TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Hi, come on in. I'm just getting [unclear].

CLIENT: But actually I have to dip out a bit early today, I have a meeting at 4:20. But I wanted to come and chat with you, check in.

THERAPIST: Okay.

CLIENT: So this is what I got from the insurance, which just said to endorse it to you on the back. Is that okay?

THERAPIST: Sure. Yeah, yeah.

CLIENT: Okay. Then I was thinking I left my checkbook at home, so can I mail you-

THERAPIST: Yeah, that's fine.

CLIENT: -the check for November-

THERAPIST: Yeah.

CLIENT: -since we're going away next week?

THERAPIST: Yeah, no worries.

CLIENT: Okay. So yeah, I wanted to chat a little bit just about like the billing and insurance and stuff, because I don't-I mean, in no way possible was I expecting you to say don't worry about the-you know, the outstanding balance and stuff like that. I appreciate it a lot. But I don't know if you-I don't know. I just wanted to chat a little bit about whether this was like something that you were actually anticipating, or-because I'm happy to-I mean, if you would like refer to somebody that was in the-like the insurance network, and I would be happy to find something that was more affordable that didn't take up your time and result in you not really getting your full cost and everything.

THERAPIST: Well, yeah, a couple of those. I mean, I have a sense of what the insurance reimburses.

CLIENT: I know.

THERAPIST: That's why, you know, with the audio recording, which does pay-reimburse-

CLIENT: Right.

THERAPIST: -and your co-pay, and what they pay. The reason that this is a little bit less is because part of it went to your deductible.

CLIENT: Right. I did speak to the woman at length about that. I still have no idea what goes where, so. [laughs]

THERAPIST: Yeah. But yeah, no, I knew this-

CLIENT: Okay.

THERAPIST: -or I had a sense of it. It seems like you're acting, you know, like you want to make sure it's okay.

CLIENT: Yeah, because I didn't-you know, because originally I remember being like, "Oh, I should really call that and double check what they're going to cover." But I don't know, I didn't because-well, you were like, "They'll cover it." So but I really-I wasn't expecting it to be such a discrepancy. So I just-yeah, I want-I didn't know if it was something, because we hadn't talked about it yet, so I didn't know if it was actually what you were anticipating. But if that's fine with you, like that-then that's fine with me. But, you know, I just[3:00]

THERAPIST: Yeah. I mean, first of all, between all of those things it's not that much different-

CLIENT: Okay.

THERAPIST: -than my full fee. And also I really do like working with grad students.

CLIENT: Mm hm.

THERAPIST: I think that people should get, you know, treatment, and I like to offer that to people who can't afford my full fee.

CLIENT: Right.

THERAPIST: And so I want to make it possible. So those two things both are important to me.

CLIENT: Yeah. And I appreciate it a lot. Thank you. So I guess if that's the case then each month going forward is that that $40 co-pay-

THERAPIST: Yeah.

CLIENT: -and will it just be what I owe and whatever they send they send?

THERAPIST: Yeah. Yup.

CLIENT: Okay. All right, well thank you, I appreciate it. You know, I was like kind of feeling-I mean I felt guilty because I was like-I had had that thought, like you should really just check with the insurance company, but I just-I didn't, so. But all right. Well, I just wanted to like clear that a little bit.

THERAPIST: Yeah. And it seems like you got really worried.

CLIENT: It wasn't like wor-I mean, in the moment I was-had like a moment of panic, because I was thinking, crap, I don't have like $800. I mean, like I do, but it's my-like what I've been saving from working that I was hoping to buy something with. [laughter] And I was like, "Oh no!" So I had like a moment of like, "Oh god, what do I do?" And I didn't want to have to ask my parents to help me out, because I know that they would have. But I was like, this whole process, I made it a point to like seek out something that I felt was affordable for me, so that I felt like I was doing this on my own and not having to ask my parents for help. Because I know that they would-and they offer it all the time.

