TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: How are you?

CLIENT: OK.

THERAPIST: How are things? (pause) It's been a while.

CLIENT: It's been a while. I guess I'd say I'm anxious more than anything, a lot. But I guess overall things are OK. (pause)

THERAPIST: You said you got a new mantra going.

CLIENT: So I try. (chuckling) The first couple were really bad and so I tried to think of one. And I don't believe it and it sounds horrible but, "It's going to be OK. Things are going to..." Like that's... so sometimes... it's interesting but sometimes in my head I'll still hear the like, "I hate myself," immediately. And I can't like... but then after that, I will think it's going to be OK. So I'm trying like hopefully eventually the first one will be erased and I won't think that. But it's really engrained so...

THERAPIST: That's what I think part of it is just even to get to start noticing how often that thought comes into your mind. [00:01:05] How much it's there as a whip. Even if all you're doing in the beginning is just now noticing it more, how engrained you're saying that is that that comes in. Is it that exact statement specifically?

CLIENT: Yea, always.

THERAPIST: Wow.

CLIENT: It's always that and it's like a daily thing, if not multiple times a day. So it's going to be OK sounds like a... it sounds a little wishy-washier. It sounds like the type of thing you don't want to hear when you're upset. Like, "Oh, it'll be OK." Almost like brushing it off. (chuckling) But it can be a little comforting even to just try to believe it. Or even just hear it after that or instead of that, it can feel a little good.

THERAPIST: You said you tried a couple of other things first that didn't stick at all.

CLIENT: I didn't intentionally try them. (chuckling) It's just like they came into my mind. [00:02:02]

THERAPIST: So what... but that they didn't work? Like it didn't feel...

CLIENT: No, they weren't good. (chuckling) They were not good.

THERAPIST: Like what? I'm curious what came up first.

CLIENT: It was like a... I guess a self-critical thought. I was looking at someone else. Actually they are on the team [ph] and she just looked like so put together. And so... and I was thinking about myself and thought of the, "I hate myself." And then I thought she's better than me. Then I thought that's not good. Like comparing that, that's not a good strategy. Then there was another one that had come into my mind. Actually not remembering it at the moment. (pause)

THERAPIST: It sounds like sort of one distortion coming in to replace another distortion more than a challenge.

CLIENT: Right. So it's going to be OK. It's... I don't know if it's that great but it's better for sure I think. It's at least not anything negative. And I find it at least triggers like a, it's not the end of the world reality. [00:03:08]

THERAPIST: Yes, yes.

CLIENT: Because I find the, I hate myself thought, it doesn't just come up in the course of a day. It comes up as I think about... something can trigger a memory and I think back on something I did or didn't do or said or didn't say, whatever. And I notice the, "I hate myself" like comes. So it's not even like if everything goes well today, I can guarantee that that's not going to come into my mind. It's more like...

THERAPIST: Interesting.

CLIENT: ...my thoughts can go there.

THERAPIST: Even by just seeing somebody on a team [ph]. In other words, you didn't do anything wrong, you didn't say anything wrong.

CLIENT: Right. But not even just that. Like something will trigger some kind of memory and I'll think back. And it could be years ago, it could be weeks ago, it could be something I did or something I didn't do. Or just something I was embarrassed. It could be a little thing. It could be like an actually significant thing. And the, I hate myself thought will pop into my head. But if at least in that situation, the, it's going to be OK, it already happened. It's over. [00:04:07] It's not the end of the world. Like so?

THERAPIST: It is a really interesting thought, your... that you've come with because, right, on the face of it, it sounds almost invalidating. "It's going to be OK, Ramona (sp?). Stop overreacting or something." But I think the reason you're saying, it might be doing something that feels better is it does sound like when the thought, I hate myself, comes up it is, in a way, triggered by tremendous anxiety. (pause) In other words, what's... it's not... what's not on... it's very obvious, I hate myself, can be a sort of self-rage, self-critical thought. But I think that what's less obvious but actually is functioning a lot of the time is that it's a thought that you have to manage your anxiety. [00:05:09]

Do you know what I mean? So you start feeling... you can start feeling out of control. You can start feeling like you'll never get to where you want to be. You can start feeling like I'm not going to get a job. I'm not going to get an A. And that, I hate myself, that kind of whipping yourself back into shape becomes a way of kind of getting control over a situation that feels out of control.

CLIENT: Yea. No, I definitely... yea. It takes control and it puts it all on me. And it just... and then it becomes like, I hate myself and if I change this and like maybe then I won't hate myself so much. Maybe then the problem won't exist. Maybe then like... so I definitely like it's very... it's a theme I'm seeing here is that it's very important for me to have complete control over the problem whether or not it's actually related to me.

THERAPIST: Right.

CLIENT: And I think it's also a way to deal with shame. [00:06:01] To deal with like I don't know depression or anger around an issue because I find it to be... I have found it to be so incredibly unproductive to get angry at the person who's actually responsible. It just led nowhere. It has made no progress, no success. It's been invalidated even that it's their fault. (chuckling) So of course, bringing it back and putting it on myself has felt like the only way.

