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CLIENT: There�s actually something that I�ve been wanting to, I don�t know, ask about or talk about that I keep Every time I leave here I think, oh, I wanted to So a few weeks ago when Ivan made the fake business card, whatever and he talked about it in couples. I was kind of struck, and I just keep coming back it a little bit, Dr. Farrow response. And she talked about how young people in general sometimes cope with fantasy. And that as they get older, it�s less and less, although sometimes they�ll come back to it. That�s what she said. That it�s not like no one else does this at all. I don�t know if she said there are different degrees of it. But she said it happens. And she said that anyone in my shoes would She�s like, there are people who would say, I�m not dealing with this and who would leave. And then she said, there are people who would she used the word muddle. She said like, try to kind of muddle through and see where it went. And that it was interesting.

I don�t think she realized after that, she�s like, then there are people who would leave. [1:21] I don�t think she I don�t know if that was like a slip. Like, her way of saying, most people would leave, this is unacceptable. Or, if she was really just, you know what I mean, kind of lost her place. But it struck me and it felt very different. And of course, the opposite side being, muddle through. I don�t know if anyone wants to look at their marriage and say, oh, I muddle through. But it struck me. And I found myself saying in the session that, you and I had talked about, you know, with Ivan working on this, it won�t be you used the phrase, it won�t be a linear change. It won�t be perfect across the board. And that small things are to be expected and could maybe be tolerated even if they�re not okay. [2:05] Larger things happening again, maybe not. But that I couldn�t expect it to happen overnight. And so I said that I didn�t know whether or not to interpret it as one of the little blips in his progress or if it was just proof that it was very much still there and maybe never going away. But I just keep coming back to her comment and thinking about it.

THERAPIST: Thinking what? I wonder what you made of that.

CLIENT: Well, it sounds a bit I guess I feel a tiny bit judged. Or I feel I think you and I have talked a little bit about my feeling or being aware of so if Ivan does this, how do I feel about myself for being someone who does that or what does that say about me. And if I�m someone who chooses to muddle through, that doesn�t feel very good, obviously. It also doesn�t paint a picture of, this could change. [3:04] It�s like, muddling through is just getting by.

THERAPIST: It�s funny, �cause I wonder if, when you hear some of these ways of reflecting back from Dr. Farrow that it gives a kind of vehicle for you to kind of project onto her some of what your own anxieties are about this.

CLIENT: Yeah.

THERAPIST: Because you�ve been upset when it feels like she doesn�t validate enough how bad things are, that she doesn�t get it. And if only she got it, she would tell you to leave him kind of thing. Do you know what I mean? That she clearly doesn�t understand it. And you�ve also had times like this where you feel upset that in some ways, she�s saying, it�s so bad, you should leave and what�s wrong with you that haven�t left yet. Do you know what I mean? And so the fact that, I mean, it feels like she can get it wrong in either perspective. I wonder if it starts to kind of show what plays out inside you about how you�re trying to get the right answer and are so judgmental of yourself for the expression, muddling through. I for example, don�t feel judgmental at all of somebody muddling through. [4:39] It�s an admirable pathway in times of struggle and uncertainty. It can be an admirable pathway to decide you�re not wanting to do that anymore. So I just wonder what maybe it�s some of your voice coming in to criticize what muddling through means. And what does that mean in your own head for yourself, you know?

CLIENT: Yeah. I can�t hear words without my own It would feel different to me than, I�m sure, to someone else. I don�t know. When I hear muddling through, I just keep coming back to settling and just scraping by and just tolerating it. Putting up with it. Being a doormat. Staying married for the sake of saying you�re staying married or like, just so you know, someone would leave, someone would muddle through, someone would hint. You know, it feels very And I�m not saying, again, she might have I don�t know what she�s really saying, but again, the coincidence of leave/stay/leave sounds it�s weighted. [6:00] And sometimes I do worry or wonder if someone who, for a living, sees all kinds of couples with all kinds of problems thinks geez, you know, take a hint, this hasn�t been working. What does that say? And I don�t know. I can�t quite figure out if things like the business card or things like Ivan�s making so much progress. Ivan is continuing to make progress. But, you know, what if what if it comes up again and again and again. What if it does get worse again? I can�t predict. There are no guarantees in marriage, which I don�t like.

