TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: It�s nice being back pretty soon actually.

THERAPIST: It will be a little easier to continue (inaudible at 00:17)

CLIENT: Yeah, and I realized Monday I really missed it.

THERAPIST: That�s new for you to say.

CLIENT: It is. I think it�s probably good, because in the beginning I think you tried to tell me I didn�t necessarily trust it or want to rely on you or feel safe about doing that. So that�s probably progress for me.

THERAPIST: I think so. It�s like, you know, maybe a little bit of development of being able to rely on someone some when you�ve had so little space to do that in minimum ways as a child. You had to become so self-sufficient, Ramona. [1:09] Take care of everything on your own. Fight to take care of everything on your own while everyone else around you wasn�t doing their job. I know we left off in a hard place. A lot of feelings. I certainly can guess about a lot of the feelings. I�m still so curious to hear from you, you know, what exactly about the items you rattled off. What hits you? How do you take them?

CLIENT: Right. Well, Ivan and I actually talked about those specific items just a little bit over the weekend in a way that was safe and productive. So we can get to that in a minute. I guess they�re all related, but different ones strike me in different ways. [2:16] So for example, the wants to have children one, that one is, you know, obviously very deeply, hurtful, painful. On a different level, because it�s not a superficial like a � It�s not one of the ones that is, you know, something that Ivan is genuinely bothered about by me, but, you know, posed in a really cruel way. It�s not one of the ones that�s just like � A couple of them are just really petty and childish. Just like, for the heck of it. It�s one that says � That one, I think, is more hurtful in some ways because it�s, depending on what you take from it, it�s indicative of being more mature and more serious about a future relationship.

THERAPIST: Oh, I see.

CLIENT: So someone who�s just like, super furious at their spouse and tears them apart not matter � I mean, very unhealthy in like, especially the way he went about it. But that�s different from like, boy in a future partner, it�s really important that we have children. [3:25]

THERAPIST: So there�s something I still don�t understand about that one through you. Do you want to have children?

CLIENT: Yeah. So that�s the kind of bizarre thing.

THERAPIST: That�s what I thought.

CLIENT: I mean, we hadn�t talked about it seriously. It wasn�t one of the reasons we got married at all, and it was understood that it was way, way, way down the road. But we had never � Ivan, we both expressed some desire that that�s something in the future. So that�s weird. And Ivan has told me, he�s like, yeah, whenever I got to that point on the list I would just like, it would � I don�t know how he worded it, but he would get so upset and so sad, because he�s like, I only ever want to touch whenever I�m with you. And it feels � I don�t know whether or not to take that in, because it feels like � I don�t know what it�s doing on that list.

THERAPIST: And that�s why � I read it over right before you and I had even met as a kind of third-party reading list. I guess I didn�t find that one hurtful at all, �cause it seemed to me he was describing you.

CLIENT: That�s part of my problem with wrapping my head around the list. Because he�s like, some of it, I just wanted to remind myself how fortunate I was and how glad I � It was self-punishing, is how he describes it. But then, when he says, I�d get to that and it would just, you know, I would just stop, because I only ever want to have children with you. So is it about someone else? Is it about reminding himself that he likes this about me? Is it kind of punishing in that he�s like, hurting me, but also � It�s very bizarre and I don�t know how to take it. [5:16]

THERAPIST: Can I � I can�t know either what�s exactly in his head. It felt like � You know when I say it felt like describing a Barbie doll. It felt like he was thinking about what is the perfect woman. And in his mind, a perfect woman would want to have children. And in that regard, it feels like you fit the bill. In his fantasy of a perfect woman, also wouldn�t get frustrated and think of how many people is a large family gathering. In his mind, you don�t fit the bill. Right? Totally unfair and idealizing again, as though the perfect woman would not ever get frustrated with anything. Right? Again, that person doesn�t exist. [6:04]

CLIENT: Which I hear you, but at the same time, when that one creeps in, I think maybe he does with he, you know, was with someone who also came from a super loud, large, in each other�s business family and they had no problem with it. That person would exist.

THERAPIST: And yet that person would not have something else. Do you know what I mean? That�s what I�m saying. I

CLIENT: No, I�m not defending. It�s hard, �cause I actually thought one of the things Ivan liked about me was that he liked that I�m private and I�m more quiet and reserved and I�m not � and he � I�ve noticed when he�s with me, he tends to be more like that when he�s with his family. All of a sudden, he is yelling at the top of his lungs at the table, just like everyone else.