THERAPIST: Yea. This is the only outlet for all those feelings. Some of which is actually meant for people out there...

CLIENT: Yea.

THERAPIST: ...originally.

CLIENT: Right, and I...

THERAPIST: And it doesn't go anywhere.

CLIENT: No, it doesn't.

THERAPIST: (inaudible at 00:06:37). Right, right. (pause) That's what you had to do.

CLIENT: It still feels that way though.

THERAPIST: That is what you're having to do, a lot of the time at least...

CLIENT: Right and it's...

THERAPIST: ...with Ivan (sp?).

CLIENT: It feels like in fact if I could turn the criticism more inward a lot of the time even if it's to criticize like don't be so critical. Even if it's that, it feels like that's the solution. [00:07:04]

I'm also noticing more and more lately, maybe it's... I don't know. It's with couples therapy but it's also in general that I don't feel like I'm allowed. Like I'm not supposed to be critical and that's one thing. But I don't feel like I'm allowed anymore to speak about the elephants in the room. Not to acknowledge them. Not to critique them. Not to bring them up confrontationally or even with like, "Hey, we have to talk about this eventually."

On top of which, there's this other layer where Ivan's (sp?) family is like, by and large, in denial about what's been going on. And he is avoiding those topics like the plague which is, I mean, connected to the problems he has. And my family kind of stopped even talking about any of it with them because they're like... so really a lot of the time doesn't feel farfetched for me to say actually I'm the problem. [00:08:01] And if I really didn't bring it up, really didn't criticize it, really did let it go, the problems really would go away.

THERAPIST: Yea, I totally get that.

CLIENT: (chuckling) So it's like I'm the only person in the universe who thinks that there are actually problems and until I deal with my stuff, I'm never going to have any progress. And it feels that way with my parents. I mean, it feels that... like it's likely... more than likely my perception alone. But it feels like instead of looking for accountability in them, I need to be looking for like letting it go from myself.

THERAPIST: Do you know the story of Emperor's New Clothes? Do you remember that?

CLIENT: I used to. I don't really anymore.

THERAPIST: It's an old fairy tale. It reminds me of that. So there's a boy... that the essence is that... of the story is there's a boy who sees that the Emperor's new clothes is that he's naked and he's going around saying to everyone, "Look at my beautiful, expensive clothes." [00:09:04]

And everyone is acting as though he has beautiful expensive clothes. "How beautiful. You're lovely." No one is saying a word. And the little boy is the only one who says, "But don't you see? He's naked. He has no clothes on." There's no one around who's confirming that because they're all... they're thinking in the story probably just kowtowing and placating to this Emperor.

That... it reminds me of that. You're the only one. If you're left to yourself in this system, if like especially I think if you're not here and we're not talking about some of the reality and have a benevolent voice coming into to say actually this isn't OK, what's happening in Ivan (sp?). You're the only one who sees it. I think that how it feels right now. You can't even... it can't be spoken about. It almost becomes unreal then. If your parents can't acknowledge it, Ivan's (sp?) parents can't acknowledge it, Ivan (sp?) can't acknowledge it it sounds like Dr. Farrow can't... isn't always acknowledging it as real. [00:10:04] So you start to doubt your own experience. Maybe it is just me. Maybe the problems... I mean, I just don't think that's true, Ramona (sp?).

CLIENT: But there comes a point where I wonder if it matters if it's true or not because it's... it comes back to... it's like it is with my parents. Does it matter anymore if they really were in the wrong or if I really could have taken care of things better? They're not going to change and I'm not. It's like there's... it almost feels like there isn't much point in coming to the... like what might look like progress in theory for me personally to say like there are some things that are my problem and are my fault that I do need to deal with. But there are also things that are not my fault and I didn't cause them and...

THERAPIST: I hear you. As a child, there was no point to come into that conclusion. That is for sure as a child because you knew. [00:11:11] You probably tested it over and over again, Ramona (sp?). We know you did in a way. Maybe this time you can clean the... all of your pleadings, your attempts. Your saying, "Maybe if I say it this way or do it this way or do it for them, maybe they'll catch on." You tried so many different ways of getting through to them and none of them worked. So you learned over time it didn't make any difference to label their problems as their problems. It did not make any difference for your experience, right? It didn't make things better for you. They didn't change as a result of your saying it.

CLIENT: Well, and even if I had really labeled it as their problem, I was never going to tell anyone. So it really was... still didn't exist in my mind. I mean, Emma (sp?) clearly supported like, "This isn't your fault." But...

THERAPIST: You were otherwise so alone with it. [00:12:01] You're not going to a group of friends and saying, "Get a load of what my parents are doing."

CLIENT: And I don't know if that would've served any purpose. I guess the point is more like... and it feels like a very repetitive thing with Ivan (sp?). I would never feel comfortable telling a soul. Maybe it's even my fault that I'm stuck alone with that. But it just doesn't feel very good.

