TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: (Clears throat) So, let's see. I think when we met last Friday Jack and I had already plan resolved (ph?)

THERAPIST: Yes.

CLIENT: A solution. I guess I wanted to talk a little bit about, I don't quite know what to call it, a state of mind. You know the state of mind of being worried that, sorry my energy is low I have a cold. [00:01:07]

THERAPIST: Oh okay.

CLIENT: It's not you and it's not really my mood it's just an illness. Just the state of mind of being worried about connection to somebody. And it's really powerful, it's like a very powerful worldview. Really everything fits into it, it's totalizing. (Pause four seconds) And one of the tough things about it I guess is that, we touched on this a bunch, it's hard even if I can get some kind of critical consciousness, which is not all the time, it's not actionable that critical consciousness. Another example, so we're trying to set up this thing, I'm trying to set up this thing with cheating (ph?), just the kind of remnants of my responsibilities over here which are important in some sense because it's my institutional affiliation. [00:02:29] And it's important for me to preserve that standpoint of being in an uncertain professional situation keeping that (inaudible at 00:02:45) in order. So, that being said, working with Phil (sp?) is a hassle and one of the ways it's a hassle is at the very least he's really spacey about e-mails. Like he'll just kind of forget the sort of information that he needs to provide to somebody, like the other day he wrote this message to the communications director at the organization ‘Yeah we're going to Africa, I wondered if you might want to get some press', which there's no way that they would, but he didn't even specify what the event was.

THERAPIST: Right. [00:03:37]

CLIENT: I write him back and say, ‘Listen, I'll tell them what's going on'. (Coughs) And I think I resent that a little bit in ways that are probably both fair at some level and also not fair in the sense that, I don't know. There's some level of resentment on my part. Fairly or unfairly, regardless it's there. So I was trying to set up a meeting this week with a candidate.

THERAPIST: For the organization?

CLIENT: Yeah for this piece that I'm sort of overseeing. And Phil (sp?) definitely wants to be there and needs to be there and his input is really important. [00:04:34] So we meet with her two weeks ago and set a meeting for today, actually, and she writes end of the last week saying she can't make it could we schedule it another time? And Phil (sp?) writes back saying, ‘Yeah we'll see you at four on Thursday'. And I'm like, what the fuck? And I write back and I say, ‘That time won't work for me', and I didn't hear from him at all. So on Monday I write and I say, ‘Are we finished rescheduling this?' I can't remember exactly how I put it, but I write where are we with rescheduling this, and he writes back saying, ‘Yeah we're meeting at 641 Huntington on the third floor'. And I'm like well that's not the issue, the issue is that I can't meet, I'm not available at four. And, you know it's like on the one hand whatever, I can't get too mad about somebody being spacey with e-mails, but on the other hand it was just very high-handed. [00:05:38] I was really pissed about that. And I wasn't just pissed about it, I was like what the fuck is going on here? And what the fuck that was going on there that I came up with was, you know, I'm never going to be able to actually have any operational control here, Phil's just too insecure to let anything go, he always needs to blah, blah, blah even though we talked about this at length and explicitly, et cetera, et cetera. And I was just trying to parse it, to figure it out, so we went back and forth for a bit and I'm like, ‘Well I have something at two on Thursday so', we have to meet with somebody else for three hours first thing in the morning so I said, ‘ why don't we meet …', and he says, ‘Okay yeah, let's meet at one'. I'm like ‘No I just told you!'

THERAPIST: Right. [00:06:43]

CLIENT: It was just the most frustrating conversation and what I'm feeling at this moment is not this is a frustrating conversation and Phil is spacey maybe there's a clinical (therapist laughs), and it's not oh Phil is high-handed and he's kind of insecure so that's kind of a hassle. It was like I've got to quit this is over, you know I can't operate under these conditions. I mean I'm exaggerating slightly, but kind of like Phil is out to get me, like Phil is out to destroy my status and make me feel shitty and embarrass me in front of this RA (ph?) and so on and so forth. So I did have some critical, a layer of a critical persona in a sense that I kind of knew, you know I sent one fairly sharp e-mail, didn't hear back. It turned out he was on the plane.

