TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: You know about this time, I really appreciate it.

THERAPIST: Sure. I'm glad at least this works and we'll try to keep figuring it out. I know it's a lot to put together right now. I got your e-mail also about the insurance. That makes sense. We'll just keep a running tally of the couple of $40 copays. Take a breath. And then whatever ends up here. As soon as you know more about your current plan, just e-mail me the details your number and all that.

CLIENT: Of course. The only thing I am I was going to take the PPO, I mean only for you. You and Dr. Farrow (sp) are the only healthcare providers I use. I mean I'll probably go to the doctor once this year but I guess the point is the PPO is exceptionally expensive.

THERAPIST: It is. Really.

CLIENT: Very, very expensive. So I was speaking with one of the HR representatives who coordinates the information about it and he said that a lot of employees take an HMO and pay for an out-of-network provider out of pocket with flex dollars, pre-tax dollars, because it's actually cheaper. So I'm going to look into that because [00:01:16]

THERAPIST: because it's tax free?

CLIENT: It is. Well, of course I'll do the flex dollars regardless, but I might look into doing the medium HMO while we're doing that especially if I don't have a regular time every single week yet.

THERAPIST: And yet, the question is what if we eventually do, is that I think that's our theme, right?

CLIENT: Of course. Of course. It's dependent upon -

THERAPIST: Yeah. How much is the PPO versus the HMO?

CLIENT: The PPO is $141 every two weeks and that's before I pay for it vision and dental and taxes and everything else.

THERAPIST: $280

CLIENT: Yeah and that's 26 periods in a year, so it's exceptionally expensive whereas the HMO I think can go $50 every two weeks to maybe close to $100? Plus, with the PPO I'd still be paying 20% in co-insurance. So, I think I'm going to look but [00:02:22]

THERAPIST: Yeah. You've got to run the numbers because if it's four times a week, it doesn't sound like it would I mean four times a month It doesn't sound like or eight times a month. Or is Emily in network through the HMO?

CLIENT: Emily's in network.

THERAPIST: She is. Ok.

CLIENT: So she shouldn't be a problem.

THERAPIST: So, we'd have to talk about what actual fee would look like.

CLIENT: And if I was still able to do the research study? I don't know if you have an ending time for the study.

THERAPIST: I think they approved it for at least a year. So, let me double-check with them.

CLIENT: Ok. Because I wouldn't want to if I decided to pay out of pocket I wouldn't want to rely on that and then find that I'm back at square one.

THERAPIST: So if you're estimating $150 or something like that, that would be $600 a month. Right?

CLIENT: Yes. [00:03:22]

THERAPIST: That's a week. I'll only be That's what it is anyway because it's going from 50 to 280? Oh no, that's not That's not per week.

CLIENT: That not, yeah. But even $100 versus $280, it just I was doing the (inaudible at 00:03:38) and it was coming up to like $6000 a year for everything and that's a lot for a I mean, I'm healthy otherwise but that's kind of a lot for me to assume.

THERAPIST: And yet, out of pocket for this you'd pay a lot more than that. If you were -

CLIENT: Possibly, but I also have to figure, "Is it going to be four times a month for 12 months?"

THERAPIST: And with your flex money, do they contribute anything or it's just your own money just tax free?

CLIENT: Yeah.

THERAPIST: So you'll run the numbers. You're on top of all this. I know it's hard to if you knew for sure we had a definitive session time (crosstalk) [00:04:17]

CLIENT: I would feel better. I would literally be choosing that plan only to see you, which is fine, I mean well-worth it. I'm very invested, but like I said, when I know if I'm going to be seeing you because otherwise I'm spending all that and not seeing anyone.

THERAPIST: Yeah, it makes sense. What are you feeling about your hopes right now? Let's say we did have a time.

CLIENT: No, my hope is definitely to continue to see you once a week. That's always been the goal and I can be as flexible as I can because I have that mandatory meeting once a week, I have an hour and a half flexible It sounds like things are pretty So I think even if I wanted to stay like an hour late one day, I could leave an extra hour earlier. So I can try to move around but I wouldn't set up something like that consistently until And I know you're busy and you have lots of patients who have waited long times and also have 8-5, 9-5 schedules. I think everybody has that schedule (laughing). I'm sure that makes it hard for you. [00:05:24]

THERAPIST: Yeah, we'll just keep trying. For now, you think you might be able to skip around? That's what I didn't know. Like if there were an opening, should I be letting you know whenever I have openings that seem like they might be lunch hour, if there was a cancelation?

