TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: That’s why I called you earlier, because I knew there was a maintenance delay at (inaudible at 0:00:05). And so anyway I’m very sorry [to be here] (ph) late.

THERAPIST: No worries, I’m sorry for… it’s aggravating to you. You got my e-mail obviously, (crosstalk).

CLIENT: I did. Yes, thank you.

THERAPIST: Yeah, I just figure, we’ll hope that it gets covered. And if it doesn’t I’m not… we’ll just consider what you’re paying right now your fee for… I think this is a short term thing, and…

CLIENT: They told me it would be, so, unless something… it should be, so…

THERAPIST: And, if you aren’t picking up with a job as of the 23rd, you can start on your husband’s (ph) insurance right then, do you think, or…?

CLIENT: That I don’t know.

THERAPIST: You don’t know. Okay.

CLIENT: (Chuckling) I just haven’t had a minute to look into it.

THERAPIST: Yeah. You have some time.

CLIENT: A little. (Pause)

THERAPIST: I know you’re probably hoping something… [0:00:57]

CLIENT: Yes.

THERAPIST: Fell in place. So where are you? [I’m in] (ph) a lot of different places. I wonder what’s top of mind for you.

CLIENT: I guess in a couple hours I’m leaving with my sister? My mom called Tuesday. There was a cancellation in her surgeon’s schedule. So our surgery is tomorrow.

THERAPIST: Oh my goodness.

CLIENT: And they won’t know until this afternoon what time surgery is. So Emma and I rearranged… scrambled and rearranged stuff (chuckling). And we’re driving so that we’ll be home around midnight. And then whatever time it is tomorrow it is. So (pause) yeah, that’s…

THERAPIST: But you wanted to be there to be at her kind of bedside, or to help out at home? What’s the…?

CLIENT: Both. Be there before, during, and after the surgery. She’ll be admitted and then hopefully come home Saturday. So I’ll be there for all of that, especially since we don’t know that my dad has any coverage. So… [0:01:57]

THERAPIST: So he might not…

CLIENT: I don’t… he didn’t say. I would assume he doesn’t have coverage, because that’s short notice. So… (Pause)

THERAPIST: His wife’s having urgent surgery. He won’t shut down for that?

CLIENT: I think he’ll try to get coverage? I don’t know how feasible it is. He has quite a heavy, heavy, heavy animal (ph) load. And there aren’t a lot of large animal vets period (chuckling), let alone in the area. So he does have people that he’s covered for a lot. And hopefully some of them… but when they cover I think it’s almost exclusively for emergencies, and then he cancels regularly scheduled things. Today is always his… Mason Dixon farms, he does them. And it’s like a huge farm. So that’s out of the way. But yeah, that’s a big thing for him. So we’ll see.

THERAPIST: He’s mostly… when you say large animal, is he most… exclusively large animal? [0:03:05]

CLIENT: Exclusive.

THERAPIST: Okay. So farm animal?

CLIENT: So (chuckling) dairy. He does a lot of dairy. But he also does llamas, alpacas. He does deer. He… I mean… goats, swine, all kinds of… he’s primarily dairy. Anything large (laughing).

THERAPIST: (Laughing)

CLIENT: He did an elephant once. There was a circus animal that needed… he took… needed stitches and [made them large] (ph) (chuckling).

THERAPIST: Wow. So it’s a real specialty then.

CLIENT: Yes (laughing). (Pause)

THERAPIST: So anyway it’s all the anticipation of this weekend then.

CLIENT: It’s bad. And when I talked to my mom on Tuesday she… (Pause) [0:03:56] I shouldn’t have felt anything maybe, but she was saying how… I said, well, you know we were planning… Emma and I already made all the plans to come home at the end of the month. We’ve been planning on that since you told me. I wrote the date in my planner. I’ve been… she’s like, I never knew you were coming home. I didn’t think anyone was coming home. I didn’t think anyone was… I never heard that. I said (chuckling), Mom, I’ve gone over this with you multiple times. No, I never thought anyone was…

THERAPIST: What?