THERAPIST: Right. [00:07:46]

CLIENT: So at a certain point after not hearing back I just sent him an e-mail saying, ‘Hey Phil can you give me a call' in the subject line. He calls, we talk, it's fine. Maybe he was just sort of unthinkingly pulling some insecure power crap but it wasn't like,

THERAPIST: Right.

CLIENT: We've been working together for a while, that kind of shit you can get through. But it was like, I was just ruined for much of that afternoon until we talked, as per usual. And it was so debilitating, it was completely debilitating, that state of being. And this was classic both in terms of my response and in terms of the triggering event.

THERAPIST: Yep. And in terms of Phil's behavior.

CLIENT: Well (both laugh) in terms of Phil's behavior I'll put that aside, but it's not like I'm not familiar with Phil's behavior enough to kind of assess what's going on here and what's likely going to come out of it, you know.

THERAPIST: Right, yep. [00:08:47]

CLIENT: So, I don't know, I mean (five second pause, client sighs) that state of mind is just so, it's the state of mind and there's this illogical semantic component to it too, I'm sure.

THERAPIST: Oh yeah.

CLIENT: Blood pressure and all these other kinds of things. And they're either mutually reinforcing to a degree that I have a really, still after all this time adelgazing (ph?) I still have a hard time kind of saying early on in the process ‘Ok I'll chill out'.

THERAPIST: Right.

CLIENT: (Five second pause) I mean this is "it"!

THERAPIST: Yeah.

CLIENT: Maybe there are some other its, but this is the biggest "it" I can think of. This episode is the biggest "it" I can think of. And you know in the end I manage it okay and I realize that some conversation's necessary because we were kind of (inaudible at 00:09:45, noise overlapping dialogue).

THERAPIST: Yeah. (Eleven second pause) Hmm. [00:09:59] (Pause one minute thirty-eight seconds, client coughs) I kind of have some thoughts about it. I do, I agree it seems like a very clear and classic example of "it". [00:11:54] And a nice one in the sense that it's relatively, you know, circumscribed, it's very clear how it all works, it happened over a short enough period of time that you know

CLIENT: (inaudible at 00:12:05]

THERAPIST: (Thirty-three second pause) But I am also wondering where your mind goes in this pattern, like what comes to mind?

CLIENT: Where my mind goes now? Is that what you're talking about? My mind right now is going to the hum, which I've never really noticed before but has probably been there all along. And I'm wondering to myself I wonder if we should turn up the white noise machine. [00:13:05]

THERAPIST: Hmm. The hum from the heating (ph?)?

CLIENT: Whatever it is, yeah. So

THERAPIST: I'm sorry, turn up the white noise machine why?

CLIENT: To cover the hum. (Client laughs, coughs) So I don't know if that is a metaphor for something or if that is a, just a

THERAPIST: Well

CLIENT: minor sign of trying to avoid, you know, situations frustrating or what. But that is where my mind was, since you asked me.

THERAPIST: Yeah that's exactly what I asked (client coughs) (Ten second pause) Well (twelve second pause) I mean it's a very striking association to me, one that you've never noticed the hum and notice it now. And two, I don't get the thing about turning up the white noise machine because it doesn't make sense to me. On the one hand it's outside in the waiting room so [00:14:33]

CLIENT: It wouldn't help much

THERAPIST: You'd have to turn it really loud. And two, then you have white noise covering a hum. I don't see, clearly white noise is preferable, but it's not obvious to me why, do you know what I mean?

CLIENT: I'm with you (therapist laughs).

THERAPIST: Okay.

CLIENT: Just reporting.

THERAPIST: No, absolutely.

CLIENT: I report, you decide. (Both laugh) That's not really true.

THERAPIST: Right. That's funny. Okay, so yeah that leaves me quite curious.

CLIENT: I don't like noise. I don't like noises. I find them very difficult. I remember, you know it's not especially novel

THERAPIST: No, go ahead.