CLIENT: So that's the only thing. I can definitely do morning or after somewhere early. Lunch might be a little trickier -

THERAPIST: It's in question.

CLIENT: because it would require Ivan helping me out, picking me up and bringing me, because it's at least a 20 minute drive if there isn't too much traffic. So we're talking 40 minutes driving and 40 So, taking a long lunch, which might be permissible, instead of coming in late and leaving early. But it might be easier to work around just morning or afternoon. [00:06:15]

THERAPIST: Sure. And yet, my guess is the lunch hour is going to open up the fastest. So do you want me to let you know of that and we can start there and keep you on the list for the other times?

CLIENT: Yes, because that's something I could definitely approach.

THERAPIST: Ok.

CLIENT: Because it's fair. If I'm coming in an hour and a half early one day, I could maybe take an additional hour and a half at lunchtime.

THERAPIST: Ok. And for now, I'll also let you know about cancelations.

CLIENT: That'd be great.

THERAPIST: You can always feel free to say no, but if there's something that might work, I'll keep you posted. 12:10 on Wednesdays is not going to work. It's a lunch hour time.

CLIENT: So right now, that's what we locked in for Dr. Farrow (sp) because it's literally a five-minute drive, so Ivan picks me up, we go, we come back and I don't get a lunch hour but it works.

THERAPIST: That makes sense. Ok. Because that's the first lunch hour that I think will open up.

CLIENT: Ok. Well, I had asked Dr. Farrow if would change on her end, if she would have another lunchtime or if I could leave earlier for one of hers.

THERAPIST: Ok. Do you want to check with her on that because that's probably the (crosstalk) [00:07:17]

CLIENT: I see her at lunch today which is why I was like, "That's a lot today" (laughing) but yeah, I will.

THERAPIST: Ok. We'll keep working on it, Ramona. I have confidence we'll find a time -

CLIENT: Ok, good.

THERAPIST: It just might take a little -

CLIENT: I understand that.

THERAPIST: bit of time, but in terms of your decision-making I don't expect it's going to be that we'll never find a time and then you won't be meeting with me.

CLIENT: Ok. Because that's my only I wouldn't want to lock into that and then I have to do that for a year and that's a lot of money if I'm, again, seeing the doctor once a year. I just need the cheapest plan. Anyway, that's good.

THERAPIST: Yeah. We'll figure something out. (pause) How are you? What is going on? How's everything?

CLIENT: Well, a lot, I guess. The job is going pretty well. I'm working with some really good people. It's a really nice environment so that's good.

THERAPIST: Really! You like it so far. That's so great. [00:08:09]

CLIENT: Yeah, I do. I'm still taking on new things, but it's good. So, I'm happy with that. I'm still adjusting to the new schedule but it's nice. In a lot of ways, it's easier than school. I get to come home and I can watch TV, or eat dinner or go to bed early, or whatever. And on the weekend I have no homework (laughing). It's really nice. So that's good. Let's see, we just started going to see Dr. Farrow (sp) again two weeks ago, you know I was telling you last week, but now we have a consistent spot with her once a week. Ivan has-I'm doing this in no particular order. Ivan has, the past couple weeks before that we had just been seeing each other like twice a week, whatever. Since then, he's been pretty consistent coming over, I don't know, four or so nights a week, maybe more, and meeting me after work and picking me up from the subway and making dinner and doing some stuff around the apartment and I'm not asking him to do any of it. So, that's been very, very nice. It's been weird. It's been like and spending some time talking about our days, spending some time, not every day that we see each other, but time talking about the problems -[00:09:40]

THERAPIST: the serious things

CLIENT: Yes, the serious discussions, but it's been nice to have positive time too.

THERAPIST: You've been doing this every day pretty much?

CLIENT: Not every single day but, yeah, most days, yeah. And this has been his initiation. I've never said, "Would you like to come over and cook dinner? Or "Would you like to do the laundry?" No, he's been asking if he can, so that's-

THERAPIST: Asking even too? Which matters.

CLIENT: Yeah, so that's been nice. It's obvious that he's putting in a lot of work. He recently saw Dr. Bellamy (sp), his psychiatrist, and she now put him on a full therapeutic dose for ADHD. He was on 20 and now he's on 25 mgs. And also added a mild anti-depressant, which he said would take a couple weeks before it would start to be in his system really, but I felt like that was good. He feels a little uncomfortable about it but I thought that was a big deal that he was willing to try that and [00:10:44]

THERAPIST: Yeah. That's huge. So he's taking the ADHD medication daily now?

CLIENT: Aderall daily, yeah.

THERAPIST: Daily.