I mean, I spoke to my mom over the weekend and she's like, "Well, I paid for your brother's therapy so I'll pay for your therapy." Which blows my mind because he has like a 55K salary. But yeah, I was like proud of myself, because I was like, "Oh, you know, I did the research and I found someone that I enjoy seeing, and we worked it out so it's affordable to me." And so I felt like I failed at that when I go the check from Blue Cross. And of course my mom's like, "Well, I just pay for it," you know. And I'm like, "No, I'm not going to-I really worked hard to make sure that I could pay for it." So that was really where I was like, "Oh." But once I got your e-mail I was like, oh, maybe you were expecting this anyway, so. [5:15]

THERAPIST: It almost seems like you feel you're by yourself. Like this is like all-

CLIENT: Not-no. I mean, I know-like I know that I'm not by myself when it comes to this kind of-I mean, in a way like I do feel like isolated and lonely sometimes with my anxiety, that nobody really understands, or like I don't feel like I can talk to the people about it. But as far as like the money is concerned I just wanted-I don't know. Like since I've got back from Egypt I've just been trying to do as much independently as possible because I don't want to-I don't think I'm doing-I think it's a disservice to me to be constantly relying on my parents for everything. Because like I'm 28 years old now, and I'm still a student, so we have like an agreement that, you know, they're going to provide support as needed, and like I don't have to pay my phone bill, and I don't have to pay my car insurance for now because I'm still in school and I'm like living off of loans. You know, my mom sees it like, well, it's not really-I'm like, "Oh, I have so much money now," and she's like, "It's not really your money because you have to give it back."

But I've just been trying to like-you know, I want to learn how to be a functional adult who knows how to like do her finances and budget and figure out-because I don't feel like I got that growing up, I don't feel-which I am like on the one hand very lucky to have not had to deal-worry about money growing up at all, but now I'm also like don't really know much aboutYou know, the first time I had to budget anything was when I was in Egypt, and they were like, "This is how much money you get each month," and I had to make it work. And so I'm still learning about-like this is the first time I've had an apartment that wasn't-you know, I lived on campus, there was no off-campus housing. [7:00]

So I've just been like very sheltered. So I've just been trying to like teach myself and kind of like separate myself from my parents' finances as much as possible, because I don't want to be in a position that my brother's in where I-like I'm fully expecting that once I become employed, you know, I'm going to take over-once I have the means to I'm going to pay my phone bill, and if it's too expensive I'll get a cheaper phone plan, you know. And so that's all. But yeah. So it's not-I don't feel like I have to do things, you know, without their financial support, I would just like to because it makes me feel more independent. So.

THERAPIST: But even with me, I mean, I sort of-even if I anticipate the difference or whatever.

CLIENT: Mm hm.

THERAPIST: You know, I sent to you, I do forty-you know, $40, and offer you $40 co-pay.

CLIENT: Yeah. Yeah.

THERAPIST: So it would be on me too, it's not just your burden. I mean, that's what I-

CLIENT: Yeah, that's true. I didn't think about that.

THERAPIST: It would be a part-you know, even if we had to negotiate something different going ahead-

CLIENT: Yeah.

THERAPIST: -I mean, I would keep my word regardless. [8:00]

CLIENT: Yeah. And I appreciate that. I just-yeah, I guess-I mean, this is literally the first time I've-you know, this is the first insurance plan that I've had, because I was covered under my dad's insurance until I turned 26. And so this is like the first time I've had my own health insurance. And, I mean, it's like-I don't know. It feels nice that I like pay for stuff. And I know it's like federal loan money, you know, but it feels nice when I like manage my-with the money that they've given me and I like manage it. And, you know, like I pay-for all of my doctors' expenses that I've had with my stomach like I've paid the co-pays, I get the bills and I pay the bills, and I pay for my prescriptions, you know. And it like makes me-it doesn't make you feel nice because I'm sick, but it's like it makes me feel independent, and like I'm taking steps towards becoming a more functional adult. So I like-you know, I'm not just-like I like being able to pay those things on my own. So. [9:00]

THERAPIST: Well, you'll continue to be able to do so in the therapy.

