TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

(long pause)

[00:01:13]

CLIENT: So, let's see, [where to] start. (pause) I think on Friday I was talking about being frustrated with — I don't know. I mean, I guess in the final analysis, it's kind of the task of making order. It feels like regardless of whether I'm on top of things or not on top of things, I'm still getting pinched. It felt frustrating, like I could see — kind of see a path toward greater order, less reflexive withholding of my favors.

[00:02:17]

And yet regardless of whether I followed it or not, I would still kind of get screwed. That was the lesson of our text message to me at that particular moment. In other words, here was an instance where I was on top of it and I still was feeling — I don't know how strongly I feel about this or how comprehensive the feeling was, but that was what I was expressing on Friday. (pause) I'm not sure how much there is in there. (pause) Maybe something significant. (pause)

[00:03:12]

I think you had a more helpful spin potentially, but I don't remember what it was. (pause) I was also saying that I felt self-conscious. Even in that state of mind, I felt kind of inarticulate, shamed, something, that made the fact of our recording these things more present than it otherwise would be.

[00:04:10]

Just as an aside, it has occurred to me that since we've changed the billing system, from my sort of fiscal point of view, the recordings are sort of moot in the sense that the insurance company will bill me, the co-pay will be implicit in whatever their reimbursement rate is, and if we were to apply the fee for the recording to my co-pay, we would have to make a separate arrangement. As it now stands, I'm just not giving you the co-pay, but that arrangement assumes that I'm liable to you for the co-pay. Whereas at this point, the co-pay is just what is deducted from the insurance company's reimbursement, rather than what you're not asking me for after you do the billing.

[00:05:21]

THERAPIST: Let's see. It doesn't — I'm not sure I'm understanding you, but I don't think it works that way in my mind anyway.

CLIENT: The insurance company reimburses for 150. Or rather, you bill the insurance company for 150, they reimburse you for 105 or whatever, and that remainder is the co-pay, right?

THERAPIST: That's right.

CLIENT: But if I'm billing them and I pay them 150 and they're sending me a sum that's less than 150, then I've already paid them the co-pay so it can't — unless you're reimbursing to me upfront in some way. You understand what I'm saying?

THERAPIST: Yeah, so I think —

CLIENT: I mean, you could deduct it from, you know, the total that I owe you. I guess that would be the solution.

[00:06:16]

THERAPIST: [Surely that]. I guess what I was imagining is you would bill them for 150 and then you would owe me 100.

CLIENT: I would owe you 100. (pause) I see what you're saying. Okay, fair enough. That makes sense. Got it.

THERAPIST: Let's look at that again. I want to make sure I get what you're thinking. Were you concerned about who was going to get the five bucks, or were you concerned —

CLIENT: No, no, that wasn't the issue.

THERAPIST: — that like you would be billing for 150 and you would owe me 150.

[00:07:17]

CLIENT: Yeah, that was the issue. (pause)

THERAPIST: And that would've changed without my saying anything about it. (pause) I guess what I'm struck by is — (pause) Look, I'm not sort of — it's not like I'm saying this because I'm insulted or I feel bad. It's more like I'm struck that you would you imagine that even though we talked about the change that would come with me turning the billing over to you, which we both acknowledge made more work for you and was a pain in the ass, that in addition I'm essentially going to be charging you $50 more without saying anything about it.

[00:08:27]

It just seems like that wouldn't be very — (voices overlapping)

CLIENT: No, I don't know that was my thought process. My thought process was more there's a change of state, there's negotiation that goes with it. I felt kind of stressed about — I mean, negotiation maybe is the wrong word to describe it, but there's kind of an administrative solution that we have to agree upon regardless of whether it is thought to be complex or difficult, some aspect of it that we hadn't touched on which is to say, you know, what I would be expected to fork over to you, that conversation about me owing you $100 was not one that we'd had as part of — that I recall at least — is part of —

THERAPIST: No, no, no. I don't think we did. I had just — at least from my perspective —

CLIENT: You just sort of —

THERAPIST: I figured it was obvious that you would essentially owe the same thing.

[00:09:24]

CLIENT: The same thing. But I didn't know how much they were reimbursing you, so that was —

THERAPIST: Oh, okay.