CLIENT: Yes. She even told him he could take it twice a day as long as it's not keeping him up, so I don't know that he's tried that yet but -

THERAPIST: I know for a while he was only taking it sporadically. It sounds like he's up to taking it more regularly?

CLIENT: I think he's at least taking it every day he goes to work.

THERAPIST: Ok.

CLIENT: I don't know more. I haven't even asked.

THERAPIST: That's something though.

CLIENT: Yes. And he says now it's no longer when he first started taking it he said would like immediately feel like, he would start to get really clear and really focused and things would go really well and then at the end of eight hours he would start to feel "fuzzy", he described it as. And he said now it's more consistent, which evidently Dr. Bellamy (sp) says is normal. So that's good.

THERAPIST: Do you know what the anti-depressant is? [ 00:11:41]

CLIENT: It's Lexapro, which she said I guess is also somewhat anti-anxiety and goes well with his Aderall. So, I feel really hopeful for him.

THERAPIST: That's very exciting.

CLIENT: It is and I guess it's even more of a big deal because I know with what Ivan's family had kind of what their response to any kind of mental healthcare, I feel like this is a really big deal for him to do that.

THERAPIST: It's been a long time coming and lots of hesitation and a lot of mooning (ph) around it for him so much shame. It sounds like it's just becoming a little more ordinary. Why not try this tool?

CLIENT: Yeah. So I'm really I think he saw at least with the Aderall that it actually really helped him and it wasn't such a big deal. So, I really hope he has a good experience with this medication and he doesn't have to switch and stop. I really hope. That would be great. So, he's seeing Dr. Bourd (sp) regularly. [00:12:45]

THERAPIST: Good. How are the two of you?

CLIENT: So that's the thing. I guess I would say overall things have been going very well. I would say it's at least a solid two weeks that he's been doing the meeting me after I get home from the subway, having dinner ready or mostly ready. We sit down at the table and talk about our days and just spend time together. That's been really, really nice. I want to be cautious because I recognize that's a lot of effort to do all those things and especially to do them without asking but I also want to I guess recognize that even though those things require effort and they're really positive and I've been really vocal about thanking him, it does address some things but it's not a response, a direct response to the lying and stuff. [00:13:49]

So, I don't want to be a harsh critic but I don't want to be too trusting. So I guess I just want to say that that takes a lot of effort and it's really great, but it's also probably relatively easier to make dinner than it is to start being really transparent about everything. So I just want to find a middle ground to acknowledge it but also not take it as, "Everything's going to be great, please move in."

THERAPIST: And knowing it's two weeks or a month now versus years for time of operating in a particular way, so you're trying sort of to take in how deep, how long-lasting the change is going to be.

CLIENT: Yes and I even said to him, "If, when he moved in, I would not expect" and I guess I don't know what really happens in other marriages, but I wouldn't expect that four out of five days a week somebody's making dinner and has the laundry done and, you know, is always there and always able to talk about your days. I wouldn't expect that. And I wouldn't want him to do all the cooking or do all the But there would probably be a happy medium from that not happening to it happening a lot consistently over a short period of time. And that would be fine. [00:15:06]

THERAPIST: Yeah. Or for the consistency to be when it's his night to make dinner, he makes dinner without being prompted, without being reminded. If laundry is his duty, he does the laundry once a week. There is consistency even if it's a little more spread out with what the goals are.

CLIENT: And I do feel like if this would continue to happen for I don't know how long and it would start to build more and more of those positive feelings or more and more space that -

THERAPIST: Trust.

CLIENT: it would be ok if Ivan didn't make dinner on his night one time or two times. There would be space for that and that would be ok. So I guess he went from here to here with some of that stuff and I'm saying it's ok that it meet somewhere in the middle. I also said I wanted to talk with Dr. Farrow (sp) about what it would look like to work towards moving in together again, for him to move back, what it would look like to do that and what it would look like to really continue to take in his positive efforts and my efforts to be less critical and allowing it, being receptive to it. To take in all of that with but also with having space to really consistently talk about and work on the elephants in the room in a way that isn't overwhelming but that's consistent and real. [00:16:35]

THERAPIST: One way even to think about it is that even if you decided preliminarily together that Ivan is going to move back in, that doesn't have to mean forgetting, letting things go, a permanent decision either. Just as separating your living spaces, you didn't have to think of that as permanent, rejoining your living spaces doesn't have to be permanent. It could be more just creating more opportunity to get to know each other, to get to know what's there, to get to know how much does this happen now that we spend all our time together. Is there trust there? And that you're still looking at the relationship and working on the issues even though you're living together. That's certainly possible. [00:17:35]

I'm curious what you decide what's up with the living situation right now.