CLIENT: Well, I appreciate it.

THERAPIST: Mm hm.

CLIENT: But so I wanted to ask you, because this like got me thinking, because there was like for however many days or hours that I was like, well maybe I-like, you know, if-like maybe I should ask Dr. Rodgers to refer me to someone that's more affordable or whatnot. But so then I just started thinking about like my therapy in general and was kind of wondering like where-I don't know, like where you see me like going. Because we haven't-I mean, like I know I come here and talk, but I haven't done therapy like this before where I just talk, I'm used to someone likeWhich isn't a bad thing, it's just new for me. I'm used to someone like telling me things and giving me like things to do, you know. I guess more like behavioral therapy I guess. But so I was just wondering, it got me thinking, like I wonder what you think about my situation in life, where you see it going, or like[10:00]

THERAPIST: Yeah, I'm happy to answer that piece. But in terms of-I mean, there are actually just different kinds of therapy.

CLIENT: No, exactly, yeah.

THERAPIST: But it sounds like in a way also-it's not really like developmentally now you've sort of graduated to this kind of therapy.

CLIENT: No. No, yeah.

THERAPIST: But when I think about out it it's sort of like this therapy feels like you have more autonomy. You know, it's less like directive, you know, in that sense. [laughs]

CLIENT: Yeah.

THERAPIST: Like it kind of parallels what you're feeling in your life.

CLIENT: Yeah. Yeah, I guess so. I guess it makes me-and it's probably like a good thing for-because I need to get better at feeling like more uncertain about things and not freaking out about it. But I just like always leave here wondering like what you're thinking and whether I am like-how do I know if I'm like making any progress, or-because I can't tell.

THERAPIST: Mm hm.

CLIENT: You know.

THERAPIST: Well, certainly it's hard to mark that week by week for sure.

CLIENT: No, yeah, and it hasn't been very long. [11:00]

THERAPIST: Mm hm. But I will say-I mean, you're dealing with a whole lot of anxiety that gets expressed in all different ways.

CLIENT: Mm hm.

THERAPIST: It gets very focused on your body as we know at times. What it means and sort of how this will unfold I don't know.

CLIENT: Right.

THERAPIST: I feel like that's what we're trying to like unwrap, for a lack of a better term. I mean, clearly I think there's a lot that we can do and that we're beginning to do to begin to kind of help-I don't if unravel's really the right word, but there's a lot of layers to it.

CLIENT: Yeah.

THERAPIST: And it's pretty profound, and it really does pretty negatively impact your life in particular areas. And in many ways you're thriving, but it really is like a lead.

CLIENT: Yeah. No, I do feel like it's like just this like one thing that kind of holds me back from really getting at my like full potential of everything in life.

THERAPIST: Uh huh.

CLIENT: So, I mean, do we-and I hate to like make this goal oriented, because maybe that's not the point, but is the goal I guess for lack of a better word to like get to the root of what's causing me to feel this way? Or to gain more of an understanding of why and then through that-is that how I like start to deal with it? Or...

THERAPIST: I mean, definitely the latter. Like certainly getting more of an understanding, which I think we've certainly been starting to do.

CLIENT: Mm hm.

THERAPIST: And it's like part of it is about the feelings that you have about yourself and your own confidence in yourself. Your abilities and the ways you feel that you've relied on your parents sort of sometimes almost to the detriment-you feel to the detriment of developing. I mean, not necessarily when you were a kid, when you're a kid people rely on their parents, so.

CLIENT: Right.

THERAPIST: But in terms of getting to the root of it, I usually don't think about it in that respect because it seems so specific, the root of it.

CLIENT: Mm hm, right.

THERAPIST: Because I think there's sort of just a lot of influences.