THERAPIST: What if I sort of don�t know how to put this. She�s working on it as a defensive style, I think. And I think he�s becoming more aware of it, just as you�re becoming more aware of how attacking you could be of other people when anxious because of deep inside, how much you�re attacking yourself. And that both realms of attack are self-protected against actually feeling unlovable and not enough and all those kind of insecure feelings from your childhood. So you guys are both working on this?

What if one way of putting it is, what if when the going gets tough under stress, he resorts to some of this even 20 years from now? [7:34] Because that�s actually what people do. Just as my hope is for you, this gets better and better and better. But under times of stress and duress, people kind of move back in time. I mean, and they�re even in their developments. Sometimes that happens because we�re human. What if he does that? Or, another way of putting it is, what if it reaches a level where it�s no longer anything you could even consider pathology, but it is still a very different style of being in a world.

What if he�s someone who, for pleasure, likes to play Dungeons and Dragons. That is the realm of where he would love to go into a fantasy land. And for you, for pleasure, you just would never enjoy that. [8:22] It doesn�t click for you. So even at the level where we�re no longer talking about pathology at all, and healthy people do this and function, it still doesn�t have to mean that you click. That could be someone who you really, had you known that this is how much he used and loved fantasy, you wouldn�t have married him. Or, it�s just not It�s not kind of where you relate in the world. It�s not how you function and cope enough in the world that it feels relatable. You know?

CLIENT: I�m not sure if I follow all of that.

THERAPIST: So I guess all I�m trying to say it that there�s one, what if the linear change goes like this and slowly, over time, it gets better and better. And yet, there are still times where it dips down. That�s part of what you�re having to say. Is that enough? Is that good enough. The second realm is what if even the pathology part of it is better, but retreating to fantasy is still something he does for fun? [9:24]

CLIENT: But see that, I knew Ivan enjoyed playing D&D with his friends sometimes.

THERAPIST: Yes. And that all feels okay.

CLIENT: It did. I didn�t enjoy it. I tried to play with them once. I didn�t It wasn�t horrible, you know, unbearable. But it�s just like, eh. I�d rather play a board game. So that wasn�t so we enjoy different hobbies. I feel like every couple has different hobbies, and they don�t necessarily You have some common ones, but you don�t have to do everything together. So it would be okay if he went over and played whatever role-playing, board game with Helen�s boyfriend. Who cares? It�s probably good for him.

It�s very different when it comes into getting a job or talking about wanting to have sex or, you know, what if in the future it came and I just started to think, and maybe this is too much, but what if one day we wanted to get a house and instead of researching and looking into it he was off doodling about this fantasy house. What if we wanted to have children and he coped in a similar I just worry. [10:33] And like, the little business card thing probably would not have bothered me even half of much, had it not followed everything else. I think I think that�s not the end of the world. But I wonder if in bigger areas in really important areas if it�s always going to come back to that, or if it becomes loud again, I can�t Then, it really I feel we slip back into I�m mommying him or responsible or feeling very much alone.

THERAPIST: I may have misheard you, but for some reason I thought you said, when you were quoting Dr. Farrow that she said, sometimes people do this they use fantasy. Did she say something about it being young or kids?

CLIENT: She said, young. She didn�t say I think she may have even said, 20s. Which I�m sure children I mean, children use children aren�t always engaged in realty. They�re children. But she did say, young adults do this, and that it becomes less and less. And that, sometimes, even when they�re older they�ll still, once in a while, it will come out.

THERAPIST: I mean, it�s not my experience that it�s ordinary to the extent that Ivan�s doing it. Do you know what I mean? So just What�s funny is I still think you�re sort of playing with, what does she actually think. Because on the one hand, she�s saying this is normal. At least you�re hearing that she�s sort of normalizing it.

CLIENT: I�m hearing her say other people do it. That doesn�t mean that it�s okay, I guess. But other people cope this way. [12:07]

THERAPIST: On the other hand, it�s just muddling through. You know what I mean? In other words, that kind of makes it as though it�s not normal and it�s something you�re really just having to compromise with right now.

CLIENT: What do Can I So like, the business card thing which has now been a long time, and I wish I had talked about this sooner. But I mean, what is How do I know if that�s I�m really working hard on this, but there, you know, here�s a slip. And it�s huge or loud, and it didn�t So he spent a few minutes fantasizing about what he wished he could be if there were no limits. Is that a small slip, or is that Was that a fair question?

