TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
CLIENT: This reminds me of when Jeremy sometimes says, “You’re not sexy, you’re amusing,” when I ask him. You’re sexy. Right now you’re not sexy, you’re amusing. [00:01:00] (long pause) I happen to know that you think that I’m incredibly sexy, which is why it’s more funny than sad.
THERAPIST: That’s good. [ ] (inaudible at 00:01:54) that’s something you happen to know. [00:01:55] (long pause) [00:03:30]
CLIENT: Did you have a good weekend?
THERAPIST: It was okay. I was sick part of last week and I sort of came back over [ ] (inaudible at 00:03:53). It was fine.
CLIENT: I was your last one [ ] (inaudible at 00:03:59) in the hospital. [00:04:01] (pause) Or not [ ].
THERAPIST: The person who was in the hospital was fine.
CLIENT: Then I’ll stop asking about that person. (long pause) It’s a pretty ridiculous dynamic.
THERAPIST: One thing that struck me about that and I don’t know what to do with it is that you haven’t thought of the possibility that it could have been a patient. [00:05:07] (pause)
CLIENT: Yeah. (pause) I don’t know what your patients are like. (pause) And the way the transference is working is that there is so much that comes up around family and I’m sort of letting it just take over. (pause) [00:06:02] I guess it’s pretty unpalatable to me to go down that road of if it’s a patient, are there patients who need you more than I do? I hope so, but then also I really don’t hope so or I really hope not. Are there patients whose call you would take and you would call them back when it’s time to see me? Same thing in combination; and I guess I don’t think I would call you on my way to the hospital. [00:07:16] (pause) But I don’t know. It hasn’t happened yet. (pause) I guess it brings up a relationship with a patient that makes me feel bad to think about, so I guess that’s why I haven’t gone there. [00:07:59] It’s conflicted. (long pause) [00:08:52] I guess there’s a lot there. (long pause)
THERAPIST: First of all, maybe I’m missing something, but it seems to me that one thing to me you’re not thinking about because you don’t want to is, if somebody is having a mental health crisis, they might call me on their way to the hospital.
CLIENT: I know.
THERAPIST: That was on your mind? [00:10:01]
CLIENT: Yeah, it was on my mind. (pause) It’s really [ ] (inaudible at 00:10:23). (pause) I think it makes me very scared (pause) that that exists. [00:11:20] (pause) But still, let’s say I was having – the closest thing I could think of is some very debilitating panic attack and I went to the hospital. (pause) [00:12:02] The way that you help me is not the way that I would want to be helped in the moment. Something like that. I guess what I’m saying is I really don’t need tough love in that moment, but I haven’t really had something like that and called you for it, so I don’t know that maybe your response would be different.
THERAPIST: I see. The tough part is . . ? (pause) [00:13:09]
CLIENT: A lot of space, not [ ] (inaudible at 00:13:13), no hugs, no reassuring things just to be reassuring – stuff that parents and spouses do. “I love you; you’re going to be fine.”
THERAPIST: So at your worst or most frightened moment, I’m at my most clinical at that moment? [00:14:01]
CLIENT: I don’t think it’s clinical. I think there is a lot of intimacy there between us during moments when I’m feeling very, very fragile and you’re giving me a lot of space and still holding it – holding me, holding it. I guess what feels like tough love is the space and I guess I’m used to the sort of smothering love where there is no space and you just get told and it often feels good. [00:15:13] So I guess I can’t imagine in a crisis that, the way that I felt. I can’t imagine you being a different way, but maybe you would be.
THERAPIST: I see. (pause) [00:16:01]
CLIENT: Also, I’m sure there are ways to have a relationship with you where the relationship isn’t such a big part of the relationship. In that case, I’m sure that it would be just way simpler to pick up the phone and call you and something that I wouldn’t think twice about and that I would just want, like any other person that I love. But sometimes, the relationship takes up most of the space and it’s hard to act or say the things I want to say. (pause) [00:17:14]
People go to the hospital for mental health crises very different from acute anxiety-related events, so that’s another thing that I’m not thinking about. (long pause) [00:18:30] When my friend, Fernando, went to [Hoag] (ph?) that was a very different sort of crisis. (pause) Then the thought keeps coming up that if somebody really had the relationship with you like this, then it is possible that a mental-health crisis would stop; and that’s naïve and I’m not quite sure why that keeps coming up, but it is. It’s like well, there is something so healing here, so holding and so protective. [00:20:12] And I actually feel like I have it and I guess it feels like it saved me, like Allison saved Jeremy or Jeremy saved Allison. Maybe not like that at all. I don’t know. So what’s the deal with other patients? [00:20:56] (long pause) I suppose I feel a little disillusioned. (pause) The potential for cure seems so [fast] (ph?) here and if somebody is going to the hospital, what does that mean? [00:22:10] What does that mean about you and them? What does that mean about them? What does that mean about you and me? I guess I’m afraid on your end you’re thinking people have got it way worse than you – or I’m afraid that you’re thinking that. (pause) Sometimes I feel, in general, like the worse I feel I feel a little relieved because I deserve you more. [00:23:02] Or like this hospital patient deserves you a lot more than I do; and yet your relationship with them is a caring one, so what’s that about? Maybe there is no [ ] (inaudible at 00:23:47). I don’t know anything. (pause) [00:24:21]
THERAPIST: It’s big, scary stuff.