CLIENT: Mm hm. [13:00]

THERAPIST: But I mean, even in your response, like our e-mail exchange, that-just that anxiety was so palpable.

CLIENT: Yeah.

THERAPIST: Like it's not going to be-like we better do something, but what's going to happen, [inarticulate sounds of anxiety].

CLIENT: Yeah, I know. That was always-I'm supposed to like show her e-mails I send about important things before I send them, because she calls it like my-she's nice about it, and she says like my Chicagoness comes out. But I've gotten into trouble before because I've been like-either I've been like too hasty, or very direct, or-and I think I'm coming off like very friendly and calm but it's not. We got like the-we're now very close friends with our downstairs neighbor, but when we first moved in and I started noticing for a while that like the door-like you needed to-the door to our like I guess-like we live in like a brownstone with like different sections of the building, it was like the door to our section of the building, if you didn't really shut it then it didn't close.

And we didn't really know our neighbors yet, and I like pretty much knew it was this girl that had just moved in in the floor below us, not the guy that we're friends with that lived on the first floor. But like I never crossed paths with him so I couldn't just be like, "Hey, I think it's like this girl that's leaving the door all the time." But we had-I don't know, we live kind of on the border of East Havertown, and like there was a shooting on our street not long before we moved in. I just didn't want the door to our building being left open, because like the locks on our unit door, like you know, anyone could pretty much just-if they wanted to get in they could get in. So that's like-the main door's like my sense of security kind of thing. [14:30]

So I wrote a note, and I put one note on her door and one note on his door, identical notes, because I didn't want her to feel like I was calling her out. But I just never see them, our schedules are opposite, so I felt that that was likeAnd I consulted with one of my friends from college and she was like, "Yeah, write this note." And I like put exclamation points, and I put smiley faces, and I thought I was being like overly nice about the situation, just like, "Hey, I've noticed the door might be broken, but let's just like try to be conscious of the fact that like you need to shut it. And I'll send an e-mail to our management company and ask them to come to take a look."

And that night he came upstairs and knocked on our door and he was like, "Did you guys write this note?" And I'm thinking, oh, he's going to come up and like high five me and be like, "Oh, thanks for writing the note," you know. He was not happy about it. And Amelia looked at the note and she was like, "I can't believe you wrote this note, it sounds so mean and aggressive," you know. So I'm always supposed to check with her about important things. And not necessarily like have her like read everything, but just like that joke between the two of us tends to make me then wait before I press send, and read it after I've calmed down a little bit. Which I didn't do last week.

THERAPIST: Certainly your e-mail did not seem unfriendly to me.

CLIENT: No, not unfriendly. But I think it's like-I guess hasteful is the right-or I don't know. Tense.

THERAPIST: Yeah, you're just anxious.

CLIENT: Yeah.

THERAPIST: And it's sort of like you need to figure something out very quickly.

CLIENT: Mm hm.

THERAPIST: And even we can't even wait till our next session, we have to figure it out in an e-mail before our session. [16:00]

CLIENT: Yeah. Well, I mean, I was a little bit concerned. I was like if I-I was concerned if I was going to need to pay that much money, I was like, "I can't afford another session." But yeah, no. I mean, it's very-you know, my mom and I have been joking around about me finding patience and where I can get some patience from. Especially with my stomach situation. Because so-I mean, I got good news on Monday that all the biopsies came back normal, and so there's nothing-you know, the ulcer's healed and all that's-the inflammation they found last week was what they called mild residual gastritis. Which basically means everything's great, and everything's getting better. But they want me to wait-still be on this diet and taking the meds for another three to four months before I can like start tapering back my meds. So I got upset about it, you know, because I just like want this to be over. And so we've been talking about how I can find some patience.