THERAPIST: I can�t know from just the action of that. Do you know what I mean? It�s sort of like saying, if someone goes out and is an alcoholic and has four drinks one night, is that a small slip or is that a sign of a much more pervasive problem starting again. In isolation, you can�t know. So I think it�s more that you�re looking to what�s happening on average, every day. If that�s a blip, and if you saw several of those in a row or periodically or frequently, then it�s becoming a pattern that is pretty intractable. I don�t know what your sense is for example, Ramona, right now. Howls it going with pulling his head out of the sand and approaching applying for jobs and approaching things in the relationship with you? [13:49]

CLIENT: He I think things are going well. I think something I said this to my sister. It sounds dumb, or it sounds like it�s never good enough, but the more things progress, the higher my expectations are, and the more I can feel let down when something doesn�t happen. And her words were, she�s like, it can feel that way, I think Ramona, because, you know, he�s able to make a lot of progress. But then, when he really targets one thing, something else kind of slips, and he�s not able to really be consistent and maintain while improving somewhere else, and that that�s hard for him, which sounds very true. [14:30]

THERAPIST: Can you give me an example when you say that?

CLIENT: Sure. So he he�s been doing I mean, he�s been targeting, trying to apply to a dozen jobs a week. He did nine jobs, then twelve jobs, then eleven jobs this past week. He�s doing really well. He�s doing really well for someone who�s been like, paralyzed and unable to think of applying for a job for over a year. He�s doing really well. And he�s getting excited when he talks about the jobs. And so that�s great. But also, in the past couple of weeks I�ve been like, oh, you know where And again, this is me like, things are going well. We can do even better. I�ve noticed like, this chore or whatever like, we should maybe do that more often. I just maybe we could figure out who does what. Like, I�ll do the floors and you do the whatever. You know. Or, do you Ivan, since you do a lot of the cooking, do you want me to do more of the cleaning than you do. [15:35] And he hasn�t been able to talk about that. Hasn�t been able to engage in it very much. Similarly, this is going to sound dumb, but he had talked weeks ago about inviting my friends over this coming weekend, because my birthday�s coming up. And he was like yeah, let�s do it. We did it last year. It was great. I�ve got it under control. You don�t need to worry about anything.

And we talked recently and found out that he wasn�t he didn�t plan anything out. And he has now, but kind of the last minute. But he wasn�t able to. And I said, you know what, are you that anxious about messaging people on Facebook or sending an e-mail or, you know. He�s like, I am. I�m like, is it really that bad? And he�s like, yeah. It�s so overwhelming. It�s so He can�t bear to like �cause he want talk to his friends. He won�t He hasn�t been able to face them since, you know, most of them since the whole seminary thing, which is so sad, �cause that�s been so long now. [16:38] And I know he has friends who are all very human, who�ve had plans, who haven�t worked out. It�s not like they all have perfect lives, and he can�t bear to say that his isn�t. But that was I don�t know.

So it�s like, he�s able to You know, on the one hand, he�s very introverted. He�s really struggling with isolation and stuff. But he�s able to apply to jobs. But then, like, the idea of even glimpsing Facebook long enough to send like, a message to a few people is like, I can�t bear. I can�t even It�s hard, because he gets very paralyzed and withdrawn, and then I become more like, you�ve got to push through this. And eventually, he hears me saying, just do it, which he said Which is really hard, because I validate that he could feel overwhelmed and anxious and But at the same time, if you say that for years and years, at some point, it becomes almost a I mean, so what are you going to do about it? Are you just going to say that forever and have no friends? That sounds harsh.

THERAPIST: You�re wanting him then, to e-mail his friends, not your friends.

CLIENT: Mine.

THERAPIST: Oh, your friends. So even there he�s anxious.

CLIENT: Oh yeah.

THERAPIST: Why with your friends is he anxious?

CLIENT: I mean, they�re pretty much his I mean, as close to having friends here as he has, because he doesn�t hang out with anyone from work. He won�t talk to -

THERAPIST: But why is he anxious?

CLIENT: Because it means Because well, like he told me weeks ago it was because he couldn�t do anything about it, because it had to be perfect, so he couldn�t do anything.

THERAPIST: So it�s his perfectionism.