THERAPIST: Yea. (pause) The question that we've been trying to think through and get to understand is whether Ivan (sp?) is exactly like your parents or not. If he is exactly like them in that they... no matter what you said and did they wouldn't change. If that's who he is, you are stuck with the same thing and then it's sort of like we have to... it is beating your head against the wall to try to kind of get him to change if that's never going to happen and then we... that sort of changes our conversation. What do you do with that then? What do you want to do with that? [00:13:04]

What does that mean to you if this is always going to be this way? It's never going to get any better. To the degree that he's maybe like them some but has more potential for change, that would invite us to think, OK, so what... how do we help you in the time that he's changing? How do we find... is there a third option besides getting angry at him in a way that it feels like you're beating your head against the wall because doesn't do any good? Or turning that anger back at yourself because I think that also destroys you. Is there any other room for anything else in between those two places, is the question if there's room for him to change.

CLIENT: So that's I guess I don't know how to describe it. But I'm noticing Ivan (sp?) is making improvement. And he came home the other day and told me how his boss took him aside and thanked him for stepping up and how he's been doing such a great job. [00:14:06] And he hasn't gotten any complaints or critiques at work in a while and they're really happy with him. He's made a lot of progress. So that gives me hope. (chuckling) It gives me a lot of hope. And that's really good. And he's felt more confident. And he's like...

THERAPIST: It's helping him.

CLIENT: Of course. I mean, of course I would feel good. And the other night I came home from volunteering and I was just really tired. And anyway, it was like dinner time and Ivan (sp?) knew I was on my way home. But when I got home, the table was set and he had made dinner completely. It was maybe I don't know just a little bit (inaudible 00:14:46) he did all of that on his own. I didn't say like, "Can you please have dinner ready by..." No. I mean, he really set a nice table.

THERAPIST: He even came up with the idea.

CLIENT: And he really went to effort and organized himself. And so I mean, there are moments like that where he completely surprises me. [00:15:04] And then there are other times when I just feel kind of it's nothing big that's happening but it's like he sleeps in really late and he still hasn't done the laundry. And he still hasn't taken out the trash and still like... (sigh). And it's not personal but it feels personal. And it feels a trigger of like... this sounds so silly. But it feels like... it feels a little bit like my mom who would stay in bed so late.

THERAPIST: That's not silly at all.

CLIENT: So late. And who would not do those things around the house. And there are times when I... no, I'm always still like, "So Ivan (sp?), the apartment kind of needs to be cleaned up, straightened up to some extent every week. Do you want to pitch in? Can you do even part of the bathroom?" And it's still that portion of asking him to do a very small part of a bigger task that should be, in this case, a joint responsibility. [00:16:06]

So why is the majority of it always on me? It's like when I would clean the whole house and ask my mom if she could vacuum the stairs. And she wouldn't. I mean, she wouldn't do it. But I know that's... it sounds, I guess, like overreacting but it really doesn't feel that way and then it triggers in me the, what about all these big problems that we're not talking about? (pause) I almost feel them. I don't know. I don't know what a good way it is to express it but in couples I feel like I've been squashed kind of because I'm not... we are not talking about any of the big stuff.

THERAPIST: When you say the big stuff, I have an idea but I'm curious what you're feeling like is the biggest elephant in the room and you want to talk about.

CLIENT: So I feel we spend a lot time building communication skills, talking about things like that. And that's great. That's important for everything but we're not talking about... we never really talked about much the whole thing with grad school. Actually that is an issue.

THERAPIST: (inaudible at 00:17:13).

CLIENT: And we're not talking about that. We're not talking about all the drama with his loans that he just didn't open mail for a year. We're not talking about actually the ways in which the depression and stuff like that really is like... I don't know how to say this without sounding like the worst person in the world but some of his... some of the actions that result from that or the inaction is problematic. And it's not that I'm... I thought about it the other day and in my head, once I finally came to a statement that clarified that. I thought I was going to sound like the worst person in the world. And then when I actually heard it in my head, I thought maybe that's not so horrible. And it was just that...

THERAPIST: Yea, what?

CLIENT: ...I wish he wasn't depressed. [00:18:03] I wish my mom wasn't depressed. I don't want...

THERAPIST: That's an understandable thing to wish for.

CLIENT: I don't want that. And it sounds like... it doesn't sound quite as horrible as I thought it would.

THERAPIST: No.

CLIENT: But I just thought I hate that.

THERAPIST: It's really, really hard to live and put up with it and tolerate someone who's depressed for a long time that you care about.

CLIENT: It's...

THERAPIST: It's draining.

CLIENT: It's draining but it's also... I guess I have never even felt like I was allowed to label it as depression with my mom and a lot of the times with Ivan (sp?). Labeling it as that is not... and my mom, never. Like growing up, she never at one point explained to us what was going on with her. A lot of the time it would be masked in a lie of physical ailment. [00:19:00]

So she was physically sick right before church every Sunday. She was fine and then she was way too sick to go to church. And it was always something. Clockwork every Saturday night she was sick. And she wasn't sick and I was so angry because my mom was lying to me every single weekend and I knew she wasn't sick. But what I didn't understand was that she was struggling with agoraphobia and she was depressed. And she had her own like anxiety stuff and I like... I guess I wish... I don't clearly know nothing about being a parent. And I don't know what...