CLIENT: but I remember at a certain point I called my mother and said, ‘You know we have to go do a couple sessions of family therapy because I'm really angry.' And she said, ‘Okay, fine'. And I got a referral and we went to this very nice, smart family therapist. We probably saw her for four or five sessions, maybe six sessions. [00:15:50] My mother was always late, always. And several times her phone went off and she didn't know how to turn it off, her mobile phone. And I remember, I was just, you know, maybe I was just so annoyed at my mother for being kind of (three second pause) disorderly. But I also think that I startle very easily and so loud noises are difficult for me. Or to put it more precisely I have very good capacity to tune things out, when I do I have an unusually good capacity, but I'm able to do so, like if I'm working very intently I have no problem with it. But once I notice it it's really hard for me to let go of it. I have a really, really hard time with that and it becomes very difficult to focus on anything else. [00:17:00] And, I mean, this really caused some serious domestic strife, I had an apartment on the second floor when I moved back to San Diego, beautiful apartment that I liked a great deal, it was economical, it was a great location, it was nice. And upstairs, the couple upstairs would turn the TV on like at ten and watch until midnight or something and I could hear it through the floor at a certain point. That started really bothering me and I couldn't get it out of my head that it was bothering me. I told you this story. Okay, anyway, so I went upstairs and at that point I think I was not super skilled with negotiation because I kind of botched it.

THERAPIST: Uh-huh.

CLIENT: Or they botched it, or it was botched between us and now there's a kind of running disagreement that the apartment manager basically refused to resolve and ended up with me leaving. And it was really over the sound of the TV.

THERAPIST: Yeah. [00:18:04]

CLIENT: Which I just somehow could not drown out.

THERAPIST: Yeah.

CLIENT: I don't know. That's really free association, but that's what comes to mind.

THERAPIST: Yeah. (Thirteen second pause) No, I think that, one thing it brings to mind for me is this sort of tension, in a way, in your character and your personality between, on one side how aware or perceptive you can be at what's going on around you (inaudible at 00:19:08) socially, but I guess also when I think about noise. [00:19:10] And how (eight second pause) there's not a nice way to put it, how oblivious you can be in other ways. You know, I think there are, you know when you're kind of caught up in your own world you can miss a lot and sometimes in striking fashion. And so there's that on one side, and yet very acute, kind of perceptive sensitivity on the other.

CLIENT: Yep.

THERAPIST: And (seventeen second pause) that does feel related to the anglevert (ph?) stuff we were talking about. I mean, because anglevert (ph?) is really the transition from one to the other. From the very, kind of

CLIENT: Transition from the one to the other, that's interesting. I would have said that anglevert (ph?) is the other. [00:20:29]

THERAPIST: Yeah. Yeah, you would have been more correct than me, but my point is kind of like (five second pause), you know we're talking about how you go from a mode in which you're sort of very attuned to what's going on around you to one in which you're very much in your own head. (Nine second pause) And maybe that's (seven second pause, sirens in the background) really it. Maybe when something happens in the world or between you and somebody else that you can't sort of handle anymore or you can't stay with as an event out there in the world you kind of get all into your own head about it. [00:21:34]

CLIENT: Yeah.

THERAPIST: You go into this other mode.

CLIENT: Yeah.

THERAPIST: Like something gets tripped where it's just too much.

CLIENT: Yeah, something gets tripped. (Five second pause) Something gets tripped. You know the automaticity of the process is scary. You know?

THERAPIST: Yeah.

CLIENT: (Five second pause) Not only don't I have control over the transition from one to the other, at least conscious control, I have unconscious control. But I can't really predict when one phenomenon will assert itself. I mean are those, you see what I'm saying? In other words, like it's unpredictable.

THERAPIST: Yeah.

CLIENT: Like, I understand it and ephesiology (ph?), I understand the process by which it happens now, I have a pretty good understanding of how I move from one to the other and what the implications are in what kind of settings in which this happens are. But I don't know why. [00:22:56] It's like a classic theodicy, you know like why do bad things happen?

THERAPIST: Mm-hmm.

CLIENT: And I don't really know when they happen why they happen, you know sometimes they could be a hum and I completely give a shit, and sometimes there could be a hum and I would. You know maybe it was that I had just arrived at a stopping point, maybe it was that it was a metaphor, whatever. I mean whatever it might be this thing interposed.