CLIENT: �Cause it wasn�t actually perfect. Yeah. Which is crazy and hard for me to understand. Because when I want something to be perfect, I get obsessive. Or, I, you know. So it�s hard to believe that It feels like, to me, it feels apathetic, or lazy. Or, and excuse. Oh, it has to be perfect, so I�m not doing anything.

THERAPIST: And yet, this is actually where there�s some there is something common about this style of being perfectionistic that is very common for people to avoid in perfectionism, as much as it is for people to overly obsess in perfectionism. You know, people who come in for example, for writer�s block and procrastination stuff. It�s because, when you get down to it, it�s because they�re so worried about not doing a good enough job that they can�t just get to it.

CLIENT: Yeah. No, we actually talked about that. Ivan said, that�s why I mean, he would do so many of his papers the night before in college. And he�s like, it�s because no draft was ever going to be good enough. And it was never -

THERAPIST: It�s very common. [19:12]

CLIENT: But I can�t believe that something you would crank out the night I mean, some people You can do. Sometimes you can pull an all-nighter and be very successful. But consistently, could it ever be better than something you worked really hard on and learned a lot from.

THERAPIST: Oh, probably not. I don�t know.

CLIENT: And like, why does that make sense to you? At some point don�t you see that that�s like, counterintuitive and counterproductive?

THERAPIST: What�s intuitive though, about it, just to get inside it, is that if you wait �til the last minute, then you know that it�s not going to be a perfect paper, and it can�t be. So then, in some ways you get in that -

CLIENT: Your fault.

THERAPIST: Right. It�s all I have to do is what I have to write for at the time I have, which is eight hours left, and it�ll have to be good enough, �cause I have to hand it in. It�s crazy. It�s not rational. And I totally get what you�re saying, but I�m just That�s the inner thought process is then, I don�t have to judge myself so harshly [20:03] If then what I hand in is now perfect, because it�s not perfect because I ran out of time, instead of the fear of facing, oh my gosh, if I write it a week in advance and then I think it�s a terrible paper. And what if I can never get it better. And so now I know that the reason my paper isn�t good is because of me instead of because I ran out of time.

CLIENT: No, but that�s like I shouldn�t� say this, but it�s like really It�s really hard to live with that. It�s really hard to validate that.

THERAPIST: Especially if you�re on -

CLIENT: It�s really hard to not take it in as like, you just didn�t care. You just did it at the last second. You threw it together. How is that perfectionistic? Or, is it really I mean, how painful can possibly be to face that you have friends I mean like, or to take that first step. I have tried to coax him so many This is wrong, I�m sure. But I�ve tried to coax him so many times. Like, just send one of your friends, you know, an e-mail or a Facebook message or a text or something. Just anything. It doesn�t even have to be a conversation. Just anything. Because he pulls away, and pulls away, and pulls away. And I worry that at some point, it�s been a couple years since he�s seen them and they aren�t even going to be real friends anymore. They�re going to be people he used to be friends with. [21:19]

THERAPIST: Why is it important to you that he be in touch with them? Just out of curiosity.

CLIENT: I think it�s important to anyone to have friends and to have an identity outside of their relationship. And to I mean, I think your self-esteem in part It�s important to have people who like you and that you like them and have common interests. To socialize. To have, you know I think it was actually wonderful that he had hobbies that, you know, he would do with his guy friends and I didn�t need to be a part of it. Like, that�s really important. I guess I just keep saying it�s important, and you�re asking why.

THERAPIST: Well, I hear you take it as an absolute given that that�s of course, that�s important for all people. And at some level, I think that�s true. I think there�s another level though, where people vary in how much having lots of friends is important to them.

CLIENT: No, and I�m not saying he needs to be the popular kid or have tons of friends. But I see You take away why it�s important, why is being isolated so bad. He�s so cut off. He�s so I mean, he�s drowned in shame over the seminary thing, so he can�t face Our one friend just finished seminary. He can�t talk to Carla and Mason, because Mason just finished seminary. Like, I�m sure he can�t. [22:45]

THERAPIST: Yeah. It then perpetuates the same, �cause he hasn�t just faced these people, owned up to it and then you move on. It�s probably not a big deal to the relationship at all.