CLIENT: He still lives in the apartment that he's renting.

THERAPIST: And did you move or let go of your house?

CLIENT: No, no. I'm sorry if I didn't I found a way to adjust the commute. It's now down to an hour about, even an hour and a few minutes so -

THERAPIST: So you're still in Waltham (ph).

CLIENT: We renewed actually, because it was time. So that felt fine.

THERAPIST: So you're in a space that you feel totally comfortable if he did want to come back, if you wanted him to come back.

CLIENT: It's the same apartment we had at least. So I mean it's kind of weird because there are times when he gets ready to leave in the evenings it feels kind of weird. [00: 18:17]

I also have been thinking about this and I think there's no way to say it without sounding like a horrible person but it feels great to come home and have him pick me up from the subway and have dinner together and talk about our days and spend time sitting on the couch or watching TV or just-It feels great. It's wonderful. But it also doesn't feel completely-I don't know. In the back of my head there's always all this other stuff and I don't want to pretend that if we have dinner often together enough or we sit on the couch together often enough or talk about our days or that if all that is positive that it addresses or we don't have to talk about all the negative. [ 00:19:10]

And I also want to be sure for myself, and I hope I wouldn't be capable of this, but I want to make sure that having dinner made after a long day or finally having him do the laundry or take out like that those things feel so good that I'm more appreciating the things than I am him. In other words, if Emma picked me up from the subway and made dinner and we hung out, would that fill the same thing? I don't think that's the case but I guess I just want to be sure because I It's kind of funny because I voiced those basic needs for so so so long and now they're being met and I don't want to be I don't want to make a reality out of his concern that it's never enough whatever he does. But I also want to say And I don't want to be a really critical or hard person on him but I also don't want to say, "As long as you keep making dinner, it's ok that you assaulted me or that you looked at those websites or"because it's not I guess I feel like they're different. [ 00:20:18]

THERAPIST: It's actually not ok. Yeah. Let me just make sure I'm understanding. The feeling overall is not wanting to have him doing these actions that are kind of the daily grind caring for the household actions, to undo or make up for in your mind, assaulting you sexually or secrets, lying to you about things. Right?

CLIENT: Right.

THERAPIST: Ok. When you're saying what you brought up about if Emma did those things for me and you said something about wanting to make sure I'm appreciating him and not the things he's doing. Can you say more about that part?

CLIENT: I want to make sure that my response to him isn't, "It's so great to have these needs met" or, given my history, that it's so great to be taken care of that I confuse that with -

THERAPIST: actually loving him as a person. [00:21:19]

CLIENT: I feel pretty confident that I can say that I love Ivan without because I felt that I did when he wasn't doing those things even and now he's doing them but I just want to be sure that I don't confuse that because that would be a mistake because then if he moves back in and we went somewhere more towards normal that it would be ok.

THERAPIST: So it's also not in addition to not making up for this separate range of betrayal kind of experiences in a relationship, not wanting it to be that simply being literally cared for every day things taking care of is so powerfully relieving and wonderful that's where you're making your decision-making from that relief and joy at that finally happening for the first time in your life. [00:22:10]

It makes a lot of sense, Ramona, as a caution. You've been so, so deprived your whole life of someone actually taking care of you that this has got to feel like on top of the world almost in a way internally. Someone actually doing this-

CLIENT: It's really nice. I look forward to going home. I look forward to it's really great. I feel loved. I feel taken care of. I feel that my needs are met, even just talking about our days. It's really great. And, again, I don't want to be-I don't know if this is harsh or critical but I guess part of me feels like Ivan could be the model husband of the year from today on and that would be great but I would still need to actually talk about and address those huge things because even if he did have the power-just like this on/off switch-he could no longer be susceptible to doing anything like that ever again, I would still need resolution. [00:23:18]

THERAPIST: Absolutely.

CLIENT: And I really do want resolution. I really don't want-So, I guess after my dad had the affair, even now my mom, years later-let's see, like six years later-my mom will still bring it up sometimes. I don't want that for Ivan and me. Not that it would ever-there would never be a day that I would say it was ok or if he asked me about it that I I don't see that ever happening in the future and I think that's how it should be. But I also wouldn't want every time I get mad at him for it to be about this.

THERAPIST: For it to get dredged up as a weapon.