THERAPIST: Really?

CLIENT: Yes. Like where they sit down to play a game and he�s just as loud and like, he doesn�t ever do the noisy thing, I think. I say noisy in that they�re very public about very private things. And extended family�s really private things. [7:03]

THERAPIST: It�s so common in couples therapy that the very thing that you love could almost identify as the reason why I married this person is that thing that starts to frustrate you however many years into the relationship sometimes. For the first year, sometimes it takes ten years to get into the relationship. But you could find each other because of the way you complement. He wanted to have something quieter. You wanted maybe to have something that could get louder in some ways. But then, when you actually had that � a lot of that � you also can get annoyed at it, right? He could get annoyed at things being quiet and if they�re too quiet.

So all that fits in the range of ordinary things people would get frustrated with each other about and then both want and also reject at the same time in each other. It didn�t strike as him being so specific about I want to have kids with this � like another woman at that point. It just felt like that�s on his list of things that would make an ideal person. And in fact, that�s a place where you guys have common ground. [8:17] Unless there�s something � I thought maybe Ramona has told him she didn�t want to have kids or something like that.

CLIENT: So that�s been � The only thing I know about that is that there have been times when Ivan has kind of � So, I mean, his parents had told my sister before we got married that we didn�t need to wait very long after we got married to have children which, needless to say, it put me through the roof. None of their business. I really don�t like � It�s so inappropriate. Anyway, so that drives me insane. But then, Ivan had � I had said oh, you know, maybe in I don�t know eight or ten years, you know, like a while. And I think he would be willing to think about it sooner, but not dramatically sooner. So I don�t know that there was any huge discrepancy.

THERAPIST: It doesn�t sound like it.

CLIENT: No, I don�t think so.

THERAPIST: You never said I think I might not want to have kids.

CLIENT: No, which would be different.

THERAPIST: It�s very different from I want to wait for a while.

CLIENT: And the only thing I know since the list and the Web sites and such is that I�ve kind of told Ivan I�m willing to keep trying and keep working on this then, see what happens for a while. Bu I, right now, don�t feel comfortable to, you know, mentally or emotionally committing to yes, I will have children with you, yes, I will stay with you for the rest of my life, yes we will have a home together. Like, a real house or � You know, I just � I can�t go from finding a list to that and going back to that [9:37] And so I�ve been up front about that, which I�m sure is hurtful for him. But he would � I would hope he would think I�m crazy if it was anything different. But that�s after the list, so I don�t -

THERAPIST: That�s after the list. You didn�t say � Yeah. It just didn�t feel personal at that point.

CLIENT: But there are things on there that � like, one of them literally is, plays musical instruments. I have learned to play like, five musical instruments. So I guess that�s okay. I guess he likes that. That�s all right.

[Laughter]

THERAPIST: And he loves that you want to have children.

CLIENT: But that�s why it doesn�t make any � He didn�t sit down and say boy, I need to remind myself, I really love these things about my wife, even though I really get angry about these things. And in the meantime, I feel not so great about being a seminary dropout was one of the things on the list. [10:37] You know, like � it just was very different. And it�s hard to � I think that�s one of the reasons it�s so hard to take in the list or so hard to talk about it. Because he really will point to � if we talk about different things on it that you have completely different motives and meanings. And how do you believe that.

THERAPIST: That�s why I keep returning to the feeling that it�s a list of an ideal person. And that ideal person actually includes a lot of you. There are a lot of things that describe you that it sounds to me like he�s � like, he�s talking about what would be a perfect person to him, a perfect woman. And you fit the bill. And, the way he attacks you and maybe is dealing with having felt attacked for the way he�s imperfect is to like, talk about the particular things he might consider in his mind, your flaws or things that irritate him. Do you know what I mean? Whereas, his own description of himself is very � it�s flawed, actually. [11:41] It�s not a perfect description, but he says it as though this should be good enough. And now, I�m going to describe the ideal woman, which is a kind of way of attacking you in some respects, but not all. This is the part � the not all could be the part about attacking himself, still, because he�s describing so much of who you are. It�s why, when I hit on something like sexy, as I�m reading it, I didn�t� know whether to take that as he thought you were or were not sexy.