CLIENT: I mean, I could have gotten it I suppose from my EOBs, but I hadn't looked at them for that purpose. On some level, it's a trivial thing. On another level, I mean, where I will agree with you in that this is a subject for our discussion between us in a more substantive way, that I'm stressed out about these things, you know, when there's a change of state that implies some kind of resolution of this sort, of a fiscal sort, a financial sort rather, billing.

THERAPIST: Right.

CLIENT: I am stressed out about it, but I think it's not that complex in the sense that I'm stressed out about it because I have a tendency to just blow these things off, and that's really been (chuckles) a big drain on my cash flow, among other things.

[00:10:24]

THERAPIST: Sure.

CLIENT: And I'd like to resolve it in a way that does not involve, you know — like my family almost broke up over shit like this. This is not, historically, these kinds of interactions have been fraught with danger.

THERAPIST: How did your family —

CLIENT: Oh, have we not talked about this? Let's see. My mother's family basically disintegrated over a will leaving her brother to, you know, go off in a huff and kind of — he was probably crazy already, but just sort of literally become a crazy old uncle. My father and uncle, his brother, had all of these I think unfortunate business relationships, probably motivated on my uncle's end by compassion rather than a desire to really maximize return on investment.

[00:11:36]

But after my father died, there was a lot of tension. I mean, not just tension, it was kind of a breach with him and his wife because they have six children and six parochial school tuitions — or had, at the time — and you know, wanted to get the investment back and there was no way he could get it back without my mother losing the house. So, I mean, you know —

THERAPIST: I didn't know that.

CLIENT: Yeah, I mean, just finances throughout not only my childhood but afterwards were very fraught. My father left my mother in bankruptcy. I mean, a very serious bankruptcy in which she drew a very harsh and punitive judge who really had her living in — squalor is a little bit — no, it's not.

[00:12:35]

I mean, she couldn't replace the roof and that was how little was left for her monthly payments, so there was rain coming in the roof. I mean, it was pretty serious. Plus, you know, whatever the interaction between those historical facts and my historical — you know, my difficulty just with the routine of bill paying. I have, you know, enough difficulty dealing with that kind of activity that, you know, I've paid thousands and thousands of dollars in fees and all these kinds of things. I mean, you know, when I have the money I still have trouble doing this. When I have the money, I still have this impairment.

[00:13:32]

So this conversation, I think, which is pretty straight-forward — on any objective level I certainly don't expect you to (chuckles) sue me in this respect.

THERAPIST: Yeah, no, I know.

CLIENT: That's not what that means. It's just that it's a conversation that we kind of have to have and it's fraught, in a way that might seem, you know, excessive or unnecessary on the face of it. (pause) And I guess the other piece is that I'm in the process of kind of getting my house in order, partly by paying off shit that I shouldn't have to pay off, and I just don't want to be wasteful with it. You know, I feel like I have a shot. Who knows how long it's going to last.

[00:14:31]

But I don't want to be profligate, so there's also the aspect of just trying to get things in order in a way that's not necessarily natural to me, and fumbling around a little bit to find the right way of asserting myself.

THERAPIST: Right. Just to be clear, I guess, in terms of the reality in what I provide you, so I will give you a bill that's appropriate to send to the insurance company and which has the $150 rate.

CLIENT: Okay.

THERAPIST: And I guess if I wanted to be more fastidious about it, I could also give you a bill that sort of lists 100 bucks per session which is what you actually owe, but if you don't mind just doing the math.

[00:15:32]

CLIENT: No, I mean, if that's the math then I can certainly do it. (laughter)

THERAPIST: [inaudible at 00:15:37]

CLIENT: Yeah, the one bill will note how many sessions I've had which is the relevant thing. (laughter) I can figure out the multiplier. (laughter)

THERAPIST: I know you can. I just wanted to be as clear as I could about it.

CLIENT: Okay, okay, fair enough.

THERAPIST: I will get that to you this weekend. I did most of them last weekend, but I didn't quite make [the rest].

CLIENT: At any rate. (pause) This is a big deal.

THERAPIST: Yeah.

