TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: So we can give a shot and at point that you are feeling uncomfortable with it or it's feeling too strange or whatever, let's talk about it.

CLIENT: Okay.

THERAPIST: Even if it's feeling strange and you don't want to stop but you want to talk about it, let's talk about it.

CLIENT: Okay.

THERAPIST: I also wanted to let you know that I did ask a couple of follow up questions based on your questions asked of my contacted the publishing company. She reassured me I was pretty sure in this but did want to say this to you: they do not store the audio record. They are not publicly accessible audio recordings. It's only transcripts.

CLIENT: Oh.

THERAPIST: So, if the -

CLIENT: Oh, that's how they oh. (Laughs)

THERAPIST: That's how it is anonymized. Even if someone you knew in school or you know went to a class that that happened, what they would get is a transcript that is anonymized with identifying data. So where you live or what your name is all that gets changed in the transcript. There's no audio recording that gets released so they can't hear your voice.

CLIENT: Okay.

THERAPIST: So. Hopefully, that's even that makes it better. Yeah, so we're all set.

CLIENT: Okay.

THERAPIST: Just try this for a while. Also, scheduling just to double check with you about trying to figure out a permanent time. Starting next week I can do 10 o'clock on Monday.

CLIENT: Yeah, I think we settled that already.

THERAPIST: Okay.

CLIENT: And that's fine.

THERAPIST: I just wanted to make sure I said that because I didn't know if that was permanently available but did I say that it was?

CLIENT: You didn't say permanently, but -

THERAPIST: Next week.

CLIENT: Sure.

THERAPIST: Yeah, so be on next week. I've been able to open it up if that hadn't been the case.

CLIENT: Okay.

THERAPIST: So, how are you?

CLIENT: It's different. So Ivan's away still.

THERAPIST: He is?

CLIENT: Yeah. He left Friday.

THERAPIST: So through a long weekend then.

CLIENT: Yeah. And he's still there and I talked to him just for like five minutes today and he found out like he starts work on Saturday but they'll want him to do some paperwork before that so I said, ‘why don't you stay until as long as you can, sort of.' So, it's interesting. I have some mixed feelings. (Laughs) I'm just a little surprised.

THERAPIST: So how's it been?

CLIENT: It's been a little weird. I felt guilty because at first like the next day I woke up and I was like it was just me and Eloise (ph) you know like it's really quiet. It's really relaxing like I you know, none of that is even going to come across like conversation is even going to it just felt I felt relieved and I feel guilty about that about relieved. But that was, it was nice. And then I decided Saturday that I needed to spring clean the apartment because then I could really relax. And so I did that and felt good about that. So I took some time to myself and it's been, I have to admit I was a little surprised because then in the evenings it was weird. I had to leave like a light on in the living room which is just so bizarre because it is a perfectly safe development and everything but I'm no used to that.

THERAPIST: You're not used to being alone.

CLIENT: Right.

THERAPIST: By yourself at night.

CLIENT: Right. The last time was I had my own apartment in college.

THERAPIST: It's been a while.

CLIENT: Yeah, it's been a little while, so. (Sigh) So, yeah, but that was fine. And I went through sort of like, ‘oh, I want to go talk to him,' like I feel so good about this that I when he comes back I feel like, good, that we've had a breath and he's got a job and, wow, we have all this to build on and another part of me wants to like keep pushing him away and just not, because I don't know if I can handle like one more time (exhalation) things falling apart or falling through. So, yeah, a lot of mixed feelings there.

THERAPIST: That makes sense to have mixed feelings and you know to pay attention to all of them. I think that that's part of what you're trying to do even having space for the first time. What is this feel like? Trying it on for size. What does it do? It sounds like it does a lot of different things. And you're trying to just kind of take it all in and probably when he comes back what will that feel like to you? Do you miss him? Are you relieved he's home? Are you mad he's home? (Chuckles)

CLIENT: Yeah, that's another piece I keep thinking about. Well, this space might be nice or it might be able to accomplish this or this or relax this way. But he's coming back in a few days so it's, yeah.

THERAPIST: How are you feeling about that, his coming back?

CLIENT: Anxious. Anxious.

THERAPIST: Do you miss him at all?

CLIENT: Yeah, a little bit.

THERAPIST: When you miss him, what do you miss when you're missing him?

CLIENT: I guess more than anything, him going home reminds or like talking to him while he's with his parents it reminds me of when we were dating or when we would both be visiting friends or whatever, because he'd say he was going to visit one of his friends while he was there and it reminded me of, I guess, better times.

THERAPIST: Old times.

CLIENT: Yeah, and how nice that was.

THERAPIST: Yeah.