CLIENT: that was a little � like, hurtful, too. Because, Ivan has told me that. He�s like, oh, I think you�re so sexy. And it�s nice to hear, but I always act and I am kind of like, embarrassed when he says it or I�m like � or I�ll like, roll my eyes, you know, if he says I look nice when I�m wearing like, my pj�s and I have my hair up. [12:33] But � so that one, I don�t know.

THERAPIST: Why roll your eyes?

CLIENT: I think I feel uncomfortable hearing really positive � I just feel uncomfortable with it.

THERAPIST: Hearing positive things about you?

CLIENT: Yeah. I think to a large extent I do. Or, I feel like it�s not true or it�s said out of niceness or obligation. Or, I grew up not hearing, you know, that my parents were proud of me very often. And I�m not like � But that was their � It wasn�t that they weren�t They just said that they didn�t � I think � If I could step back, they didn�t want to be like Ivan�s parents. Over the moon proud, over everyday normal things. Or, acting like Ivan was a rocket scientist when he�s fine. You know, there�s nothing embarrassing about him being a normal student in college. You know, so I think that was the �

THERAPIST: But they err in such an opposite direction. Do you know that?

CLIENT: I think it can be � it can feel a little extreme. But either way, I think calling it I feel uncomfortable around.

THERAPIST: And of course you feel uncomfortable now, because it�s not built into the fabric of how relationships work. That people recognize really positive parts of you. They see them, love them, admire them, speak about that, talk to you about them, applaud them in front of you. [14:02] That�s not what your parents did, so it feels really, really uncomfortable. I mean, this is the funny part about the list is that there are ways to me, I have to say to you. As much of what�s on that list is admiring you as criticizing you. Do you know what I mean? I mean, there are some that are clearly criticisms that would not � the family, you know. Right? So that�s clearly a criticism. But then, these other ways it feels like he�s actually describing what he loves about you. And I think it�s just as uncomfortable for you to hear compliments as it is for you to hear and think about what you feel like is inadequate about yourself.

CLIENT: I think that�s very true, but I think another part of it is, it�s hard to stomach both. Like, it�s hard to believe that someone who thinks that I�m just like, I don�t know, that a more ideal person would be more at home like, in a really big family gathering. Like, to hear that in the same sentence as oh, I really think you�re sexy. It�s hard to stomach both. It�s also really hard � and this is something I think growing up with was very clear for me. It�s hard to hear from someone that they love you or you�re really important to them, and their actions will not show that. [15:13] If Ivan really thinks that I have all these great qualities and, you know, he�s really � that he�s trying to remind himself how fortunate he is, why won�t he be honest with me? Why doesn�t he respect me? Why doesn�t he hold up his end of the bargain?

You know, if you felt that you were with someone like that, wouldn�t you want � It�s just really � It�s really hard. And sometimes, even when Ivan says he loves me, it�s really hard, since the lists and the Web sites and stuff, it�s really hard to say it back. And I�m not sure that it�s that I don�t feel it. It�s just like it feels like a slap in the face. It feels like � It feels like my dad telling me how important I am to him when he�s never home. You know like, that�s � It feels like the same thing. And it�s like, in some ways almost crueler than just being upfront and saying, no, you�re not very important and I�m not home, and that�s how it is and we shouldn�t bond. [16:10]

THERAPIST: I understand. I mean, so it�s left you in your devilment with this feeling when someone says something positive to you, they probably don�t really mean it. Like, words become not that important.

CLIENT: Or, if they do mean it, they�re not going to back it up, so really, what�s the point.

THERAPIST: This is you saying to Ivan, don�t worry about it. You don�t need to plan anything. It�s fine. We don�t need to go on a picnic, you know. Or, rolling your eyes when he says you look pretty in your pajamas and your hair up. Like, that�s that kind of protective mechanism. Like, you don�t really mean that. And don�t worry, I�m not going to take your compliment and run. Because the alternative is that you go, really? You think so? And you feel it. And then, if he actions bear out again, this feeling that he doesn�t think so � you�re devastated.

CLIENT: It feels worse. It�s also hard for me on a level to think that about myself. I think it�s hard to take in a compliment if you can�t see any truth in it.

THERAPIST: Well, especially if you haven�t been told that by your own parents. [17:09] Like, did they say to you things like, you�re pretty or you look so beautiful in that dress?

