TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
CLIENT: I told her about my concern and I asked her what her thoughts were and like if she trusts the people and how the process works, and what her take on how much is really being absorbed by the transcribers with the anonymizer. So there's a couple of transcribers, there's only one anonymizer, and they have about 20 patients a month.
THERAPIST: You mean each transcriber transcribes?
CLIENT: No, the company follows about 20 patients a month total. How many patients do you send the recordings for? [00:01:00]
THERAPIST: I don't want to say.
CLIENT: Is it 20?
THERAPIST: Yeah.
CLIENT: Okay. She thinks that the so the transcribers are doing like a million other things. She thinks they're really pretty robotic in terms of how they approach listening. The anonymizer, who she offered to put in touch with me, and I could get in touch with her, I know her name. She has been doing this for a long time and it seems like the type of listening you have to do as an anonymizer is very specific and doesn't allow that much room for following a long-term narrative from week to week. But it could. I mean, she was very honest and straightforward about like this is what we ask them to do, they go and do the HIPAA training, which if it's the HIPAA training I've been through, it's like not really anything. [00:02:26]
THERAPIST: Okay.
CLIENT: They have the science staff and they seem like really upstanding people and you hope for the best, is basically what she said, and she said we had no complaints whatsoever. The turnover is like, they do quarterly uploads, so it's like every three months. Yeah, that was it. She offered to send me stuff that she's done, and I didn't tell her your name or my name. I don't think I need to do that.
THERAPIST: Yeah, I've looked earlier on. I probably have a couple of dozen transcripts, and I found some minor problems with anonymization, that I talked to Robin about and she passed along to the anonymizers. There were things like [00:03:35]
CLIENT: I'm not too concerned about the graduate students combing through these transcripts. I'm more concerned about the anonymizer and how much that person could potentially know if she were following closely, like decided I'm a good president or something, which I don't want to do, but if I do something like that, where it matters what's in public records or even what's in private records, I could see that as being something that makes me not sleep well at night.
THERAPIST: Right. What they communicated to me was that there is no which I'm sure Robin told you, there is no non-anonymized record kept. [00:04:37]
CLIENT: Yeah. That the recordings are destroyed.
THERAPIST: Right. The recording and the non-anonymized transcripts are destroyed, but it's absolutely true that that relies on the sort of honesty and conscientiousness of the transcriber and anonymizer.
CLIENT: Yeah. The horoscope that my horoscope that some people in my family believe… Have I told you about my horoscope? That I'm supposed to be famous at age 35?
THERAPIST: That I didn't remember.
CLIENT: And that if I get married in graduate school, I will have a good marriage, which my mom told me about my sophomore year in college or something. I don't pay too much attention to the horoscope, but being famous, the prospect of being famous, makes this sort of a stickier thing, but I think about it for like one second, and then it's like I don't care. [00:06:24]
THERAPIST: Mm-hmm. (pause) I have something I was going to thinking about what you wrote yesterday. I guess I didn't have much to say beyond printing it up and asking you about you were thinking of me and missing me and wishing we had more time today.
CLIENT: Mm-hmm. I really wanted to talk to you yesterday. (pause) I was also going to talk to you today. [00:08:04]
THERAPIST: If you want, I can arrange back to back sessions on Thursday, starting at 3:45, and going to 5:15.
CLIENT: Okay, maybe I'll look into that fact.
THERAPIST: Okay.
CLIENT: Can I tell you on a Thursday to Thursday basis?
THERAPIST: That's probably tough for me, because it's much easier for me to kind of have things scheduled more, like early.
CLIENT: Okay.
THERAPIST: You know? I can certainly maybe we can figure it out.
CLIENT: You just had a timer on me in that case. [00:09:09]
THERAPIST: It depends on the practice that I'm doing. I mean sometimes it's like, the fact is that it's not like that, but usually I do.
CLIENT: It would be nice to sit together for part of the session and then talk about it, or I think that you can do whatever you want, and maybe after that.
THERAPIST: Sure. (pause)
CLIENT: What else do you think about that? [00:10:11]
THERAPIST: About our sitting together? (pause) I have to think about whether I would feel like it was all right for me to like, sort of boundary wise, but I mean not at all, because I don't think it's nice, but I think that was one thought that occurred to me, and I also wondered what you would anticipate about it. [00:11:39]
CLIENT: I anticipate stuff coming up for me that won't come up if we don't in a normal day here.