THERAPIST: Mm hm. [17:00]

CLIENT: But that's definitely-I'm very-I get very tense and I need to know things, I need to have things resolved quickly. And that comes out in every aspect of my life. And it's usually things that like after the fact kind of turn into like jokes, you know. But I think it's like definitely kind of an issue that I do this all the time. I mean, when Amelia and I were dating, first started dating, and it was about a month-so probably like four months into our relationship, and about a month before we were closing our service in Egypt, and I was, you know, realizing that I'm falling in love with her and that I want to try to transplant our relationship back to the States. And it was during a time when we were all applying to graduate schools and kind of looking at what our next options were once we moved back to the United States. And I decided one day that that's a conversation I want to have with Amelia, and I want to talk to her about looking at schools in same cities, and making conscious decisions so that we can try to move to the same city. And then, you know, the conversation about moving in together after the same city happened, like you know, kind of naturally happened after that. [18:15]

But I remember the day that I decided I wanted to talk to her about that I left work in my village early, got on the bus to her village, and I met her at her work, her like-the center she worked at, and then we were stopping at the market on the way back to her apartment to get some food for dinner. And like I couldn't even wait until-it was like a two hour bus ride, so maybe three hours after I made the decision to have this conversation with her I'm standing with her in the vegetable market in her village trying to ask her to-like can we think about moving to the same city? And she's like, "Like, can you wait five minutes, because we're going to be home soon, you know?" And I'm like, "No, I can't wait. Like we need to talk about this, and I've been thinking about it the whole bus ride." And even the guy-the vegetable guy, who doesn't speak English, can like tell from our like mannerisms and body language, and he says to us in Arabic-like we're about to pay, he's like, "Why don't you girls take a minute and work this out before you pay for your vegetables," you know, and I like couldn't. [19:15]

So like we joke about the time I chased her around like the [souk?] in trying be like, "Well, you can bear with me." But it was like I can't-not that I can't, I probably could force myself to wait, you know. But yeah, I'm extremely, extremely impatient, and I get very tense if I'm in a situation of like unknown.

THERAPIST: Is anyone else in your family like that?

CLIENT: My dad.

THERAPIST: Your dad, uh huh.

CLIENT: And my brother.

THERAPIST: He's got like, "No, right away." Or they both have to like do something right away.

CLIENT: My dad more so than my brother, yeah.

THERAPIST: Okay.

CLIENT: Yeah. My dad and I are very similar, I'm finding out more and more.

THERAPIST: Mm hm.

CLIENT: Now that I'm open with him and my mom more about like my anxiety issues I'm finding out how similar we are. And just spending time-like now that I've been paying attention to the way that like my anxiety manifests itself, and when I spend time with my parents I can now see that it comes out in very similar ways.

THERAPIST: As your dad. [20:15]

CLIENT: Oh yeah. Like we are very, very cranky and passive aggressive a little bit, because like we know that-we know what's wrong, but like we're still upset about it and so-but like, I don't know, like he takes it out on my mom a little bit, I take it out on Amelia a little bit. Just kind of like walking around the house and cleaning, vacuuming, that's like our release. So Amelia was laughing when we were home for Thanksgiving, because he was just like vacuuming the whole time. She was like, "I see where you get it." [laughs] So yeah.

THERAPIST: Were you around him a lot growing up? Was he around a lot?

CLIENT: You know, like both my parents were around relatively equally. Maybe my dad a little bit more than my mom. But they both worked full time, and it wasn't-I don't look back on childhood and feel like I spent more time with one versus the other. Like we always did stuff as a family. I think I was around my au pairs most of the time, and my babysitters most of the time. But... Yeah, I don't think I was around him any more than I was around anyone else, but...

THERAPIST: Yeah, I was just more curious about just-

CLIENT: If I picked that up from-

THERAPIST: Yeah.

CLIENT: Yeah.

THERAPIST: Exposure. I mean, there's sort of the genetic element.

CLIENT: Yeah.

THERAPIST: But just the exposure element.