CLIENT: Yeah. And so pretty much acted like nobody cares, nobody was going to come anyway. I’m just... she was like, I just wanted to let you know, as if it’s, I don’t know, a really small thing. And it’s frustrating because I know she’s in a vulnerable place. And she’s really worked up about the surgery. It was just hard to hear that it was almost like… she almost keeps pushing away, asking if she can drive herself home, all that kind of dramatic stuff. It’s just hard, because I don’t think she… not that it really matters very much. [0:04:59] But I don’t think she realizes we’re coming to take care of her, but we’re also coming because we’re concerned. And this is upsetting to anyone who has a loved one. And it’s just… it feels like, I don’t know… almost like a slap in the face, like, well, I didn’t think you were coming anyway (chuckling). I told you we were coming so many times.

THERAPIST: You’ve had that conversation (crosstalk).

CLIENT: We’ve had that conversation.

THERAPIST: Do you think she’s just playing it off characterologically (sp?)? She doesn’t actually forget.

CLIENT: No, I don’t think she actually... I mean, we didn’t… we knew that her surgery was on the 28th. And I had said, I didn’t know if we were going to come in on Tuesday or what time exactly we were going to come in, but that we were planning on it, so…

THERAPIST: So she knew she could work that as, they might not have come anyway.

CLIENT: (Laughing) I think she knew… it was pretty clear, and then that she’d never heard about that, it was just…

THERAPIST: So she really plays the kind of woe-is-me martyr. No one cares about me and…

CLIENT: Which is hard, because I… again, I legitimize that my dad’s not around a lot. [0:05:58] And that is real, and she’s not making that up. But…

THERAPIST: But you’re not your dad, and your sister’s not your dad. You’re separate people.

CLIENT: No, and she’s not the only one who’s experienced that with my dad. I really do get it (chuckling), in a different role, but I really do get it. And it’s just hard because what she’s going in for is obviously very serious. So I can’t say that she’s overreacting or she’s… but it’s just… it hurts to be pushed away to be kind of insulted with, well, I didn’t expect you to come home. You can just come home later in the month, and we’ll do fun stuff instead. It’s just, she has to know to some extent how that comes off? And then my sister called her back later, because my mom hung up on me. She’s like, I think I caught you at a really bad time, Ramona, that you’re upset about this. And so…

THERAPIST: She doesn’t get it.

CLIENT: No.

THERAPIST: Because I was just thinking, let’s say… I mean, maybe she’s saying to herself, this isn’t that important to me that you’re there. [0:06:56] I’ll be fine. She could just say, let’s talk about it, because it doesn’t feel that important to me. Is it important to you? What does it mean to you to be here? Have a more direct conversation about it. But it’s all very passive. It’s like there’s passive aggression (inaudible at 0:07:10).

CLIENT: Yeah, but this is not something new. And it… and then my sister called her later. And she said Mom was very relieved that we’re coming home. And so I think she’s just really worked up and…

THERAPIST: She says one thing and means another actually.

CLIENT: And her saying that she thinks that my dad was planning on how to get all her stuff out of the house… because clearly she’s going to die from this surgery? That’s what she’s implying. It’s like, she doesn’t… I don’t think she means that. I don’t think she thinks that. I don’t think she actually believes that there’s a high chance of her dying from this surgery that her surgeon does at least twice a week. I think it’s more she’s really upset. And unfortunately it doesn’t come out in an appropriate… her comments aren’t very appropriate. [0:07:58]

So it’s just… (chuckling) it sucks quite frankly, because it’s hard. I really want to be compassionate, and I really want to go home and pretend like I’m not upset that she pretended we were never going to come… like, nobody cares about… so I’ll pretend like none of that’s going on and not respond to any additional comments and want to be compassionate. But at the same time it’s just hard to hear those things sometimes. And… (Pause) It’s just hard. I get that she’s mad at my dad? I get it. I really do. But saying something like that and having that picture in my head is not… it’s not helping her. It’s not helping me.

THERAPIST: Yeah. The feelings you understand. The root feelings, I think, make a lot of sense to you. But the way she handles them and expresses them is crazy. It’s not helpful to either one of you. It’s very passive, or it’s very aggressive. Or it’s very distortive. It’s not direct communication, or it’s not communicated through the right people, to your dad instead of to you. [0:08:59]

CLIENT: No, and… but, I mean, this has been the norm. And I…

THERAPIST: I know you’re used to it, Ramona. But I think we’re just getting to kind of know the impact this has had on you your whole life.