THERAPIST: Stuff that comes up pretty easily when you're sitting elsewhere? Do you have particular things in mind?
CLIENT: I guess I don't. I don't.
THERAPIST: Oh, okay, that's fine.
CLIENT: I mean I do but not anything specific.
THERAPIST: I didn't know whether you meant you could refer to it but not it wouldn't come up in as full a way, or with the feelings or something, or whether you just have the sense. Do you know what I mean? I just wasn't sure which of those types of experiences you were referring to that would make sense and that I could elaborate on. [00:12:58]
CLIENT: I think it would remove some of the pro forma like aspect, that I still feel. (pause) And it would also bring a bit of stillness that I don't feel. (pause) Not stillness, like in anything but in any sense, but like worrying about how many minutes. I think it would bring my attention towards something more useful and meaningful to me than it's almost over kind of thoughts, and I think that contrast will help me talk about how the it's almost over thoughts stop me, seem to dominate, like I'm that aware of them, that I didn't go there. (pause) I wanted to talk to you yesterday and for more time today because I have a lot to talk about. It feels like it needs to be sort of relaxed. (pause) There's something that I (inaudible). [00:15:44]
THERAPIST: Well, I'm thinking. I… (pause) I wonder if (pause) you have other mixed feelings about sharing some of the things that you were talking about a few things today that you can't quite access or don't quite feel comfortable sharing, because of various constraints, like anxiety about time or feeling like you don't have enough time, or just not feeling at ease or having trouble feeling in touch. And I wonder if you feel mixed about sharing them. On the one hand you do and you want to connect about them. Then you could feel the closeness that goes along with that as well, talk about whatever they are. But you're also weary, I think particularly from those stupid, crummy boundaries like time and how open I'll be in responding, because those things can really hurt when you're sharing something that really matters. And then in particular, it pretty much sucks to be in a way good in a way, but it sucks to be sharing with somebody who's not who imposes these sort of constraints or closed offness or whatever, and you don't want to get hurt. [00:19:00]
CLIENT: Those words are great.
THERAPIST: Thanks.
CLIENT: I think that you are just too, you're still in that one position, that I am sometimes. Because I'll always think like it's coming from you. I think there's a joint feeling of play by the rules.
THERAPIST: I see.
CLIENT: We both need to follow them.
THERAPIST: Ah-huh.
CLIENT: You are better at following them than I am, so you're the one who points them out more. (pause) I talked to my mom about why she didn't ask me about sadness during the wedding and why she seemed real sad and why she didn't talk about it with me, and other stuff like that. And she said that she was very sad for a time and she dealt with her feelings by herself. She was very sad when Jeremy moved in, not about it, but that was her like letting me go.
THERAPIST: I see. [00:21:21]
CLIENT: And she felt that for that year, she would I don't know how long these feelings stuck around because she didn't tell me about them, but it seems like there was sort of a hard time about that for her and the wedding was not the wedding was sad but it wasn't raw. Those feelings weren't raw for her. I don't know why she didn't talk to me about them when they were happening. So she assumed that I had already dealt with some of the sadness too because to her, the dating for seven years and moving in together was kind of like the big change and she thought that whatever I think she thought that I wasn't really that bad, because I wasn't. I was like so euphoric when Jeremy moved here and had no thoughts and feelings about my parents, like everything was still the same and I just had this other person coming in. [00:22:45]
THERAPIST: Yeah, that was not a transition with your parents.
CLIENT: No.
THERAPIST: Even though maybe it was for your mom.
CLIENT: It had nothing to do with yeah. It had nothing to do with my parents. It was like Jeremy is joining our family, not I'm making my own family that's harder and smaller and less fun and less nurturing, which is what it feels like now. So she thought that I wasn't really feeling sad, but then was really surprised by the flood of anxiety and didn't really know what to make of it and didn't know why it was there and was confused by it. And she said that my dad had not dealt with any sadness really, until after the wedding, and then there was lots of sadness (inaudible). [00:23:51]
THERAPIST: Did she ask you about the anxiety at the time? I understand she's referring to a conversation we just had, but I don't -
CLIENT: At the wedding?
THERAPIST: Yeah.
