TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: This was a really rough weekend, but she's doing well, so...

THERAPIST: She is?

CLIENT: Yeah. So it went well. The actual surgery went really well, evidently, so...

THERAPIST: That's a relief.

CLIENT: Yes. [laughs] She's very relieved that it's over and now, when the 28th rolls around, she'll be in so much better shape, then, so that's good.

THERAPIST: Now what, along those lines? She just waits and do some follow-up to see if they got everything?

CLIENT: Right. Yes. That's pretty much it. I think he was going to do another biopsy, maybe. (inaudible at 00:00:39) I know he took some samples, I believe, during the surgery and they're waiting on those results, so, hopefully, hopefully it's all gone.

Yeah, it's a really nice doctor and a really nice anesthesiologist, and it's good, overall.

THERAPIST: You talked to both of them? [00:01:01]

CLIENT: Mm-hmm.

THERAPIST: Like, sitting in the waiting room, they would come out, you mean (crosstalk at 00:01:06)

CLIENT: Yeah, the doctor came out in the waiting room, but I also was in pre-op with her, so met both of them then, too.

THERAPIST: Your (inaudible at 00:01:13) wasn't?

CLIENT: No. [sighs]

THERAPIST: Yes! (crosstalk at 00:01:18)

CLIENT: Yeah, he missed seeing her at the hospital before she went in. They did take her in, I don't know, 25 minutes early, but... He was away, because he had a conference. He had a three-day continuing-ed conference. Though he at least went that morning to sign in, and he said he didn't know he would-I don't think he ever did, like, that day, get to go back. On Saturday, he spent most of the day there. I guess he'd gone on Thursday. [00:02:00] But yeah, he said-

THERAPIST: (crosstalk at 00:02:02) Saturday?

CLIENT: Friday, Friday.

THERAPIST: Okay.

CLIENT: [sighs] So he was there while she was in surgery.

THERAPIST: Thursday, Saturday...

CLIENT: It's Thursday, Friday, Saturday conference.

THERAPIST: Yeah.

CLIENT: And so Friday, he went in the morning to sign in, at least. And then-

THERAPIST: And missed her going in surgery. And he was there Thursday, at the conference?

CLIENT: Right, right. I mean, no, he needed to be there all three days, and I don't think he ended up actually (inaudible at 00:02:29) in the conference, which is problematic, but it sounded like he had let it go to the last minute and getting close to the deadline for the year's continuing-ed credits, so it's a mess. It's the same thing as usual.

But Emma and I were both there with her, and he was there while she was in surgery and then when she woke up and everything. [00:03:01] [sighs] Didn't see much of him.

THERAPIST: Then he wasn't there Saturday?

CLIENT: We went last morning, because she was supposed to be discharged in the morning, but then actually it wasn't until, what, 8:30 at night that we were finally able to take her? Because her calcium was low, and that's a common thing.

Anyway, he came with us. Drove separately again and stayed very briefly, and then went to his conference. Then after he went to the conference, he did some emergencies. He vaccinated some animals for some kind of fair that was coming up. Some things that maybe someone else could have done.

This is how it's always been.

THERAPIST: Even the conference, there are online things you can do for CE credit (crosstalk at 00:03:54).

CLIENT: I don't know. Yeah, I really don't know, for him. And this was in his specialty that they had, but it sounded like there were other conferences that had-this wasn't the only conference, [laughs] (inaudible at 00:04:07) it sounded like he waited until the last minute.

So that's kind of how it goes, I guess. Then Friday night, he didn't show up at home until a little after 10:00, whatever, at night. He just kept going. [laughs] It's just...

THERAPIST: You're used to this (crosstalk at 00:04:26)

CLIENT: I'm very used to it.

THERAPIST: I don't think you know how extreme it is, because you're so used to it, you know what I mean (crosstalk at 00:04:37)

CLIENT: I mean, I get that that's not normal and it's not healthy, that I don't think I'm as shocked or worked-up about it as someone else would be, because was always been.

But I felt so horrible, because only one person could go with her into actual pre-op until right before OR, so I went, because Emma's not as comfortable with needles and stuff, and anyway, it was fine. [0:05:00] But she was really worked-up really, really, really worked-up.

It was difficult, because throughout the weekend, a lot, when he was there, when he wasn't there, she would just make comments about him, and would say things like, "Can you please talk to your dad? He's home at midnight, he leaves by 7:00 in the morning, I never see him, he's never home"-it's such a difficult situation to be put in the middle of.

THERAPIST: Oh, it's horrible! And it's none of her business!

CLIENT: No, it's not. I really do understand what that feels like, I really did live did with that. I know she's not making it up, she's not exaggerating, I'm sure.