CLIENT: I mean…

THERAPIST: It’s part of why what’s happening with Ivan is so frustrating. It’s because it’s the same thing. It’s the same thing, some of this stuff.

CLIENT: But I do feel bad, because I do… she’s already… my mother has been depressed for the… if not all of my life, and pretty significantly so, debilitatingly so. And it’s hard… I’m sure that this is not… I mean, anyone would feel depressed if they got a cancer diagnosis? That would be a normal, healthy… for someone who’s already depressed and already isolated in the house all the time and…

THERAPIST: Yeah, and what a healthier response would be to that is to say, I’m so… I’m having a really hard time, I’m so depressed. [0:09:56] Actually it would mean a lot, Ramona, if you came down. Thank you for offering that. It means a lot to me.

CLIENT: Well, the… she said she didn’t expect it and she understood if we couldn’t. And it… I guess that it would feel different to me if she said, of course I would love to see you, of course I value your support. But if you can’t make it I understand.

THERAPIST: Right, very different.

CLIENT: That would feel different from, I wasn’t expecting anyone to come. I asked if I can drive myself home, if I don’t even need to be put… it really is… it’s so deeply insulting (chuckling).

THERAPIST: Yeah. And that’s Ivan, too. I don’t need anything, I don’t want anything. It’s all my fault. You don’t even deserve to be with me, don’t worry about me, when he’s actually secretly then taking anyway. It’s not that he doesn’t need or want anything. It’s just underground. Your mother’s doing the same thing. Don’t worry. Don’t come. I’m fine. I’ll drive myself. But secretly she wants you there. And she’s going to take it once you’re there. And she’s sort of… she knows you at some level… that you’re going to come. [0:11:00] She knows that. But she does it in this very passive way instead of being more direct.

CLIENT: I know. It’s just hard to filter out… (Pause) She really is scared. My mom is 66.

THERAPIST: Of course she is!

CLIENT: She’s not a young, healthy… (chuckling) she’s not my other… my friends’ moms’ age.

THERAPIST: Yeah, and she’s entitled to those feelings. What we’re talking about is that… the way they come out.

CLIENT: No, I know it’s not okay.

THERAPIST: She can say, Ramona, I’m terrified. This is hard for me. I’m having a hard time. Thank you for coming down. I can use all the support I could get right now. Or, are you sure this okay with you, because it means a lot to me? More direct about the feelings. The feelings are so understandable, so understandable.

CLIENT: I get that it’s not okay. It just hasn’t… it’s only helpful after I hang up the phone or after I… to take some space and say, I’m not going to get worked up over these comments. [0:12:02] Or I’m not going to… that’s her. It’s not… it’s okay to not… it’s just really hard. And I’m really hoping that this weekend I don’t respond and I don’t get drawn into trying to engage in… when she says something like, your father’s going to move my stuff out. I’m sorry, I can’t get that out of my head.

THERAPIST: Yeah, how do you let that thought out of your head (crosstalk)?

CLIENT: I can’t… I have a visual image, and I just… I can’t… it’s such a horrible thing to say to your kind no matter what. It’s just horrible.

THERAPIST: In a way what you’re wanting to practice and you’re bracing yourself for is, how do you start to let her just be… [it’s like your mom doing] (ph) her thing. This is what your mom does. This is how she distorts her world. It has nothing to do with you actually. And so how do you get enough distance in a way to start seeing (ph)… what you’re doing with Ivan is, wow, these are his deficits. It’s very sad and disappointing. [0:12:58] And you’ll come back here when you’re back and be able to sort of just sit with who she is and how this all went, and how sad it is that you have to get some distance, even when you’re there, in order to tolerate her.

CLIENT: It’s just (chuckling)… it’s always hard. Even if something like this wasn’t going on, it’s really hard to not get drawn into the same thing I… and as it is Emma and I are fully planning on taking care of all 20, 21 now, of the pets, while… because now she legitimately will need that. And my dad… I told Emma, what is going to happen when we leave? She’s like, well, he’s going to have to step up and take care of them. And I secretly thought to myself, or they could not have 21 pets. Wouldn’t this…? (Chuckling) And I hate… I really do hate this about myself. But… because this should be the farthest thing from my mind with my mom being sick and with everything going on. [0:13:54] But I thought, what if she could finally think for a minute, given this, this could be a bit of a... she needs to prioritize her health care or…

THERAPIST: Maybe (ph) this would be a wakeup call, instead of 21 pets.