THERAPIST: Yes, you do. You know some things about what you would've done differently if you were her (inaudible at 00:19:40).

CLIENT: I guess may... but I don't know what is... is it fair to even expect that, at any point, she would've explained what depression is or what she was dealing with? Or why staying in bed or staying in your pj's all day long is not... instead of being really defensive about it the entire time, that's not (pause) normal. [00:20:04]

THERAPIST: It's harder for me imagine that if you went through a bout of very severe depression with a child that you might not say something different than she said to you.

CLIENT: I don't...

THERAPIST: So you couldn't get out of bed.

CLIENT: I don't know. Again, like I just feel... even to the day, I don't feel like I can say anything about it to her. I don't feel like I can say much about it to Ivan (sp?). And I feel so frustrated because no one in my family is going to say like, "Mom, I'm worried about you. You're really depressed." Because she'll get exceptionally angry and no one in Ivan's (sp?) family is going to say like, "I know you're struggling with this. How's it going?" Because he's not depressed. He's brilliant. He's not having any...

THERAPIST: It's such a repetition for you.

CLIENT: It is and I feel... I guess I feel... Ivan (sp?) has sometimes made comments to the effect of like, "I'm not your parents. This is not me." And I'll say, "No, you're not. You're you." [00:21:05] And it makes me so angry because I get... from him saying that, I get the impression that I'm just overreacting and I'm projecting everything that my parents did onto him and it's so unfair. And I just really need to deal with it and get over it. But in reality, a lot of it is a lot the same.

THERAPIST: I mean, since sometimes people see things in other people that are only a little bit there. And the things that are a little bit they see really big because of their own histories. A lot of the time, Ramona (sp?), people end up, for example, marrying someone who is just like their parents or a parent, a caregiver. Who actually is like that because that is what's familiar and safe unconsciously. You don't know you're doing it. It's not like people go do that on purpose. But this is why someone who's beaten as a child I've said this to you marries someone who beats her as an adult. That's not... it's not that she's pretending that's happening or she's projecting onto her husband that he's beating her up. [00:22:04] He's actually beating her up just the way she was beaten up as a child. That's really happening.

So it's my experience again I don't hear Ivan's (sp?) side of the story but I do hear... even still I've met him once, I hear through both Dr. Farrow and Dr. Bourd this is really happening in him. I think the only places you get stuck around it are around finding what that third option might be besides desperately and being enraged and critical of him and desperately being enraged and critical of yourself. That's what the legacy of your childhood with your mom in this instance and dad. Because your dad also wasn't speaking up saying, "Ramona (sp?), your mother is really severely depressed. This has nothing to do with you. The reason she stays in bed all day long has nothing to do with you. I don't want you to take responsibility for it. I'm going to hire a housekeeper so we can get some help around the house, right?" [00:23:12]

He wasn't also standing next to you saying, "The Emperor is naked. I see it, too." So this legacy leaves you only with the options you had either to just try to get through to them desperately or to put it back all in on yourself is the ways of getting control. You don't have internalized inside you how to negotiate the differences and disagreements and problems feeling like you don't have to turn all in on yourself. And you also could have some different kind of patience and love grow around it, too. Like it would've been so much better for you had your mother said to you, "I'm so depressed. This is something called depression. This is what it's called. This is what I'm doing trying to get myself into treatment and get better. This has nothing to do with you. I don't want you to feel responsible for me. I love you so much. I wish I could get out of bed but I can't." [00:24:06]

That would've been really different even though she still would've been depressed. Do you see what I mean? Just some communication some holding in mind your mind and still trying to take care of your mind's needs even while doing that. And I think had even that happened, even if she still had severe depression, you would've been able to say, "OK, this is my mom and her problem and I'm not happy." It doesn't mean you... then the depression isn't a problem. It's still problem if she's lying in bed all day long. That's not good for any person, right?

So you could have your reaction but also not have it feel like your whole sense of yourself revolves around what's happening with her. You could feel free to kind of feel good about yourself regardless of what's happening with her. And I think that's what's still stuck with this with Ivan (sp?) that it's hard to kind of feel like you see what's happening with him. And have some reactions to it. Feelings about it and frustrations and disappointments and have what's happening with him not totally impact your sense of you. [00:25:09] Does that make sense?

CLIENT: Yea. And I feel like I've made a tiny bit of progress with that to some extent. I don't think, by and large, Ivan (sp?) is not doing like... he's not... I don't know. He doesn't talk about it. He doesn't really acknowledge it. And I don't completely blame him for that because I mean, he's... I'm really the only person... I mean, I'm really the only person outside of Dr. Bourd and Dr. Farrow who has any like... who's ever going to talk to him about it right now in anyway. And I just know the other day he got off the phone with his parents and they were finally going to like, no, no, send the like insurance reimbursement. This is like five months later. And I'm like, "Ivan (sp?), that's pretty... that's a long time."

THERAPIST: Yes, it is.

CLIENT: And I'm like that's kind of... (chuckling)

THERAPIST: That's really happening, Ramona (sp?).

CLIENT: Right.