CLIENT: It was interesting a little bit because I sent him like a he texted me yesterday just like, ‘how are you doing?' and that was the first time we talked since we left which was, yeah, which you know was kind of (laughs) was even more because Saturday night I was already planning like, ‘he's going to call tonight, he's going to want to talk. I don't know if I'm going to do that because I don't know how I feel about that,' but then he didn't call and said, ‘whoa, that's not like Ivan.' And then it almost bothered me a little bit which was weird and so hypocritical. So, the next day it wasn't until the afternoon but he just texted, ‘how are you doing?' and I said, ‘fine,' and I just asked him if he had done anything about his appointment because he didn't know about his scheduling and cancellation policy and about when Ivan was coming back. I had no clue and that concerned me money-wise so I just asked him about that and he didn't answer so I had texted back, ‘can you just please respond, please.' And he just never answered. So I ended up calling him late at night and I'm like, ‘you know you didn't answer, so what did you do about that?' and so he was, you know, ‘oh, I had turned my phone on silent and I forgot. I let it go.' And I felt more upset by that than I thought I would. It was such a little thing.

THERAPIST: And this was Saturday or Sunday?

CLIENT: Sunday.

THERAPIST: Sunday, right.

CLIENT: Yeah, and it I don't know, it was weird because I thought at first like, ‘okay maybe he's trying to give me some space that's why he's not talking to me at all or maybe a lot of times when he does visit his family or even when we were dating or he's just with his family they are so busy and they plan, like they pack the days and they go see their big family and that's what they do so it's really more of a time thing I think, sometimes. So I wondered, was it he was too busy with his family, having a great time. Was he moping and he didn't want to and then I thought, ‘well what if he just doesn't need to talk to me because he's being taken care of, he doesn't need me right now because he's got his parents right now to take care of him.' And then it felt like you know what if his attachment to me isn't based on love, what if it's based on need? And that didn't feel very good.

THERAPIST: What if it's based on filling in his deficits.

CLIENT: Right.

THERAPIST: Rather than -

CLIENT: Because he needs someone.

THERAPIST: Yeah.

(Pause): [00:08:13 00:08:23]

THERAPIST: You know in a way I think that's part of what's so painful about where you are right now is that you are identifying both of you I think, that that's a piece of what you do for each other is fill in deficits. His are more extreme or louder in a way because they have to do with the fact of his functioning. Right? (inaudible) might have something to do with relaxing, letting go, not being so worried about whether it's perfectly clean. At the moment he's not helping you too much with that because he's so preoccupied with his own stuff. But what if that's true, if it's about deficits, if it's a big piece of what's brought you to him is about deficits? What does that mean? [00:08:52]

CLIENT: His or mine?

THERAPIST: Well, I guess about both of yours.

CLIENT: It doesn't feel very good. If that's what the relationship is based on. That's not what a marriage should be?

(Pause): [00:09:30 00:09:35]

THERAPIST: And maybe if it's that and some love thrown in, that there's a big piece of it that's about that.

CLIENT: I guess I would be surprised also, but ashamed. Ashamed and embarrassed because it's not the right reason to marry someone, but at the same time I guess, I don't know much about marriage, I guess, but I feel like most people marry someone because they bring out the best in them or they do need each other on some I mean if they didn't need each other at all, why would they get married? Things like that that's maybe okay, and maybe even healthy, but I don't know where that line of dependency is where it's no longer healthy and it slowly becomes the reason.

THERAPIST: I mean I think you're totally right in some ways. It's probably more common than not. It's probably the norm about how people finding someone who provides something that they really need and didn't have. You know you could say that's a healthy thing, it's a forward striving for getting something that you didn't get as a kid, that you really needed. It's when you start to grow enough in yourself and you realize I don't need that from this person that it starts to, it becomes a rubbing point. People say the thing you most love about the person becomes the thing that most irritates you 10 years into the marriage or something. That's a piece of the thing that provides something you desperately needed at one point in life can also be something that once you are your whole self bothers you about the other person. So these are the questions you're asking yourself is to what degree is this continuing to be within the range of normal growth curves and challenges for a couple and to what degree are we really this far apart in who we are once we come together.

CLIENT: I think part of it's okay with me because so one of the things that Ivan fulfills for me is he's really a laid back person. He doesn't worry about things, he doesn't stress out, like I never see him like pulling out his hair, like, this doesn't happen. Ivan never really never pulled all nighters to study or like study for weeks in advance. He's just not that kind of person at all, whatsoever. And sometimes that was really good for me to have that influence but then in our marriage when his responsibility or lack thereof had a very direct impact on me. I feel like it tips way to so no longer did it relax me at all in way, shape or form. It actually made any anxiety more, much worse.