THERAPIST: Then you turn to someone else besides your daughters to talk about that. A therapist, a friend...

CLIENT: It's difficult. When she asked me to talk to him, I really feel like I want to, because it bothers me, too. He's now 59, he's too old to be doing this crazy-having this crazy lifestyle all the time. It's hard, when she says stuff like that. [00:06:01]

When he came to her at the-when we saw her back in her room, she was like, "Oh, Barry, I haven't seen you in months." It's really difficult, because it's hard to-I don't condone it, I don't think that what he's doing is okay, but...

THERAPIST: How are they together when they are together? Do they get along?

CLIENT: No.

THERAPIST: I hear that kind of cutting comment. They're not otherwise friendly? What is it like when they're (crosstalk at 00:06:36)

CLIENT: They are friendly if he is doing something actively for her. Otherwise, it's pretty much not-this is horrible, but my mom is very, very critical of him. These are a lot of valid points. In front of us, especially, it feels like she frequently tries to really embarrass him and put him down and... [00:07:02]

She said stuff to us like, "Well, one of these times, of course, he'll fall asleep while he's driving." Stuff like that. His favorite place to sleep is at the fast food restaurant down the road, he falls asleep there, he takes a nap-lots of things like that.

Emma pointed out, it's not always just to us. There were nurses that she was complaining about him to, even cutting comments. It's really, really hard to-it's not her fault that he's a workaholic, but I do think that it's not totally coincidental that he's not home, because I don't think anyone could take that all the time.

THERAPIST: (crosstalk at 00:07:47) avoiding her too, too.

CLIENT: It's a complicated... And she says how alone she is, but it's difficult-it's not okay that my dad's never home and that's not helpful to either of them, I'm sure, ultimately, but [0:08:01]

THERAPIST: But she's not acting in such a way that would make him want to come home more.

CLIENT: No, and maybe that's not her responsibility to make him come-I don't know. It feels like she could socialize. She could get out. There are people who've tried. She does have some friends. She does... It's really a tough, tough situation, and it's been this way for so long, and... [sighs] It just really [laughs] is a difficult weekend.

We got back at 11:45 last night. We got in at 2:00 a.m. on Friday, we finally got in. And then we had to get up [laughs] at 6:15. We had not gone to bed before 3:00 and it was really crazy, the long weekend. We spent pretty much Friday and Saturday at the hospital.

As rotten as it kind of was, it was good, in a sense, because I really felt kind of worked-up. I kept thinking if I had spent the day at home, if she had been home, I probably would have taken care of a million things, so... [00:09:00]

THERAPIST: Yeah. You think you were prevented almost from doing that by being (00:09:03) at the hospital.

CLIENT: Right. So, anyway, I guess she's doing a little better. I did feel bad, because before we left, Sunday morning, we did some things. We made her some food, we made her some meals, she'd asked if we could vacuum the stairs so I vacuumed the stairs. Taking care of the pets [laughs] all the pets.

She needed to walk, so I said, "Let's go walk out the lane." My parents live back in the country so they got a lane instead of a driveway. We did that, but it was really tough, because she was saying how she feels-asked her how she felt, "Oh, I feel really insecure. Your dad's not here, and now you're leaving." I felt horrible. I wanted to say [laughs], "Emma, can't you take off tomorrow? Can't we stay longer?" But any amount of time wouldn't have been long enough.

THERAPIST: And she's still not seeing that (inaudible at 00:09:57)

CLIENT: She had mentioned that she might be interested in a support group, so I really encouraged that. [00:10:02] Because it seems like she wants to talk about it. She asks if we're ashamed to tell people that she has cancer. She feels ashamed that she has-I don't know if she really does or if she's looking for a way to introduce the topic, like she needs to talk about it. [sighs] It's difficult.

I encouraged her, I said, "The support group might be really great." The pastor from the church that she has sometimes gone to is-I know she would be willing to talk to her or spend time with her, even on the phone or something.

I felt out of line, but I did say, "Do you have someone to help you, anyone to feel down around this? And I know you struggled with that, aside from-this would be especially tough. Do you have someone to help you with some depression?" I felt out of line saying that, but I felt no one else was going to say it and I felt it was important.

THERAPIST: (crosstalk at 00:11:02)

CLIENT: It's difficult, because it's such a sensitive topic.

THERAPIST: Yeah, sure.

CLIENT: In fact, she said, "Oh, when I talk like this, it's my dad in me." Almost like it's his fault that she... I said, "No, it's okay to have it and to work on it." I said, "Do you need help finding someone? I'd be happy to help you find someone." She was seeing but this person isn't licensed and not covered by Medicare. I said, "Well..." [sighs] There's a small practice in town and they're all licensed, and I said, "Why don't you look into that?"