THERAPIST: That's a real five months. [00:26:03]

CLIENT: Yea. No, and I'm like, "Ivan (sp?), that's not..." And I told him I didn't think that was OK. That he could feel and he was pretty sharp with me after he got off the phone and pretty angry with me. And I said, "So, did you tell your parents that you felt a little frustrated about this or did you tell them how you felt about it at all?" He's like, "Yea, I said it was a little frustrating." And I just... it occurred to me maybe it's not a coincidence that he's really angry with me after he's getting off the phone and raising his voice. And maybe I didn't do anything wrong. Maybe he's really angry with them and that's OK. But I still feel really frustrated because I wish... I actually think it would be a really healthy thing if he could find an appropriate way to tell them that he did feel angry or that he like... that it wasn't maybe super acceptable to...

THERAPIST: You're so right and it's also so good and healthy that you could, for that split second, make that connection that maybe he's not actually angry at you. [00:27:07] In fact, it's safe to get angry for him. One of the things that means is that that's... you're like a safe outlet. I know that's not exactly the fun to be and a safe place for somebody to angry. But that's means your relationship with him is in a different maturity level than the relationship he has with his parents where it's not safe. And those feelings are just a found the outlet in you but they're actually meant for them. They're the feelings he couldn't express to them.

CLIENT: I know. I just... it's not fair and clearly I do not have a perfect in relationship with my parents. But I guess... I don't know. I wish Ivan (sp?) would confront... I mean, he rarely would confront me even. He can get angry at me and yell at me to some extent which is almost like...

THERAPIST: And that's new, right?

CLIENT: Right. And it's...

THERAPIST: That's pretty new.

CLIENT: Sometimes it's good. It comes out in a really kind of uncontrolled way because he is... it's like he has no clue how to do this. How do you get angry with someone? [00:28:03] How is that ever OK? I just wish maybe that could never happen but I know his parents a lot of times have told him he's just being moody or he's like... they just brush it off. And that's just Ivan (sp?) and that's just... and I guess I wish... I told him it's OK to get angry and I said, "Even if they can't handle, even if they aren't going to respond appropriately, it's OK to say, 'This is really frustrating,' or just to get it out to some extent." (pause)

THERAPIST: I also wondered if, as you were telling me the story, the only piece of the anger that might actually have been for you and maybe this is just the way I heard it. But the way you said it to me was that you said to him, "This... Ivan (sp?), this is not OK what they're doing."

CLIENT: Yea, he doesn't... that's not like...

THERAPIST: I think that... so I just wonder about like if you said, "Ivan (sp?), that I feel... I'm sad for you. That feels like neglect abuse, Ivan (sp?). Five months." [00:29:10] Do you know what I mean? In other words, picking up on your empathy for him instead of... I might hear... if I'm him, I might hear your saying, "This is not OK," as a kind of attack of him and an attack of his parents. Instead of the... what you're actually feeling also is like, wow, for a second how... poor Ivan (sp?), too. It's certainly not OK for you either because this is affecting you. But he's had to put up with this his whole life also, this kind of neglect.

CLIENT: It's just... it's hard because I find my... absolutely I find myself getting angry at them and I know there is no way. He can't get angry at them and he can never say like, "I'm angry with my parents." That would be way over the top for him. So clearly he's not going to respond to me saying that about them. He's not going to respond to that well. But I don't know. [00:30:02] It's hard because I want him to be able to express that and I also...

THERAPIST: I just I guess I'm wondering if he might have more space to feel... actually to start to feel his own anger if you were to say, "That's... I'm sorry." Do you know what I mean? Then it actually gets... his experience gets validated and he gets to... it gets to grow from within him. I think when he hears you getting angry and he gets scared. He just gets scared at anger period I think. And he sort of clams up and goes inside and that got angry back at you. In a way, the essence of what you're saying is this is really not OK. It's very poor treatment of him. It's neglectful.

CLIENT: And I've tried to... it's more... I guess it's my opinion but I've tried to tell him like even if your parent... it seems like his parents actually struggle with a lot of the same stuff that he does. It's not entirely like he developed these problems on his own. [00:31:02]

THERAPIST: No.

CLIENT: I think a lot of them were shown to him to some extent.

THERAPIST: This is case in point.

CLIENT: So I tried to like... even if like... it's OK to say you're angry at your parents like they really procrastinated or whatever. And to still say you love them and they're your parents and they're really important to you. It's OK to recognize that they're flawed and still...

Things are also just feeling, I guess, pretty hot right now around that subject because I was talking about visiting my parents towards the end of the summer. I really need to get my car inspected anyway and I need to go to Louisiana. So we're talking about that and I'm just feeling like overwhelmed. And I already have a mental list of projects I want to do at home. And it's just really hard to talk to my parents on the phone and really hard to like... my dad is trying to give me job advice and my mom is like...

THERAPIST: Do you have a specific time you're supposed to go home? [00:32:03]

CLIENT: We were talking about the end of August because Emma (sp?) has a little bit of vacation time so maybe taking a long weekend.

THERAPIST: So that she'd be down there with you?

CLIENT: Yea. And Ivan (sp?) may or may not. So that's like I'm already so worked up about that.