CLIENT: Exactly. And I�ve tried to tell him so many times. Even other friends. I mean, we went to a Christian-based school. We went to a Lutheran school. A few people went to seminary after that. (inaudible 23:07). One of our friends, he�s like, I don�t know what happened with Liam, but he went to seminary and he didn�t get a call. And that has to be tough on him. But I�m like, why don�t you reach out to him and find out what�s going on. He can�t do it, even though I know if he told Liam what happened, he�d be like, that�s so tough, I wish you had told me. You know. And eventually, they�d move on. And Liam would say, yeah, and this happened to me. And that�s embarrassing, too. I wish he could get to that. I think that would be so good for him to help overcome some of the shame. To find out not everybody else�s plans worked out perfectly either. [23:51] It�s okay. Not to normalize or minimize what he went through at seminary. But it doesn�t have to define the rest of his life. And he can�t -

THERAPIST: Is he interested in working on this part of things?

CLIENT: I�m not sure. I mean whenever we hang out with my friends, he�s really into it. And there have been a couple of times when like, he�s gone with my ex-boyfriend or, you know, just the guys, and they�ve done stuff. And that�s good. And I think they get along well. But they�re really not friends. It�s different than making your own. I have this I shouldn�t have this either, I�m sure. But I kind of have this secret hope that if he got one of these teaching/tutoring whatever jobs, that first of all, he would feel really good about that and he would be excited to talk about his day, instead of oh, it was the same. You know, he�s never excited or passionate. But also, that he�d make friends that had common He�d have his own thing. And I could tag along to hang out with his friends.

THERAPIST: This is exactly what I�m wondering. It�s so common when people get themselves into the feeling that they�re deep inside a hole of especially of self-esteem. That you don�t want to see anyone until you feel like you�ve gotten yourself out a little bit. So for example, if he�s ashamed of working at Subway, to go see friends means they say, oh, so what are you doing these days? And he has to face all of the shame that�s happening right now, not even about the past. [25:25] That it�s possible, I could imagine, that as he gets into a place where he feels a little bit better about what he�s doing that he can then say, okay, I want to bring this to someone else. And then, he starts to make new friends and new jobs. You know, people aren�t friends with all their college friends forever.

CLIENT: No, and I�m not trying to force. But I mean, not a word. Like, we have friends who are having a baby. Like, he can�t Friends who have gotten new jobs who have moved to He just has so much trouble.

THERAPIST: He has shame. �Cause I�m sure when he hears that they�re having a baby or they�ve got a new job. There are all forward movements in their lives.

CLIENT: Yeah. I will say though, and this is bizarre. But we have one friend Okay, it�s Ivan�s friend from high school. They I mean, he was Ivan�s best man. They�ve just stayed friends even though they didn�t go to the same college or anything. And this guy is very, very, very, very Catholic. And I don�t say that because there�s anything wrong with being Catholic, I just mean he�s very clear on what he thinks is okay and what�s not okay. And it was nice, because he and Ivan differed on what they their theological, whatever, philosophies. And they would talk about that and enjoy that and respectfully disagree. Which was good for Ivan. [26:43] But he Ivan told him eventually about seminary and about even what was going on with me and him to some extent, which is bizarre. Because of all his friends, he is by far the most judgmental. The most, this is how it should be, type of person. And it�s so bizarre. It�s so bizarre. I mean, I�m glad that he was able to talk to him.

THERAPIST: But he picks the one person who�s going to play out the punishment and the judgment. Do know what I mean?

CLIENT: But why would you do that when you have other friends that you were equally close to that would be more forgiving and supportive?

THERAPIST: Because he�s Ivan. Meaning, that is there he lives. In extreme judgment, self-judgment and chastising. Do you know what I mean? He�s in some ways, expecting and waiting for that to come. So to tell someone who�d not going to do that? I mean, that doesn�t jibe with how he treats his own self. He tells probably unconsciously on purpose the one person who will also join him in judging him. This is him and the whip, right? It�s all about self-chastising. Kind of constantly to an extreme that�s really destructive to him. It doesn�t let up and allow him to just be human. [28:16]

CLIENT: I think selfishly, a very small part of it, but a true part of it is, I think Ivan would be a happier, healthier person if he were able to get over a lot of this shame.

THERAPIST: Of course.

CLIENT: And I would love I mean, who doesn�t want to see that in their partner? Who doesn�t want to see someone like, who has friends and wants to go out and have fun like -

THERAPIST: I was wondering that too, when I asked you why it�s important. I can imagine that being a person you�re more drawn to who has friends, who�s not afraid.

