TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: I will [try to] (ph) pay your bill this weekend.

THERAPIST: Great. You'll pay (inaudible at 00:10) bill?

CLIENT: Maybe next week.

THERAPIST: Nice. Very good timing.

(silence)

CLIENT: So, the New York is complete. We settled on terms. I'm flying out there on Monday.

THERAPIST: Oh, congratulations.

CLIENT: Thank you. And, you know, it's going to solve the money problems, so (inaudible at 01:13) (laughter)

THERAPIST: Will you have different insurance?

CLIENT: I'll take Cobra while we're figuring out, you know right now I'm a contractor and I think there's some question as to exactly where this project will sit from. But, you know, right now we have a handshake deal that this is something we're going to do. We'll be on the (ph) short term contract. (pause) These are old friends and colleagues and (sighs) on the one hand, I feel just an almost indescribable sense of relief that there's really something that's actually viable for the long term. And, you know, it's clear to me how much of what we've been talking about, really, for the last months has been just stress, sort of kind of existential stress. Not causally (ph). I guess that's the other hand the other hand is I feel concerned that (pause) like I don't want how can I put this? I feel concerned. Let me just put that out there full (inaudible at 02:54). I feel as if this gig is a [inaudible] or rather if this gig is like some kind of silver bullet (inaudible at 03:09). You know, if this gig solves things, solves everything, then so much is riding on it I fear that I won't be able to deliver.

I guess that's what it is. I have concern about my ability to deliver when the stakes are very high and the stakes appear to be just sort of basic well-being well beyond, you know, the kind of (pause) prospect of a professional path and the kind of bourgeois household and sort of, you know, the things that I want beyond that is like (pause) I was at the point a month ago where I just couldn't be with myself when it's status was uncertain. I couldn't pursue any other path. I couldn't, you know I put all of my eggs in this basket and, you know, it looks like the basket is going to hold, for the moment at least. I fear that if all the eggs remain in this basket, in a psychic sense as well as a fiscal and whatever other sense, that it's integrity will not be sustainable. Does that make sense? [00:04:33]

THERAPSIT: Yes.

CLIENT: So I guess that's my concern.

THERAPIST: It's something about the extent of your investment in this or kind of dependent (ph) on it will get in the way of your being able to work the way you need to (ph).

CLIENT: It's more complicated in that too, as I think about it out loud here. I'm uncertain about it. It's a huge change. I mean, it's almost huge in a multi-generational sense. I mean, you imagine. Certainly my upbringing was pretty miscellaneous but, you know, I have (pause) it's hard for me to think of myself joining an organization that will give you, you know, just this insane consulting contract at the drop of a hat. Now, you know, as I sent them my CV and they did a, you know, kind of...

THERAPIST: What's insane about it? [00:05:35]

CLIENT: It's a crazy amount of money. It's just ridiculous. I mean, it's like, you know, it's the establishment. I have to buy a suit. I have to look, you know, really put together. I have to think about how to conduct myself in a manner that's commensurate. You know, once I'm on payroll I won't be able to write letters for the nation. I mean, you know, I've (pause) I don't know if there's a change in values that internally I'm uncertain about but I know how these things works, you know. So if it's going to fly, if the basket is going to have integrity, you know, there's a level on which I genuinely need to commit. I can't be ambivalent about it. And, you know, I'm trying to think about whether I'm capable of it in an organizational sense, you know, conver-freaking-sational (ph) and logistical organizational, et cetera. I think I am. It seems pretty clear to me that those parts of it, if my head is right, I can do. And I think what I fear is that (pause) I don't actually I don't know, I don't know. I don't know if I'm as confident as I just presented myself to be but I definitely fear that I'll be kind of a house divided against myself and then I'll have trouble committing, you know, in the way that I need to commit in order to make this, you know, viable, interpersonally viable, you know, psychically viable, intellectually and so on and so forth. [00:07:22]