THERAPIST: Do you remember a time when his being laid back actually felt helpful to you? So this was in college? What do you remember what would that look like then?

CLIENT: I guess, I mean Ivan was very encouraging and he, but just it wasn't always so much something he did for me or said for me, it was his own attitude. So, Ivan did something, he would do things that were crazy like pull an all-nighter for his paper that he put off until the last minute but he wasn't freaking out and he wasn't all like, no, it was just a fact of life type thing for him. He just, you know, could keep going and just he never got stressed out about those types of things.

THERAPIST: And that could feel healthy, like a healthy influence when it wasn't it was just a sort of external feedback but didn't actually affect your life.

CLIENT: Right and I think too, the fact that he was able to be pretty happy being like that and he could walk into class late, totally a mess, you know, clothes that don't match like the way guys dress a lot (laughter) and you know it wasn't something that upset him. It wasn't something that he was fine about it. He was able to be happy that way. He wasn't so worried about what people thought or about judgment and that's something that's always been huge for me. So, I guess that's something that I admired in him to an extent.

THERAPIST: And something that in a way you could maybe be helped by some in the future like that that is essentially a good influence but maybe at an extreme in effecting your life it's too much of it right now, rather than being calming it's really, really ramping up your anxiety because it's been an extreme laid backness.

CLIENT: Yeah and even worse, I feel he genuinely has made some progress and he has made some steps and now he does have this job and like little things have happened but I'm just really scared to acknowledge them or say much about them because I'm so worried that this is not going to be a continual thing upwards.

THERAPIST: As he's looking for another job, what is he looking for?

CLIENT: I have no idea. He told me that anything that pays better than -

THERAPIST: But that could be anything. Is he looking for something in other words that would just be a better paying retail? Or -

CLIENT: Better paying anything, I think.

THERAPIST: What would be your ideal? Is he looking for a job that could then be a career path?

CLIENT: I don't know.

THERAPIST: No, you don't know.

CLIENT: I've encouraged that. Especially here there are so many historical landmarks and things because he loves this stuff. He's at talking about those things and I said why don't you get into that, that's something sort of academically focused. You can put on your resume and he'll sort of go I don't know how genuine his interest is in that. So, I don't know if he has a plan. He might, he might not. It's kind of gotten to the point where we can't talk about the job thing.

(Pause): [00:15:48 00:15:55]

THERAPIST: How would you feel if he (inaudible) but worked at Starbucks or something, some equivalent like that for the next few years? [00:16:04]

CLIENT: It wouldn't be enough for me.

THERAPIST: It wouldn't.

CLIENT: I maybe shouldn't proud, like I'm not proud to say that because I don't look down on people who work at Starbucks by any means. I mean it's respectable, it's honest, it's great, really, truly, but I guess I feel it's underemployment for him because he did go to college; he did do a little grad school. He has abilities beyond making coffee. Again, there's nothing wrong with that. Like, but I just you know for his age and education I think I would expect or hope for more and that maybe has more to do with my standards. The truth is, the other day I had told him, ‘I don't need you to be a surgeon or lawyer, or anything fancy, I just need you to do something.'

THERAPIST: Do what? That's what I wondered. What this seems a little strange but I wonder what it is that would feel like enough for you. What would feel okay? And it isn't a surgeon. I don't hear you saying you want him to be a surgeon.

CLIENT: No. But honestly, I think the truth is I think I'd feel great if I knew that Ivan had a great profession like that and you know, was comfortable financially and we didn't need to worry about that and he had a career that indicated a lot of drive and ambition and motivation and a clear plan for retirement and the whole deal, sort of. That would feel wonderful, but I could definitely be satisfied with less than that for now anyways. That's not old but I'm just worried that it may never the problem is he wasn't happy, he wasn't satisfied with waiting tables but he did it for over a year and to me that doesn't and he only stopped doing it because the restaurant closed. So to me that doesn't say like this isn't enough for me, it doesn't say that to me.

THERAPIST: So maybe one of the things you're picking up on being important to you is a kind of ambition or something -

CLIENT: And hard work.

THERAPIST: rather than taking the path of least resistance, right, pushing hard towards something you feel you're interested in. Like if he were in a profession that didn't make as much money as a surgeon like something if you were a teacher for example and pushed hard being a teacher. Would that feel good enough like, okay for you?

CLIENT: I think so. I think I've tried to emphasize to him that it's not as much about the money as maybe it comes across as being. If he wanted to teach, I don't know, college or even high school maybe? And he was passionate about that and he really made a career worked really hard and did lots of things with that. If I made more money I think that would be fine. But it's just, there's no it doesn't feel like there's any drive or any, in fact it almost feels like he's getting the job because everyone in his life at the moment is say, ‘you have to get a job.' And, so the problem I don't think has ever been whether or not there is a job.