CLIENT: And I want to actually get over-if I forgive him and move on it doesn't mean it was ever ok but that we don't have to keep going to couple's therapy for years and talking about the same thing. I actually would want to make progress. But that would also involve it not continuing to happen. [00:24:10]

THERAPIST: Yeah this is where I think the word "forgive" gets a little-it's a little tricky of a word because, in a way, you're saying it's not forgivable, it's not ok and yet there may be ways, you wanted to find a way to have it be processed and understood, known to each other enough that both really trust that you understood what happened and it's part of the past and it's not going to keep happening in the present.

CLIENT: Right.

THERAPIST: which is really different. Yeah. There's so much for you on this, Ramona. It makes me wonder. Did your parents-do you know what they did together around your father's affair? How it got processed with each other or did they go to couple's therapy? [00:25:02]

CLIENT: My mom said at some point they did. I know that I begged them to go at the time and they didn't and then she said somewhat recently, she told me that they did at some point. But mostly it got processed-I talked with my mom. My mom talked with me a lot, a lot, a lot. And even when Ivan -

THERAPIST: Ramona, I'm confused.

CLIENT: This is years, like, so it's not something that I'm actively upset about. But even when I brought up that Ivan assaulted me and I talked to my mom about it and then the second time that I talked to her about it, literally the second time, she's like, "You've got to get over it. You've got to-" She didn't want to talk about it even when I started to think about if I need to move, "What do I do? What do I do?" She was like, "I think you should talk to your therapist or Emma. I don't think I can help." And it was like the same But I felt better because you had talked a little bit about the fact that that happens so I felt a little bit more, "That happens. It's-" It doesn't make it ok. But she did say to me in that conversation, she's like, "But the one thing that I want talk about you, say that it's not appropriate for me to talk about it with you." And that would be the affair. [00:26:10]

So it felt horrible, of course, because I felt that turning to my mom after what Ivan did to me even though it I guess she shouldn't have to hear something like that, but I felt like it was ok to turn to-

THERAPIST: She's your mom.

CLIENT: Yeah. I felt like it was ok and I wasn't pulling her in on gory details. I felt like it was ok and then for her to say, "But you don't want to talk about the affair that your dad had." It felt horrible because I'm not her mom and it's even harder because my grandma has passed away and she reminds me that she doesn't have her to talk to anymore and I do feel horrible about that but I still feel like it's inappropriate for her to talk about problems with my dad with me. [00:27:00]

THERAPIST: Absolutely.

CLIENT: Maybe I'm wrong. I don't know, but I didn't think it was inappropriate for me to turn to her about something with Ivan. So, all I'm saying is I don't know the right way to process that and what my mom went through is different from what I'm going through with Ivan but I don't want to do that.

THERAPIST: It's just remarkable, Ramona, how much you have taken care of your parents. I think one of the things you're saying in everything you're-the articulation of your goals about what you don't want to do right now with Ivan and your cautions to yourself-is that, I don't think you are quite yet in a place of knowing and understanding that being taken care of should be a given with someone who loves you. Does that make sense? [00:28:02]

In other words, there was very little taking care of you. In fact, you were taking care of them. You're cleaning the house, you're organizing, you're reminding of bills, you're helping your mother with her mood, you're helping your mother with their marriage, you're begging your parents to get into couple's therapy or individual therapy, right? You don't know inside you that being taken care of is like the bare minimum. That was never a given. So, the caution you're saying to yourself is not wanting to have it be that Ivan finally doing ordinary, maybe bare-minimum minimizes it too much, but sort of ordinary, expectable daily care-taking of the way you operate with someone who you love. To have that be so exhilarating that that alone is enough-that's your history of not knowing. That should absolutely be there and then you get to expect something even more about connectedness, about relatedness, about how you click together, about what actually works personality-wise in the relationship. You've been so deprived of the care-taking that I think there's a way that can feel like, "Oh my God, I finally have this thing" that actually you should have had all along. [00:29:29]

That's the self-esteem stuff we've been talking about about hating yourself, of like not quite, until relatively recently, feeling like, "Of course you deserve to be taken care of!" That's what loving relationships are and if that's not happening it's not that other people perfectly do that ever for each other everyone screws up for their spouses, even at the healthiest place, but that would be something then that gets justified to be talked about and worked through as a just given. Of course I expect that! Of course that's something I deserve! That has not been there. [00:30:11]

CLIENT: It's been great. It's been really great. The one day I got home and Ivan was excited because-I don't know if you know what Pinterest is-but (laughing)

THERAPIST: Yes.

CLIENT: There are recipes and I pin recipes and I like to try new things but Ivan went on my board and found a couple things and made them for dinner that night and I just like could have about cried when I sat down because it was all made, all on the table, done. He set this-

THERAPIST: And he found what you were particularly interested in.