THERAPIST: Call them, yeah.

CLIENT: I said, "You could at least try it." So I don't know, but I felt... It's hard, because going home, really want to make my dad come home and make my mom go talk to someone and get help with depression, and make her get out some.

But, overall, I think it went well and she was very grateful that we were there. [00:12:04]

THERAPIST: And I know; I hear that you want to make them do these things. I still think, Ramona, you're saying, "You need to see someone, Mom. Here's a practice, why don't you call? Yes, go to the support group," is a healthier kind of intervention for you to be having, even with some hope, even though you know it's not likely she's going to follow through on any of these things, then you're getting pulled into feeling like you have to cure her depression somehow. Do you know what I mean?

CLIENT: Maybe. [sighs]

THERAPIST: Whether it works or not probably won't work. But it's still you saying, "This isn't actually my responsibility" to cure her. She needs help and there are professional people who could help her with what's going inside her and it's not your job. It is help to offer and try to help her get in and encroach her to get in.

You might even get tired of doing that, but that's a much healthier place for you, as a daughter, to be in, than feeling like you somehow could do something, like fix the house somehow, or if only you asked her the right question, or let her see the light in the conversation that everything would change. [00:13:09] It's not going to change from that.

And there's a little bit of you saying, "Here are the things that could help," and actually, it's not you that's going to be that helpful with the long-run, deep stuff no matter how hard you try, no matter how many extra days you add on to being there.

CLIENT: It was hard to leave. But I guess I felt proud, a little bit, of myself, because I-in the moment, in the session when you said, "Take a walk, ask yourself if it's your responsibility to do these things, go out, go do something with your sister," that felt so... Not to put any judgment on the advice, but it felt so-

THERAPIST: I want to hear it. [laughs] No, I want to know how it felt!

CLIENT: In my own experience, it felt so, I don't know. Not inadequate, but taking a walk is... [00:14:00] [laughs] Taking a walk is not going to-it felt like it's hard to explain what it's really like. It's such a dramatic word, but it feels like a trauma and it feels like revisiting the trauma and it feels so-the dynamic and everything that goes on, it's so intense and it's so triggering, for me.

And so, the thought of taking a walk or stopping and saying, "Is this my responsibility?" felt like it wouldn't begin to-it's like a Band-Aid on a really major thing.

But, [laughs] in the heat of it-so my mom had done some stuff. A lot of it was the typical rearranging furniture, displaying her Hummel collection, switching out the curio cabinet, things like that. The floor isn't clean at all. That's the way it's always been, but at least that shows some motivation and some... [00:15:01]

And so anyway, in some senses, it felt even harder, because I thought, "Here, she's really trying. If I helped her, it would be even better," as opposed to, "If she's not trying, it doesn't (inaudible at 00:15:10)."

I did catch myself when we got in; I guess it was Friday when we finally got back in the evening. Emma and I were just completely exhausted, and the downstairs, the table wasn't cleared off. It was a mess. It was a mess. So Emma and I made some pasta, whatever, and we had to make a second box because it was out-of-date. It was over a year out-of-date.

Maybe [laughs] that could happen to anyone, but it felt like my parents are older, they're not taking care of themselves, they're not-I don't know. For whatever reason, a couple of out-of-date food items really upset me.

But we finally made some food and I said, "Why don't we go upstairs? I'm getting worked up. I don't want to look at this. I just can't right now." [00:16:01] And so I did! Went up to my room, which was nice and the way I left it, more or less she moved some furniture in that she didn't have room for, I guess.

So we did. And we just did it because we were too exhausted, we could not. It was okay. And because we spent so much time in the hospital, we didn't really have the option. But, early Saturday morning, I thought, "Okay." The pets need some care and I thought, "Is it my responsibility? No." But then I thought, no matter what, if I had the perfect home life, and my parents had pets and mom went in to get surgery, I would take care of all the pets, anyway.

THERAPIST: Absolutely, absolutely!

CLIENT: So I thought, "That's not so terrible." So I cleaned all the cat litters, took care of all the... And then Sunday morning, Emma took care of all the birds. And we cooked her soup, that she would have a big thing of homemade soup for the week, and I made her breakfast and stuff. She had specifically asked, "Could someone clean the stairs?" [00:17:03] So I got them vacuumed. I didn't get more done but I thought, "That's okay."

And I took some time, there were a couple things that I had at home that I wanted to clean up and bring back.

THERAPIST: For yourself?

CLIENT: And so I thought, "That's okay." I got some of that done. It was okay.