(Pause): [00:19:13 00:19:18]

THERAPIST: That also seems so important for the work you're doing as a couple and just inside yourself to know what you're wanting to say to him. That it really isn't does he have a job or not have a job or did he pay this bill or not, but that you're you would be more, feel more attracted to him with him having drives and ambitions and goals that he feels passionate about.

CLIENT: Right.

THERAPIST: Rather than feeling like he's doing things because he's being told to do them.

CLIENT: Right, because I think that's a big that's where I feel like, where I'm really wanting is before we got married or even when we got married I had this vision of Ivan having his master's degree, he had a clear career path, he was going to get a PhD, he was going to write books someday, like he like we were going to get a house someday. In our 30s we were maybe going to have children. Like we had a very, very vague, like most couples might have, some kind of idea, some common and then we got married and he works construction and then the restaurant job and then he failed out of grad school and then there is no then there's nothing. So we go from really comfortable, solid, something to work with to nothing like no idea what he's doing tomorrow and that's what's not okay.

THERAPIST: You thought when you were dating, so before marriage had you talked about this plan you're describing? You actually talked with each other about it. It wasn't just kind of in your mind. Huh. And he would share this with you. That was his vision, too. He was going to get a PhD was his decision? In anthropology?

CLIENT: In theology. I mean he was getting a masters in anthropology, so, and he was going to. That was his plan and eventually, ‘oh, I don't want to write books that nobody reads which is a little true. A lot of those books don't get very well read outside the schools, but, so I have no clue if now it's about his failure more than I ‘cause he keeps saying it's not about school but it's also become a dirty word that no one can use around him, so it's like bizarre. I don't know what to make of that.

THERAPIST: That path would have been to be a professor?

CLIENT: Right. Yeah.

THERAPIST: So it's really, you used the word ‘mourning' your continuously trying to wrap your mind around that not being the pathway.

CLIENT: And that's not just, I mean, that he was able to lie about, you know, a big chunk of time actually like the most serious part of our relationship, our engagement period, like he was able to lie about so many things and the business with the loans and so many outcomes with his depression it's just all been too much and it feels like all of a sudden I went from this comfortable place where I knew what I was getting into and it looked like a good future to -

THERAPIST: You're feeling betrayed.

CLIENT: Right. And I also feel like I don't really know him right now, like who is this person? This is not so it's a bit much.

THERAPIST: It's also not that you're feeling like okay, well I knew him for a long period of time and then he's gotten depressed so who's this person who has depression but that even back, you're saying I guess I'm still catching onto when all of the, for example, all of the lying about telling you things were going well in school that was during your engagement.

CLIENT: But I never knew he was lying.

THERAPIST: Right.

CLIENT: I mean all the weekends that I said, ‘so are you sure you want to come visit this weekend because I understand if you like, I've got work to do, too.' ‘No, no, I'm going to read out ahead so that I can take the weekend off.' So I mean so many times we had that discussion and then when he got there, I mean I had no clue.

(Pause): [00:23:25 00:23:30]

THERAPIST: It's really, it's does not mean it's insurmountable it's a level of betrayal about the foundation of what you're thinking you're building together.

CLIENT: Right. I think it's exacerbated by this thing that's been happening with my parents. It's a lot to have people sort of reveal that they're sort of capable of something or that they're not something you thought they fundamentally were. It's a lot.

THERAPIST: As you're seeing it with your parents. I can think of several examples of what's in your mind. Your dad's a failure?

CLIENT: I guess I would say that. I guess I would say the whole, you know I went to register for classes one day and nothing was paid because they spent my college fund that wasn't money they saved to begin with? Things like that. Things like ‘by the way I had another husband and another daughter.' Like, ‘by the way, I cancelled your health insurance and never told you.' It's like this crazy, bizarre (exhalation).

THERAPIST: There's a list -

CLIENT: Right.

THERAPIST: of ways you've been betrayed.

(Pause): [00:24:44 00:24:49]

THERAPIST: What are your feelings about that with your parents?

CLIENT: They're all over the place and unfortunately I feel every time it comes up I like revert into this helpless, little girl who has no control over it. It's actually something I'd like to talk about today if I have enough time.

THERAPIST: Of course.