CLIENT: Yeah, which I it wouldn't have even mattered like the point is -But it was just like the most thoughtful, loving and, in reality, he made dinner so it wasn't like a, you know. But it was huge and it just felt so, so good and I felt very I don't know. I felt really good.

THERAPIST: That's an example, I think, of where there actually is something happening that's beyond the bare minimum of keeping up with responsibilities. He didn't have to do that. It's not that you'd expect every time, but the fact that he's thinking, "What would Ramona like?" and even making an added effort in a way that's about the level of not just meeting your physical daily material scheduling logistical needs, but getting to know you and interested in your preferences, your likes, your dislikes, your mind, that also was not happening for you as a kid. [00:31:33]

CLIENT: It has really gone back to feeling like it did when we were dating.

THERAPIST: It was like this in the beginning.

CLIENT: Yeah. It wasn't always-and we didn't live together and we didn't have the resources in some ways but when we got together it was a special time or it was something planned even if it was-like, "There will be some kind of dinner. There will be-" And really enjoying the time together and then there would always be a point at which one of us would leave and not want to leave and it's felt like that. I also just want to be sure-I guess when Ivan was in school, he came to visit me on the weekends and things were fine. I mean he was happy on the weekends but, obviously, very, very depressed during the week. I want to be sure that's not what's happening because I worry that it is. [00:32:28]

And, not that I want him to not be happy when he sees me, but I want to make sure that he's not depending on me. I do worry. He is still having some suicidal thoughts sometimes; he's still-And he's working on that with Dr. Bourd (sp).

THERAPIST: So he's told you about that?

CLIENT: Yes.

THERAPIST: That's a good sign.

CLIENT: which is good. It's hard to hear and I want-I guess that's another thing before we would move forward-I want to make sure that he's stable and safe. I guess I feel good that it's out in the air and Dr. Bourd (sp) knows about it and is working with him.

THERAPIST: And that he's talking to you about it. [00:33:11]

I mean another thing you're describing is there's a way Ivan and maybe even to some degree you would get into the kind of a bubble of experience together where things look great, they're happy, they're getting taken care of in this aspect of your relationship when you were together again, early on. And yet, it's in a compartment where in this compartment for him, all this other stuff was going on that you didn't know about and maybe even, to some degree, he didn't know about. He could convince himself everything's great over here and sort of almost forget how bad it is over here and that rigidity of the strong wall between those two compartments I think is part of what's felt like such a betrayal. You didn't know there's this whole other room over here where other things are going on and that's even happened more recently, right? [00:34:11]

You could probably feel eager yourself-the reason you connected in this way-the relief of having someone, even when you first met each other, who was just there and loving you and you're enjoying each other's time, you're taking care of each other, might have meant for you that you just wanted to be in this bubble with him and maybe there were signs or other things that you were used to not looking at too because this was such a relief to be over here and that you're both trying to say, "I want all of you to be known and all of me to be known." This is what I hear you saying when you say, "I want to really appreciate what he's doing and I don't also want to let go of the things right now that I really feel are important for me to have processed more." [00:35:03]

That's you holding on to the whole picture and then I think you're saying, "Ivan, increasingly, I want to make sure that I know what's going on in its entirety." That's part of what builds trust in each other. I actually think he'll trust you more, oddly, by your holding on to the whole thing about your feelings even, your appreciation, your knowing and seeing what's happening in the present and also your caution about the past will help him. It helps him break down the barrier to the degree that you're not forgetting, right? getting everything on each side, each of you, integrated.

CLIENT: So I wonder and it's maybe not-I don't know if it's a good question but sometimes I think about our overall relationship the past five years and I think there are a lot of good memories and a lot of good periods of time that I guess I would say were pretty healthy, pretty normal. [00:36:06]

There was never a year or even a long-where we never had an argument but I would think it was pretty normal, to some extent. And then I guess I would look back on the two years when we had just been married and feel like a big chunk of it-I don't know. There have been chunks of progress but there have also been chunks of low lows, the lowest lows. And I just wonder realistically-I don't want to be I don't know, cynical-we haven't been married very long I guess but I just want to know is there a point at which there is too much water under the bridge or there is too much of an unhealthy experience that's happened in the relationship that it's realistic-I just want to be realistic and I want to be cautious. [00:37:07]

THERAPIST: I wonder how you feel about that question right now. Is there too much water under the bridge to recover? What is your gut telling you right now about that?