THERAPIST: In fact, that, too might happen if the (crosstalk at 00:17:23)

CLIENT: Right!

THERAPIST: (crosstalk at 00:17:25) really clean and sort of ordinary. That's all within range of ordinary.

CLIENT: It was really, really difficult, because I thought, "This floor is so dirty. I've got to at least mop this and put down some rugs. I've got to do this." And I didn't get to it and it wasn't the end of the world.

It kind of occurred to me, in a strange way, I think trying to figure it out on my own, but I thought maybe it's sometimes so important to me that it's done. Maybe part of that is because I associate those things being done with them putting us first, or prioritizing that we're taken care of. [00:18:05] It's so much in my childhood growing up there. I always felt that if the meals are made or if the house was clean, that that would be a reflection of that. I understand that that's not what it is, but I think even if, in a very strange way, if it gets done, I still have a little bit of that relief.

THERAPIST: You end up feeling loved and taken care of.

CLIENT: Even if they're not doing it, the outcome is still what I would be looking for from them.

THERAPIST: That's so interesting.

CLIENT: I don't know.

THERAPIST: It makes a lot of sense (crosstalk at 00:18:39)

CLIENT: [laughs] It might be very random, but I do realize it's more important to me, probably, than to them.

THERAPIST: Yeah. And what we were talking about before you left was how important it was to managing your anxiety, but you're adding, even to managing, you're feeling taken care of and loved, in a way. That even as a kid, maybe there's a way the house being clean became this kind of concrete, symbolic demonstration of whether you were loved or not. [00:19:07] Do you know what I mean?

CLIENT: I think so.

THERAPIST: It gets conflated with something else. In other words, there are people who grow up in brand spanking, perfectly clean houses, where the parents are obsessively clean, and there's no love at all, right? There are times where people grow up in a barn, and it's constantly like a barn, and there's so much love that that doesn't become that important, either.

I think in your feeling like that became for some reason the way it felt to you, there could be an expression of something loving, of putting you first. That's what you're saying.

CLIENT: I think, too, because in the hospital, my mom, she-I can't even tell you, she talked about the pets non-stop. "Are they okay?" One of the first questions out of her mouth, "Did Jessie," this really old cat that she adopted, she found on the street literally, "Is she okay? Did she get her special food? Did she get her this, did she get her that?" [00:20:01] Asking about all of them. That's normal. Between her and my dad, it occurred to me that so much of the time animals come first.

THERAPIST: Why does the attention go to the animals?

CLIENT: And it's not that-I mean, I love animals and it's great that they care for them, but it's like 20 pets.

THERAPIST: Sometimes it feels like at the cost of the more (crosstalk at 00:20:24)

CLIENT: It's been at the cost of even what's good for them, which drives my dad to be out until midnight, which drives her to... I talked to her briefly, this morning, to see how she's doing. "Oh, I took care of the cat litters." That's fine, but why is-

THERAPIST: (crosstalk at 00:20:38) crazy.

CLIENT: [laughs] Right. It's too much. I don't know. It's hard. But I guess it's so bizarre, and I think I made it up completely that I felt a little good that when I went to change the cat litters, they were really bad. But I noticed she had done some stuff around the house. [00:21:00] When we got in, one of the first things she said was, "I went until I couldn't go anymore." She had done some housework.

A part of me had this fantasy, maybe the cat litters were actually neglected for a couple days. Maybe she really did clean up a little bit for us to come home. It sounds strange in the circumstances, that I would-

THERAPIST: (inaudible at 00:21:23), no, I get it.

CLIENT: It's almost like what if we finally-I don't know, it's a really difficult weekend. But, she's doing well, so...

THERAPIST: On many levels. And some things that you did that were a little bit different from your first time (crosstalk at 00:21:44) feel proud of.

CLIENT: Yeah!

THERAPIST: Do you get my e-mail back to (crosstalk at 00:21:49)

CLIENT: No, I did, and I had a chance to read it but I never had a chance to respond.

THERAPIST: Which is totally fine.

CLIENT: I was not home at all.

THERAPIST: I know you were busy this weekend, of course. I just wanted to make sure you read it.

CLIENT: No, and I appreciated it. [00:22:00] I think it's true, what you said. I am deeply furious with my parents and there's no way for it to come out at this-I don't know what to do with that. And deeply disappointed, I think is the phrase you used and it is true. And I am aware sometimes that I am irritable when these types of situations come up, because when I go home, it's so important to put together, to not be emotional, to be completely responsible, to take care of everything, to let all those comments no matter how hurtful they might be about me or my dad or anyone just let them go and keep going.