THERAPIST: What are the projects you're going to do at your parent's house?

CLIENT: (pause) I mean...

THERAPIST: Cleaning?

CLIENT: Yea, I'll... I mean, I will clean to some extent. Obviously that's always... the other day I was just talking to her on the phone and saying like, "Maybe we will be coming home within a few weeks or whatever." And I just casually like, "So how are things going at the house?" And because selfishly I kind of wanted to have a heads up in what I was going to walk into because it really ranges dramatically and it's really hard to drive eight hours and not... and just like walk in the door and have no reaction no matter no matter what it is. It's really hard to do that. But asking is like a recipe for disaster and she like... first thing out of her mouth was, "Your dad gives me no help. I have to..." So who knows what it's like. [00:33:10]

And they just took in another pet. So I'm really angry and really dreading it and really like... I want to see my parents. I love my parents but it's so hard to go home and not say a word about everything that's staring you in the face. (pause) So yea, I have a list of things I want to do when I'm there and it's just like...

THERAPIST: So what would be like, Ramona (sp?), to...

CLIENT: To go home and not...

THERAPIST: ...say... actually I don't even care if you make the list and then you rip it up and say, "I'm not doing the things on the list. This is not my house. It is not... I'm not living here." You have to spend, I don't know, what? Three, four, five days there?

CLIENT: Yea.

THERAPIST: A week?

CLIENT: No. I mean, not that long but...

THERAPIST: OK. Long weekend and then you're back to your house. (chuckling) Put the energy into your house.

CLIENT: I felt really bad because my mom said, "I'm sure it's not as clean as your apartment." [00:34:04] And it was almost like... it was an insult. It wasn't like, "Your apartment is really nice. I'm not as fussy." No, it was an insult. It's like I'm too picky. I'm too... even though if the house is really disgusting, then if I suggest that it needs to be cleaned, "You have to have it perfect. You have to have it immaculate."

It's again, like I'm imagining the problem. But Emma (sp?) has suggested like it's... she got really worked up the other week when we talked about it because she said she doesn't know. She feels torn because they need help with things to some extent. But she also just wants to spend time with them because they are getting older but also just we don't go home very often. We don't see them very often to just actually have quality time with them.

THERAPIST: When she says they need help with things, does this mean they're actually asking the two of you...

CLIENT: So...

THERAPIST: "When you guys come home, can you do this, this and this?"

CLIENT: ...there is one thing that my mom is already been asking about if we could help with. [00:35:02]

THERAPIST: With what?

CLIENT: So she has maybe 100 nursing uniforms. She was a nurse off and on for a while. And she hasn't worked in years now.

THERAPIST: A hundred?

CLIENT: No, she probably has 100. I mean some of it she's never worn.

THERAPIST: How? (chuckling)

CLIENT: Because she has a problem with shopping. But she... yea, she probably has 100. I mean, they're all just like in... they're multiple huge containers of them. And so she wants to sell them. She agreed to sell them. And I said, "But if you sell them, you can't go buy new if you decide that you ever want to like... so maybe you want to keep just a few or maybe that has to be enough," which she can't control. I've learned to stop trying that but she's like, "Yea, I guess we should take pictures of them and try to sell them." And so part of me had like a little moment where mentally I thought like I wanted to almost say to her, "You can do that on your own. That's not my job." [00:36:10]

Using a camera or uploading to the online... that might not be the easiest or most intuitive thing for her. My mom is 66. But I just had that thought. You're a grown up. They're your uniforms. You can sell them. I had that thought and I would never say that to her and clearly if we go home, I will help to do it but... so that's one thing she asked for. So Emma (sp?) said, "Well, she asked for that so we can do that. But maybe we should leave the rest of it go."

THERAPIST: Will she get a lot of money for these then? They're new, I don't know.

CLIENT: Some of them are new. Some of them have barely been worn. I mean, they're all in perfect condition.

THERAPIST: So they are a lot of money?

CLIENT: She spent a fortune on them. She might not get... I mean, she probably won't get half of what... but better than just donating all of them. [00:37:04]

THERAPIST: And then what will she do with the money?

CLIENT: I don't want to know. I don't want to know. Probably buy more stuff or spend it on the pets.

THERAPIST: (inaudible at 00:37:14).

CLIENT: No, it's a problem. It's an actual problem.

THERAPIST: She likes shopping.

CLIENT: Yes, absolutely. It's a really, really... it's a really big problem.

THERAPIST: What else does she shop for? Is it clothes?

CLIENT: She has a couple thousand books. Not like she has a lot of books. How isn't that... no, she has a couple thousand legitimately. And she keeps buying more.

THERAPIST: That she reads, too?

CLIENT: She reads a lot.

THERAPIST: She's a reader?

CLIENT: But she has... I mean, of them, I don't know what percentage she's actually read. I mean, she keeps buying more even if...

THERAPIST: And she's not going to the library or something.

CLIENT: She goes to the library sometimes, she says. But when she came up to visit, she spent more time than anything I feel like in bookstores. She'll buy big bags of books. [00:38:00]

THERAPIST: Seriously?