CLIENT: I guess it feels like we've made progress in a lot of things that I didn't know that we necessarily could. I feel like I've made progress even in the past year that I didn't necessarily know that I could or should, so I've been surprised but I also sometimes have this feeling that other couples fight. Surely they must fight even though none of my friends talk about ever having disagreements with their significant other-anything significant. I don't know to what extent and sometimes I feel-most times I feel like we're the only ones who have any of these problems and maybe it really is so crazy or so extreme or so-that, if everyone knew the gory details they'd be like, "Don't bother going to couple's therapy. You can't undo all of that no matter how good things got." [00:38:19]

THERAPIST: Yes, it's such a complicated question. I don't even know if you're looking for a concrete answer or not or if it's just something wondering to yourself.

CLIENT: No, I kind of looking for an answer if that is something that happens with couples and it's-I don't know.

THERAPIST: One of the things I'd say is some-Yes, there are couples who never reach the points you two have reached in how bad things have been, but that can be a little bit I don't know what the word is. I want to be careful taking it at face value, so here are a couple things. There are some people who have had healthy backgrounds and it's relatively benign with the ordinary fights and things that come up, right? [00:39:15]

There are couples where they stay in a complementary, very unhealthy relationship for the entire duration of their marriage. In other words, the woman, for example, who's a doormat and the man who's constantly having his way and using her or vice versa. Right? That kind of complementarity. For some people, they never break out of it. So the woman never comes-or the man would never come and say, "You know what, I'm tired of this. I realize I'm getting suppressed as a person and I can't stand this anymore. That's when the big blowup would happen that could last years and get them into couple's therapy. Some people never do enough individual work to break out of an unhealthy pattern. So it looks like they're not fighting but it doesn't mean the problem isn't there. It's just that they live with the problem for ever. [00:40:08]

You and Ivan have been, in many ways, doing a brave thing of actually starting to grow as people and say, "I'm changing. I'm knowing more about myself. I'm knowing more about what was happening years ago, what I've pushed out of my mind and am now starting to let in." And that does create tremendous turbulence in relationships when that starts to happen. I don't think that necessarily means it's insurmountable.

Another layer to add for you-I don't know a ton about Ivan's history, the details of his family history and what really happened and all the exchanges. I do know about yours and I know that there's been a tremendous amount of trauma and when there is for people, they bring what happens to them inside the trauma in their family to their marriage. [00:41:08]

That's what you have inside you-what you thought about yourself as a result of not mattering in your family in so many different ways. You carried around with you, "I don't matter." So that was going to play out in your marriage and is a pretty big thing to change, so it's going to look even more turbulent in a way when there's a trauma history when you actually really start working on it. It's a lot of work. That, again, doesn't mean insurmountable. Some people aren't up for the task, right? And you start to realize it's just too much. Some people are. Some people realize once they do all the work on their family and their sense of themselves that, "I married this person for the wrong reasons. I was marrying this person for old, neurotic or traumatized reasons. When I feel better about myself, I'd rather be with somebody else." And that's when people part ways and it could even be amicably, that both parties feel that way. "We connected for unhealthy reasons rather than healthy ones." [00:42:13]

It could be that you get to work through your stuff and you find that now we get to know who we are as actual people rather than our unhealthy stuff, there's a lot of healthy connectedness that's there, that's potential in us, that we knew of, maybe, as potential but that never go to fully be and that now that we're-You're both working on it. This is the best-case scenario in some ways. You're both in individual therapy. You're in couple's therapy. There's a lot of work happening simultaneously. If it were just you and he weren't, that's harder or vice versa.

CLIENT: You had said before, if I understood correctly, that sometimes couples find out that the reason that they originally got married was because they met needs, that they-for wrong reasons or for (pause)-and that they choose to stay together and that they can have a healthy relationship. Because sometimes I do wonder that Ivan and I in each of our places not that we didn't love each other because I believe there was a substantial relationship before we got married-but that-what if those needs change and what the reasons for initially marrying-what if our situation changes? I don't know. Is that possible? Would that be a good thing? [00:43:28]

THERAPIST: Yeah, I mean, again, one of the things I'd say about ordinary healthy marriage is that people, if they're healthy, develop until the day they die, right? There is, at every phase of life, every decade, new changes, new growth, new understandings about the world, new understandings about oneself, new relationships, children, right? Or new jobs or-So you are going to keep developing whether you like it or not and Ivan is too. To the degree-I guess one of the things I'm trying to say is that in health, marriage I think is about continuously re-finding new levels of relatedness, right? [00:44:17]