CLIENT: I think that was hard for them in some ways. I actually � I don�t know what brought it up, but the other day, I was thinking back on this time in church and this is going to sound really bizarre. But I mean, Emma and I � I don�t know. We always � we dressed nicely. My parents always made sure we had nice clothes. We had like, restrictions on when we could start makeup and stuff like that. But there was a girl in our church who was � she was incredibly nice. She was so sweet. She came from a really sweet family. They were all so sweet. And I remember my mom talking to her mom when I was around. And she just said how her daughter had so much inner beauty. And the woman�s daughter, not us.

And she�s like, I think sometimes my girls get caught up in � or what did she say like � something I don�t know. Something to the effect of how we weren�t as developed in that way. [18:12] And this other woman�s daughter was really, really overweight. But that doesn�t mean she was completely unattractive, but I just � and she � It was clear she didn�t really care about her appearance very much, which is fine. But I remember feeling so lousy because I think Emma and I were honest and respectful and we were going to church with our parents and not putting up a fuss about it. And I remember thinking I shouldn�t have to feel like I don�t have that type of � because �

THERAPIST: That you don�t have � I think I�m not following. That you didn�t have �

CLIENT: That we weren�t as equally beautiful on the inside as it were, because we didn�t� struggle with the same things that her daughter was. Because I mean, Emma had braces. I had tons of acne. Like, we had our own issues, but it just felt bad. [19:03]

THERAPIST: Like, it didn�t somehow feel that she was saying her daughter has this inner beauty, but you don�t?

CLIENT: Yeah. Just like she wished that we � that her own daughters were more like that or whatever.

THERAPIST: Your mother said this.

CLIENT: Yes. Just something like oh, I wish my daughters were more � I think sometimes they, I don�t know if she used the word superficial. But, you know, that we weren�t as � which I thought was really unfair.

THERAPIST: Into appearance in some ways?

CLIENT: Yeah. But I thought it was such an extreme. Because it was clear � I mean, this other girl never dated, just was not interested in boys, not interested in personal � Like, not even as much as basic hygiene or, you know, staying fit or � And there�s a difference, obviously.

THERAPIST: And so, do you remember � So your mother said, I wish my daughters were more like that about this _

CLIENT: Just � She said something like she wished that we would � I don�t know. That we sometimes forget or we think that that�s � I can�t remember how she put it. [20:08] But I remember it was always � I don�t know. That stuck with me and that was when I was still in high school.

THERAPIST: That�s so, so hurtful and so sad.

CLIENT: It�s okay. I mean, I just remember thinking like, I never looked down at this other girl, because she � because she was really overweight or because she didn�t really care about her appearance. And she was really nice. She was very beautiful on the inside. But I just with that, because Emma and I had different issues like acne and braces, I wish that we weren�t looked down by our mom.

THERAPIST: That�s the point, Ramona, is that there�s a way of loving your inner beauty and not having to criticize your appearance or criticize you for valuing what you put on your body. [21:04] Do you know what I mean? There�s a way of upholding both. Being proud of lots of different parts of you.

CLIENT: It�s okay. I just �

THERAPIST: It�s not okay. It�s not okay.

CLIENT: I mean, I�m over it.

THERAPIST: No, you�re not. So this is why we�re talking about it today. These kinds of things get inside in your heart, in your sense of your self-concept and they�re exactly why, when you read this list now, it hits so many nerves. If you were over it, the list would be like, oh, what is Ivan doing with all this stuff? Like, what�s his problem. It has nothing to do with you or very little to do with you. To do with you in a way that�s like okay, yeah, you�re annoyed at me, because I get annoyed at your family functions. We can talk about that in couples therapy. I�m not perfect and someone else would be annoyed at something else. It would not be a big deal. But these hit nerves that were made raw as a child because of what was missing, you know, with the neglect of someone just admiring, actually admiring your physical appearance. I know that in the way your mom was talking about it starts to sound like it�s shallow. But you can fall for an entire person including what you see, what you feel for him. It�s like, they weren�t in love with you. Really in love with you. [22:09]

CLIENT: Again, it�s so hard, because my parents have always, you know. In fact, my mom, how many times � The one thing your father and I have always agreed on is how much we love both of you. Which is like a double �

THERAPIST: What does that mean if you�re never home or don�t come out of your bedroom.

CLIENT: A double-edged sword. �Cause it�s like �

THERAPIST: They�re words. They start becoming words, Ramona. They�re just words. And kids see through that.

