CLIENT: Yeah. You can’t do that at restaurants. Yeah. I have no clue what size those sodas are and there wasn’t an order (inaudible at 00:13:51).

THERAPIST: Yeah. Sometimes if you get a small or large, but that’s not available every place. Yeah. So maybe that idea of kind of thinking about what you would typically do and making another choice some of the time.

CLIENT: Yeah. And I guess I could go back to drinking diet soda. It’s just that usually I like Root Beer or Orange Soda. They don’t usually have diet Root Beer or diet Orange Soda in restaurants. Most of the time at home I’m not drinking soda.

THERAPIST: So that’s one place where you can cut back a little bit. Where are other places that feel reasonable to you to make small changes that are sustainable? I know a long time ago we had kind of looked at what your typical week of eating was like and I don’t know how much that’s the same or different. [00:14:52]

CLIENT: Well, I guess it’s pretty much the same. I’ve been trying to eat more clementines and stuff. I guess I can cut down, especially at my place the bowls are really small so a bowl of pasta is less than it used to me. And usually I’m not getting seconds on that but sometimes I am when I’m really hungry.

THERAPIST: Have you ever measured it so you know like what’s a bowl at your house is at a cup, a half a cup?

CLIENT: It would definitely be more than half a cup. It’s probably a cup. [Even if it’s] (ph) less than a cup. Yeah. I don’t actually know. [00:15:31]

THERAPIST: You know, I think the idea of measuring your food every time you eat is unrealistic. It also sets you up for, rather than paying attention to your physical cues, paying attention to something else to determine how much you want to eat. But doing it now, since you have new dishes, filling your dish the way you typically would and then measuring it just to get a sense of what the serving size is, and then not measuring anymore. Just so you can get a sense of what does my serving of pasta usually look like? How does that correlate to what the suggested serving size is? So that you can get a sense of how much you’re eating when you serve yourself.

CLIENT: Yeah. I can do that.

THERAPIST: So stick with what typical is for you and then (inaudible at 00:16:28) getting some information.

CLIENT: I went to the doctor and he said apparently I’ve lost a pound since December. And I think that’s actually more because I think I gained more weight. There was one appointment that I had my snow boots on and I didn’t really feel like getting weighed and asked if I could get out of getting weighed and they were like, “Oh, sure. That’s fine.” But I think that I had actually gained more weight and so I guess I lost that weight too.

THERAPIST: So maybe headed in a direction towards health.

CLIENT: Yeah. Because even if I’m just like become more in shape, that’ll be fine. And the doctor said I only have to lose five to ten pounds. That would be enough to…

THERAPIST: To make a difference.

CLIENT: Yeah. And then I won’t be pre-diabetic anymore.

THERAPIST: And I know that really the goal is to lose weight to take you out of that pre-diabetic area that is scary.

CLIENT: Yeah. (inaudible at 00:17:27) the pre-diabetic thing is going down. Like you want to be 5.6 or below and the first time they measured me was 5.8 and the second time was 5.7.

THERAPIST: But what is that measurement of?

CLIENT: Blood sugar.

THERAPIST: Blood sugar. Okay.

CLIENT: Yeah. I think it’s the molecules tools (ph) that attach to something. It’s like [not done fasting] (ph) and actually, they want to test me again fasting (ph) but not until May.

THERAPIST: That’s a couple months away. So a realistic goal might be to lose, between now and May, being able to lose that five to ten pounds. Ten would be a little much. You know, losing weight slowly is more sustainable than trying to take off a number of pounds at once. So thinking about losing two to three pounds in a month is a nice slow reasonable goal that you can obtain.

CLIENT: Yeah. And I’m thinking I’m not sure whether or not it would be a good idea for breakfast to switch over to doing this (inaudible 00:18:41) shake thing for breakfast.

THERAPIST: What’s a typical breakfast now?

CLIENT: A typical breakfast either is wake up at noon and get lunch (chuckles) or if Sydney is also up we might go to Dunkin Donuts and I’ll get a bagel and coffee for the day that it was…

THERAPIST: Anything on your bagel?

