TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Why?

CLIENT: Yeah.

THERAPIST: Because I think it might help.

CLIENT: How so?

THERAPIST: Because coming in four times a week sometimes makes it easier to do this kind of work, and it makes it easier to get into things and get traction on things. And sometimes it doesn’t. And sometimes people like it and sometimes people don’t like it. So I know you have not been thrilled about the idea when I have brought it up before, but I figured I’d bring it up again anyway. I’m not saying you have to do it. I’m not saying I don’t think we can work on things this way. I just had the thought that it might make things easier. [1:00] And I also imagine that one of the issues was money, and so I mean I was willing to, between the recording [ph?] insurance, I was willing to forgot the two... the remainder of the… what I would charge you for the third and fourth visits each week, which would mean it wouldn’t actually cost you anymore.

CLIENT: Than it is now?

THERAPIST: Than it is now. That’s not… I know that’s not the only factor but I imagine it was one factor. It would also, even if you decided to do it now, it would probably take me a little time to find the other appointments times. Not sure how long but…

CLIENT: Yeah, I think that’s the number one thing that comes to my mind. Thinking about it is just like when the hell would I ever do that. When the hell would I have time… I can barely… I feel like these times, even, I sometimes have to… just with all the crazy event stuff that’s going on at work, whatever. Certainly during the summer it might be easier to find time. I just… immediately the first thing that I think of is just anxiety regarding trying to schedule it even. [2:11] And so I don’t know. I just don’t… I can’t… I don’t see where that other time would be. And then I’m also worried about it being too much, and then I’m just at work or I could come before work or… if I come during work then what if it’s too much or whatever and then I have to go back to work and do my day. I don’t know. That’s probably what is the thing holding me back the most, is just thinking about how it would be possible to schedule it.

THERAPIST: The time and the possibility of it being overwhelming.

CLIENT: Mm-hm. (pause)

THERAPIST: What [inaudible] talk about it? [3:13]

CLIENT: Well, my mom said she wasn’t sure that it would be the thing for me, so that is resonating in my head as well.

THERAPIST: Sure. Do you know why?

CLIENT: I don’t know, I think she just, I don’t know, maybe she was more just no, find some medication that works or something, or that she did analysis and felt like it wasn’t all that helpful to her. (pause) I’m just, I think, in general, overwhelmed at everything, and thinking about what I need to do gets very overwhelming because I have all these ideas and all these things that are going on and so A) I’m dropping the class. [4:22] I just can’t… I mean maybe I’ll try to continue doing some of the work, but it’s just too much and I just… and it sucks because it’s really interesting stuff but I just can’t figure out how to get my mind in the right place to set enough side… time aside to do it. Or this weekend I had plenty of time to do it but I was depressed all weekend and didn’t want to, and got involved in doing other things and stuff that I felt was easier for me to just procrastinate. But clean my house, I can do that, and I know that I won’t fail. Or I won’t get frustrated because I know how to do it. Or like yesterday I got up in the morning, I did some cleaning, and then I decided to do my taxes on TurboTax. And I realized I did it and I went right through, and then I realized after I was like wow, I just did that without getting frustrated or anxious or overwhelmed or anything. And I was really proud of myself. But then almost as instantly as I had that feeling I was surprised that I got through it without getting frustrated because typically that could be something that would really trigger frustration. I’m so stupid, I can’t figure this out or whatever. But then almost immediately after I thought of that I got overwhelmed and sad and had to lay down for an hour crying. [5:40] I just was… I think I was frustrated at myself that I was giving myself a pat on the back for fucking doing my taxes online, like where it walks you through it, and felt stupid. And then was like oh, you did your taxes, but you still have all this other shit to do and you’re still a mess and you don’t… didn’t do your homework. And I actually got sad.