CLIENT: Yeah. (pause) [00:25:07] My grandfather’s wound opening is getting real intense real fast as a result of his . . . I think he’s still listening to the series that my dad got him that started my mom in meditation practice, so I’m not sure how much he’s doing it. My mom called me on Friday and told me [ ] is really, really, really upset often. He was weeping and weeping for his son yesterday. He was very agitated and very upset. This is my dad’s brother who committed suicide. [00:26:11] She called and she was like, “Is this supposed to happen?” There was some question, like is this supposed to be happening? I think she just wanted to talk about it because it really upset my mom and my dad. I was so obnoxiously self-righteous in my response. I was like, “This is a painful process, mom. Yeah, that’s supposed to be happening. What do you expect? You sit and things come up and you let them come up. I’m sure there is a lot more where that came from.” [00:27:09] Then later on I was like, “I bet if you sat dad down, both he and [ ] (inaudible at 00:27:15) . . .” They seem to have the same coping mechanism. Anyway, I think I managed to be soft enough where I wasn’t being a total bitch. (pause) He’s mourning a lot and I made it clear that my mom and dad are super, super important in helping him and carrying him when it seems like he needs to be carried. [00:28:05] Also, if it’s really painful, then sometimes it’s like he’s not going to go back to it. I don’t know how to balance the [ ] (inaudible at 00:28:17) or curiosity in the container part of it with the stuff that comes up inside, to loosen, let go a little bit, practice [ ] (inaudible at 00:28:35) I don’t think so, but you could check.
[ ] (inaudible at 00:28:54) (long pause) [00:29:45]
CLIENT: I asked how he was doing the next day and mom said that he is very grateful that he’s meeting his [ ] and he feels good about his practice. (pause) It came up just now because my parents – I don’t think my dad would have reacted this way; I’m sure he’s scared to – but my mom is really, really scared that he might fall into a depression. She kept saying that she wanted to know if it is because of the meditation or if he keeps falling into a depression for some other reason. I was like, “He might fall into a depression. Look how much stuff he has in his life.” But it was like “maybe he should stop.” [00:31:01] She really listened to me, so it wasn’t forceful. She was really frightened.
Bringing up my uncle who committed suicide in the first place – how much fear was there? How much shame was there, even in a different part of the country in medical school? It’s sort of what you did. You sent your kids all over and you saw your kids in summer. That’s what my dad and his sister did, too. And they lost another sibling, that uncle and a fourth; there was a fourth that I just learned about two weeks ago, Polly, who died when she was two. I had never heard about her. She died of diphtheria. [00:32:03] So it started out with four and now it’s two. (pause) My grandfather is 89 and I’m sure the mourning just never ends when you lose a child [ ] (inaudible at 00:32:31). He didn’t mourn, but he and my dad are both haunted by nightmares about my uncle. I’ve never heard them talk about him or his death. It seems like there is a lot stored up or something. [00:33:01] I think about the patient calling on the way to the hospital and what it might have been like for him, if it were completely different. (pause) [00:34:09] There is also the sense that [he] is 89. We don’t want to disrupt his life too much; he’s fragile. I had a different view on it. “Mom, he’s preparing to die finally. This is probably okay. This is probably going to be fine for him. It might be very freeing.” (pause) [00:35:01] So I imagine what the reaction might be to a mental health crisis hospital trip in my family, if it would be similar to what the reaction is to my grandfather’s intensity in what he’s feeling or [ ] (inaudible at 00:35:24), but I don’t really know what the reaction was because I wasn’t there. (pause) [00:36:03]
THERAPIST: And then I think you also worry. I guess it seems to me like there is a small echo of some of the worries your mom has in your thoughts about me or you not being able to be [ ] (inaudible at 00:36:51). (pause) [00:37:21]
CLIENT: Like [afraid of] (ph?) the hospital patient? Yeah.
THERAPIST: Or I guess in a way for you as you worried that moment would be between you and me.
CLIENT: I guess it’s more worrisome that I couldn’t imagine calling you because it might upset you more in that behavioral crisis, but that’s the thing I struggle with all the time. [00:38:31] Would I have gotten in touch with you between sessions? There is always that same loop and usually I decide that it helps me more just to call you or to talk to you, but there is somehow [ ] (inaudible at 00:38:54) in the way before I reach that position because I’m so sensitive to it. [00:39:11] (long pause) [00:41:04] Okay.
THERAPIST: Okay. Sorry I didn’t have something open earlier on Tuesday.
CLIENT: Let me know if you ever do.
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