CLIENT: Well, I don�t want to see him sad and ashamed, and so shut down that he can�t even send a text. He shouldn�t feel -

THERAPIST: It�s not sexy, for example.

CLIENT: It�s not. And I feel like a horrible person even thinking -

THERAPIST: Why?

CLIENT: Because, what kind of person looks at their spouse and says, they�re really depressed and they�re so isolated and they�re so down that they can�t even You know, we can�t necessary do stuff with our friends, because they can�t bear to face them. Who�s able to look at that and say well, I�m not very attracted to that?

THERAPIST: A human person. That�s the kind of person.

CLIENT: I mean, maybe, but it feels very It�s hard. Because, when Ivan was talking about the list or talking about the big things things that he�s very deeply ashamed of. He doesn�t respond the way I would. If I I mean, I don�t know what it�s like to be in his shoes. But if I had done something pretty damaging like that to Ivan and I think I have with the criticism. Different, but I mean at the same time, I think I have, you know, sat upright and looked at him and said, let�s talk about this. Let�s work on this. I know this is happening. And it�s a very different response from when we talk about what he�s And he�s like, cowering over. He�s mumbling. He�s looking at the floor. I mean, it�s like, it�s the end of the world. And so it�s really hard to How do I say this without being the worst person in the world? It�s really hard to be the person who was wronged when the person who did it to you is like, acting like you just physically beat them half to death. [30:32] And that sounds Oh, my gosh. That sounds horrible, but it�s what happens.

THERAPIST: See, Ramona, that�s where it�s so tricky in your relationship. And I think that�s where he gets you. And sometimes, maybe even where things get a little stuck in the couples therapy. Because he�s so successful at making it be that he�s the victim. Even if we take the word, victim out for either one of you, it is quite ordinary for a person so to say, for example, he wants to have more of a sexual relationship with you. That�s his wish. One of the reasons you may not be interested in that, is because he�s cowering in shame all the time. That�s not -

CLIENT: But how do you say that to someone?

THERAPIST: It�s hard to hear. But there are ways to begin to put it into words. That this actually is part of the system of how people get drawn to each other or repelled by each other. People do say, in couples therapy, you know, 20 years into treatment, I�m not attracted to you right now, because your self-esteem is in the and this is hard to hear, �cause you�re already feeling this way, but it has an impact on the relationship. Do you know what I mean?

CLIENT: I do. But I�ve never been able to say that to him. And in fact, I�ve There have been times in the past few weeks or so when I�ve Ivan and I have talked about becoming physical again or starting to have sex again which is like, I�m so embarrassed even to say that. But I could never initiate anything with Ivan. [32:07] Or I could never say like, how do you feel about trying that this weekend. Or, you know, I could just never say that to Ivan. And I also sometimes wonder, with everything that�s happened, I wonder if it isn�t natural to feel not drawn completely drawn to him or feel like, sexy or feel like I did when we started dating. You know, like, anyone who went through that wouldn�t be like, yeah, let�s make out now, you know. That doesn�t necessarily But sometimes, I worry is it that or it like, there�s something wrong with me or something�s wrong with how we just don�t love each other that that�s not happening.

THERAPIST: There�s a lot of things going on.

CLIENT: I don�t feel as a Sometimes I think when he would get a new job and he would come home. I just picture this. He would come home, and I�d say, how your day was. And instead of it being doom and gloom or like, oh, nothing new. It was busy. Or, I had to stay late. It would be something exciting or something enjoyable and he would be, you know, smiling and enjoying himself. And maybe his day maybe he did something really awesome and my day was really boring. Or, he could have a night where he�s like, do you mind if I just go out with the guys. You know. Or, just being a more independent, dynamic, motivated. This is horrible. Less depressed, les ashamed, less feeling horrible about himself. [33:38]

THERAPIST: One way of saying it to him that might be palatable. It�s something you can try on for size inside yourself. I don�t imagine you ever said to him, you�re sexy.

CLIENT: No.