THERAPIST: Oh was it kind of as though you sort of couldn’t tolerate the little bit of credit you were giving yourself there without a kind of avalanche of well all this other stuff. Yeah. And I guess I should say again [inaudible] I’m not going to sit here and harp on it, but I do want to explain my thinking. You’ve been having a really rough time, and the idea… and it always works partly one way, partly another, but the idea with that would be to have more time here to kind of contain that, not… surely there are times when people are going through the treatment that it itself becomes quite overwhelming and so it spills… that spills over into other things, but the idea, also, that it actually helps to contain [inaudible] difficulty and all that stuff, which then frees things up the rest of the time to some extent. [7:18] Do you know what I mean? So… and I’m not… I couldn’t say in advance… I’m sure what… which… where… which way it would go, more so, initially. I don’t know that. But yeah, I mean sometimes that’s what it does. So that was, I guess, part of what my thinking was, was that you’re having a really hard time and you’ve had some anxiety and panic recently, and crying, and it’s just been really low. And part of that was having more of a place here to put that or more of a place more often to put that might make things easier outside. But maybe that’s not what you anticipate.

CLIENT: But I don’t want to contain it. I want to figure out coping, ways to deal with it, so I don’t have to be in analysis and on medication my whole life. I don’t want to just have two more days to sit here and kvetch about things.

THERAPIST: I understand, but (pause) well let me back up and look at that a second. [8:55] I mean I guess when you put it like that it makes it sound as though my agenda is for you to have two more hours to kvetch in so that you feel a little better elsewhere, and that’s really the only point. I mean I guess that would seem, in a way, kind of self-serving on my part if I was sort of suggesting it that way, with the idea in my head that you’d just be dependent on this and on me for the rest of your life as on medication.

CLIENT: Well I understand it’s not what you’re saying or suggesting or thinking. But that is a concern.

THERAPIST: Well maybe, yeah. I mean…

CLIENT: Or maybe it would make it so that I’m actually able to start working on stuff or something through my complaining. But I also don’t really… it’s just all very overwhelming. [10:09] (pause) There’s too much that I need to work on or get to the bottom of or figure out. I don’t (pause) I just don’t really know where to start. I thought I, I don’t know. (pause)

THERAPIST: I don’t know, it seems to me that the primary thing that you’re really having trouble with is, I think, getting in a romantic relationship with work for you. [11:53] And that’s not all psychology. Some of that is life. But I guess my impression is that in a way that’s the thing you’re really most upset about.

CLIENT: Yeah, but now it’s turning into I’m most upset about the fact that I make all the wrong choices and I’m a bad friend or not… it’s turned into just I hate myself so I don’t even give a shit about a relationship. Of course I haven’t been able to be in a relationship or have found one because I suck. That’s where I’m at right now. But I don’t even care. It’s not… no, I don’t… it’s not even a concern. I don’t give a fuck. I don’t… what… I don’t (pause) I haven’t done anything that warrants me being in a good relationship or having anybody to be with. So that’s where I am. And so I just need to figure out how to cope with my stress and depression and anxiety without medication, and that’s all I want to fucking do. [13:01]

THERAPIST: But [inaudible] the things that have, really, I think goes the other way. I think the things that have tended to upset you most and knock you down the most have had been to do with when relationships with men don’t work out or…

CLIENT: Yeah, because… and that’s why I’m such a loser.

THERAPIST: And they made you feel so shitty about yourself that you have trouble doing other things. I mean I guess that’s why… part of why I think that’s kind of the central or motivating issue.

CLIENT: Well that’s pathetic. (pause) And no, because I still had all these issues when I was with [inaudible] self-esteem stuff, and not being able to stick with my workout. And anxiety and frustration and anger and all of that shit was all still there still.