THERAPIST: And the buttoned-up, everything tightly under wraps, and then sometimes being irritated is your protection, I think. And I think that's what you were saying, that, "I can't. You don't understand. Why would I start letting myself feel right now?" You have to protect yourself and prepare for this weekend.

CLIENT: It doesn't feel possible, if that makes sense. [00:23:04]

THERAPIST: Yeah. No, it does make sense. It's so ingrained in you. And yet, a little of something became possible. That's where I think that there's a little, little bit by little bit, there might be little room to do something that surprises you maybe even that you hadn't intended but all of the sudden, you find yourself doing something different and it's okay. It's not the end of the world, you said.

I also want to say that, just to be clear, I wasn't trying to say that it was only your projection onto me of your being frustrated at your parents and disappointed, because I think you might have been. You're saying this to me, what it felt like in the moment as we were talking was, "Really? Go for a walk? Do I not understand" (crosstalk at 00:23:47)

CLIENT: Which isn't fair, because it was helpful to take a breather... Emma and I sat in the courtyard at the hospital, sometimes, because it was really hard to listen to some of that for hours on end. It was somewhat helpful advice, but in the moment, it felt so... it felt like a Band-Aid. [00:24:04]

THERAPIST: I get it. And it didn't feel like it could really touch the level of trauma you were walking back into.

That's where I again want to clarify, I can understand that. And there might even been a way that I didn't use the right language, that if I'd used a slightly-different language, you would feel that I understood it better, do you know what I mean? It's not only projection, in other words, there may be something that I was missing in the way I was talking about it that might have actually felt and been invalidating.

I think, for example, I didn't use the language that is inside me, that I didn't say it out loud, that this truly is trauma for you, Ramona. And when I say something like, "Talk a walk," it isn't meant to say like that's all it is. When I'm actually was speaking to him, rattling off this quick list of things that seem sort of benign and silly on the surface, is trying to develop more of a protective barrier between you and the trauma of returning to your home. [00:25:09]

I would speak to you about this if we were even talking about someone who had physically abused you as a child, and you felt you had to go home to see them, right? Sometimes people, they can't keep (inaudible at 00:25:21). How do you develop more of a safety zone, for yourself, so that you have some space not to get totally pulled back into being right back in the trauma, doing what you did as a little girl and letting yourself get treated that (inaudible at 000:25:35)?

So that's, I think, what taking a walk is about, or getting to lunch with your sister it's sort of like finding safe zones where you are protected. You find your adult self and you protect yourself, even if it's for an hour. Even if it is a Band-Aid an hour of protection then bleeding out is better than none at all, you know what I mean?

It of course doesn't touch the depths of this, but it's sort of about how do we get through this weekend and minimize the hurt to you, right? [00:26:07] Sometimes, that is about Band-Aids getting (inaudible at 00:26:08) while you come back and we continue to do the long run of work.

CLIENT: I think it part of it, too, was maybe my... I don't know if "fault" is the right word, but having unrealistic expectations and feeling like seeing you a second time in a week was-I really started to rely [laughs] on you and I really started to feel like, "I really need to do this. This is really important."

And almost coming into it with not a rational mindset but almost [laughs] an expectation that everything that's been going on with Ivan, everything that's going on with my parents, everything that's going on with my mom's surgery, everything that's going on with my job search, all of this huge heavy stuff that I walk around, trying to compartmentalize and keep saying that I'm fine, and walking into it here and thinking that in one short session, you were going to have some kind of magic solution with your expertise.

Not to diminish the power of what you can do in a session, but that would be unrealistic, [laughs] no matter who you were. [00:27:05]

THERAPIST: I hear you. Of course, of course.

CLIENT: That would be (crosstalk at 00:27:05), you can't do that. Not even on the surface. I think I would have felt agitated, regardless, because it's such an agitating situation. And then...

THERAPIST: Well, and even letting yourself actually need and want and open yourself up to a second session, you're saying there's this wish, maybe this, somehow, would change everything dramatically. And then it doesn't, and it's such a disappointment. The wish makes so much sense, so much sense.

CLIENT: I get that it's not rational. I'm responsible, and I get that.

THERAPIST: But the wish is understandable. Do you know what I mean?

CLIENT: [crying]

THERAPIST: I actually wouldn't call the wish irrational. Who wouldn't wish that adding a second session, or within the first of our sessions of therapy, everything would be all set, right? That's ordinary. That seems actually quite rational thing to wish for. [0:28:01]

It doesn't mean it works that way. It's a working through that takes a lot of work, but I get that feeling. That makes a lot of sense.

I believe you were angry at me, that it didn't do that.

CLIENT: I guess I walked out feeling not helped and feeling like there's no way that the advice-almost like, with all your expertise, and I'm thinking, "Take a walk? This is not going to..."