THERAPIST: Probably in the whole history of your marriage. So it�s new for me to say those words to you as something that could possibly come out of your mouth. Instead of pointing out how he�s not sexy or whatever word, romantic or appealing or attractive when he�s doing the thing that repels you, you could start to comment in some way when he does something that excites you. So you could say, man, is your motivation today sexy. Or something that�s like, wow, I feel so excited to be around you when he comes home and says, I got a job. And you see so the parts of him. So I actually think, Ramona this is true for you. As much as you don�t use that language with me a lot of the time, you do start to sound and look and feel to me, drawn to him when he starts doing like, acting like a mature adult and motivating and organizing and he cleaned the house. Or, whatever he did that feels like, oh my gosh, he�s getting stuff done. You look like you�re really drawn to that person. It�s when he doesn�t that you get repelled.

So starting to play around with noticing when he does that. And some way that you could tie it so that he knows that�s actually something you find attractive. [35:09] Right? That�s someone you could have sex with. That�s someone you could want to walk over and kiss, because you�re loving who he is this day. Motivated. On top of stuff. Successful. So even just playing around with that language when something good happens that makes you feel that towards him. Let him know. So that he may also It�s a way for him to start beginning to pair that oh, so if I get oh, 10 job applications done in the next three days, then maybe she�ll want to kiss me? I never thought about it that way. But that�s actually kind of the way it works. He�s acting more like an adult. Period. Like, even not being a child. Instead, he�s being an adult. It�s not sexy to be in the mother-child role. It�s not a sexy role. Just start to help him connect that a little bit when you feel it. I think it�s a way of noting positive instead of a negative that isn�t as critical.

CLIENT: How do I There are times I wish even he would hold me or hug me or kiss me or just be more But I don�t know how to say that, and I definitely don�t know how to initiate that. And here�s something that I feel really horrible about for thinking or feeling. Ivan is Ivan struggled with his weight since he was a child.

THERAPIST: Can I pause you for one second. Really horrible. Really horrible. Really horrible. It�s a monster that you�re describing that you feel about yourself, Ramona.

CLIENT: Well, because who looks at their spouse and says, I don�t feel as attracted to you, or I don�t feel this is sexy, because you don�t take care of your body?

THERAPIST: Lots and lots and lots of people. That comes up in couples therapy all the time.

CLIENT: But how do you say that without being superficial and shallow and not caring about like -

THERAPIST: Some of it is superficial. [37:09] Some of it is. Appearance is part of what people get drawn to in each other. Some of it is motivation around self-care. A person who cares enough about himself that he�s interested in taking care of all parts of him, including appearance. Is someone you then feel motivated to be around. It�s as though It�s kind of like, you think of it in the extreme. You don�t shower. You don�t bathe. You don�t cut your hair. You are disheveled and then, you�re supposed to go sleep with someone? I mean that�s not actually the way sexiness and relatedness and people get excited about each other involves appearance. It can involve different aspects of appearance and people can be drawn to different parts of appearance. It doesn�t have to be an exact body or an exact outfit. But appearance, and general self-care around appearance is part of how people get drawn to each other. It�s a slice of the whole pie. It�s not the whole pie. It�s part of it. For humans. [38:16] You�re so mean to yourself, Ramona. The image you have.

CLIENT: It feels like I�m mean to him, because he He struggled with this since I mean, ever. Since he was a little kid. He�s always been overweight. He�s been bullied through school. He�s been I mean, and it was drilled into him like, coping through food, being comforted through food. He will still go home, and his mom will be like, have more, have more. Like, let me get this for you. Like, it�s a huge way that they relate. It�s a huge way that they celebrate. It�s huge. And it�s so hard, because he could exercise all day every day, and it still wouldn�t get to the root of the problem. But at the same time, I selfishly I think Ivan He can be very handsome when he cleans up which is also hard for him to do. [39:07] It�s hard for him to shave every day. It�s hard. But yeah, part of me wishes he would lose the weight, and that would be really attractive. And I wonder what that -

THERAPIST: Has he been going to the gym?

CLIENT: He goes sometimes. And he does We just got really healthy food. I won�t buy certain foods for myself, even, �cause then, it won�t go well.

THERAPIST: It�s a delicate subject. I�m not saying to you that it isn�t hard for couples to talk about, to bring up with each other in ways that aren�t shaming to each other. It is part of the relationship, though, that it�s very common to eventually make it into the room between two people. And it may be that you can say You begin by talking about this. And my worst fear is to make this feel worse or to shame you. Or, to be a monster or and yet, I�m interested in being physically closer to each other. It�s because I want to work on this with you and I want to be closer to you that I sometimes wonder if how you take care of your body isn�t something that could be an impediment to us. [40:38] You know? I think the more that you�re brining in that it�s out of It�s not just out of criticism. You�re actually wanting to bring it up, because you want to get closer. Do you know what I mean? It�s another place where you can also say hey Ivan, sweetie if he comes home from the gym. Or, something that begins to kind of link I like it when you take care of yourself. I�m drawn to that person. Let me kiss that shaved face. Or whatever it is. You go grab his hand, and give him a kiss on the cheek after he�s done that.