I mean, if I'm I don't know. Anyway, I'm just sort of venting my concern I guess. It's not a well thought out analysis or anything. So that's one thing that's going on. And the other big thing that's going on has been, you know, this thing with Jennie where (pause), you know, has (pause) tomorrow (inaudible at 07:50) keep yesterday and the day before and we had, you know, we had a big (pause) I guess confrontation, like a conflict that we'd really been, you know, sort of very (pause) we've just been paving over with affection. I guess affection and, you know, mutual regard and whatever came to a head and it's been a really difficult conflict. I mean, I guess yesterday what came so I said basically, you know, "I want more compassion from you." And she said basically, "I want you to listen me more and not burden me so much with, you know, with what's troubling you." And I guess what so tomorrow's intervention was that (pause) we would kind of step up our knees as a zero-sum game where, you know, when I want affection or compassion and not listening, and when she wants me to listen she's refusing to be burdened because she feels like I'm not listening, if that makes sense. Is that (inaudible at 09:22)?

THERAPIST: Say that again.

CLIENT: Look, I (pause) it always feels kind of funny and weird to, you know, talk about our relationship issue in this way but I know why I feel resistance or it feels funny. It feels like a self-help book. It feels like (inaudible at 09:43). I guess it sort of boil down to the lowest common denominator. I wanted her to kind of acknowledge well, I wanted her to acknowledge, you know, what I had been willing to contribute to the relationship by taking this...

THERAPIST: (inaudible at 10:14)

CLIENT: ...clearly, clearly, you know, potentially troubled position. And it felt to me like I had done it for the relationship at least. I had made the decision to do this partly at her behest, you know, so we could support a household together. You know, that was, like, the best option at the time. I wanted not to feel as if some of the angst that I was feeling as a result of this is a direct result of this, you know, kind of professional situation was out of bounds where she knew it was just too much for her to, you know, to kind of assimilate. And I felt angry about that. I felt angry that (pause), you know, this burden that I had taken on, which has some, you know, significant side effects for me, was just too much for her to bear. The side effects of that were too much to bear. (sighs)

I guess I wasn't totally conscious of how much I was blaming her or the way in which I was expressing it in a kind of blaming way. I was... [00:11:33]

THERAPIST: I see. Like you were blaming her for having...

CLIENT: For how bad that I felt, or at least that's the way that she was feeling. You know, so she would feel blamed and she would feel like I was putting her responsible. She would feel like the situation, you know, the sort of a rationale for taking Phil up on this offer was more complex and I wasn't applying for other jobs in the Boston area that, you know, would be alternative. And she just...

THERAPIST: You wanted to be appreciated and she felt like you were blaming her.

CLIENT: She felt like I was blaming her. And so, you know, I mean, we kind of figured that out yesterday and that was a huge deal. I mean, basically we had this huge blow-up. I'm not great at expressing anger, as you know, and it comes out in some convoluted ways but, you know, I had said to her, you know, as this was sort of bubbling out earlier in the week, you know, let's sort of save that for tomorrow. And I did and I, you know, I yelled. And it was tough. And she responded, you know, the way that she does, which is not yelling but being kind of cold and not very compassionate. [00:12:42]

And so we, you know, we really sort of had it out with mediation. Tammy just let us go. And then, you know, it was hard. It was painful. We each went and hung out with a friend afterwards for a few hours and then came back at nine or so and, I don't know, [it was just as if] something had just been aired and we hadn't quite sort of figured it all out and Tammy saw us yesterday too and kind of talked about some of what I just described.

But I don't know. You know, and the relationship was really in the balance, it felt like, you know. It was really a question of whether, you know, whether somehow, it felt very existential, being able to navigate this conflict well. I mean, this is big, long term, months long conflict. Actually, in some ways a conflict that has existed most of the time that we've been together. And, you know, I guess we had to figure out whether we could get through it. And, you know, as I was walking and I was, you know, thinking about it, I knew that I wanted to be with her. I knew that I certainly didn't want, you know, beyond that in a kind of, I don't know, life instrumental sense. Maybe it's a little instrumental. I didn't want, you know, I didn't want everything to change and I didn't want to sort of be in a position of making decisions where everything changes at once. Do you understand what I mean? [00:14:40]

So it felt very weighty and it also feels like we kind of got through it, at least for the moment. So that was good. (pause) So I guess where I am right now is (pause), you know, I'm trying to put on this new sort of inhabit this new space, you know, to think about this new project and think about these new colleagues, this new work environment, this new kind of thing of mine without leaving everything behind. I feel myself avoiding you know, people have been very nice and actually reach out to me quite a bit at work. I have a hard time. I can feel myself struggling with, you know, on the one hand the sense of being a little bit frustrated, you know, of having felt devalued. And I think what I felt devalued by ultimately was structural. I think that people have been very good willed and, you know, wanted good things for me. But, like, the situation was such that there just wasn't a place for me where I could...