THERAPIST: Right. And maybe another important aspect of this is that just because you don't, you're not aware of why it happens or even what's happening as it happens, and just because you don't have any control over any of that or appropriate insight in the moment into it, that doesn't mean it's not happening for a reason. [00:24:00]

CLIENT: (Thirteen second pause) Okay now I think we're getting into philosophy.

THERAPIST: (Chuckles) I don't, well.

CLIENT: There's a medieval philosopher that said that all science (inaudible at 00:24:28) is ultimately philosophy. I guess that's not surprising.

THERAPIST: I guess what I had in mind is that I think you have, I didn't mean it in a kind of philosophical sense. I meant it (thirty-four second pause), let's say this analogy (inaudible at 00:25:24) whether you were in a conversation with somebody that you were close to if there was a kid or to an adult and they say something and it makes you cry. [00:25:37] And it's not, you don't know in the moment why what they said was so hurtful. That's not so hard to imagine something like that could happen.

CLIENT: Mm-hmm.

THERAPIST: And (six second pause) in this analogy, I often hear you say things like, ‘well what they said just had a nearly physiological impact on me, it affected my (inaudible at 00:26:06) and then I start to cry'. And what I'm saying is, well no it meant something to you. And sure what it meant to you triggered this physiological reaction, but just because you don't know why it was upsetting or you didn't even have any other way of knowing you were upset in the moment, there's a meaning it had for you.

CLIENT: Sure. [00:26:36]

THERAPIST: That (inaudible at 00:26:40, train whistle) to make you cry. So I feel like sometimes you kind of skip that step a little bit? You feel like if you don't understand how it worked then it sort of bypassed your mind altogether. And that's the sense in which I mean this, that even though (seven second pause), you know, it's unclear in the moment why Phil seems at fault about the scheduling of those interviews is affecting you the way it is. And even if your experience of it, it just happens you know the same way somebody bangs their knee and goes shit. It's because it has, what is a meaning for you.

CLIENT: Sure. [00:27:44] No agreed. I agree completely.

THERAPIST: Exactly what my point is.

CLIENT: Well yeah (coughs). I'm losing the point likely because it's not a cogent (ph?) point, but because, umm. I mean from my point of view, whether we're talking about causation as a process of, as a meaning related process, or causation as a physiological process, or you know whatever different levels on which one could analyze how one thing comes to happen, I'm finding it hard to predict it and I'm finding it hard to interrupt it.

THERAPIST: Yep.

CLIENT: You know, those two, you know I could set some sort of broad boundary conditions, I could say this is what's likely going to be sort of the background for progression to a state of mind like this, but I can't say well if this background is operative then this will happen. That's kind of scary. [00:28:56] And then the other thing that's kind of scary is that even when I'm more or less aware of what's going on, I won't say that I can't intervene in the sense that ultimately I did.

THERAPIST: Right.

CLIENT: But I was already there. I intervened half-consciously, I did the right thing but what was going on in my head was like these wild thoughts of like having it out with Phil. And it was only when I actually, he called and I heard his voice and we had this brief, kind of friendly exchange that I realized, or not realized but I was brought back to the state where oh yeah we have a connection, it's durable. I'm not going to be sort of cast out and I don't need to behave reciprocally in a way that casts out. You understand what I'm saying? So that's what I'm struggling with, the lack of predictability and the lack of divertability. But those two things, and so the meaning is important. You know I think we could tease it out and I think that would be valuable, but those are the two things that I'm struggling with and neither of them are dependent on drawing meaning from this episode per se. [00:30:08]

THERAPIST: I was with you up until the last

CLIENT: The last?

THERAPIST: the last sentence, not that I didn't follow it, it's just that I entirely disagree.

CLIENT: (Both laugh) Okay (inaudible at 00:30:27) chaos could give birth to a dancing star. So specify your disagreement.

THERAPIST: Sure.

CLIENT: So I understand better where I've gone wrong.

THERAPIST: (Clears throat, nineteen second pause) Well it would be really, I think it would be really helpful for knowing more about what upsets you so much when Phil does this. I don't mean why he's, clearly why he's upsetting. [00:31:13]

CLIENT: Yeah. It's pretty straightforward and I think both pieces are true, he's both spacey and insecure.

THERAPIST: Right.

CLIENT: And both would periodically come up.