CLIENT: So, it's connected to other examples but so today I talked to my mom just really briefly because I needed a recipe because I was making a care package. My dad's getting surgery on Wednesday, whatever. And then she's like, ‘well, I don't know when we'll see you next,' and I said, ‘well I'd said you and dad were more than welcome to come for Easter, like it's not a lot of time for us to make the journey but and she's like, ‘well, I told you we weren't coming.' And I said, ‘no, you didn't. You said you didn't think dad would take the time off but you didn't say you weren't coming.' And she said, ‘well, it's such a short amount of time.' And I said, ‘you can come for more than Easter Sunday,' and like she just, she wasn't having it. She was like, ‘well, we're not going to go into this, so this is a bad subject. We're not going to go into this and I'm not proud to admit but I said, you're old enough, like we're going to have this discussion. Like you can deal with this. And it's again, that me just trying to force this like, this role on her like she should take the leadership role or she should have the responsibility or and she's like, ‘no, I'm old enough. I shouldn't have to deal with this.' And I said, like I don't understand, I really just invited you for Easter. I don't see you being victimized here, like I think this is fine and she's like, ‘Ramona, you want to be careful because you might say something you're going to regret and someday you won't be able to correct it.' As in, you know, she's 63. That's what it's about she's 63 and someday I'll have these things and I won't be able to apologize for them. And it's just like it's a lot but it's also frustration because I don't understand so if you're not coming you know, that's fine but why? Because she doesn't work, she doesn't volunteer, she doesn't see her friends, she doesn't if anything, it's about the past (sigh) and it's you know.

THERAPIST: When you kept saying, ‘talk about this,' I'm not even sure what is the ‘this'?

CLIENT: That she won't (cross talk) I mean I want a reason [00:27:15]

THERAPIST: That she won't come up? Is there a reason?

CLIENT: I'm like, I want

THERAPIST: You mean she won't even give you a reason why she won't come?

CLIENT: Well, but the reason is you know, it's a short period of time but I'm like, ‘you can come and stay for the whole weekend. You can stay for a long week no and she's like, ‘well, your dad, your dad, your dad, your dad, he won't take off for it.' And, I'm like, I know his I know about his work schedule as well as anyone else and if he only wants to come for the day which he would totally do because no one's going to want him unless there's an absolute emergency, I'm like, ‘that's fine, but that doesn't effect when you come, you know.' She can't fly. She's terrified to fly so she wouldn't anyway, but I'm sure he would and I'm like, that doesn't effect,' and she's like, ‘well, I thought you were talking about us coming,' and I said, ‘yeah, but.' So it's just like anything to skirt the issue and get and she's like, ‘we're not going to talk about this,' and she does her very calm, ‘all right well I'll talk to you another time, I love you,' and she starts, you know she's going to hang up on me regardless and I just, we've done this so many times and it's bizarre because my sister warned me, ‘do not expect them to come, Ramona, do not expect her to don't do it.' But every time I like am left crying like this little girl who has been rejected or abandoned or which is so silly because I'm a grown adult. It's not the end of the world and I'm not upset because I don't see them on Easter. I've had that before but it's about she's done this so many times. We've had this situation so many times where it's like this tug of war and it will even be like I'm coming, I'm not coming for this amount of time. No, I'm only coming for and it goes on and I can't like get out of it. I can't break that cycle and I am left frustrated and I know, like I tried to call her back but she already turned off her phone. And it's probably going to be a few days until she would even consider talking to me again and at that point it's not going to be an apology, it's going to be like it never happened. And it's just so frustrating.

THERAPIST: It's so unbelievably sad and painful to hear.

CLIENT: I don't know if this happens to other but it's like I don't part of me wanted to be like I' sure other parents if they had an invitation from their kids to come for Easter I think that's a nice thing. You know. It's no strings. But it's not a she's like, ‘well, why don't you invite your in-laws? They haven't been there.' Like, it's just so -

THERAPIST: What happens in your mind about why she doesn't want to come up? What do you imagine why not?

CLIENT: I think there's always the fundamental, I mean for my wedding there was like, ‘oh my gosh, what are we going to do about the pets?' Because that's such a big priority and I, of course, they need to be taken care of, but she really, like they really so many that it's extreme and with all the birds, someone would have to come in, but most of the time no one can come in because the house is a mess and they don't want anyone to come in or it's just like this big, long, and that's something that's something that's like a hot button for me. So there's that.

THERAPIST: So the pets get taken care of instead of you, their daughter.

CLIENT: That's like a common theme but, I mean I understand that she just can't leave them for days and -

THERAPIST: But she could have fewer pets and spend time with her daughter.

CLIENT: Yeah, she could. But it's not so I don't know if it's that. You know she has fears of crowds, or fears of flying or like the last time she came up once and she took the train and she talked about how great the train was and how easy it was. It was like one of two modes of transportation that she doesn't get sick on or is afraid of but I don't even know. Like I really don't and then I feel that maybe she doesn't love me or maybe she is abandon it's like all these irrational childlike fears that come rushing back every time this happened and I need to find a way, if I can't control you know, I'm not going to stop talking to her and this maybe I can't stop this from happening but I need to find a way to control the way I feel afterwards.