CLIENT: Cream Cheese. Usually I use less than half of the container of Cream Cheese that they give me and the container is this big and this tall. And sometimes it’s rice cakes and cream cheese if I’m at home.

THERAPIST: So that’s a big difference between a rice cake and a bagel in terms of how many calories.

CLIENT: Yeah. Well, (inaudible at 00:19:35) have a lot of rice cakes which will…

THERAPIST: Yeah. I mean obviously, pay attention to what the serving size is. You know, I think if you were thinking about doing meal replacements, I think that’s a conversation you really need to have with a nutritionist or a dietician. Somebody who really specializes in that. I’d be hesitant to encourage you to replace a meal with something that’s not real food, but sometimes that is a suggestion that people make but I think you really need to sit and talk with somebody who is more of an expert and would be able to do some of the calculations with you about weight and height and body composition factors. I think a lot needs to go into big decisions like that.

CLIENT: Yeah. I mean I wouldn’t do it for any other meal but breakfast because I like having real food too much and their diet I think is a little bit way –like the one that they have written on their container is way too rigid and involves—I added it up and it’s about 1,200 calories a day. [00:20:47]

THERAPIST: That seems really low to me. It’s something you’d want to not drop down to without a doctor’s recommendation.

CLIENT: Yeah. Which is why I wouldn’t do that. I mean, I guess replacing the not having breakfast at all. Because I was having breakfast most of the time but that was because I had to have breakfast to go to work and now that I’m not going to work…

THERAPIST: Yeah. If you’re up in the morning eating is important. If you’re sleeping through the morning, well then, you know, your first meal of the day. Call it whatever you want to call it. I’m certainly happy to discuss food options with you because that is something I have a background in but we start talking about meal replacements and things like that, it gets a little bit further out of what I’m comfortable with (pause). [00:21:40]

CLIENT: That’s okay. Also, even joining music again, I think, adds to the walking that I’ve been doing because I have to, you know, wherever I park the car it’s still at least a five minute walk to rehearsal and back another five minutes.

THERAPIST: Yeah. So those little bits during the day add up to just having a more active day. That all counts in terms of moving your body and using the fuel that you put into it.

CLIENT: I just wasn’t getting out of the house besides work that much.

THERAPIST: Yeah, which doesn’t feel good in lots of ways. The commute was stressful, and you certainly started to feel isolated.

CLIENT: And I e-mailed a couple of friends and we’ll have to figure out, because the day we originally chose didn’t work but I might be getting together with one of my friends and knitting sometime this week. [00:22:47]

THERAPIST: Good for you. You’re really reaching out. How are things feeling with Sydney?

CLIENT: Things are okay. The problem with –because I was having all the emotional problems that I was having, it wore (ph) away at him and he’s still in recovery for that. I think things are getting a little bit better and getting better at not fighting with him and trying to not get annoyed when he holds up our plans.

THERAPIST: So he feels like it was your distress that was setting off his panic?

CLIENT: At least somewhat.

THERAPIST: It makes sense that you guys would affect one another. Certainly you do feel affected by his emotions and he might feel affected by yours. [00:23:46]

CLIENT: Well the panic today he didn’t actually take his meds (ph) this morning and didn’t realize until we were out at the restaurant, so he was going to take his meds when he got back. Unfortunately, he tried calling again over the weekend his psychiatrist and his psychiatrist still hasn’t gotten back to him yet. So that’s been rather frustrating. But because he’s so depressed I don’t know that he would see a new psychiatrist.

I don’t know. I don’t know whether or not his psychiatrist is a good doctor but I think the fact that he is impossible to get a hold of is really really not good. Sydney has missed a bunch of appointments though, but then rescheduling them is really hard. I don’t know if his psychiatrist is possibly not getting back to him because he’s skipped meetings at the last minute. Like he cancels day of when he’s in the middle of a panic. You (ph) think so, because I guess they usually schedule them for early afternoon which is a hard time for him and he’s much better off in (ph) morning and can get to morning appointments. But yeah, I don’t know what’s going on with the psychiatrist. [00:25:21]

THERAPIST: Does he see the same person for meds and therapy?