CLIENT: Yea, yea. (pause) So she didn't go see where Emma (sp?) worked but she went to bookstores. Sorry, that's like a really rude to say about your mom.

THERAPIST: That is not rude.

CLIENT: But I'm bitter about it clearly.

THERAPIST: You can go to a bookstore any time. You're here to visit your daughters.

CLIENT: No, she shops to... it's definitely a coping mechanism for her. And everybody has... my coping mechanisms are probably equally bad in different ways. But it's a frustrating thing. Just like they found a stray cat and now they're taking it in. And I said, "So what are you going to do about that?" As if like trying to for the millionth time with them to coax like, "Maybe just find it a really great home. Spend some time and... because you have 20 pets." "But no, I set him up in your sister's room."

THERAPIST: Oh my goodness.

CLIENT: "He'll be fine."

THERAPIST: Oh my goodness.

CLIENT: And it's just like it's horrible because it makes me cringe inside and I should be able to let it go. But it's like... it's really like all that on the table, it's hard to just go home and not saying anything if the house is a mess. [00:39:07] And not saying anything if they took in yet another pet and not say anything if my dad comes home at midnight from work. It's really hard. I end up right back in that child role of coaxing and cleaning and very much bargaining.

THERAPIST: So what would happen, Ramona (sp?), if you decided that you're not going to help with projects around the house? What do you... is something going to happen while you're home? Will they get really mad?

CLIENT: I don't think so.

THERAPIST: It doesn't actually sound like they would. It's not like they're demanding you do this.

CLIENT: No, she... no, my mom has said and my dad to some extent that they feel bad that we come home and help. And I think it's just really hard for a lot of reasons because there's the whole like it's always been this way. Emma (sp?) and I have always cleaned it up since... I mean, since we were very little. [00:40:07]

THERAPIST: It's hard to break out of that cycle.

CLIENT: It's really hard to let it go. It's also like my dad is in his late 50s. My mom is in her later 60s. It's like... it's now getting to the point that even if they... there's no depression. There were no marital issue. There were like...

THERAPIST: (inaudible at 00:40:23) some help.

CLIENT: Of course. They have a 16 room house. They have a big house and they have 20 pets. And he has a whole business that he's the only like... they really could use some help and there really are some projects that would be overwhelming for Emma (sp?) and I, let alone...

THERAPIST: Sure. The only thing though is here's what I'm feeling about where you are now. As a child, it did affect your daily life if you didn't... if you couldn't find a pathway or if there are dust bunnies everywhere or if there's clutter everywhere. It was affecting your sanity, your living space, your comfort. You had to do these things in order to keep up with your own life. You now don't have to do that at that house. [00:41:11]

CLIENT: No, but it's still... it's not just... it's never been just about what Emma (sp?) and I needed. Emma (sp?) has tried to tell me like just clean your... and there were times when she came home from college and she cleaned her room and she stayed in her room and she let it go. And my mom would say that she was lounging on the end of spine. And pretty much call her lazy because she wasn't...

THERAPIST: Really? So she would do that.

CLIENT: Yes. And I don't think she ever had the idea that other people came home from college and had a break. And their parents made dinner and their parents cleaned the house and they weren't lazy.

THERAPIST: Or they came home to a fairly clean house.

CLIENT: Right.

THERAPIST: (inaudible at 00:41:52) massive undertakings.

CLIENT: Like normal amounts of helping out as opposed to...

THERAPIST: Clearing the dishes, that kind of thing.

CLIENT: So Emma (sp?) has done that. [00:42:02] Emma (sp?) has suggested that we do that. She's like, "You know what? Instead of taking on all the projects," she's like, "I know there's still some stuff in my bedroom closet. I should just stick with that. If I want to go through like that, that's fine." But she's like, "Maybe we don't need to..." And she said, "Maybe we should just try to coax them to do some fun things or go out to dinner or go out kayaking with my dad because we always say we'll do that." But the other... there's so much. But the other thing is even if we sat around the house and ignored everything which would feel impossible... it probably would be impossible.

THERAPIST: Hard.

CLIENT: My dad is not like...

THERAPIST: Home.

CLIENT: He's not going to take off. He's not going to get coverage while we are home and he is on call 24/7. And he schedules a lot but he also gets a lot of emergencies and he travels. And he does Alabama and LA so he... yea. I mean, if he comes home early, it's like 7:00, 8:00 at night. [00:43:01] That's so early for him. That's... he... and then my mom will say, "He does that when you're home." And it's like it feels like crap.

And my mom will stay in her bedroom a lot even if we are home. And it's not like she doesn't care that we're there. And Emma (sp?) says even if they're not there with us the whole time, they like that we're there. And I think it feels good to them that we... even if we don't do a ton. Even if it doesn't look like what a visit would look like to us. It's just... it's so complicated.

THERAPIST: They might like that you're there but they're not actually showing that they're really enjoying and making room for spending time with you.

CLIENT: I mean they are in the ways that they're able. My dad coming home at 7:00 or 8:00 at night, that's huge for him.

THERAPIST: That's crazy. That's so messed up.