CLIENT: Or I thought, I wish she could find some really… spend some time and find some really great homes for some of them. And they would actually be happier, and she would actually maybe be… she could be okay.

THERAPIST: She could be relieved, maybe (crosstalk).

CLIENT: Well, and I’m starting to worry, can she really take care of them the way…? And I know that shouldn’t… but it’s just something that’s been so… something I’ve always hated that I really… I think it’s inappropriate for me to look at this as a way to change that. But it’s just, it still drives me insane that I will go home, and I will clean, and I will take care of the pets, and I will mow the lawn, and I will…

THERAPIST: You are so judgmental of your thoughts and feelings. So judgmental of yourself.

CLIENT: But I think it’s important to keep yourself in check. I think it’s important to realize that, even if my dad is always a workaholic or my mom always has 20 some pets or the house is… they think they still stay in this huge house with all of that? [0:15:02] And they don’t take care of it. I should love them and try to have a good relationship with them regardless and try to let go and try to stop changing it, because ultimately they would need to do that. It’s just, I hear this rational side. And I really get it to an extent. My sister has had this talk with me about a million times.

THERAPIST: Saying what? What’s the rational side?

CLIENT: We can spend all our time cleaning while we’re home, doing projects, working nonstop, we can spend all our time doing that. When we leave, it’s up to them. And when we go back it’s always… with the exception of two visits in the past couple years it’s always gone back to exactly the same. And Emma said, maybe it would be wiser even if it’s difficult to just try to have some quality time with them, even if my dad’s not home or my mom is hiding in her bedroom. [0:16:04] Just try as much… or, if they’re not interested, go out on our own.

THERAPIST: With her, yeah.

CLIENT: It’s just not easy.

THERAPIST: Because it doesn’t sound like it makes too much of a difference if you clean and do all these projects.

CLIENT: I think it… Emma is trying to say, and I think it’s important to me. I really genuinely hate that my parents live like that, and I of course want to do it for them. But it’s psychologically painful to be in that environment and think about that environment.

THERAPIST: So it’s almost what you do to manage your feelings when you go home. If just you could get some order in that environment, you would feel better in the environment.

CLIENT: I think I always also subconsciously believe very strongly that, if I could clean up the house and if I could take care of all this stuff and if I could (chuckling) mediate all their arguments, that things would be better. [0:16:59] And if I had been able to ever… one of the summers that… I spent every summer doing the same thing and taking care of the house all summer long. And, if I had ever caught up enough or got a good enough plan or strategy or way to manage it all, that it would have been different. And I know that that’s not reality? But it really… I can’t tell you how strongly…

THERAPIST: That feeling (crosstalk).

CLIENT: Yes, and it felt like, if I could change that, that then my parents would get along. Maybe my dad would come home, maybe my mom wouldn’t… I think I magnified it so much. And it… I mean, it felt important for very legitimate reasons. It’s important to have a clean place to go home after school. It’s important for everybody to have a clean, safe environment, a sanitary one at least. So that feels true. But it was more…

THERAPIST: But you’re saying there’s a whole fantasy in a way, that if only you could get it clean enough and in enough order, everything right for a second, that maybe the whole system would change. [0:18:03] Maybe your dad would start coming home more (ph). Maybe your mom would feel less depressed. Right?

CLIENT: It’s a tremendous sense of responsibility. When we go home, we will more than likely talk to my dad yet again about the fact that he is diabetic and gets fast food on the run in between calls and has gained… he lost a lot of weight. Now he’s gaining weight back, and how we should talk to him. And it’s just always… talk to him about cutting back, talk to him… it’s just, it feels like so much responsibility and I…

THERAPIST: Like you and your sister are the parents.

CLIENT: But it’s… that role reversal has been in place for many years.

THERAPIST: Always.

CLIENT: And now it feels like trying to undo that is almost stupid, because they’re actually getting to the point where there would be a natural shift. [0:18:58] There would be a natural shift for the adult children to take care of them. (Chuckling) So it feels like we’re getting there.

THERAPIST: Yeah. That, I think… still the reality of that sometimes (inaudible at 0:19:10) when you reach that turning point where you’re taking care of your own parents more, I think for you could still feel different than the feeling of it being compulsive. Do you know what I mean? It sounds like you still feel at some level like you just have to almost. You can’t not clean.