CLIENT: Nope. His therapist is actually right over on the street. His psychiatrist is (inaudible at 00:25:35) which is also harder to get to. I mean, at least now I don’t have my job anymore so he can have the car. His problem was also he didn’t have the car so he had to take the T to get there.

Well, there was at least one time that he skipped an appointment when I was actually home from work and was willing to drive him over. So it’s not just the commute, but that’s a factor. But I think he really needs to be on anti-anxiety meds because he’s not on anti-anxiety meds because he has the same Serotonin syndrome thing that I do. So he can’t take SSRIs so he’s on lomutrin (ph), which is not good for anxiety.

THERAPIST: It’s interesting you guys have had some of the same reactions and some of the same med switches.

CLIENT: It took a lot longer for him. Like he had been on SSRIs for at least like a year before the Serotonin syndrome thing popped up. But like ever since the first time that he reacted badly—each time they tried a different drug he reacted badly more quickly again, so yeah. (Pause) I don’t know. (inaudible at 00:27:00) And I’m trying to get him to come with me to Contra dancing. I’m going to not ask him about tonight anymore because of his panic, but see if I can get him to go either to Swing on Wednesday or the Contra on Thursday.

THERAPIST: Is that something he’s done with you in the past?

CLIENT: Nope. I mean, I hadn’t gone dancing in the entire time that we were dating until this past week.

THERAPIST: Oh wow. I didn’t realize it had been that long.

CLIENT: Yeah. I guess the last Contra dance I had been to would have been New Year’s Eve of 2011 going into 2012.

THERAPIST: That’s a long time ago.

CLIENT: And then I started dating him in like January 2012.

THERAPIST: Well, I think it’s important for you to go. It’s definitely something you enjoyed. And if he’s willing to go with you and you have something you can enjoy together that’s great. But not making it dependent on him, because it sounds like you enjoy getting back in touch with this. [00:27:57]

CLIENT: And I’m not making it dependent on him, but I do think he needs to also get exercise because I am fine with him and his body and the way he looks but him being out of shape and always needing to lie down after being up for a short period of time is really frustrating to deal with and probably not good for him. So I asked him if there was some form of exercise that he’d prefer but he didn’t have any ideas for that. He said he wanted to come to Contra with me. I mean that was before he had his panic attack today. I’m going to assume today is out, but hopefully I’ll get him to go with me.

THERAPIST: I hope he will. If you could both enjoy that would be great. Then you could reinforce each other and go. [00:28:54]

CLIENT: And he might be joining music though he’s going to take another week to think about that.

THERAPIST: Do you want to do everything together?

CLIENT: No. Well they only have four guys as compared to eight girls. So it’s really really off balance right now. And they have me singing tenor for pretty much everything, which is fine but just shows how desperately they need men. I guess Contra dancing isn’t as big of a deal. It’d be nice to have him come Swing dancing with me…

THERAPIST: Because then you’d have a built-in partner.

CLIENT: And then I wouldn’t have to ask people to dance and it wouldn’t be awkward anymore, but Contra I don’t mind going by myself. I mean I can do Swing by myself. It would just be preferable to have a dance partner with me. I guess the thing about going to Contra by myself is navigating my way to Concord when it’s really dark out. Was not the best experience in the world. I ended up going a slightly different way than what they had the directions they had given me, but it ended up going to the same place so I didn’t actually get lost. [00:30:19]

THERAPIST: It sounds like you did it. You were successful.

CLIENT: It was just…

THERAPIST: Trusting yourself.

CLIENT: Yeah. I’m not a fan of the drive, but I can do it. (Pause) Yeah. I can get out of the house by myself and do things by myself. Maybe it would be better if he didn’t join Tequia. I don’t know.