That�s part of what will also reinforce He�ll start to associate self-esteem. His own appearance will start to be like oh, maybe I�ll shave tomorrow if that�s what happens when I shave. That you shouldn�t be afraid also of expressing affection and admiration for those moves, so that you�re communicating with him without being shaming. That you really think that way of taking care of himself is cool, and that�s someone you�re drawn to. [41:38] When you said, a few minutes ago, I could never go and you were talking about initiating. Why? When you said that, I wasn�t quite sure what that meant?

CLIENT: I�m just so self-conscious and so embarrassed and so still It�s also really hard to imagine It�s really hard to imagine having sex with my husband after what�s happened, and me not being wow, he did that to you. And eventually, you just like I don�t want it to mean that it�s okay. That it erases it. That he doesn�t have to work on things. I don�t want it what does it say about me. It�s so scary. And I just am so worried. I think that I�m a little bit like him. I�m so worried about it going wrong. Or, I�m so worried that he�ll be critical of it that I would That it seems like a small just to have it be part of the relationship seems like, at least I know then what it�s doing. [42:44] I know what�s happening. Whereas, if you bring it in What if, you know, what if I find out something else? Or, what if something else goes wrong? Or, what if we don�t fully get through digesting the list and stuff. Or, what if Dr. Farrow really meant, you are crazy for being with someone who did that to you. And I�m sleeping with them? It�s scary to me.

THERAPIST: And what if you feel that some and those feelings also can become a vehicle for avoidance?

CLIENT: No, I think they definitely can. And I guess I should point out, too. Even when we were dating, Ivan would still initiate kissing and making out and stuff. And I was very on-board with it. It was very much an agreement. But I just would never I think I�d just be too shy or too worried or too self-conscious. What am I doing that�s wrong? Oh, I should feel guilty about this. [43:42]

THERAPIST: It reminds me a little bit of us getting started. Like, today I was quiet and I didn�t say anything to kind of help you get started. And I can imagine a little bit of some of that same thing. Like, can I start talking? Is there something I�m supposed to say? Am I allowed to just start where I want to start? In many ways, initiation of sex. I mean, it�s a one kind of particular example of what it means of having the initiative and freedom to be yourself in your desires all that time. Including starting a therapy session. Can you just start with whatever you want to start with and it�s okay. It�s good. It�s welcomed. There�s no way of getting it wrong, �cause it�s you.

CLIENT: Something I�d like to talk about more is how �Cause my mom tells me, no matter how good some of your friends look, no matter how great some of their relationships look. No matter how many new cars or new houses, everybody has problems. Everybody. And I still can�t really believe that. [44:57] But I don�t I wonder how couples who have problems, how do they integrate having sex, and then, the next day saying, boy, you know, this bill�s overdue. We�ve got to work on this. And then, you know, the next day having sex. How does that work and that it�s okay? And I don�t and when I go the other end and withhold, because we can�t have sex until the relationship is perfect, so we�ll never have sex. But I know. Another time.

THERAPIST: It�s a great question for us to come back to when you return. Tuesday, I think works mostly?

CLIENT: No, it should work. I�ll confirm. But that shouldn�t be a problem. And then, I�ll e-mail you about the other dates when I find out my work calendar.

THERAPIST: So what I wrote back I don�t know if you got my response.

CLIENT: I did. I just haven�t been on the network yet to see. But I think you were saying the 23rd.

THERAPIST: Yes. The 24th, I�m out of the office the whole day, so I can�t do Tuesday. If you can do that, go back to Mondays. We can do Tuesday next week, Monday if you can�t. Then, Tuesday again. This is Oh, no, then we�re good. The only thing is that the following week so the week of July 7th, I�m out that whole week actually, so we�d miss the 8th. But basically, from the first onward Tuesdays would work. I know it�s a little chaotic.

CLIENT: Thank you very much.

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