CLIENT: I'm sure I would have like noticed it growing up I'm sure. Yeah. Yeah, I mean, he's always just gotten-like he gets very intense about things, in the same way that I do.

THERAPIST: It has this sort of like-I think about eating disorder, it has a sort of purge-esque quality to it, like you've got to get it out. [22:00]

CLIENT: Mm hm.

THERAPIST: You can't keep it down.

CLIENT: Mm hm. Which is interesting, because as much as I've struggled with eating, it's never been something that I've been able to or had a desire to do.

THERAPIST: Yeah, it's something that you mentioned.

CLIENT: Yeah, no, that's like-you know, I definitely would-yeah, I just-I remember trying once, but I just like-it was just likeAnd I had the thought of like maybe I should try it, but then I was like, "Oh, no, I'm not going to try that." Like it was just never something that interested me. Never something that I felt like I had to do either, I didn't feel compelled to do that. And I really hate throwing up actually. Like even if I feel nauseous, I will try my best not to just like not throw up. So yeah, I never had that issue. [pause] Because like as much anxiety as I have about things going in, once it's in and nothing bad happens in like five or ten minutes, then I'm like, okay, I'm all right, I can have some more of it now, you know. So. Like I just discovered that I can eat-like Greek yogurt doesn't make me die. So I've been like really enjoying myself now at dinner, or like whatever meals I have yogurt with. I haven't had yogurt in a long time, so. [23:30]

THERAPIST: What was the concern originally about Greek yogurt?

CLIENT: I had had-it was because I had gotten really sick off a different type of yogurt, it was like a Danon Light and Fit or something that's like very processed and lots of chemicals, and that had given me really bad symptoms when I first got sick. So kind of like-you know when you get sick from something you don't really want to eat it anymore anyway. But so like after that had kind of passed away though, or like gone away, like I didn't have that like "oo" feeling when I thought about yogurt, I was still like nervous about any kind of yogurt. And we made like [botkas? 24:02] for the holiday and I was like, "I'll just try a little bit," you know, instead of sour cream on it, and nothing happened, so. [long pause] What are you thinking?

THERAPIST: I was just thinking about-sort of thinking about how to put words to your anxiety, and just this-it seems like this overwhelming feeling like feeling that everything's going to be okay.

CLIENT: Yeah. When I went to therapy after I got back from Egypt I remember telling her that felt like I was just like waiting for something bad to happen. Oh yeah, I told you this. And she said I had [unclear 25:10] syndrome, because I was just like life was soAnd I still feel that way, like I feel like everything's so good that like I'm just like waiting for something to go wrong, you know.

THERAPIST: Yeah, but it's like your insides are not matching the outside.

CLIENT: Yeah.

THERAPIST: Because there's this gnawing sense that things will go very awry, and so it's not-there's no correspondence.

CLIENT: Yeah.

THERAPIST: It's like at least if it-I mean, obviously you want things to go well, but if things were not going well at least there would be some symmetry or something-

CLIENT: Mm hm. I know, it's frustrating. I should be like-I should stressed because of school, you know, and because I'm about to graduate my Master's degree in a job market where I have people with Master's degree applying for my position, you know. And I should be stressed about getting a job, and I should be stressed about finishing my thesis and doing well. But like I don't get stressed about those things. You know what I mean? And it's like I just want to be stressed about like the regular stuff, you know. [pause]

THERAPIST: Well, it seems like when you get particular ideas in your mind they don't let up, they kind of just flash in there-

CLIENT: Mm hm.

THERAPIST: -and put their hooks in. [26:45]

CLIENT: Yeah. [pause] Yeah. I feel like I've always been like that. Like when my mom talks about how I was growing up, and I was like a teenager and stuff, she's like-she'll say that there was no like talking me out of something. Like I got something-like an idea in my mind, and like I wanted to do something, and like there was no talking me out of it, you know. Like she'll tell the story of when I went abroad to Madagascar for the first time, and I was like-I was a baby, I was only 19, you know, and I had never been out of the country before by myself. I had been as far as New Hampshire for sleep away camp, but like I had never been overnight or anything like that. I mean, I was in college in Indiana but. And I just called her up and said, "I'm going to do this program." I mean, it wasn't like, "Hey, what do you think about me doing this program," it was just like, "I'm gonna sign up for this and I'm going to go to Madagascar."