THERAPIST: (inaudible at 16:08)

CLIENT: ....could kind of inhabit this (ph). At the end of the day, that's really the problem. You know, Phil (sp?) and I liked each other and we wanted to work together. Phil (sp?), you know, has some structural limitations that I think he's compounded by the way that he's operated. But at the end of the day, you know, those are structural limitations and he overpromised, but I expected that overpromise and, you know, I was capable of seeing if he was overpromising. I have that capacity. And, you know, some of the reasons why I ignored that had to do with, you know, Jennie (sp?) and our situation but some of them, you know, some of them also had to do with me just kind of ignoring things that I saw clearly because I wanted them. So I thought that [owned that] (ph), I think. You know, I wanted the appointment. And on the other hand I said, you know, it was clear to me that there was a kind of structural weirdness to getting in an instructorship. [00:17:07]

THERAPIST: I don't disagree but I would...

CLIENT: Yeah, you want to (inaudible at 17:14)

THERAPIST: ...put it slightly differently, which is to say that all around you want a home.

CLIENT: I want a home, that's right. Fair enough. (inaudible at 17:26)

THERAPIST: Sure. And I think that (pause) specifically your worry about not having or finding one can make it hard for you to sort of see and acknowledge problems with this sort of unfortunate ironic effect that it makes it harder to then [stand where] (ph) you want.

CLIENT: Yes, OK, perfect. I endorse that. I endorse that fully. So at any rate, you know, so I can kind of see how it happened. I have felt, especially while I was seen with her, I did have a home. So that's very good. You know, now that I have a home, now that I can see a place for me myself to inhabit, all of these other things suddenly seem easier. And, you know, in a home, in the professional sense, in a home with Jennie (sp?) and they're related to each other in the sense that in order to, like, furnish our home, you know, we need cash. [00:18:41]

So, there you have it. That's where I am right now. And, you know, I feel (pause) I have a lot of bad habits that are the product of kind of existing in the state of homelessness. But they linger and it will be a challenge to kind of undo them. I think that's what I originally imagined doing with you (laughter), which is coming and getting those tools. And you're right to shy away from an instrumental solution because, you know, in some sense the home was the prerequisite for, you know, for working on them. I think part of the concern that I feel, that I spoke of at the top, is related to the knowledge that I have some bad habits that make working harder and that I need to acquire if I will be able to inhabit this home, you know. [00:19:54]

I am capable of it. It's evident to me that I am capable of it but I feel a sense of responsibility and urgency to think about how to improve my habits and my sort of sense of order and execution of that sense. Because I can get (ph) that and I can sort of reconcile, you know, the question of values and value. Those seem like the two big things right now, going forward.

THERAPIST: I guess to me the (pause) is the extent of the (pause) anxiety and also anger (pause) that you feel when a home seems in jeopardy. And (pause) I, you know, I hope not. I hope the sailing is as smooth as it could possibly be but life being what it is I imagine there will be moments in the probably not too distant future which will feel like that, both with Jennie (sp?) and with the new job, which is not to say you will in some sense in reality be on a crucifix (ph). And I think you'll feel that way. [00:22:00]

CLIENT: Well, (inaudible at 22:03). OK, so what's the prophylactic intervention here?

THERAPIST: Well...

CLIENT: Just acknowledging it? Just saying, "This is going to come and, you know, you'll have to deal w/ it better than you have in the past"?

THERAPIST: I think that you're kind of (pause) unwillingness to sort of see that and kind of take it seriously and anticipate it's (ph) much less than it used to be.

CLIENT: Unwillingness is less. My willingness is greater.

THERAPIST: Yeah, you're more willing.

CLIENT: Yeah, I see it clearly. I see it clearly. (pause) That's what you were calling responsibility several weeks ago.