CLIENT: Exactly.

THERAPIST: You cannot… it doesn’t… it’s not an option psychologically to not do those things. Your parents, when you’re not there, are somehow functioning. (Chuckling) (Pause) Do you recognize that?

CLIENT: They’re surviving. I don’t…

THERAPIST: They’re surviving. I’m not saying their functioning level’s very high. But they’re going to do… they’ve been doing that. [0:19:55] They’re going to keep doing that. They’re not going to change by your getting it cleaner.

CLIENT: No, but it just… I know this is a problem. But I can’t let it go. And I know that’s something I need to work on. But it’s not that simple. Not cleaning the house sounds like a really simple thing to do. Psychologically, that’s not…

THERAPIST: Yeah, so I hear you saying… you’re sort of saying to me, not even a chance (laughing)? I don’t even want to talk about it?

CLIENT: It’s not. It’s just not.

THERAPIST: What would happen if you didn’t? What if you went home, and you couldn’t clean, you were not allowed to clean?

CLIENT: I couldn’t stay in that house.

THERAPIST: Yeah, what…? So you’d start getting so anxious or antsy or mad or…?

CLIENT: So anxious, so worked up, so upset. Every time I walk in that house I am so upset and so devastated and so disappointed and so… I hate… I just… it brings it all back. And immediately I am right back where I was. And it’s like I never left.

THERAPIST: So it really triggers you and pulls you back into being like a child, how it felt as a child. [0:20:58]

CLIENT: It’s completely… I’m right back there. And I’m just as vulnerable. And no matter how old I am it feels like I’m right back…

THERAPIST: Yeah. So here’s the only thing. You’ve found now in your marriage, much to your surprise, that you’ve been playing out the fantasy of, if only I do enough, if I clean enough, if I take care of everything, then somehow that would make things better? It isn’t true, right? You end up so resentful, angry, falling out of love if you’re doing everything. It actually doesn’t solve the problem. The fantasy isn’t true, is not going to change your parents. It’s not, I don’t think, oddly (ph) going to make you happier.

CLIENT: No. [0:21:56]

THERAPIST: I don’t think you’re any happier. So you get it clean, and then you hate them, and you’re resentful. And now your weekend was spent cleaning all weekend long instead of actually spending quality time or doing some things you might want to do yourself when you’re down there. (Pause) I actually don’t think you feel better at the end of it all. You might in the heat of the moment feel good. Like, it feels better to get the counter clean rather than stare at those spots (chuckling). But at the end of the weekend and it being now clean, and you know it’s going to go back, and you know nothing’s changed…

CLIENT: That’s the thing. There’s never the belief. I know it sounds crazy. But there’s never the belief, once it’s cleaned up and once… or once I’ve tackled a big project, there’s never the belief. I never think about that, that it’s going to go back the same way, that no one’s going… I never. I can’t tell you how many times my sister and I have both begged and pleaded with my parents, hire somebody to come in and clean the floors at… anything. [0:22:57] And of course my dad would say he wasn’t going to pay for it, which, if my mom’s not working or volunteering or anything under the sun, I guess I could understand that would seem silly. (Chuckling) But… and she’s not been able to… it’s just… I can’t explain it. It’s so deeply disturbing. And it almost feels… it feels good to go home and see… not to see the disaster, but to dig into it and to take it from that and make it clean.

And on some level it… parts of it feel absolutely necessary. If we’re going to actually have dinner together at… (chuckling) in the home, I really do need to clean the dining room floor and the dining room table and clear off so there’s a place to sit. That really does have to happen. And it’s hard to stop at the basics. It’s hard to not look around. It would be impossible. [0:23:54] My sister always tells me, just tidy up your room if stuff has been left in it or whatever. Clean it up? And you can stay in your room. You can have a clean place to stay, and that’s all you really need. It feels hellish to stay in there. It just… (Pause) I had a nightmare last night that the end of the weekend came, and my mom said, you haven’t been here long enough, you haven’t done enough. It’s not long enough. And I’m… it’s just… I don’t know why. It’s…

THERAPIST: It’s not enough.