CLIENT: I think it was more � I mean, my mom was very, very tough and critical, and I don�t think she � I don�t think it ever even occurred to her most of the time that she was. I think it still doesn�t most of the time. She says that no, her parents didn�t tell her that they were proud and that they, you know, they had very strict rules. And in fact, evidently my grandmother would sometimes tell her that she wasn�t strict enough with us which I was like � you kidding? But just little things like her telling me how much she weighed when she graduated high school. Or the time Emma like, she was � Emma was in all the musicals. Emma is incredibly musically talented. And this one guy remarked how like, teeny or like, tiny she was when he lifted her like, for this dance scene or whatever. And my mom made fun of her, because she felt flattered. You know, she felt flattered.

THERAPIST: Oh, my goodness. Your mother made fun of her for feeling flattered.

CLIENT: Yeah. She had mocked her a little bit. And it�s not like Emma then started, you know, not eating, because this boy said she was so petite. She was just flattered. For that reason Emma will never talk about anything dating remotely with my parents, I think. [24:04]

THERAPIST: You know what you�re starting to articulate that I don�t think I�ve ever heard or understood in quite this way before. But your mother, when she�s telling you her own weight when she graduated from high school, she�s putting her parents up on a pedestal and then, attacks the two of you if you do that at all. Do you see what I mean?

CLIENT: I don�t think she � I don�t think she means to, though.

THERAPIST: I�m not saying it�s conscious. I don�t think it�s � It�s completely unconscious. But it�s almost slightly competitive with you.

CLIENT: No. I mean, yeah, it can be. When I got married she spent the whole time we went looking for dresses looking at mother of the bride dresses, she got like, seven dresses.

THERAPIST: Wow.

CLIENT: That was tough, yeah. Just � But I don�t think it�s ever � So my mom would never � I have never heard my mom say that she thinks like, that she looks beautiful, which I don�t know if that�s a normal thing, if moms would normally do that ever, if they would ever look in the mirror and say, boy, I look nice or, you know. But I�ve never heard her say that. She like, won�t take photos. The vast majority of the time, she won�t get in a photo, �cause she�s like, I hate the way I look. I�m such a fat slob. Like, she�ll say things like that about herself. [25:24] And so �

THERAPIST: She�s full of self-loathing.

CLIENT: My mom suffered with depression for I think the majority of my life.

THERAPIST: That�s not just depression. In other words, not just the diagnosis of actual real self-hatred and puts herself down and models that then through you, too. Like, this is how to feel towards yourself. And then, plays it out a little bit with you and Emma. You know, like you both get a little demeaned if you start to feel proud of something in your appearance. That gets knocked down pretty quickly instead of her saying something like, you know what, I�ve suffered my whole life feeling bad about myself, but I so hope you guys don�t. I think you�re beautiful people in and out. And I think you look great in that dress. Good for you. Or, I�m so glad, that�s such a nice compliment he said that to you. You know? That just like allows you to have feeling beautiful or feeling admirable. Feeling lovable. Feeling beautiful on the inside. Whatever the compliment may be. It got sort of knocked down, because she in some ways can�t tolerate the two of you growing past that either. [26:50]

CLIENT: It�s a little weird, because lately, she � she�s told us how she�ll like tell, like when she goes for her doctor�s appointment, she�s like, I give them updates on your girls. That�s so embarrassing. Don�t do that, Mom. Or, when she went to visit my great and uncle and her cousins and such, because this one aunt was a super close sister of my grandmother�s. She�s like, and I told them all about you and what�s going on with you. And of course, they always ask, which is true. They�re always sweet like that. [27:27] But she�s like, yeah, I was bragging. And this is bizarre for my mother. It was very bizarre for her.

THERAPIST: New.

CLIENT: It�s so new. My jaw almost dropped, actually, �cause we were talking about my one second cousin. She just had � they just had another child, a new baby boy. And they did photo shoots and they made a fuss because they have two girls and now they have a boy. And my mom�s like, oh, they make such a fuss. She�s like, he�s not half as cute as you girls were. And my jaw almost dropped, because this is like, my mom would never, ever, ever like, say anything like that. That was a pretty big deal.

THERAPIST: She�s changing.

CLIENT: I mean, maybe. It�s just � But then, I still � I don�t know. I think Emma and I feel the same way.