CLIENT: Usually it's 11:00. Like usually...

THERAPIST: My goodness.

CLIENT: Yea. (pause)

THERAPIST: Oh my goodness.

CLIENT: No, he... like work... I don't ever say that my dad is a workaholic and that he works a lot.

THERAPIST: Truly addicted to work.

CLIENT: No, like we're talking 7:00 to 11:00 he's gone. [00:44:04]

THERAPIST: Wow.

CLIENT: It doesn't happen as much on Sundays because people don't want to schedule stuff on Sundays but I mean, he's still... and then it's like paperwork. He should be doing paperwork. So it's like never... anyway, so that's coming up and that's like something I need to deal with. I need to like do some personal work around that.

But also I got an e-mail from my mother-in-law saying, "We want you to come visit August or September. Don't make it too long like until you get here." And it's so awkward because Ivan's (sp?) sister just got back from Europe. She was there for a year. And they didn't talk for the year. I invited her. I'm like, "We should Skype." And she...

THERAPIST: (inaudible at 00:44:47) parents?

CLIENT: No, no, no, no, no.

THERAPIST: (inaudible at 00:44:49).

CLIENT: His sister and Ivan (sp?) did not.

THERAPIST: She was gone for a year.

CLIENT: No, they just like didn't really ever... like on Thanksgiving the phone got passed around and I think he said hi to her. This is it. [00:45:02] And several times, I messaged her and said like, "We should set up a Skype or something." And she just never really like... so I let it go. But now she got back and I'm like so neither of you are going to acknowledge that you haven't even like talked. No, no one is going to acknowledge it. No one is going to...

THERAPIST: Are they in a fight?

CLIENT: No, no.

THERAPIST: There's not some tension going on?

CLIENT: No. I mean, there's definitely tension with her and me. (pause) No, they don't fight. They just don't talk to each other.

THERAPIST: You're so alone.

CLIENT: And now they want us to visit. But his dad, also in the same breath, asked if they could visit. So I'm not sure what's... but I'm just like... so now we were talking about when we go home to visit my parents, Ivan (sp?) going too and us driving up to New Orleans for part of that time and coming back. And I'm already thinking like I don't know if I could handle everything at home and then go up there and everything there and then...

THERAPIST: It's like graduation all over again.

CLIENT: Right. But 30 hours of driving and...

THERAPIST: Yea. Add that on top of it. [00:46:03]

CLIENT: So the anxiety is pretty high plus I'm thinking like I cannot face any of them if I do not have a job. And I'm feeling really anxious and crummy about that. So anyway...

THERAPIST: Well, we're going to have to stop but let's prioritize talking about what I'm going to ask you to think about this this week. What might be a reasonable setup for goals and expectations for you to set up for yourself for a visit home with your parents? And by that I mean this. I'm suggesting to you, all right, what if you scrap the list and you kind of look at me like not a chance that that's happening. So maybe that's not reasonable and realistic. Maybe that's asking too much of you. Do you know what I mean? That it just this is so engrained in you and even your sister to do this. that what would be something that would be challenging yourself to try something new around it a little bit? What would be something like it carves out a little bit of space for you to let go of the piece of the responsibility? [00:47:08]

It might look something like maybe you say, "OK, we will agree for a couple hours on one of the days. We're going to sit down," and help her take photos and put stuff up on eBay or whatever that would look like. "That would be the project that we tackle but that we won't tackle some other..." like cleaning up the garage or whatever would be the other kinds of things that are running on your list that you'll agree to one but not an endless list.

And that you and your sister might then try to say, "We would love it if we could somehow do X, Y, Z together." I don't know what that would be kayaking, going out to movies, going out to dinner. Communicating that to your parents and even maybe agreeing with each other even if your parents don't show up in whatever capacity that you and Emma (sp?) do that that you enjoy your hometown together. You do something. Share vacation time together. And again, this is just one iteration of what that could look like. But just trying to think about, OK, how do we give a little more space for new adult Ramona (sp?) to not feel quite as responsible because this actually doesn't impact your daily life anymore? [00:48:10] It's going to impact a weekend but you have your own independent life now. You don't... it's not your household you're living in and you can start to try to press a little bit into letting go of some of that. Does that make sense to think about?

I also want to ask if there's room for you to do this when this week if you notice a time or two or three where the statement, "I hate myself" comes up, could you write a little bit about where you are, what's happening, how that thought came up? Just kind of what the context is just so we can get a couple... it's partly for us to talk about but also partly for you to really get to like, what are the feelings? Is it shame? Is it anxiety? Is it anger that should be going out but doesn't have outlet out so it's turning back on myself that's driving that thought? [00:49:01]

And then what happens when you say "It's going to be OK." Even using it at home. It's going to be OK. We're going to figure something out that's going to protect you a little bit. Not a lot. Maybe not a lot yet but a little bit so that there's something new starting to grow about the potential in you. And just write just a few... jot down a few details. If you want to e-mail it to me, that's cool. If you want to bring it in, bring it in. Does that make sense?

CLIENT: Yes.

THERAPIST: OK. Good to see you.

END TRANSCRIPT