CLIENT: You know, we've talked about work process and I'm struggling with that. I don't know whether it's easier just because I don't feel as if it's like impeding — in the immediate term, it's not impeding my ability to earn a living, so that takes some of the pressure off.

THERAPIST: Yeah.

[00:16:31]

CLIENT: I'm not sure if it makes the process any easier (laughter), but it does take some of the pressure off and I have been, you know, fairly productive.

THERAPIST: Good.

CLIENT: Though the process has been difficult and I get pent up — is that the technical word? I get sort of agitated enough, like keeping the house clean is difficult which leads to some tension with Jennie (ph). So the process is not perfect, but I feel some movement there, which is interesting and worth talking about but we'll park for the moment.

THERAPIST: Sure.

CLIENT: This financial stuff I really feel is front and center right now. I just paid off my credit card, all of my credit card bill.

THERAPIST: That's great.

[00:17:26]

CLIENT: It was the first thing I did, you know, as soon as I had some resources. (pause) There's like a huge library fine. There's all kinds —

THERAPIST: What's a huge library fine?

CLIENT: What is a huge library fine? Like $800.

THERAPIST: Oh.

CLIENT: (pause) Yeah and, you know, it's like I'm looking for the books and they could be in five different offices and two different houses. I mean, it's like, you know, just my life has been scattered for the last four years over so many locations that I suppose some of that is less about management and more about just whatever, all the same.

[00:18:31]

I have to kind of confront it now and I have to address it, and at some point in the immediate future I'm going to have to pay for it. I don't know. I feel like if, as part of that process, I don't deal with it then that would be a bad thing. Just figuring out what's going on and figuring out how to manage it better feels important.

My running has been very — I mean, I think one of the reasons, if it's just a cramp or something less than a serious injury, but what happened was I just stopped running basically for the better part of a week. I'd been up to 40 miles and this regular activity just sort of stopped when I had something that I had to come through with.

[00:19:35]

I mentioned a moment ago that maintaining the house simultaneous to having something expected of me was difficult, and another maintenance function I just, you know, whose order kind of collapsed was running. So I went out for a long run on Saturday and basically over-exerted, I think. You know, I mean, that's what happens when you reach a certain state and —

THERAPIST: How far did you go?

CLIENT: Nine miles. I was actually going for 10 1/2, but I mean I wasn't pushing myself but it's like you haven't run at all and you go for 10 1/2 miles in your shorts and you're liable to have a strain, and that's what I have. (pause)

[00:20:45]

[inaudible] I imagine it as punishment. That would be an evocative way of putting it. (pause) Yeah, so I feel like this thing is related to the kind of brown-out. You know, this financial difficulty with — I mean, it's not just — it's like the same — I'm struggling for words. (pause) This same phenomenon that impedes bill paying also impedes returning library books. It's exactly the same.

[00:21:36]

THERAPIST: And cleaning up and getting things done.

CLIENT: And cleaning up and getting things done and running. It's the same thing. It's related to feeling [unassignment] in some other domain or something. There's something, some state of mind that makes it difficult to do regular maintenance or things that require regular maintenance. (pause) I don't know what it is.

THERAPIST: Well, it sounds like a way of externalizing how you're stuck.

CLIENT: Mail will pile up, unopened, unaddressed. Sometimes the loan people will start calling. Voice-mail will pile up. I just won't be responsive.

[00:22:38]

THERAPIST: Yeah, you're kind of in a state.

CLIENT: I mean, this state has ruined my credit rating. It's causing me to spend complete thousands of useless dollars on whatever. I've lost things that I haven't come through with on time, et cetera. I mean, they're merciless. And I don't care. (pause)

[00:23:26]

It's as if my state is, you know, confronting this massive battleship of, you know, the entire reality of modern society and the full knowledge that it's not going to stop. (laughter) This gigantic armored vehicle is going to keep on and you just stand there anyway. (pause)

THERAPIST: That's evocative. I mean, to put it that way. (long pause)

[00:24:35]

I mean, it usually starts — I mean, this is part of what you're saying — with trouble producing at work. (pause)

CLIENT: I don't know that's universal. It might be that I'm infatuated with somebody — I'm just trying to think of the different kinds of things that would lead to such a state. Maybe — that is common.