And in the end, some of that advice was very helpful. Like I said, I think I had expectations that some of these really huge-maybe not even expectations so much as a need for some relief, because it felt like things kept getting piled on. And I had to keep going and had to keep saying, "It's fine." [laughs] No matter what, I have to keep going.

THERAPIST: So I have a question about that, then. When you become aware of maybe that's where you were, just hoping there would be some answer that would get rid of some of this for you, did you have thoughts or ideas about what you were hoping I would say? [00:29:11] Is there something you were wishing to hear? When you imagine, if I only said this about the weekend, then you would have felt better?

CLIENT: No. I don't think there's any-I think I was maybe looking for more validation about how difficult it is to be so triggered, because I already feel like I'm overreacting when I use the word "trauma." If I feel like the response is, "Try going for a walk or asking if it's your responsibility," I feel like I'm really overreacting. But inside of me and I don't know if it's right or wrong but I do feel so upset and so worked-up thinking about it and being in the situation. It's really difficult.

I hear how silly it is to say, "Oh, it's so hard to not clean those floors," or, "It's so hard to not coax this or that." [00:30:00] It sounds really silly.

THERAPIST: See, I don't think it sounds silly.

CLIENT: But it's so, I don't know. It's really, really, really, really difficult.

THERAPIST: I don't actually think it sounds silly at all, Ramona. I think it's interesting, because when we started working together I don't know if you remember my saying, in a number of different ways, how unbelievably traumatic your upbringing was in the story that I'd heard so far and what little I heard at that point.

And you, then, would say, "Yeah, but I'm used to it," and sort of, "What's the point of going back there? It's not a big deal."

I don't know that you have taken in, fully, how traumatic an experience your childhood was, in so many different ways. I don't think it's just, for example, that you were crazy over-the-top cleaner, and if only you would have been less clean and less critical, it wouldn't have been so bad. [00:31:06] The reason you were so focused on cleaning because if you were treating something that was very awry in the family. Not in you in your family.

That's been pretty loud and clear to me from the beginning. Maybe you're at a place so you could heard more about that from me, and I wasn't quite picking up on that. Maybe you could have taken in more of that instead of my just easing off and using that language too much. In the beginning, I thought that made you sort of pull back even further, that I knew to tiptoe around a little bit and not say too much too strongly, because I didn't want to push you away.

Maybe in the face of it, you are aware. Your emotions tell you something. You wouldn't feel like this for no reason, Ramona. People's emotional lives develop for reasons, right? You wouldn't feel this overwhelmed. [00:32:01] You wouldn't feel like, "I can't not clean," for no reason, right? That comes from somewhere.

You're discovering even your own self, it comes from this feeling of trying to create feeling loved by two parents. Not just one, two who are absorbed with animals over their own children.

CLIENT: It sounds silly, but it does bring some psychological relief, it feels that way.

THERAPIST: Absolutely.

CLIENT: Looking at even if things are just as tense or the comments are just as inappropriate, to have that in a setting that is clean and orderly and, I don't know. I want to use almost the word "purified" or "cleansed" or "good." It feels more bearable. It feels like it's easier. And I know that's a fallacy, but... [00:33:00]

THERAPIST: I actually don't think it is. I don't think you'd do it if it didn't feel better, right? If it made you feel just worse, you'd stop doing it.

CLIENT: What I'm saying, I get that it doesn't actually help the problem. Even in my own apartment-

THERAPIST: (crosstalk at 00:33:13)

CLIENT: If this problem is going to exist, I at least want my life to be as in order as my apartment or my... I don't know why. It's a deep thing.

Is it okay if I talk about Ivan a little bit?

THERAPIST: Of course.

CLIENT: I don't mean to-this is important, but I feel like I... I've been trying to shove it to the back of my mind for the weekend, because I just couldn't, but he didn't call. And he didn't call.

THERAPIST: The whole time you were down there?

CLIENT: He left my mom one voice-mail, evidently. But he never called me. He sent a couple of texts and that was it. He never even really was, "How did it go? I want to talk," he just didn't. [00:34:04] He just didn't.

THERAPIST: How do you understand that?

CLIENT: I asked him, when I got home last night, "You never called. No matter what we were dealing with, I know whose fault it was, I don't understand why you couldn't even drop that for the weekend to call. This was not a routine thing. This is a really, really big deal, and really, really difficult for my family."

He said, "Well, I got some terse responses to the couple of texts that I did send." And I said, "Yeah, I did send you short answers when you asked if I'm going to be home on Sunday, I only answered with, 'Yes.'" I was so furious at him that... I swore at him, I said, "Are you really serious right now? That's a reason to not bother-"

THERAPIST: Really fucking serious.