CLIENT: Well, we were I mean, we talk every day and we'd talk about pretty much anything that's going on. So she knew about it. She was no one really asked me about it in a way that I think would have been helpful. There was lots of listening, there was lots of what can we do, there was lots of like, do you want to get married to Jeremy? There was lots of to Jeremy, do you want to get married to our daughter? And when we said yes then it was like okay, you need to figure out this medication thing, figure out how it works, and like have it by your side and do all the other things that you need to do to get through this, was basically the attitude. This is like the two days before the wedding. In the weeks leading up to it, there was a bit more patience, a bit more exploration, and I bit more just like me telling them about how scary it felt. But, there was no sense of like -
THERAPIST: You are so alone in that. [00:25:36]
CLIENT: I was really alone.
THERAPIST: What about that scenario of all the excitement, enthusiasm and love and celebration and togetherness and a lot of mess, sort of being sad or anxious all at the same time.
CLIENT: In an Indian wedding tradition, there is a very important ceremony that happens at the end of the wedding ceremony, called the Bidaai, and that is when -
THERAPIST: Say that again.
CLIENT: Bidaai. It's when the bride's family says goodbye to her and like gives her to the groom's family. In contemporary westernized Indian weddings, usually that's left out. We didn't do it either but my mom and I talked yesterday for a while, about what's that actually like, and it sounds like it would have been incredibly useful for me. She said that what the ceremony basically is, is like hysterical crying on the part of the bride and the mom. And then it's like you're hysterically crying and you hug your parents and then you hug your husband's family and everything just gets like (sighs), like -
THERAPIST: Yeah. [00:27:20]
CLIENT: Like opened up. Which I didn't really know. I didn't really know like how it goes down, and I told her that I thought that would have been immensely useful. But instead, like I didn't cry the entire time, except for the morning after the wedding. I didn't cry and I didn't nothing was really acknowledged about how hard it was, and on top of that, there is like all this momentum, so there wasn't much time for me to really pay attention.
THERAPIST: Yeah.
CLIENT: I think it was hard for my mom to talk to me about this yesterday. There is this sense of like, well how are you doing now, kind of thing, and I was like, I'm finding it very important and useful to talk about how I was doing back then, and she said, "Good. I'm glad this is useful." I stopped taking Zoloft, I want to say two weeks ago, and I'm feeling the biggest thing that I'm feeling is I'm feeling happier and I'm feeling much more anxious during I still have that anxious energy that I think is very forward propelling. [00:29:38]
THERAPIST: What time did you talk to your mom yesterday?
CLIENT: That wasn't yesterday, it was Monday.
THERAPIST: I'm sorry.
CLIENT: I kept saying yesterday too. It was whatever, I don't know, between 5:00 and 7:00 p.m.
THERAPIST: I have wondered how it related to thinking about and wanting to talk to me. In other words, like that had to have been like before.
CLIENT: I had a panic attack Monday night at midnight?
THERAPIST: Oh, how terrible.
CLIENT: And I have not had a panic attack before, except once before the wedding, and I don't know why now. I think there are lots of possibilities. I was really tired. I had gone to sleep before everybody else. It was sort of a late night. Dad stayed up really late, like being really engaged in this conversation they were having about their education and what are you taking now, compared to decades ago, what books they're reading and what classes. So it was sort of a lively… [00:31:24]
THERAPIST: I want to get the timing. So you talked to your mother on Monday.
CLIENT: I talked to my mother on Monday.
THERAPIST: And the panic attack was Monday?
CLIENT: Monday at midnight. There was also like -
THERAPIST: Right, and it was the party.
CLIENT: Yeah, I mean it was like just us.
THERAPIST: Okay.