THERAPIST: How about this one. It seems to start with feeling ignored or badly done by, in a more personal —

CLIENT: (yawning) I mean, you know, in this past week where Jennie (ph) and I have had some tension over the house, I didn't feel badly done by. I just felt like it was something that I owed.

[00:25:38]

THERAPIST: Right, it was this thing at work — I mean, that's where it starts, right, is with the thing at work?

CLIENT: Yeah, but I didn't feel badly done by. I didn't feel —

THERAPIST: What was the situation at work? I mean, you had been asked to write something.

CLIENT: Yeah, I'd been asked to write something.

THERAPIST: What was it?

CLIENT: It was a concept note. I mean, you know, the project was subjectively made more difficult by a lack of clarity on the part of my collaborators and —

THERAPIST: That's right. You had explained about how you were switched over to this other office and —

CLIENT: Umm, yeah, I mean, you know, I guess it's kind of complicated in that sense. There's some bureaucratic institutional politics that are underway that have impeded their responsiveness, for example, when I would produce something.

[00:26:32]

So I would produce something and they wouldn't respond and yet, you know, I was obligated to kind of come out with the next thing even though they hadn't been responsive. But truth is, I have one guy that I'm collaborating with very closely and we talk a lot.

THERAPIST: A guy in that office?

CLIENT: No, no, who —

THERAPIST: Independent.

CLIENT: Yeah, independent. So I was wondering how much I needed to explain, then I realized that you had the picture already. So, yeah, so Jack (ph) who I've been working with all along and is in the president's office, we talk regularly and are involved in things along a different track. This group — frankly I'm a little skeptical about their added value but, you know, it needs to go through them for complicated institutional reasons and they're involved in whatever.

[00:27:29]

In any case, this project was for the process that they need to initiate. In other words, this is a concept note that is owned by them that they then take through channels as part of their brief and scope of work. Sorry, I've got some crud on here. So yeah, so they have not been super responsive but I don't feel as if my identity as a productive contributor is dependent on interacting with them.

And yet, you know, it was a project that needs to go to them and I need to produce it and that felt somewhat burdensome, I don't think because I was resentful or felt [hard done] by, just because there are some complexities about producing with people who are, you know, completely engaged with you.

[00:28:40]

We had very good conversations. I flew down and we talked about what it would look like but, you know, I'm a little uncertain about this particular project and I think any difficulty putting it together has more to do with that than to a sense of pique. I don't know if that distinction is important. It may not be, but at any rate the sense of — the challenge of producing owes to that, rather than to this dynamic that was common over the last years.

THERAPIST: I guess I want to clarify when you refer to the challenge of producing, it sounds like there are potentially two things getting in the way, and I'm not clear how much is one and how much is the other.

[00:29:42]

One is that it sounds as though there are things that you actually need from them that you don't get in a timely way, and that is in a sense on them and that makes it difficult for you to produce. The other is something in you where, you know, you have the time, you intend to do it and it's difficult to get it done, and not because it's that you don't have what you need from them but because of some reaction you're having to what's going on. I had assumed there was some of the latter involved, but —

CLIENT: I think there — I mean, there is —

THERAPIST: Yeah.

CLIENT: Except for the last sentence or clause or however you structured it grammatically, I agree with that completely.

[00:30:39]

THERAPIST: Yeah.

CLIENT: I don't know enough at this point to say that it's some reaction to what's going on. All I know is that there is some interference.

THERAPIST: Yeah.

CLIENT: It's not happening — (voices overlapping)

THERAPIST: I understand. I take your point not so much about being [hard done] by as being, I guess, a bit frustrated and maybe more so like skeptical of this group and their value-add efficacy, something along those lines.

CLIENT: Yeah, yeah. I think that's fair.

THERAPIST: It's not like —

CLIENT: Yeah, I mean, if we wanted to kind of present it as an exercise in belated childhood development, we could say that (pause) I feel — I just don't want to work with them. I just don't want to.

[00:31:43]

I don't feel especially stimulated by our interaction. You know, like as an adult, obviously I don't operate that way and yet at some level it's conceivable at least that I do. I'm just a little bit snooty and don't feel like engaging with them because I feel like our intellectual engagement is insufficient to call-out the effort. Maybe there's some of that. You know, you want to work with the people that you feel really stimulated by.