CLIENT: I'm really sorry that I said that, because that's so inappropriate. It's not okay to speak like that to anyone, but I did, because after all that he did and the way he responded to it, and then going off to his parents' and not speaking to me while he's there, and then this? [00:35:10] He doesn't call and I said to him, quite frankly, "It's not like if we had been dating for a week, I would have expected you to call. This is not a little-no matter how serious or not-serious our relationship was, I would have expected something."

THERAPIST: I know you and him talked earlier in the week, where you said to him, "I don't want to talk until you're ready to take ownership." Do you think he was following-which, again, is not an excuse, because it's still blind to the fact that he should have called anyway to say, "Regardless of what's going on, I just wanted to say I'm thinking about you." Did he say he was following that, or (inaudible at 00:35:44)?

CLIENT: He's mentioned that and he said-he didn't really say, but earlier in the week, he had said, "I don't know how to find the words." I don't know. I said, "You could have at least tried and called and asked if I wanted to talk about it. You could have, at bare minimum... This is not okay." [00:36:09]

He didn't so much as send a card or-it was nothing, truly nothing. I don't understand that at all. And that sounds very-that's not how I would portray Ivan. Even after what he did, I would not-

THERAPIST: That's not typical (crosstalk at 00:36:28)

CLIENT: That's not! I don't get it. In general, I don't get if your spouse's parent a really immediate family member I don't get how you don't... I feel like even if I had done what he did, I still would wonder why he wouldn't call in this type of a situation. It feels very extreme.

THERAPIST: What does he say about why he didn't call, then, even just to say, "How are you doing? How's your mom?"

CLIENT: The responses he got to the couple of texts that he did send were terse.

THERAPIST: (crosstalk at 00:37:02). Okay.

CLIENT: That's why he couldn't call.

THERAPIST: He thought you wouldn't want to hear from him, then.

CLIENT: I don't know if that's true. I don't know if that's legitimate. It sounds like a really lame excuse, quite frankly. I'm really worked-up. I don't know what to do. I really feel like he's leaving me no choice but to suggest a separation, because it feels like he's not working to resolve it.

THERAPIST: You don't see him putting in a lot of effort, trying to make this better right now.

CLIENT: When I got home, it was clear he had done some laundry. He had tidied the apartment a little bit. He says he's still been sleeping on the couch even over the weekend, because he didn't want to sleep in our bed until things were resolved, even if I wasn't there. [00:38:01]

I said, "Things are not going to be resolved by refusing to speak to me." He told me that he acknowledges that what he did and he's trying to think about how it would feel for me and recognize how traumatizing that would be.

THERAPIST: He said that?

CLIENT: He did say that. I don't know. He spoke for maybe a minute or two last night, after I said, "It's been two and a half weeks and you still haven't come up with the words? Seriously?"

But I guess I felt a little good, because the typical me, over the weekend, would have called after him a lot, would have been coaxing him, would have been obsessing about it, and I didn't at all.

It feels really bad. It feels really overwhelming. It feels... [00:39:00]

THERAPIST: What he did do, when you say he talked for about a minute about it, and he acknowledged some things that sound like they're important. Did it feel genuine? Did it hit the nerve inside you that felt like, "Oh, he's starting something that feels like that's what I need more of?" Or did it feel like it was Band-Aid-ing, too (inaudible at 00:39:23)?

CLIENT: I guess it felt like a mix. It felt inadequate, especially-I feel like my standards are now raised in what I would expect, because it's been over two weeks. I was half-expecting to come home and find that he had written a 20-page explanation, something really-that he had been really dealing with it and thinking about it and processing it.

No matter how genuine and I'm not sure how genuine it was speaking for a minute, really just a few sentences is not... [00:40:01]

THERAPIST: It's just a drop in the bucket...

CLIENT: It's a drop in the bucket.

THERAPIST: ...compared to what you want to hear.

(inaudible at 00:40:06) wonders what actually, if you could say, what would help you to hear from him? What would make a difference right now?

CLIENT: I'm not sure, but I do feel like a part of it would be an explanation. I still, truly, honest-to-goodness don't understand what it happened. I really don't.

THERAPIST: What if he doesn't get it yet? What if he's sort of going, "Why would I do this thing? It's a horrible thing, what I did." You know what I mean? I'm just asking. Maybe he knows, but what if he doesn't-I guess I might more expect that he doesn't know why he did it, that's the long-term, individual work. What if he doesn't know?