THERAPIST: Of course. You can�t just start saying that when you�re � how old are you?

CLIENT: Twenty-five.

THERAPIST: It doesn�t undo what was missing for 24 years. And it can even make you suspicious right now like, why is she saying that? What does it mean? Where is it coming from?

CLIENT: Yeah. My sister. Somehow it came up over the weekend. Her title changed at work. She�s now clinical director of consulting and I was like wow, Emma, that�s awesome. And she was like, embarrassed. She�s like oh, no. I didn�t change my business cards or anything. She�s like, it�s not a big deal. [28:51]

THERAPIST: That�s so sad both of you. It�s hard to have goodness and hard to have that recognized by people. It reminded me of your getting your job. And it was more just sort of like more just okay, thank goodness there�s the relief of the anxiety. But there�s certainly nothing good about this. It was so hard to really be proud and celebratory. Or for you even now to look back on your accomplishments in your life and be thrilled at what you�ve done instead of be focused on what you haven�t done or what�s to be done next or, you know, the endless list of things that show you haven�t reached a point of adequacy yet. [29:41] It�s so hard to take in what you�ve done and be proud of it. It�s not an internalized a parent who�s really proud of you and showing you. And boy, does this flesh out more understanding about what this list triggers in you, Ramona. This is so, so vulnerable. It�s almost like there are compliments, there are little criticisms, and yet inside you, even compliments you�re ready to get taken away. They can�t be real.

CLIENT: Another one in that group of items was comfortable with her own body. [30:40] And that really struck a nerve in me, because that�s something that Ivan actually has articulated to me.

THERAPIST: Meaning, wishing you were more comfortable?

CLIENT: And that�s been really hard to take in.

THERAPIST: He said that to you even before the list? Do you know what he means when he says that?

CLIENT: I mean, we talked about it a little bit over the weekend, and that actually was helpful. But I told him part of my problem with even reading that was � So I, you know, I do have trouble being comfortable, not just with sex with my own body or, you know, I have trouble being comfortable in a swimsuit. I have trouble being comfortable if I�m sitting on the couch and watching a movie. Like, what am I doing? I just have trouble being comfortable with things like that. Just relaxing or enjoying. [31:55] That was always a hard kind of � that was kind of a trigger with me and Ivan, because when we got married I had never had sex. And for me, it was excruciatingly painful, �cause actually it has never not been. But anyway, it was hard that �

THERAPIST: It�s never not been.

CLIENT: And so it�s hard, because that was like � so the reason I was so uncomfortable was because it was so new and so foreign and so previously filled with guilt, shame, forbidden, you know. And that�s not just a switch you turn off or on. And that was hard, because I was looking � or I was expecting or, I don� know, that Ivan would be more supportive and more patient and more like, of course you�re not comfortable with this. It�s really weird for both of us. And sometimes I would hear him say � and sometimes I will say, Ivan has said a lot of times you have no reason to feel self-conscious, you are beautiful. You shouldn�t hide. You have nothing to feel embarrassed about. I don�t know. It doesn�t change it for me.

THERAPIST: It�s so ingrained. It�s not going to change by him saying that once or twice. [33:10]

CLIENT: I mean, it�s nice to hear that, but it�s really hard to feel comfortable with it. It�s even hard if I try to feel comfortable with it. Like, the times when we have had sex, the next day or transitioning into the next activity or whatever, not feeling weird or uncomfortable or ashamed or dirty or, you know, wrong. And it was interesting, because over the weekend, we talked about it a little bit and I said that I � that I also felt a little like, he had nerve to say that to me. Because I was like you have � I feel like you have never been self-conscious about your body or about anything related to sex. And of course, it�s never been uncomfortable for you. And �

THERAPIST: Never � you mean literally hasn�t or were you being sarcastic?

CLIENT: No, no, no. Truly. It�s clearly not been painful for him. And sometimes I was like, I wondered, because there have been times when Ivan�s � his hygiene or his grooming has been less than amazing or like, he really habit � like, he really is very overweight and really � And I was like, I feel like you � that�s you�re never self-conscious. And he�s like, actually, I�m always self-conscious. He�s like, whenever we have � he�s like I�m very � I�m very embarrassed and self-conscious. Then, I was shocked, because Ivan has never articulated this. Ivan has never been reluctant about anything as the result. [34:43] And then I wondered if he �

THERAPIST: (inaudible at 34:44) saying that?