And I remember I didn't even know how to say Madagascar, and we were both-my mom and I were like looking and we're like, "Do you think it's Madagascar?" Like, "How do we think we pronounce this country's name," you know. And she said, she's like, "I know you. I wasn't going to argue with you because there was going to be no talking you out of it. When you want to do something you always just go do it no matter what I say anyway." [28:00]

And when she told me not to get tattoos I got a tattoo, she told me not to get anything pierced, I got everything pierced, and it was likeSo we always like joke about it, you know. But I've just always-I don't know. I think it also relates to my inability to like compromise. And I feel like it's like I have this problem where if I don't get my way, you know, I'll like throw the adult version of like a temper tantrum and-or just be like really like pissed off or cranky about it. And Amelia and I were talking about it this weekend, because I justLike she has finals right now, so she's really busy and she's really stressed. And like instead of me being understanding about that and-you know, I wanted to like spend Saturday night together and she was like 45 minutes late coming home. And I like had to go and make a snarky comment before waiting and thinking about it. [29:00]

You know, last year when I had my finals, like I came home to freshly baked cupcakes and a bouquet of flowers and little motivational statements on index cards taped up all around the apartment. And like all I can do for her is give her a snarky comment about how-I'm like she's not home for dinner yet, or something like that. And I like for some reason like all of a sudden this light bulb went on on Saturday during this conversation where I was like, "Wow. I have no ability to not get my way and be mature about it." And I don't know why it took me this long to realize that I can't, that I don't do that. But yeah, it felt really bad. [pause] And I feel like that's all connected somehow. [30:00]

THERAPIST: Yeah. Well, once you get an anxious thought in your head there's no talking you out of it.

CLIENT: Right. Until someone who's like very qualified in whatever I'm anxious about can tell me, you know. Like if I'm anxious about my stomach, if the doctor calls and tells me like, "You're healed," you know, then I'll believe her. But like if Amelia tells me, "You're fine," I don't believe her, you know.

THERAPIST: Yeah, I was thinking in terms of this diet. I mean, in some ways it makes sense, but there's a way in which you go to like this extremely literal-

CLIENT: Yeah.

THERAPIST: -interpretation of things, like as literal as possible.

CLIENT: Mm hm.

THERAPIST: And you clearly have a sort of metaphoric creative mind.

CLIENT: Mm hm.

THERAPIST: You can get very, very literal.

CLIENT: Yeah. Yeah, I'm sure-you know, like right now I'm waiting for this physician's assistant who I've been working with to call me to talk about the letter-because I was like seeing a physician's assistant, but she can't perform the endoscopy, so I was getting the tests done by this doctor, and so then the doctor was giving me the instructions. But they send you these letters in the mail with like no information on them. It just says like, "Hey, it was great to see you. And congratulations, your ulcer's healed, but there's just some mild gastritis. So come talk to me in four months about stepping down your medication." But I'm like, that doesn't-you know, I would like to like ask them questions and be like, well, if it took the ulcer only two months to heal why is it going to take this mild inflammation four months to heal? You know. But so I usually like then will call the physician's assistant who will explain to me everything. [31:30]

So it's like these two different people that I've been like trying to get information out of. And I haven't been able-I haven't heard back from her yet, but I'm like assuming that when I talk to her she's going to tell me that, "Look, if you're feeling well you can introduce some new foods as long as you stay on the medication." But like-and I'm pretty sure that's what she's going to say, because I'm pretty sure she's said that to me in the past, but I like won't budge until I hear from her, you know, and that I hear that it's okay. [pause] So I would like her to call me sooner rather than later [laughs] so I can start eating again. Yeah, I just like don't trust anyone. Or myself. I need to go in like one minute.