THERAPIST: Yeah. And it's tough and I think it's a very scary thought to know that (pause) in other words, I think your experience of this is, like, kind of less bimodal than it used to be where you were either sort of (inaudible at 23:33). And that requires a kind of ongoing recognition of the worry or the frustration that could be looming (ph), which I think is the ability to kind of tolerate that and do it. I think it's the thing that's somewhat prophylactic because if you don't you wind up getting hit sort of blindsided, is the better word when something happened.

CLIENT: Yeah, I guess one of the things that's scary or that I feel concerned about (pause) is that often I'm often of convetiology (ph) of the feeling and not able to interrupt it. You know, I'm aware that when I'm completely checked out, you know, basically what it's coming from but I can't sort of change my consciousness and respond in a different way. And that's still a big issue and I'm not sorry, become instrumental again in my I feel like I need some way of doing that and I don't yet have it and, you know, I'm entering environmental (inaudible at 25:02)

THERAPIST: So, what could come up at work or with Jennie (sp?) that could (inaudible at 25:15) in other words, what large or small goings-on could in other words, could we look back three months from now and say, "Jeez, maybe we could have called that."

CLIENT: Well, I mean, this often seems to be triggered when I feel, you know, devalued and kind of minimized. And, you know, in an environmentto see some degree I'll be protected in the sense that, you know, apparently Kevin has been saying that I'm coming on board so that, you know, people aren't going to be openly aiming for me. But, you know, it's like it's a high dollar institution and that means that people are very competitive and they're competitive for, you know, their own credit and they're competitive for their success and that means that, you know, when you have people competing for those kinds of commodities that means that part of the game is, you know, devaluing the work of other people or, you know, asserting your hierarchical superiority or what have you. [00:26:29]

So I don't know exactly how that'll come up and how they'll interact but, you know, this is a risk and I think the other side of that risk is my, you know, over asserting myself, you know, in a way that forces my colleagues to kind of distance themselves from me in a way that would be very upsetting. I remember, you know, in 2008 when I came back. Now, granted, you know, my household was sort of in a total shambles and, you know, my head was in a very bad place. I'm far, far more involved, you know, in many ways than I was then but I remember how it happened, you know. I kind of over asserted myself and over presumed on my connections, at least, you know, by my likes, by my evaluation, and the results were not very good, you know. People pushed back. My colleagues, you know, my old friends kind of distanced themselves a little bit and I just felt completely at sea. I didn't like myself, you know. I was angry at myself. I was angry at the position that I was in. I felt isolated and, you know, kind of alienated. [00:27:56]

So that's the other side of the dangers, the other kind of situation in which I can imagine this complex being trigged. It's hard to navigate. It's hard to balance, you know, those two competing priorities. I want to show my value. I want to create a home for myself. I have to compete with people to do that but I have to do it in a way that's socialized and that's right.

THERAPIST: What will you actually be doing? What's your role?

CLIENT: So, Kevin came on and one of the things that was kind of a central talking point was what he's been calling for five or four years now a science of delivery, which is essentially, you know, I think the kind of classic attempt to use operational science as it's evolved in the private sector to improve kind of the tenth yard, you know, improve the implementation of social programs. Basically in a nutshell that's what it is. It's public sector... [00:29:19]

(crosstalk)

CLIENT: ...not done a really good job of moving from policy to execution. You know, the evaluation of them has been, you know, extensive but not necessarily very effective and the question is whether there are some consistent tools and institutions that can be developed in order to improve how they actually going into practice in all sorts of different Settings and how, you know, you can take a success or a failure in one place and, you know, use it programmatically in another place.

So, I mean, he opened this idea of the Medical School and frankly, it's not an environment that's really well-suited to this kind of thing because they don't have any policymaking power, even though they think they do. And, you know, even though the whole sector in the U.S. is a large part of the economy and very well-favored, in most developing countries that's not the case. So then he went to the university. He wanted to do something, you know, he set up a delivery science center or something like that, but it was pretty moribund, you know, partly because the school is just a difficult place to navigate probably because he had a lot of other shit to do. I was looking at it and they haven't really done anything. [00:30:40]

But now he's at, you know, a major development institution, quite frankly a place where you could really do something like this in a big way. And so he's been talking it up in his speeches and in a sort of initial problematic of a five year administration and really wants to move on it but it's a black box. So what does delivery science mean? You know, what kind of principles are you talking about? What kind of tools would be included in this rubric? What kinds of institutions will be developed within, you know, the larger institution of the World Bank in collaborations within different countries?