CLIENT: Jus happy, really happy times, very lucid and honest and there was people everyone was just really happy to be together and hear whatever is going on. So the talk with my mom sort of fits into that. Dad expressed how he, on his birthday, was thinking a lot about his brothers, all of whom are now dead. The last one died this year or the last two died this year. He had four brothers. It was like really this is why I want more time. I think it was a really good illustration of how that sort of offering, like today I'm thinking a lot about my brothers and how I'm the only one left, gets turned into kind of this compact, this like compact box in my family, with like a bunch of humor sprinkled onto it. So people are like yeah. And I asked him, "Are you feeling lonely because of those thoughts?" And he said yes and the only one left, and then my brother said, "And Margaret Thatcher died," and I said, "And she was your long lost brother, I don't know if you know." He found that to be really funny and then we just like riffed on that for a while, like well she's called the Iron Lady, but you outlived her even, so you must be the iron man. And that was the extent of the I'm feeling bad because my brothers are all dead conversation, and I wouldn't have noticed that (inaudible). [00:34:18]
I went to bed before the NCAA final was over. Everyone else was watching the game. My brother was supposed to come in through my room, into the prayer room, which was pictured in a lot of the wedding photos, where he was going to sleep. I was sleeping in his bed. It was really, really, really, really, hot, like upstairs in that room, and I had to wake up early to catch my 8:30 flight, for which we needed to leave at 7:00, and I was super tired and I was not finding it easy to wind down or meditate, because I was so tired. My journey to Virginia was fine but it was long, it was like five hours on various trains and planes. So, something startled me around midnight, which was like an hour after I tried to go to bed. I didn't sleep well for that hour and my brother had come into the room and was making some noise in his room, and I was like unbearably hot, so I got up, went to my parents' room, asked if they were using their fan, and brought the fan over, opened the window, which like I don't know why that didn't occur to me. My mom was like, "You can open the window." [00:36:14]
And then I basically, I turned the fan on and laid back down and was just sort of in a completely different mental state, like feeling super agitated, super frustrated, really physically uncomfortable, anxious about not falling asleep, anxious about not like how these feelings feel different and how Zoloft might be affecting it, or lack of Zoloft, how I don't usually carry Ativan around with me, but how like maybe I should have brought it with me. And then sort of that developed into uncontrollable racing thoughts and feeling like I was going to die and needed a lot of help and couldn't ask for it, and being anxious about whether I should ask for help. (sighs) It was horrible. [00:37:39]
THERAPIST: It sounds horrible and I think (pause) you fear as well, it's hard to be in touch with (pause) what you were feeling that made you so worked up.
CLIENT: Yeah, it was hard.
THERAPIST: I think you're probably really upset.
CLIENT: Now?
THERAPIST: Probably. [00:38:40]
CLIENT: Did you say you are or you were?
THERAPIST: I said are, but I didn't finish the -
CLIENT: Sorry.
THERAPIST: That's okay. We only have about five minutes. I think you (pause) I think the constraint here, of maybe time especially, feels to you a little like the constraints in your family around what is and isn't okay to talk about. I think you feel similarly kind of hemmed in and sort of blocked in a way, from really being able to feel what you feel, particularly how you feel sad, upset, frustrated. I think with your family, it's probably to do with your sort of euphoria and frustration and sadness as it becomes more evident how you can't talk about some things with your family, who you love so dearly, some things that matter tremendously to you.
CLIENT: I don't know. I don't know if that's happening. [00:40:33]
THERAPIST: My impression is that you sort of in a way, more like you can talk about it, but also feeling sort of hemmed in by the time in a way that make you feel like -
CLIENT: Yeah.
THERAPIST: you really can't fully get into it.
CLIENT: That's definitely true.
THERAPIST: Sometimes I imagine that sort of feels somewhat akin to that sense of being hemmed in, in your family, and probably is a little in parallel with feeling sort of like, you know, the air in the room is like hot and closed, and curiously, you didn't think to open the window.
CLIENT: Mm-hmm. Why don't you ask or care about how I got out of it, because that seems pretty important to me but I'm hesitant to bring it up, because you also think that I am focusing on the good. [00:41:52]
THERAPIST: I do care how you got out of it. I just sort of haven't got there in my thinking on it. And I don't know if it would feel to me, like you were avoiding other stuff or saying something. I mean, it's never felt like you're just avoiding stuff, and maybe it wouldn't feel like that at all. How did you get out of it?
CLIENT: I sat with it. I guess I meditated and I sort of imagined okay, all thoughts and feelings are little slices and they're all part of me, but they're not the whole thing and they're impermanent, and all I have to do is bear them. So it's like okay, here's another slice. It feels like it's going to kill me. [00:43:47]
THERAPIST: I'm smiling because it's like, yeah that sounds like avoiding things to me. It sounds like the opposite.
CLIENT: No, it doesn't sound like avoiding things at all.
THERAPIST: Yeah.
CLIENT: And there is also, like a lot of like okay, what's my head doing, like what are my ears doing, what's my neck doing, and I was scanning my body sort of up and down, which I found to be very helpful. Yeah, it was pretty amazing.
THERAPIST: Good.
CLIENT: It was very different from where I would have been ten or eleven months ago.
THERAPIST: Mm-hmm, good. Well, we should stop. [00:44:50]
CLIENT: So, if I did 3:45 on Thursday, I think it would be in place of today.
THERAPIST: Okay. Just let me know.
CLIENT: Okay.
THERAPIST: Bye-bye.
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