THERAPIST: Okay. That's not a small problem.

CLIENT: I know.

THERAPIST: It makes me think about the door and issues around security.

CLIENT: Mm hm. Oh yeah. Yeah. Like I like being able to feel in a sense and know for certainty that everything is like safe and okay, you know. Like I don't want to start eating things that might bring the ulcer back, you know what I mean? Because there's still-like that's what happens, it starts out as gastritis and then turns into an ulcer. So like I want to make sure-you know what I mean? But like without someone telling me definitively that it won't change the healing properties, you know. If you want to have like one beer, you know what I mean, take a Pepcid and then have your beer, or something like that. If it doesn't hurt you then it's not-you know. But I like to like know for certain before I like will do anything.

But it's kind of funny, because then I'm also like extremely hasty about other things, you know. It's like this weird contradiction, where like I won't eat a tomato without a doctor telling me that it's not going to give me an ulcer. But I don't take like an extra day or a couple hours or a couple days to like calm down before I like write a very like haste note or e-mail or make a phone-you know what I mean? So it's weird. [pause] [34:00]

THERAPIST: [unclear]

CLIENT: Yeah, I'm gonna leave. I'll be a little bit late but... I found out about this call like a couple days ago, but I was-like wanted to come in anyway for the majority of the time, so.

THERAPIST: And you're gone now the next two Thursdays. Is that one Thursday or two Thursdays?

CLIENT: I think it's two Thursdays. Well, Christmas Eve is-I mean, the day after Christmas is a Thursday, right?

THERAPIST: Yeah.

CLIENT: Yeah. And so we fly-we're like on a red eye that night, so we don't get in until Friday. So I won't see you until the first Thursday in January.

THERAPIST: Which is I think the 2nd. I think January-it's the day after Thanks-uh, the day after Thanksgiving-the day after New Years.

CLIENT: So are you seeing people that day?

THERAPIST: Yeah. Yeah, I'll be-

CLIENT: Okay. We'll be here.

THERAPIST: Yeah. No, I'm just not here that Wednesday, but I'll be the rest of the time.

CLIENT: Okay. I don't think I have the day off work, so. Even if I did, I'm just down the street. Okay, so we'll just plan on that.

THERAPIST: Okay.

CLIENT: And I don't know, does anything change like once the new year changes over with your schedule? Or is this time still good? [35:00]

THERAPIST: Yeah, this time's still good.

CLIENT: Oh, actually, this time might not beSo I'm going back to school on the 15th.

THERAPIST: Okay.

CLIENT: So for the day after New Years I would still be at [unclear 35:13], but I don't have my class schedule yet.

THERAPIST: Okay.

CLIENT: So I should have that by the time I come in-

THERAPIST: Okay.

CLIENT: -in January. And then we can talk about whether this still works or whether we need [unclear].

THERAPIST: Okay. Well, hopefully [unclear].

CLIENT: Yeah, yeah, I have to see. They don't let us register until the week of class [unclear]. So I'll take a look at that.

THERAPIST: Well, I hope you have a good vacation.

CLIENT: Thank you.

THERAPIST: And a happy New Year.

CLIENT: Yeah, I don't know-if you're going anywhere have fun, or even if you're not.

THERAPIST: Thank you so much.

CLIENT: Enjoy the holidays.

THERAPIST: Okay. I'll see you.

CLIENT: And thanks again, I really appreciate it.

THERAPIST: Oh sure.

CLIENT: I don't want to break up. [laughter]

THERAPIST: You can tell Bethany, but you don't have to.

CLIENT: Well, I'm-I just-I really appreciate it.

THERAPIST: Okay.

CLIENT: So.

THERAPIST: Okay, well take [unclear].

CLIENT: All right.

END TRANSCRIPT