CLIENT: I am something of a rational person to some extent. And I can say (pause), I get it. Cleaning the house isn’t going to fix things. It might be important, but it’s not going to stay that way. It’s not going to fix the… that was never the underlying problem. My sister has tried to teach me that a million times. That’s… the fact that the house is clean is just a symptom of much bigger problems? [0:24:57] It’s one thing to get it, and it’s another thing to accept it. And I just can’t.

THERAPIST: See, I think the piece, the lynch pin that’s missing in just challenging that cognitively… because it sounds, Ramona, like you can say what the distortion is, and you can say what the challenging counter-thought would be pretty… very accurately. But there’s some… I think what feels like it’s missing is knowing how much you are regulating your own emotions by cleaning. It’s funny, because it can look like behaviors (inaudible at 0:25:29). But I think there’s actually a lot of feeling you’re having. And I’m also struck today by… we’ve been talking [a little bit] (ph) about the layers of armor and how much feeling even does or does not come up here with me, where you’re, quote, allowed to and even supposed to have all your feelings, and how much your armor has protected you from being vulnerable and actually relying on another person to be accountable, to trust that they’re going to do what they say they’re going to do or not. [0:26:16] It feels… say, I can feel your armor a little thicker today? And it feels like the preparation for going home.

CLIENT: It has to be. I’m already anticipating that it’s not going to be a great weekend. It’s not going to be pleasant. There will be those comments. I’m sure the house will be a mess. I’m sure that the new pet will infuriate me, and I will have to pretend like it doesn’t (chuckling).

THERAPIST: You know what you’re in for.

CLIENT: Yes.

THERAPIST: I’m not even going to… there’s no debating that. I think it’s probably… it sounds realistic. That’s not an aspersion.

CLIENT: No, it is.

THERAPIST: That’s what you’re inching into this weekend. I don’t think we yet have hit on the enormity of how much feeling there is for you in even just that, what going home is like for you. [0:27:02] There’s so much feeling, that I think you thicken up. You get in that kind of lockdown (ph) clean mode because that’s how you keep in control of all of the feelings that you are having. Do you know what I mean? And I think until there’s some other way that we, you and I, figure out of allowing those feelings to be more a part of you and be safe in your adult life, even when you go home, or finding some other ways to manage those feelings… defenses are good to have. We don’t want to have no defenses. They protect us sometimes. We all need them sometimes. Even going home, everyone needs some defenses going home to their families. No matter how long you’re in this work, it triggers a lot of old stuff for people? But there may be ways that this particular set of defenses is so compulsive that it hurts you. [0:27:58] You come home really hurt and wounded over time.

It may not be. You may end this work and say, nope, whenever I go home this is kind of what I’ve got to do to take care of myself. That may permanently remain… I feel very respectful of whatever unfolds this weekend. You’re doing the best you can do with what’s inside you. But I think just the starting point is, trying to think a little bit and let yourself feel, as this weekend unfolds, what you are feeling. And if there’s any space to allow that to happen, to come out more… maybe you and Emma would go out to lunch or something, and get out of the house, share some time together. Even getting to the hospital might be a relief, right? Being away from your home. Cleaning your room where you sleep sounds totally reasonable. You’re allowed… you want to create a space where you can feel safe and comfortable. Maybe there’ll be little teeny places where you can say, you know what? [0:28:54] No. I’m going to let that one go. And I’m instead going to go for a walk. Or I’m going to instead go run an errand with Emma or something. Do you know what I mean?

CLIENT: Yes.

THERAPIST: Of course for you you need to get the dining room table clean if that’s where you guys eat, and have some clean dishes and some places to cook if you’re going to be helping out with the cooking. That all seems like taking care of Ramona’s psyche, you know what I mean, in a way that is reasonable? Maybe there’ll be places where you’ll start to notice that there’s a little room to say, how else do I take care of me? Where are you?

CLIENT: I’m just really anxious, when Ivan’s getting home today, that I won’t see him at all, because I’m going to be leaving. And he’s actually at Dr. Bourd, or he will be this afternoon. He’s going straight from… and then he’ll go straight from there to work. And so I won’t see him at all? [Right now] (ph) he’s not really talking to me.

THERAPIST: You haven’t been talking on the phone?

CLIENT: He called on Sunday. [0:29:58] And I had told him I wasn’t up for talking about the day. I wanted… [was ready] (ph) to talk? Yep.