THERAPIST: I think it’s important for you to think about that too. Your (ph) decision doesn’t need to be completely up to him. This is something that you have done. This is sort of your territory. In deciding whether or not you want to share all of the activities or if you want something to yourself. Figure out what feels best for you.

CLIENT: (inaudible at 00:31:13) something to myself I could always see if I could get a knitting circle together, because that is not an interest that he shares. Yeah. I don’t know.

THERAPIST: Something to just let yourself think about. (Pause)

CLIENT: How can I make myself be more willing to cook and do dishes? Or is there no way to do that?

THERAPIST: Well, what would feel like a reward for doing that? The easiest way to motivate yourself to do something is to give yourself a reward for doing it. Is there something you could work toward? What would make it worth it? [00:32:14]

CLIENT: The problem is I can’t really just buy any sort of financial reward because I’m not earning any income so I’m trying to only buy things that I need for the most part. And for rewarding myself with like time knitting. I guess I could hold off and like I can’t knit until I wash these dishes. I guess usually the reward is washing the dishes so that I can be able to have dinner at home, which doesn’t really feel like much of a reward but it does get me to do the dishes. (Pause) I need to go to the grocery store and have just like (inaudible at 00:33:06) do all the things and I don’t really want to do all the things so I’m putting the rest (ph) of them off until tomorrow.

THERAPIST: What is it that you really have to do? Instead of thinking about it as all the things, what is it that you really need to do?

CLIENT: I need to go grocery shopping, I need to do the dishes, which I realized with my cups, the glasses are kind of long so I need to buy a bottle (ph) brush, so that also means going to the store to get that.

THERAPIST: [You usually] (ph) can get that in the grocery store.

CLIENT: I mean, I was planning on also going to the hardware store because I also have to get a screw to put something in, so that there’s that errand too. And then there’s laundry.

THERAPIST: If they’re all things that feel unappealing to you, you can spread them out. Pick one unappealing thing to tackle per day. You know, that’s one way of maybe getting yourself on a routine of crossing off one chore type of thing a day. Or if it feels like there’s a way to combine them to make it easier for yourself, thinking about stores that are close together, getting as much done in one place as you can. This screw is going to be a little bit hard to come by not at a separate store. (Chuckles) [00:34:33]

CLIENT: I can’t get that at the grocery store.

THERAPIST: No, I don’t think so. (Chuckles) But you might be able to find a place close by or something like that makes a little bit easier.

CLIENT: You know, I’m really not that far from the grocery store or hardware store. It’s just finding the time to do that and originally we were going to at least do the hardware store after we both had our therapy, but now Sydney is probably doing a phone session because of his panic.

THERAPIST: So your whole plan changes.

CLIENT: I mean I guess there’s no reason why I couldn’t stop on the way home and get the screw and the bottle brush by myself. I don’t think we (ph) would also do the grocery shopping today.

THERAPIST: Well, what about just walking to one of the hardware stores in the square and picking it up before you go home?

CLIENT: I’m not sure if I have enough parking for that. I might, but I don’t want to risk it. I don’t know, I guess I probably do. I guess I can do that. [00:35:37]

THERAPIST: Did you park in a two hour spot or an hour?

CLIENT: I got myself an hour and a half parking.

THERAPIST: Because there’s a—right kitty-corner. So that doesn’t require a lot more effort. You’re already out here. It definitely would have a screw. I don’t know about the bottle brush, but that might be one way of checking off a few things with pretty minimal extra effort.

CLIENT: I can probably do that. (Pause) That would just leave the dishes and laundry and grocery shopping.

THERAPIST: Maybe knowing that you’ve tackled something today maybe start off the day when you have maybe more energy and get something checked off right away the next day. (Pause) What is your sleeping schedule been like since you stopped working? [00:36:38]

CLIENT: So I try to go to bed, problem (ph) was Sydney wanting to stay up and also me getting back from dance so late. You know, Contra is like 7:30 to 10:30 and then a half hour drive back. Swing dance is 9:00 to 11:30. I ended up leaving at 11:15 last time. So getting back late and then Sydney wanting to watch the television and me being like, “Okay. I haven’t gotten to do anything on the Internet and stuff. So like, going to bed at 2:00.