(Pause): [00:31:27 00:31:35]

THERAPIST: It's a moment of being abandoned and it's not the big abandonments of your childhood but it's still a moment of hoping that she's going to be present in your life in this way like wanting to visit your daughter, daughters for holiday weekend and there's a hope and then it gets crushed and that's what sounds like is the what you get locked into, that you hope and then it gets crushed and then you hope again and it gets crushed. The question of why opening up the hope I guess a little bit more where how you find yourself back in the place of hoping this time will be different, it sounds like you know from experience that repeatedly it's not different.

CLIENT: No.

THERAPIST: Does she ever come through and sort of shock you? Like, ‘oh wow, she was really there for me this time'?

CLIENT: On the phone she can, absolutely. There have been some times where she has shocked the heck out of me and there has been zero judgment and she has just been completely there but in terms of doing something like coming to visit or like that, if it involves her going somewhere it's not okay. If it involves us going there it's okay as we go there, like it's okay for us to go if we have a planned visit but it's not always okay once we're there. It just feels like such a I'm just really tired of it. It's so frustrating because you know, I thought (laughter) that was something nice and I thought, and then she's like, ‘well, I know you've been under a lot of stress recently,' and she's referring of course to the problems with Ivan and I and part of me feels so frustrated by that because that's her that's another excuse to throw on the pile and I'm like, ‘you know, I invited you. If I thought I was too,' or what she could have said, even was, ‘are you aren't too stressed to do this? Are you sure it's not going to be a bad time?' Like, it's over a month away and that -

THERAPIST: It's also not crossing her mind that it's a stressful time and therefore maybe it would be helpful to have your mother around for a visit.

CLIENT: Yeah.

THERAPIST: That maybe you'd want to see family as a support. Do you know what I mean? That thought doesn't even enter the realm -

CLIENT: But it does. Because a few weeks ago I was on the phone with her and she just said, ‘you know if you want me to come up for a while I could do that.' And I'm like, ‘oh, I'll think about it.'

THERAPIST: And she'll offer.

CLIENT: Yeah, but then it's I think she offered because she knew I wasn't going to take her up on it at the time because I was too overwhelmed to deal with the potential tug of like I couldn't do it and so -

(Pause): [00:34:32 00:34:38]

CLIENT: Right. So, I mean it's okay to offer then but then when I suggest something that we would usually have a big family get together on Easter and that's not. So I don't know what it's about. But it feels like it's about abandonment and I -

THERAPIST: How could it not feel that way? It doesn't mean it is that way but it's your own mother saying, ‘no I'm not going to come see you.'

CLIENT: And that's okay, like I think I can handle that but there's no like, ‘I just don't want to,' or, ‘it's to difficult for me to travel.'

THERAPIST: There's no discussion.

CLIENT: Right and it's what I hate most is then it's followed by when she's going to hang up I'm not going to hear from her for days and it always feels like I'm devastated when that happens, every time.

THERAPIST: You get punished. It's as though you did something wrong. You get then the silent treatment. She's mad at you then.

CLIENT: But this is a any argument with my mom growing up whether it was about my dad, about her, about stuff with even us any argument, if it got to a point where she didn't want to talk about it, deal with it, if it had gone on too long, if she just didn't feel she'd go to her room, lock the door, she's done. I mean like any extreme. Like leave the house that's more my dad's thing, but it feels horrible. I feel so insecure and I always feel this like, ‘do you love me,' like impulse and that's and I've like said something like that to her before and she's never it's always like, ‘well, if you don't hear me saying you love me, then you're not listening.' It's not, ‘of course I love you.' And I, I'm just really frustrated because, again, I need to find a way to not have that meltdown, that devastation every time.

(Pause): [00:36:31 00:36:37]

THERAPIST: I think in the long run we need to help you do that, too. There's so much though that you are opening up at least to me for the first time that it's just, it's huge what you're describing got set up and settled inside you in your development that I think I don't know that we could jump to kind of an intervention to get you not to feel this way by next week -

CLIENT: No, I understand.

THERAPIST: Although I get that I'm totally on board that in the long run putting into perspective what's happened to you and how that's created feelings of insecurity inside you bearing the sadness about what you never had and then getting to a place where you have a totally different perspective on it and you don't hope for something different, I think would be really valuable for you. I think that there's some work we've got to do between here and there to get there, though, and just your talking about it, you're starting to do that. By opening this up. It's really extreme what you're describing in her. I don't know if you know that.

CLIENT: I don't know.

(Pause): [00:37:49 00:37:53]

THERAPIST: She sounds, in other words, quite psychiatrically impaired. Very ill.