THERAPIST: (Crosstalk), yeah.

CLIENT: So he…

THERAPIST: And you haven’t called him (crosstalk)?

CLIENT: He called… not Monday, not Tuesday. He called yesterday morning, and I said… I reminded him of that. And he said, no, I thought we weren’t talking because you needed space. And I said, no, that’s not fair. I told you, when you’re ready to talk… (chuckling) so he put it on me, which he usually does. And when he goes home he usually is very busy, because they do a ton of family stuff, which… (Pause) Anyway, he said he wasn’t sure how to find the words. And so he still hasn’t. None of it’s happened. And I’m… I’ve been thinking a lot about separating. And I told Emma

THERAPIST: You did?

CLIENT: I did.

THERAPIST: How’d that go?

CLIENT: I didn’t cry, I didn’t anything. I just told her. She… (chuckling) I felt good because she had a response. [0:30:58] And I felt good that I hadn’t… it wasn’t just me. It wasn’t all on me anymore. And she was able to handle it.

THERAPIST: (Crosstalk) a witness.

CLIENT: Yep. And…

THERAPIST: And she didn’t get so overwhelmed that she (crosstalk).

CLIENT: No, I mean, she… (chuckling) she said… she’s like, obviously I want to kill him. She was really… not inappropriate, but she expressed anger. And she expressed, you don’t have to put up with this even though you are married? That is not…

THERAPIST: Yeah. Good. Good. You two are witnesses for each other. You have each other when you’re down there. (Pause) I’m glad you found your anxiety, Ramona. And I think that’s even a little crack in the armor, to say this is actually what you’re feeling, terribly anxious. This is really scary, this weekend, for so many different reasons. [0:31:55] Where you are with Ivan, that’s all up in the air and uncertain and not being spoken right now. You’re headed home into the environment of your home, per usual, and with everything that that carries all by itself. Your mom’s going into the hospital to have surgery, major surgery. That’s scary, whether you hate her or love her or whatever your feelings are about her, about the house. That’s terrifying, she’s your mom. So no wonder you’re scared and anxious. And I actually think the more you get to have some of those feelings and just let them be, and let them be ordinary and understandable and expectable right now, you might not have to get so compulsively, and even self-destructively, driven into the kind of clean, clean, clean, clean, clean, clean, clean.

CLIENT: There’s no room for any of those feelings. It all just keeps piling on my back, and I cannot stop. [0:32:55] And I don’t have a job yet. And I’m compulsively checking my e-mail (chuckling). I’m supposed to be hearing back from people, and it… unbelievable amounts of anxiety. And there is no room to… there’s just no room for it. (Pause)

THERAPIST: So you’re not willing (chuckling).

CLIENT: I would be, but who’s going to support that?

THERAPIST: Not really.

CLIENT: Who’s going to listen to that (chuckling)? And how is that… how will I have room for that? I don’t see any... (Pause)

THERAPIST: I hear you. It feels like you’re (inaudible at 0:33:28) right now. In a way it’s very protective. (inaudible at 0:33:33) I honor and respect if that feels like the way that gets you through that is most protective right now. For working over time, I don’t know that that’s actually true or not. But I hear that right now it feels like that’s the only way to be. If there’s ever a moment where it occurs to you to try something else, that’s all. I would encourage you, if it ever crosses your mind for a fleeting second… [0:33:56]

CLIENT: But, with all due respect, what would I do (chuckling)?

THERAPIST: I’ve already told you. Things like going out to lunch with Emma. Something that gets you away instead of the cleaning, cleaning, organizing, cleaning, organizing, cleaning. Something that focuses on quality time spent or some self-care while down there that isn’t only just about cleaning. Do you know what I mean?

CLIENT: Do you think that will alleviate anxiety?

THERAPIST: I don’t actually think it will alleviate anxiety. I think you’ll feel your anxiety more. But it brings it more into a relationship rather than just leaving you by yourself in a cocoon of just self-sufficiency. So… it might not work. It might not even cross your mind. So you’ll let me know when you come back. Be in touch. You know I’m around if anything gets really hairy. Okay? (Pause) I’ll see you Monday.

CLIENT: Okay.

THERAPIST: Yes? We’re on for Monday. Okay. [0:34:59]

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