So they don't know and now it's, like, starting right now so they had a bunch of I guess information science people within the bank, knowledge management people within the bank, come up with, you know, some presentations. And I'm not quite sure. I haven't spoken with him directly yet, so I don't know how he's thinking about them. There's some aspects of what they came up with I'm a little skeptical about. You know, they want to own this major new initiative of his and I think that at the end of the day probably he wants somebody, you know, he knows well and is loyal and he can trust to give a good critical evaluation, you know, to be involved at a kind of central level. [00:32:05]

So he wants I mean, I don't know institutionally what my role is or could ultimately be but basically, you know, he wants me and Jack (ph) or when well, I've talked about Sergio (ph) but to, you know, to kind of be his men in Mexico as this thing gets put together. That's my sense.

THERAPIST: So...

CLIENT: So we would be responsible for basically sort of orchestrating, organizing, you know, a space for critical evaluation and, you know, institutional development of this idea, of this principle.

THERAPIST: Sort of like theoretic project managing is a big project of...

CLIENT: Yeah. I don't know exactly it's not clear to me and I'm not sure it's clear to anybody at this point, you know, exactly what the formal role will ultimately evolve into. But he kind of wants us to put it together synthetically. It's like, there are all of these pieces, you know. There's a lot of invested interest. People want to push it in one direction or another. And my sense is that he would like us, assuming that I can get my head right, is he said to me pretty openly, quite frankly, and sort of work with people as a team, he wants us to kind of herd the cats. If that's project managing, I guess that's right. [00:33:39]

But, you know, I mean, we have a lot of respect for each other in terms of the way that...

THERAPIST: You and Jack are somewhat co-equal or...

CLIENT: Yeah, for sure. IN fact, they gave me the same consulting view (ph) they gave Jack. (laughter) And I think that had nothing to do with anybody. I think they just assumed they did my CV to the people who evaluate such things at the bank. So yes, we're co-equal. We're co-equal.

THERAPIST: And you both report to Kevin?

CLIENT: I think I report to Kevin's communications director formally because you can't really report to Kevin unless you're traveling all over the world. That's not where we're at at this point, right now anyway. But, you know, ultimately we report to Kevin in some sense, in the sense that the expectation is that, you know, he's got this central agenda and he wants us to make it happen. I think that's right. I think, you know, some of it is dependent on, you know, how well it goes over the next few months in terms of how much formal responsibility I ultimately get but I think that if it goes well in this I mean, I think my responsibility in the immediate term is to kind of get it done on paper, you know, to kind of take the various ideas that people have and to develop, you know, some clear and discreet a work plan, basically. A work plan and associated, you know, like a white paper and some associated project-related stuff. I think that's what the consultancy's going to be about. He's coming back from China on Monday and we're going to talk with some other people about the stuff. But that's my intuition about... [00:35:40]

So that's pretty clear. It's big. It's exciting. It's something stewable (ph). It's about 8:30.

THERAPIST: Nope.

CLIENT: Not yet?

THERAPIST: (inaudible at 35:54)

CLIENT: I spent apparently quite a bit of energy anticipating these things.

THERAPIST: I guess so.

CLIENT: And I expect my friends and colleagues in the same way to see if I've overstayed my welcome so it's not a minor sort of interactive dynamic. Just (ph) expecting you to see if it's 8:30.

THERAPIST: Yeah, I imagine you're really anxious about not feeling welcome.

CLIENT: (sighs) Yep, exactly.

THERAPIST: And that that can feel kind of dichotomous. You know, at 8:29 (inaudible at 36:57) comfortable and at 8:30, in 30 seconds, it's a different ballgame.

CLIENT: Sure. I mean, to me (ph) it's kind of, I don't know, a completely different ballgame (inaudible at 37:15) that it's ambiguous but no? Is that...

THERAPIST: Well, tell me about it.