THERAPIST: I didn’t say they were the only things, but I think this was the main thing. I mean often a part… well let’s see. I mean two things. One, I mean, as you said, it’s clear, aside from some of the stuff about the relationship that you really did feel good about, you were happier when you were with him. [14:46] I mean you came here when you were with him so obviously there were things you wanted to work on. And I remember right at first when you came here you said I don’t want to think about or work on my relationship really. There are other things I want to work on. Now it gets tricky to sort out what’s what because you had trouble having confidence to confront him a lot because he didn’t listen to you when you tried to, or he would criticize you or just walk away. So is it the relationship or is your confidence? It’s tricky. I guess what I’m saying, what I’m trying to say, is I am aware that these days you feel like the problem is you are just so inherently fucked up that relationship, in a way, is the last thing on your mind because you feel like you have such a mess to clean up before you get to that. [15:59] But what I’m saying is those are the… it’s stuff in a relationship that most recently, with Lucas and [inaudible] that have been a lot of what’s been making you feel like such a mess. And then you’re just so in that feeling that it’s hard to see what’s what. And my intent in saying that is not just to argue and say no, you’re wrong; I’m right. It’s to say it reminds me of if you have a leak in your house somewhere and a room fills up with muddy yucky stuff and everything is a mess, and you say no, the pipe over here is the thing that burst and that’s… and the room is now flooded and your stuff is all fucked up and this and that, but it came from here, this thing here, this one local problem. It’s not like everything about the room forever is all fucked up. It’s like there’s this one thing here that’s broke, and because obviously when you’re in the middle of that, standing in… shin deep in water and your shit’s all fucked up because there’s a mess, it feels like everything’s gone to hell in a hand basket. But I don’t know; am I making any sense? [17:34]

CLIENT: Yeah. (pause) I’m having trouble getting past just the feeling of well who cares? I’ve tried for however long since this breakup and nothing’s working, so who cares. Nobody wants to be with me. Nobody really wants to be my friend that much. My job sucks and I’m not getting a new job. Nobody wants to give me a new job so who gives a shit about anything about what I do. I don’t care. Nobody else cares. What difference is it going to make? And it’s… I’m having a hard time getting past that feeling right now.

THERAPIST: Well of course you’re feeling that way right now. [18:36] You’ve had a lot of stuff that has not at all gone the way you wanted. I mean with relationships, with friendship stuff, some of which I know about, and with looking for jobs. I mean you’ve been looking for jobs for a while, first in Texas and then around MIT, and haven’t found anything that’s worked. And you’ve gotten close to a few things and they haven’t panned out, and it’s been trying and awful. And you’ve been trying with relationships, too, without anything working out. So I’m not surprised you’re feeling that way. I mean if… I don’t think what you’re…

CLIENT: Yeah, but I think I’m the reason. I don’t think anybody else is the reason. There must be something wrong with my experience or my resume or my cover letter or me as a person that people don’t want to get close to me or something, or stay close to me, or hang out with me, or whatever at a… why would it be them? It’s obviously me if it’s everybody and everything, is how I feel. [19:54] (pause)

THERAPIST: Well I’m sure there are things about you that are contributing to this. I don’t know that they’re the things that you’re saying just now. But (pause) I mean (pause) I mean (pause) we’ve talked about a bunch of things that relate to that, although I’m aware that (pause) that I haven’t made anything work out. [23:12] I mean you tend to not just anticipate that you’ll be disappointed, or that things will work out, but almost to feel a lot of shame for trying something, or to try things that already feel kind of fucked up, I think of Lucas, to you. (pause) And it has been hard so far to… for us to kind of get traction on that to understand what… how that would happen, how that would work. [24:41] I’m less clear if or what… do anything, and if so what it is about job stuff has to do with you. I feel further from that. I hear that you’ve applied. I know that you’ve applied for it; it sounds reasonable to me, and I know you’ve told me about a bunch of stuff that hasn’t worked out. I feel like, on some way, I’m not in a position to be as clear about why that stuff hasn’t worked out.

CLIENT: Well I don’t know.

THERAPIST: I know.

CLIENT: Guess it’s because I don’t interview well or something. I don’t know.