CLIENT: My mom has suffered with depression ever since I was little and really, like to the extent that every Saturday night she would become sick and it took me a long time to figure out she was lying because physically she was but she wasn't lying. Because she was like, ‘oh I have a stomach ache,' or, ‘oh, I have a headache.' Because Sunday morning was church and she didn't want to go because she struggles with agoraphobia, depression, anxiety, all kinds of things like guilt. She'd like she had so many things and she never explained, you know, and I don't know how you would.

THERAPIST: (Cross talk inaudible) [00:38:34]

CLIENT: I don't know how you would but I know I was very, very angry at her for a long time because I figured out she was lying to me.

THERAPIST: Yeah. There's depression. There's tremendous anxiety in her. You're describing also it sounds like agoraphobia. You know it's that, it sounds like.

CLIENT: She tells me she used to be terrified to walk out to the wash line when we were little like steps from the side door, she used to barely leave the house. She barely leaves the house now. And it's difficult in and of itself but I just, I guess I feel like sometimes those things have gotten in the way of what I needed.

THERAPIST: Ah, yes!

CLIENT: But again like it's not my mom's fault that she has depression but again, like all the years that she sort of stayed in bed or didn't cook or clean or didn't I got really angry about that. I'm still angry about that.

THERAPIST: Did she go to therapy or treatment or to the hospital?

CLIENT: She's been to see a number of people. She sees someone now. I'm never quite sure what their qualifications are, but that's my way of saying I question their qualifications, but she sees someone now but she also tells me like, ‘oh your dad makes such a fuss about paying the co-pay every week,' sometimes I just don't ask and so I don't know.

THERAPIST: And in your childhood she did see someone.

CLIENT: I don't know.

THERAPIST: You don't know.

CLIENT: I don't know when I was little because there was no acknowledgement of it when I was little and I didn't figure out that this was a real thing that I just saw my mom doesn't clean the house. That's lazy, irresponsible, whatever, like -

(Pause): [00:40:17 00:40:22]

THERAPIST: Yeah, and she's not on medications as far as you know?

CLIENT: She is.

THERAPIST: She is.

CLIENT: And she's been on for many years, that I know.

THERAPIST: What is she taking? Do you -

CLIENT: I don't know.

(Pause): [00:40:26 00:40:31]

CLIENT: I don't know. I know she's tried a number of different combinations and she's stressed and that's been a problem. Side effects. But sometimes she'll talk about, I mean when she did clean up the house last Thanksgiving, she talked about you know, they finally found something that was starting to work they were gradually upping her dose and it was helping her and so I mean, there are times like that.

THERAPIST: You know it's interesting because it makes you wonder if having all of the pets might be one way of then allowing her not to have to leave the house. Do you know what I mean it becomes like a level of something that binds her to the house and then can become an excuse not to go to far or even how filthy things become. It's both just an expression of what she can't get herself to do because she's so depressed but then it also becomes another way of locking the world out. Do you know what I mean? That there's so much yuckiness inside so now we just have to keep it to ourselves.

CLIENT: That never occurred to me. That sounds very reasonable, but that never occurred to me.

THERAPIST: I mean I guess that there are layers and layers of then what starts to help enable the pathology that's already there to kind of lock it in place you know, for example, you think that the first thing that comes to her mind about why she wouldn't come up is, ‘oh, the pets.' It's not really the pets, right? But it becomes a reason that gives her a legitimate excuse to stay home. You know, legitimate in quotes.

CLIENT: No, it sounds, I mean a while ago I suggested that she start doing volunteer work. She's a nurse, I mean, she hasn't worked in years but she has skills and anyway, and she, no, she got a puppy. (Exhalation) It's been something I've never been able to understand, but I don't think 15 pets makes her any happier than zero pets, but its hard because I like my mom is not a horrible person, she's not someone who doesn't love her daughter like she really does, but some of these patterns are really tough and I don't I just want to find a way to work with the relationship but it's getting really hard to even have a phone conversation sometimes.

THERAPIST: You're so not taking care of the relationship. I mean that's what's painful listening to it. It's not only do her various psychological illnesses really impede her capacity to be a mother to you but she doesn't even then say, let's say she is that ill and you're a kid there isn't someone, either her or your father, saying, ‘Ramona, this is what's going on with your mother,' or, ‘this is what's going on with me. It has nothing to do with you and I want you to know it has nothing to do with you. It's my problem and sometimes it might mean that I'm mean to you or I'm grouchy or I can't come to your school function or whatever is the thing, and believe me, I want to be there but I have this thing called agoraphobia and it means that I'm terrified when I go outside and it's going to have an impact on your life but I want you to know it has nothing to do with you and I wish I could be there.' Do you know what I mean? Even that layer of taking care of you, even if all she could do was do it from the home is absent. Explaining, giving you context, helping you know it has nothing to do with you.