THERAPIST: There’s a lot of time between getting home at maybe 11:30 and 2:00?

CLIENT: That’s true.

THERAPIST: Where does all that time slip away to? [00:37:38]

CLIENT: (Pause) I guess waiting for Sydney to finish up whatever video game he’s playing before we watch the show we want to watch. (chuckles) Like Friday night, we were up pretty late but then Sydney couldn’t get back to sleep. We were up until 3:00. And then Sydney woke me up—well, first he work me up at 6:00 and then he woke me up again at 8:00 and we ended up getting an early breakfast and resetting our sleep schedule. Saturday night we went to bed at like 10:30 and last night we went to bed at like 12:00.

THERAPIST: Yeah. It’s kind of all over the place. [00:38:39]

CLIENT: Yeah. I’m trying to make it more regular.

THERAPIST: I think maybe you might find that if you are able to have a more regular bedtime, you know, skewing (ph) to the earlier end of the times that you mentioned. You know, getting to bed by 11:00 or even midnight is going to make a big difference between going to bed at 2:00 or 3:00, because I think when you sleep really late in the morning, kind of sleeping through the whole morning and waking up around noon, it gives you much less time in the day to accomplish some these things on your list. Because even though you might stay up for the same amount of hours, you’re not going shopping at 10:00 at night. You’re not going to go do laundry at 10:00 at night.

So it shortens the number of hours that you have to do some of these chore type things or errands that you find it hard to approach and if you’re starting your day really late, and then by the time you get breakfast and do something to relax or get ready and get out of the house, a lot of that time is kind of gone for you. [00:39:47]

So it might be easier to kind of set yourself on a schedule and getting up in the morning time and then using that morning time to tick off one these kinds of chores when stores are open. And if you find that getting to the store’s a really big deterrent, then figuring out what things you can do online and removing one barrier. If getting to a place is the big barrier, then figuring out whether it’s worth it to order groceries or look around the house for the things that you need to pick up and see what you can order from Amazon. You know, those conveniences exist now for almost everything.

CLIENT: That’s true. Just figure getting groceries online would be really expensive.

THERAPIST: Look and see what the cost difference is. If that would make a noticeable difference to making it easier for you to make food at home and make a healthier choice… Do a true cost comparison rather than assuming what it’s going to be. [00:40:56]

CLIENT: Okay. (Pause)

THERAPIST: So let’s pick just one of the things that we’ve discussed to focus on for this week. What would you like it to be?

CLIENT: (Pause) I guess the continuing to get out more thing.

THERAPIST: Yeah. Allow yourself to focus on one piece at a time. Getting out more really seems to have made a difference in how you feel. Let’s see if you can repeat some of the things you did last week this week and start to solidify that as a behavior change, making that choice to get out. And these other ideas, we’ll kind of keep them on file to be implemented when the time feels right. [00:41:54]

CLIENT: Okay.

THERAPIST: Anything else we should have caught up on today?

CLIENT: No, but we should do scheduling.

THERAPIST: Okay. I have your regular 2:30 Monday space available, unless there are some weeks that you are not available.

CLIENT: I guess we could do a phone session. I’m not sure. Or if I should just cancel it for… the 10th I’ll be around. The 17th I’ll be around, but the 24th I’m going to be house-sitting.

THERAPIST: Are you gone that whole week or just that day?

CLIENT: I’m gone that whole week. [00:42:58]

THERAPIST: Okay. Would you like to do a phone session that week so you don’t miss? Or do you just want to reconvene on the 31st?

CLIENT: I think we could just reconvene on the 31st. I’ll also have to double check to make sure that I am in fact done by then.

THERAPIST: Okay. I’ll put you in for the 31st for now, and if you find out that you’re not going to be back by then we will pick another date that week so not missing two weeks in a row. I will see you next week.

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