CLIENT: Yeah. So then I wondered if the comment came from truth and that he really wishes I was more comfortable. But also, in that he doesn�t like that about himself.

THERAPIST: Which in a way, stops being a kind of critical attack, but as something in health, if you were coming into a couples therapy. You might both want more. You could say, yeah, we�re really uncomfortable. We�re self-conscious about our bodies and it inhibits our capacity for physical intimacy. And we want to work on it. That doesn�t have to be just a scathing attack. Do you know what I mean? [35:21] Even if there�s something true about it. You�re acknowledging I am uncomfortable in my body. I think he�s right about that. And he�s trying to say to you look, I am, too. It may override, you know, some physical desire may override it sometimes. But it sounds like he also has a lot of other anxieties about himself he carries around all the time. So you know, one of the things that makes me wonder like, even before you get to sex, that�s the loudest example possible. But even just your body in a bathing suit or your body sitting on a couch even fully clothed, relaxing. It�s like, it�s hard pleasurable experiences of your body are really foreign.

You know, even that you start with saying even sitting on a couch, watching a movie could feel like awkward or stiff or I don�t know what to do with my body. [36:18] That it�s hard � a starting point of describing it, it�s hard to just relax. Just relax. Relax in a bathing suit. Don�t worry about it. Enjoy it. Or watching a movie. Or letting your body literally, physically relax into the couch. Put your feet up, you know. Lounge back, put your head on his shoulder. You know, whatever it is. There�s been so much anxiety in your childhood. A kind of hyper-vigilant attention states. When you�re in a fight or flight kind of mechanism. It�s your body in a preparedness tension. There�s no room for like, pleasure. Relaxation. That only comes when things are okay and you know everything�s fine. You never knew everything was fine growing up.

CLIENT: It�s also like, I had the TV on yesterday. Ivan was called in to do an extra shift. And I felt better, �cause I got up and I like, did the dishes and I wiped down the counters. And the TV was still on. I was listening to it. But I felt so much better. Or, but the times when we have had sex, I am like, in my mind, almost thinking like, you know, I feel like I�ve wasted the evening or I�ve wasted the morning if I, you know, wasn�t up by a certain time or slept in the next morning as a result. Or like, you know, this isn�t okay.

THERAPIST: It�s like, any pleasure is a waste of time. [38:00] If that�s all it does is bring like good feelings. Wasteful. Not productive. That�s a painful way to be in life.

CLIENT: It�s more � I feel some amount of guilt or some amount of shame or some amount of need to say to Ivan when I got home like ah, I didn�t start working on the closet. You know, like just some kind of �

THERAPIST: Whereas, he might love it if you said, I didn�t work on the closet today. I decided to read a book instead or watch a movie.

CLIENT: That�s where I think we get � one of the things I loved about Ivan was that he would try to help me de-stress and show me that I didn�t have to � And then, we tipped the scales I think.

THERAPIST: It�s like you�re both really good at one side of it and you need to rub off a little on each other to come towards the center. But when the going gets tough, go back to these extremes. And you get frustrated with each other, understandably for it. Him, for getting frustrated with you for like, why can�t you relax a little and like, do something pleasurable. Stop and smell the roses. It�s not a waste of time, you know. I think, Ramona, though, part of what we�re identifying for you is that like, in trauma, overt trauma states, when you were waiting for dangerous things to happen all the time which you were in many ways. Like, the bills not getting paid or coming home to filth and feeling like you�re kind of drowning all the time in things not being taken care of. The responsibilities of not being followed through on. It�s when responsibilities get followed through on enough that people get to relax and have pleasure. Play a game. Have sex. Watch a movie. Whatever it is. That is like an ordinary adaptive, healthy part of existence alongside taking care of responsibilities.

Your parents did not take care of responsibilities. So it left you preoccupied, vigilantly, with trying to get things done. And in a state of pretty acute anxiety all the time. And I don�t know that your body yet knows it�s not the same. [40:20] You�re not in your family childhood. It�s not the same. Your place is a lot cleaner. You can let it go today and it will be okay. Nothing bed�s going to happen. You can clean it tomorrow. You can watch the movie tonight. It takes bodies a while to catch up to know literally in ourselves okay, I can relax. Like, you might want to try it one time when you�re sitting on the couch and you notice feeling stiff and awkward or uncomfortable.