CLIENT: Tell you about it. (pause) Till 8:30 it's my time. After 8:30 it's your time. That's nothing (ph) different.

(silence)

CLIENT: I'm being a little gross about it but, you know, I think that's how it computes at some level.

THERAPIST: And (pause) what are the implications of that?

(silence)

CLIENT: What are the implications of that?

THERAPIST: I guess...

CLIENT: I'm thinking about it. I'm not dismissing the question, I'm just sort of considering it. [00:38:30]

THERAPIST: I guess what I think I'm kind of what [I'm realizing] (ph) I have in mind is (pause) I don't quite know how to put it yet but I'll throw something out there. So it's almost like the relationship changing. You know, it's not like you're you and I'm me and the relationship's the same and, you know, it has this boundary or limitation to it. It's like the arrangement's different between us, you know what I mean?

CLIENT: I mean, the only (ph) thing that provoked a similar worry, I think is the best way to put it on my art or at least sort of statement of, you know, the terms of interaction was my debt to you. That (ph) the dynamics, how I think about that debt, initially at least, provoked a similar sort of worry. We negotiated over it and I don't feel great about how well I delivered on my end of it but, you know, I did get a sense in the end that, you know, we're managing it as best we can and our relationship hadn't really changed, you know, that we could kind of interact in the same way despite the fact that in some sense I was on your time just to try to use the same terms of reference. [00:40:19]

So, you know, if that's the precedent then it's funny hat I think about things in this way because it's not necessarily the case but at 8:30, you know, everything has to change and we have to interact in a different way because it's on your time. The relationship is continuous and, you know, (pause) it's not fully articulated by who's time it is. And yet I still have this construction (ph) and it's a very powerful one and (think that this is not the only place where it comes up.

(silence)

CLIENT: My father used to say, when we complained about my grandmother's cooking I think I mentioned this to you before maybe "It's more a blessing to receive than to give." [00:42:01]

THERAPIST: Meaning?

CLIENT: Meaning that (pause) well, the sort of usual expression is, "It's more a blessing to give than to receive." And I think what he was saying was that, you know, you need to...

THERAPIST: (inaudible at 42:28)

CLIENT: You need to be able to accept things when people offer them to you, you know, without being resentful or appreciating that this is part of your relationship, is receiving things as well as giving them. Does that make sense? That's how I understood it anyway. You know she's an old lady. It makes her happy to give us things. But the kind of larger point that I've always imperfectly (inaudible at 42:55) past precedent would suggest that I've always taken from it is that, you know, in any relationship there's some accepting and if you're not good at accepting or accepting means that you become constrained or feel constrained or altered in the relationship then that's a bad thing. You know, you have to how to accept things and not feel as if, you know, you've done a terrible thing that alters the relationship entirely.

And I think that a lot of the difficulty that I felt and, you know, just the sense of, I don't know, the strain that I felt or some occasional catatonia (ph) that I felt stems from that dynamic as much as, you know, being without a home and being I mean, I think that's there too, you know. People offering me things and feeling like I have to deliver on them and not being able to deliver on them. [00:44:16]

THERAPIST: I don't see those things as sort of different in a way, in a sense that there's no place that's 100 percent home and there's no relationship that's 100 percent right (ph) and reliable. And it can be difficult to sort of be OK with the uncertainties and limitations and (inaudible at 44:41).

CLIENT: I think so, I think so. OK. Your time.

THERAPIST: Yeah, we should stop.

CLIENT: So I will see you on Wednesday. I'm back oh, wait problem. I'm coming back Wednesday morning after. I think yeah, I get back at 10:46. So if we can't reschedule then we should just plan on meeting Friday.

THERAPIST: I'm (ph) looking at later Wednesday or Thursday or Friday.

CLIENT: Do you want me to call you and you can look at...

THERAPIST: No, it's OK. At the moment because I know I just (inaudible at 45:22) for somebody late in the day yesterday. I don't think I have it (inaudible at 45:25) so if you don't hear from me let's just assume we're on for Friday. But if I can find something or something (ph) opens up, I will let you know.

CLIENT: That sounds great (ph). OK (inaudible at 45:37). I'll see you next week

THERAPIST: Yeah.

CLIENT: Bye.

THERAPIST: Bye.

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