THERAPIST: Yeah, like with Jack (ph), it sounds like.

CLIENT: Like with Jack (ph) it's great, you know. I like producing with and for Jack (ph). This is somebody that I like a lot, that I respect a lot, that I feel sort of excited about working with. It's fun. (pause)

[00:32:52]

I don't know. I mean, in terms of what they're not giving me, they're basically not giving me edits. So I'll do something and then their response will lag, and then either they'll respond with something that's just kind of BS in my view that I have to re-write again, which has happened a couple of times, or they just won't respond.

THERAPIST: Yeah. And either way, there's not the kind of more stimulating, even like, competence.

CLIENT: I mean, in fairness, I'm aware at some level that when they come back with something that I'm kind of contemptuous of, it's not only them, it's also that they've had to interact with their vice president.

[00:33:48]

THERAPIST: I see.

CLIENT: You know, like they come back with edits and they've had to be responsible to — whatever. Like at some intellectual level, I'm aware that this is kind of a complicated social system that they have to deal with that I'm insulated from that makes our engagement less fun than it conceivably might otherwise be. But at any rate, that's the way that it feels.

Yeah, I mean, I guess this is the situation that I have to deal with in terms of their engagement with me. They've got stuff going on. They've got bureaucratic stuff that they have to deal with, and I guess one thing I could do is try to enforce a more kind of effective and engaged collaboration strategy.

[00:34:47]

And then the other thing I could do is try and get a handle on what's going on, on my end. I guess what I feel you pushing me to do is to first do the analysis and kind of figure out what's going on for me.

THERAPIST: Yeah, I guess the thing I'm wondering about is it sounds like you're speaking about it sort of, I don't know, in a way from a more kind of reasonable or grown-up's perspective, like "Yeah, I don't want to work with them really, but, you know, I have some perspective on why they're behaving the way they're behaving and clearly on the fact that I do need to work with them and this is a reasonable situation in some sense."

[00:35:41]

And what I'm wondering about is, I guess it had been my impression that it's this situation at work that has triggered the other sort of brown-out that you were describing.

CLIENT: It wasn't a complete brown-out, and I came through with stuff in a timely way other than this more complex writing project.

THERAPIST: [inaudible at 00:36:04] you put it last week that you had gotten sort of stopped in your tracks literally with running, and it sounds like with some stuff in the house too.

CLIENT: Yeah.

THERAPIST: And I guess my impression is that you really don't want this to be affecting you in the ways that it seems to be.

CLIENT: That's true. I want to be really competent and on top of things and just to do work, you know, in the way that I'm being paid to do work.

THERAPIST: Right.

[00:36:38]

CLIENT: There's certainly not been any —

THERAPIST: And the idea that this situation with them which is in some ways a pain in the ass but in some ways relatively reasonable, the idea that would be shaking you up in the ways that it seems to be —

CLIENT: Yeah, yeah.

THERAPIST: — you really don't like.

CLIENT: Yeah. I mean, I really don't like being shaken up.

THERAPIST: Sure.

CLIENT: I really don't like the implications of being shaken up.

THERAPIST: Sure.

CLIENT: Then [inaudible at 00:37:16] I really don't like the idea of coming through this very difficult period being in a place where I really could have created some stability and not dealing with this dynamic, this recurring dynamic that for all of my adult life has really been a drain in every possible way.

[00:37:42]

Like, it's time and so at some level it's doubly frustrating that at this moment where I feel like I have the mandate, the internal mandate to address this, here I am, it's front and center. And I fear, I guess, coming through it and not addressing it and then being on the other end and then, you know, God knows what will happen in a year. I don't have a sense of clarity and stability about where things are, but I just want to take advantage of this moment of relative — ease isn't quite the right word, but a moment when at least from a fiscal point of view —

THERAPIST: Relative security.

CLIENT: Relative security, momentary security. I don't want to come through it and not have figured out exactly what's going on and move to address it.

[00:38:47]

THERAPIST: Well, we should stop for now.

CLIENT: Okay, so Friday.

THERAPIST: Right.

CLIENT: See you then.

THERAPIST: Yep.

END TRANSCRIPT