THERAPIST: Well I mean it’s not simple. There have been cases where clearly it’s not about anything you’ve done wrong. There’s stuff you’ve applied for that they’ve hired an internal candidate or stuff like that where it probably had nothing to do with you. Although I know there have been other cases where you got to a second interview or… and it didn’t work out. And I don’t know how to explain that. I don’t know if that means you were one of three or four people. And it doesn’t necessarily mean that there’s something wrong when everybody doesn’t get it, but I’m not… I don’t know. Maybe you don’t interview well. I’m not sure. [26:08]

CLIENT: But that’s why, again, this is just another thing that just makes me feel like what’s the point. Who cares. (pause)

THERAPIST: You’re giving up.

CLIENT: Mm-hm. I don’t want to but I just… okay, I’ll keep trying stuff. Fine, I’ll come do analysis, I’ll keep taking medication, I’ll try some other stuff, whatever. [27:12] It just feels like my life has turned into only being about how to not feel bad anymore. That’s literally the only thing that I feel like I can concentrate on or that I think about. Okay, how do I get up this morning and do stuff and not be late to work. How do I go to work and get through the day even though I hate all this stuff and I’m so sick of it. How do I get home and deal with not getting upset about Ally being gross. It’s… that’s all I do. How do I deal with the fact that I’m… am rejected again? How do I deal with the fact that nobody calls me for plans? What can I do to feel better? What can I think? What can I write about? What can I read? [28:46] (pause) I thought the class would help me and then it all it did was make me feel upset and anxious. And now I just feel worse about myself because I’m dropping it like a fucking waste of life.

THERAPIST: What was it that you were supposed to do this weekend?

CLIENT: For schoolwork? I don’t even know, watch a lecture, watch a million videos, read a thousand pages, write two activities. I don’t fucking know. I didn’t even look at it. And then my final paper’s due during advisory committee weekend. I don’t have any time anyway. [30:04] I don’t like hating my life and I didn’t feel like I hated my life before. (pause)

THERAPIST: Yeah, you didn’t come in here hating your life. It’s true.

CLIENT: So I get what you’re saying about relationships and stuff, it’s just like now it feels like it’s so much bigger than that, that it’s like who even cares that it was a catalyst or... who cares. (pause)

THERAPIST: I also think, even as we’re talking today, there’s something happening that’s making you feel worse than when you came in. [35:04] I don’t mean you’re having a hard time… I’m not saying I think you’re feeling worse now than you ever do, I just mean if I sort of think about [inaudible] gone (pause)

CLIENT: Because it’s not helping, nothing’s helping because I come and I talk about how much I hate my life, and I leave and continue hating my life and get rejected or whatever.

THERAPIST: Something happens that makes you hate your life.

CLIENT: For example, I have to go back to work right now, to work until 8:30 for a fucking event that is fucking stupid. [36:15] (pause)

THERAPIST: But that’s not actually what happens here. I mean some days it does but a lot of it isn’t like that, where you come in talking about hating your life and then you go out and hate your life, and then something happens to make you hate it more. I mean I think (pause) you’re so angry, I think, and so disappointed, really mostly with yourself, but it’s kind of like… I mean you, without meaning to or without wanting to, in a way, take aim at everything else, too, which mostly makes you feel worse. [38:46]

CLIENT: Yeah.

THERAPIST: I don’t mean… I’m not saying that it mostly makes you feel worse, you should stop doing that, I mean the unfortunate… you don’t take aim at something and blast somebody or trash something and then feel better for it. We both can imagine people who do that, and oh, I just trashed so and so; now I feel better. For you it’s usually hey great, that’s my friend. That’s the kind of friends I have. I’m such a shithead because I’ve got such a fucking asshole for a friend. Whatever.

CLIENT: Yeah, that’s true. I don’t know, I just kind of feel like I don’t know what to do anymore. (pause)

THERAPIST: All right, well let’s [inaudible]

CLIENT: Okay. So see you on Friday. Thanks, that was a [inaudible]

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