Have you ever done progressive muscle relaxation before in CBT? Like, just try and see what happens if I just try to tell myself that it actually is okay to relax right now. Nothing bad is going to happen. So once you get on board with that, how to then let it go through your muscles to just see what it�s like to just start to melt into the couch a little more. Let it go a little more. [41:20] It also makes me wonder what it was like for you physically in your family. What kind of physical affection was there?

CLIENT: Yeah. When we were little, we were hugged all the time.

THERAPIST: By both of your parents?

CLIENT: Mostly I guess, my mom. And there was a time when we were really little when we would wait up for my dad and we�d like, run to the door and he would hug us. So yeah.

THERAPIST: And like snuggle, and read books and all that? Close, physical, relaxed contact?

CLIENT: That, maybe not so much.

THERAPIST: So when you say we were hugged and kissed all the time, do you mean like �

CLIENT: When we were little.

THERAPIST: Little? How old?

CLIENT: Maybe elementary mostly? And I remember getting a little older. I don�t know how � maybe end of elementary or like, middle school that I would go not tuck my mom in, but I would go and say good night to her. I would have this like, routine and I would always say, good night, God bless and I love you. And I would like, sometimes she�d be asleep, so I�d like, take off her glasses, �cause she always reads before bed, and turn off the light. [42:33] It�s not like, you know, it�s not like I was taking careI mean, I guess I was in a small way. But it�s not like, a big deal. And I was past the point I think, of being tucked in on my own.

THERAPIST: You�re tucking your mom in, though. Do you realize that?

CLIENT: Yeah. But I guess it didn�t� bother me. I think it was something I felt good about.

THERAPIST: You got tucked in when you were like, smaller?

CLIENT: I think so. I don�t really remember. I slept � Emma and I shared the same room like, in the same bed when we were pretty little. And then, she moved down to her room.

THERAPIST: How about being physical with her? Was that relaxing?

CLIENT: I guess we hugged sometimes. To this day, it�s really hard and awkward for Emma to hug. Even when my parents always kiss us on the cheek when they see us and when we leave, it�s awkward for her. Uncomfortable. Or, if I go to hug her after we hang out, I think it�s a little weird for her. [43:45]

THERAPIST: So she has it, too, in a way. This kind of �

CLIENT: She�s much more reserved physically than I am.

THERAPIST: Again, both speak to a kind of � what wasn�t there to make everything feel along these lines, normal and comfortable, you know. I was thinking about you in a bathing suit how complicated it becomes, because there�s the one side where you can be anxious about your body. Like, literally, does it look okay, or insecure about shape or size or, you know, things like that. There�s another side where it�s also in a way, anxious to feel good in your body. Like, what happened with your mother, you know, these comments we�re talking about where she�s kind of like, don�t feel too good about your body. I wish you focused more on your inner beauty. Those inhibit the feelings of pride or even like, I know this may be a strange word to say, but exhibitionism that is so normal in people.

Like, the idea of having joy and pleasure in being looked at. And like, feeling sexy or feeling vivacious or feeling someone�s eyes go to you is such an ordinary, pleasurable experience. You know, little kids. You can watch two or three year olds flaunting their dress-ups and this and that, and look at me, I�m beautiful. That�s where it�s really loud, this kind of look at me and I love it when you look at me that is so healthy to have. And it gets integrated slowly into the fabric of who a person is. But you and Emma saying that kind of, look at me, whatever version it took got kind of criticized. [45:50] So this leaves you damned if you do and damned if you don�t in a way. Like, there are even inhibitions about feeling good in a bathing suit. What is the feeling you�re having with like, this feels great. I love it if someone�s looking at me strutting down the beach or something. You know, that wasn�t allowed either. We�ve got to stop. I�m so glad we had these back-to-back and I�ll see you Monday. Ramona, are you around Memorial Day?

CLIENT: Geez, I haven�t even thought what date it is. It�s always Monday, but what date is it?

THERAPIST: The 26th, I think.

CLIENT: I�m sure we probably have off work.

THERAPIST: You probably might be here. �Cause I was not going to work, but I actually may be back in the office and I�m just � figured I�d check with you, �cause I know a lot of people travel also themselves.

CLIENT: No, I don�t think I was planning to go anywhere. But yeah, thank you.

THERAPIST: I�ll let you know as soon as I know for sure.

CLIENT: Okay.

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