CLIENT: Something that my sister said struck a chord with me, because I kept telling her with some of these things, I didn't know if it was genuinely a mental health problem -for lack of a better description that was at the root of it, or it was a passive-aggressive. [00:41:10] It was a choice. It was a willful thing. Not just with him doing that while I (inaudible at 00:41:16). Those reactions from me would be very different, and my ability to give him another chance, very different.

What she said was, "I think there comes a point, Ramona, when it doesn't matter why it's happening. It's happening and it's unacceptable."

And so, I think that's kind of my answer.

THERAPIST: If I'm hearing something that might-if there's anything you could hear from him right now that would make a difference, it's maybe him, even if he said, "Ramona, I don't know why I did this. I know I have to work on figuring that out, but yet, I know that it is absolutely unacceptable and I'm so sorry for the way this impacted you."

Which is different than, "I'm so bad, I'm so bad, I'm so bad, I'm so evil, I'm so horrible, I'm a monster," right? [00:42:04] That's not actually saying, "This is not acceptable," to your face, with eye contact, "I am sorry and I get it."

CLIENT: There's never any eye contact. [laughs]

THERAPIST: (crosstalk at 00:42:13)

CLIENT: I get that he's ashamed, but I need this.

THERAPIST: When is couples' therapy this week? When are you going to start?

CLIENT: Thursday.

THERAPIST: Thursday. (crosstalk at 00:42:28) going?

CLIENT: I guess. I have no clue what to do, I guess.

THERAPIST: The more you can go in not looking to change him but not looking even for the answer right now about-in one session, you don't have to come up with whether you're going to separate or not, unless you really want to. You don't have to.

But go in with trying to get some of your armor away and (inaudible at 00:42:56) sharing how hard and how sad and how sad you are, and what you wish you would hear from him, the kinds of things that you feel like you want to hear that would move you. And how that's different than feeling him whipping himself, that doesn't move this inside. It doesn't actually feel like you're making contact with each other.

Talking about what it is would make a difference for you, instead of whatever's going on with him. I think that has the greatest chance of seeing what could happen inside him, when you're in that place. In some ways, that might be useful for you to know, because then, if you still get any changes when you lead with your vulnerability if he doesn't soften and go, "Oh, Ramona," and look up and make eye contact with you if none of that starts to happen, you also then know some more about what he's capable of and what he's not capable of. Do you know what I mean?

It's speaking from your experience; it's speaking from your vulnerability. [00:44:00] Just come in with that inside you, as saying, "I know I wear a lot of armor and sometimes it comes out as critical. I'm going to try to take some of that off and just share with you how sad and hurt and upsetting," how much your trust is shattered, how confused you are. All those vulnerable feelings, I think have the greatest chance of eliciting of more contact with him.

We'll continue next Monday.

CLIENT: I need to... ugh. I don't have a job and I need to speak with my dad about potentially being on his policy, short-term.

THERAPIST: Because that will be past the 23rd, by then, right? Yeah.

CLIENT: Yeah. [laughs] Three days.

So I need to see what could happen. [00:45:00] So I don't know if that would even-

THERAPIST: You would find out what the coverage is and, yeah. You want to find out specifically if he has (inaudible at 00:45:06) plan.

CLIENT: Okay.

THERAPIST: So that's one of the things, because that will allow you to see someone out-of-network and get some coverage for that.

CLIENT: You're not in-network with-

THERAPIST: I'm not in-network for any insurance, but if he has a PPO plan...

CLIENT: Okay.

THERAPIST: ...which you have now, you've had a PPO, where you're allowed to see somebody out of network and they cover...

CLIENT: Okay.

THERAPIST: ... a significant portion. You've had good insurance, so. You might not be able to start as of the 23rd...

CLIENT: I didn't think so.

THERAPIST: Yeah. Do you want to check with them and see...

CLIENT: Yes, I do.

THERAPIST: ...if you could start for September 1st? Maybe you get in on the 23rd. Let me know, keep me posted.

CLIENT: Okay, okay.

THERAPIST: Okay.

CLIENT: Okay.

THERAPIST: So, do you need this, getting around? Your last bit of cash? [laughs]

CLIENT: Oh, no, no.

THERAPIST: I don't want to take this-

CLIENT: No, no, I have a card. There was another one at home.

THERAPIST: You sure?

CLIENT: Yeah, yeah, thank you, though. THERAPIST: I don't want to leave you cashless, though. [00:46:00]

CLIENT: No. I'll let you know, and then we'll decide whether or not we can meet based on that.

THERAPIST: Let's meet Monday either way, okay? And hopefully you'll know more by then. But just keep me posted once you (crosstalk at 00:46:12).

CLIENT: Okay, okay, I will.

THERAPIST: Okay?

END TRANSCRIPT