CLIENT: I think right now my goal is I'm still not over, for whatever reason, I mean if it's wrong or right but somewhat over like that neglect or like those cycles or all those things because it's not that long ago that I lived there. But, I want to and it's still happening, but real, in our conversations and things like that but I want to get to the point where (exhales) I'm okay and that even if it never stops that I realize I didn't get it when I really needed it but now I don't need them to take care of me and I can be okay even if I don't feel emotionally cared for.

THERAPIST: It's a part of getting over it is talking about it for a little while. If you can bear it.

CLIENT: Yeah.

THERAPIST: I know you know a lot of these stories in your own head and you can feel like, ‘ okay well I've thought about that and thought about it and thought about it, why am I not over it,' but to actually share it and know it and own it with another person is a very different experience than us, you know, stuck inside our own heads. There's a processing of experience that can help put it tuck it inside in a different way when it happens with another person, becomes more real and more integrated then. So it just seems to me there's so, so much that you've been on top of by yourself but that actually getting it known and shared here might help it consolidate inside in a very different way that would allow you to move on.

CLIENT: That would be good.

THERAPIST: I was struck by, about half way through our discussion today we're going to stop in a second but you said, ‘and that is something I wanted to talk about if that's okay.' You know you can start wherever you want to start. You know that. Do you feel like you need my help to get started though sometimes?

CLIENT: Yeah.

THERAPIST: Is that part of it?

CLIENT: Yeah, I do.

THERAPIST: Okay.

CLIENT: I feel I need you to take more control because there's so much going on and I could talk about today, I could talk about 10 years ago. I need some focus. I may be a little more CBT-like, I need more control from you, maybe.

THERAPIST: Yeah. I think that that may be something that allows you to feel calmer here, right? Is not so much that I think there's a little bit around the fantasy that I'm in control and can kind of give you control and then you can feel comfortable here? That that's okay, that's kind of where it is and I'm willing and wanting to help make it safe enough for you to open up parts of this that are not safe for you. I don't think that telling you, CBTing you through that exchange with your mother actually is what's going to be most helpful though right now. If, in other words, if doing some of that to get you to feel like you can start to open up your feelings about this helps I think that makes a lot of sense. I think the airing more of the feeling, which I can put in CBT language if you want to. It has to do with affective exposure so in behavioral therapy we're talking about putting somebody who's agoraphobic in on the outside allowing them to have a full blown panic attack and exposing themselves to the behavior that brings on the affect this is a place in behavioral language where you can talk about affective exposure to the things that are tucked away inside. So, I think to the degree that I can help create this as a safer place for you to bring those out and feel them; you do a lot of work not to feel them. You know, you'll say something that sounds really sad and then you'll immediately say, ‘yeah, but that was a long time ago.' Or you'll say, ‘yeah, but I don't want to fault her.' But there are a lot of sort of follow up comments that stop you I think from actually feeling that you're really sad or really mad about that thing that happened. Do you know what I mean?

CLIENT: I do. Is that important?

THERAPIST: I think it's very important because the more we can help you get to the feelings that I think are there it's when they're stuck feeling attached to a person that hasn't that you didn't get to know in your conscious experience that you do continue to go back to that same person looking for something to be different. So, to me a piece of trying to get noticing what it is that stops you from just feeling the feelings that are there it doesn't mean she's evil, it doesn't mean she's hasn't done anything good for you it doesn't mean she's not a well intentioned person, but you can still have feelings about it. So starting to allow some more space or noticing when you cut off the space what's happening inside you to eventually to allow more of those feelings there I think will allow you to move on in a different way than you've been able to do before with this stuff that gets stuck inside now.

(Pause): [00:49:21 00:49:25]

THERAPIST: Sound reasonable?

CLIENT: Yeah. Thank you.

THERAPIST: Okay.

CLIENT: So next week.

THERAPIST: So next week at 10.

CLIENT: Okay. I also need to ask you I mentioned I did a little bit of journaling? Would that be valuable to -?

THERAPIST: Extremely.

CLIENT: Okay.

THERAPIST: Extremely. Either if you want to give it to me or bring it in and read it or great.

CLIENT: But can it stay -

THERAPIST: I would put it in a file -

CLIENT: Thank you.

THERAPIST: I could give it back to you.

CLIENT: No. I mean I don't need to keep it, I just -

THERAPIST: I keep a record of my so I'll just put it in there.

CLIENT: Okay, thank you. I'll see you next Sunday.

THERAPIST: Yeah, see you then.

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