So people start to develop like this and then you say, "Wait. How can we-Can we bring these together? How do we find new ways in which we connect given that we've grown a little bit like this?" And that's, I think, the turning point for people about whether can they find some new contact because you're both more emotionally prepared for something or does it feel like-It really feels like that-It starts to solidify that you're on very different wavelengths and paths. So, again, I don't think that just because development and change is happening in a person, it doesn't necessarily mean that you're not going to be able to work-bring it to the marriage and actually have it work out in the marriage. It might, but it doesn't necessarily have to mean that because I think even when marriage is going as well as it possibly can, it involves growing apart, finding each other, growing some apart, finding each other as people develop. Does that make sense? [00:45:18]

CLIENT: It does. I guess what I sometimes fear since we've been married for such a relatively short period of time compared-we're young, too. And when we've been in couple's therapy for a significant amount of time, is that a really good thing because we are addressing things early on and we're really putting in the work? Is that a good thing or, I secretly often feel like that we shouldn't have any problems or we shouldn't be in couple's therapy until we've been married for like ten years. Most people have problems over a long period of time because they have all this other stuff and they have homes and children and-That's where I wonder, "Oh my gosh, is there hope?" [00:46:01]

THERAPIST: What does that mean? Yeah. This is where I'm not sure there's going to be a concrete answer to tell you, like the stamp of, "Yes, this means your marriage in doomed or no, it doesn't." People do this at different in different ways. Some people It's actually not uncommon for people to say the first year of marriage is the most horrible year of the entire marriage. Probably in about a third of marriages that's what happens, right?

CLIENT: And I felt ok about that especially given the fact that we both made tons of life changes that year and then, on top of which, Ivan finally-I shouldn't say finally-he started getting help for his ADHD and his depression and I started getting help again. And so, in a lot of ways it makes sense that the first year was rough and that that's the case for a lot of people, especially if they move and start a new school, a new job, new everything (laughing) and that, in the second year, we've tackled a lot of big things. [00:46:59]

THERAPIST: So then I hear you looking for what is the outside norm a little bit -

CLIENT: Yeah.

THERAPIST: kind of to tell you whether this is ok enough or not. I think, Ramona, our task is to help you, over time, figure out for yourself, is this good enough or not? Is this working for you or not? And, for Ivan, the same thing Is it working for him? And I could care less, in a way, what works for other people. What matters is what works for you. It matters a lot if you are feeling like you're letting yourself back into something that really isn't good for you. That matters, even if, for someone else, it would be. If someone else thinks it definitely wouldn't be but you're feeling like, "No, this is working. I'm thrilled. This marriage is now better than it would have been had we never gone through all of this." That's what matters. Your experience of, "Do I feel comfortable, loved, safe, happy enough?" [00:48:04]

I think the key is the enough word because there's no perfect, but is it good enough? And holding that question in mind for yourself and for what's good enough for you, we're going to be keeping on keeping in mind when "good enough" for you has been really quite low. That's where you started so the concern will be how do we continue to work on your sense of what is ok enough for you, what is the set of compromises that feel good enough, what's the set that really isn't that's going to make you unhappy for a long time. And I think that's what you're saying. You're holding in mind, "Ok, today felt good enough. Tomorrow and then the next day feels good enough." But there's a lot more that you're still feeling now about it is the past and understanding with him going to feel like it's good enough for you to feel like you can safely move forward in the relationship or not. [00:49:06]

Or, once you kind of get used to being taken care of, do you feel like even the contact you have with each other is good enough, like the conversation, the what draws your minds to each other. It's a whole other level of question. So, I think you just keep asking that of yourself. "Is this good enough? Is this good enough? What's missing?"

And, stop. It's so good to see you.

CLIENT: Thanks again for letting me-

THERAPIST: Well, we'll keep on being in touch.

CLIENT: (coughing) Excuse me. So Tuesday I should plan on a phone session?

THERAPIST: Yes, let's do that for now and then-Did you say Monday also at 11:40 might be possible?

CLIENT: It might. It's just hard being that I'm taking an early lunch. I'm just trying-I don't know. I'm still very much the new person and it looks like it's ok but I'm just trying to take a relatively normal lunch hour right now. But I have been told I could take a late lunch as long as it doesn't interfere with any meetings.

THERAPIST: Ok, because that's another one that might be one of the ones that would open up sooner rather than later-that, in addition to the Wednesday at 12:10 are the two that could be-

CLIENT: Yeah, definitely let me know because I could ask my boss if I could take a long lunch instead of coming in early or leaving later one day. I don't see the difference. I think as long as I've been there for eight hours-

THERAPIST: as long as you're not missing a meeting or something like that. Ok.

CLIENT: Thank you.

THERAPIST: Talk to you soon.

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