THERAPIST: But (clears throat) it's not clear what meaning his actions have for you that drives you so nuts.

CLIENT: Huh. (Six second pause) I mean and that is important, that meaning is important, that causal connection is important for the ability to divert. Or maybe, even more pointedly, the ability to evaluate that meaning is important for the ability to divert. Because of course it's not always going to be in the long-term interactions that this comes up.

THERAPIST: Right. (Five second pause) And moreover there is something so disturbing about how this is upsetting that you haven't yet been able to let yourself know what's upsetting you so much about it. [00:32:38] (Five second pause) I mean it's very disturbing when this happens.

CLIENT: Oh God, yeah. I mean it's.

THERAPIST: It's horrible. And it really throws you. (Ten second pause) Another way to say it is like, so far you can't really bear to think about it. I don't mean you can't think about the episode, clearly you do and you're much much better at identifying what happened and sort of seeing it, especially after the fact, but you're so upset, in some way when it's happening that you can't allow yourself to see.

CLIENT: So upset when it's happening that I can't allow myself to see. What am I not seeing? What do I need to see? [00:33:40]

THERAPIST: (Eight second pause) Well why are you so upset?

CLIENT: You mean in the moment I can't let myself see?

THERAPIST: Yeah, I mean you can point to the actions that have caused or the events that have caused it. But you don't know, you're in the position of the person who's crying and doesn't know why.

CLIENT: In the moment.

THERAPIST: Yes.

CLIENT: In the moment I don't have access to it.

THERAPIST: Right.

CLIENT: This powerful, analytical faculty is completely

THERAPIST: Right. And in this moment as well. Like you can categorize what happened much better, identify it with other similar events, but you don't know now either. I mean and neither do I for that matter.

CLIENT: Hmm. What don't I know? [00:34:45]

THERAPIST: Why Phil being his usual flaky, insecure self over something relatively minor sent you into a total tailspin.

CLIENT: Well I think I have some ideas about that.

THERAPIST: Oh okay?

CLIENT: And again maybe this is just kind of rogue taxonomy. What do I got? I mean I think it's this very pervasive theme of abandonment and feeling as if it's inevitable that I will be abandoned. And that

THERAPIST: Saying you know you feel quite abandoned?

CLIENT: I feel abandoned and, you know, literally when there's this completely spacey connection, communication in which half the time he's not answering I have to parse it as either there's no partner in peace, or there's some reason that he's withholding this communication. That's kind of the way that it computes in the moment. And when I parse it in this way it's a very negative mode, it's a very self-critical mode so the assumption is that either there is a rationale for this errant communication and it's inevitably going to result in my being disempowered or abandoned or both. [00:36:21] That's the construction. Neurosis, if you will.

THERAPIST: What do you mean abandoned?

CLIENT: That despite the agreement that we made, that this would be the piece that I have to oversee, you know give me some operational control, he's just going to keep on interfering and asserting himself and I'm going to be disempowered. And/or it will get so intolerable that, I'm going to be disempowered and put into a position of just kind of doing scout work, even for this one remaining project. And if I don't like it I can lump it.

THERAPIST: You mean that you don't matter?

CLIENT: Yeah. I guess. That's concisely it, that I don't matter. [00:37:27] (Eleven second pause) But the fact that I have access to that kind of blows up your theory.

THERAPIST: Umm?

CLIENT: (Six second pause) But what I don't have access to is the kind of analysis that we're doing now, it's not that I don't have access to the emotions themselves.

THERAPIST: (Twenty second pause) Well, so maybe actually at the moment where you start to feel abandoned, I don't think this is just worries about being abandoned sometime in the future, although I'm sure that's part of it, I think it's also probably the experience of having it happen in the present. [00:38:48] I have the sense that you're kind of acutely aware of the whole relationship, let's say with Phil, that you (eight second pause) I mean clearly it must feel like a very important relationship at that moment. You must have a sense, I mean otherwise you wouldn't be so upset.

CLIENT: Yeah and that's the curious thing. I guess it's by proxy, the relationship with this extended group of people that I hooked up with the very week that my dad died, or that my dad was in the hospital.

THERAPIST: Yeah.

CLIENT: So I think that's where the stakes are rather than. I like Phil, I feel friendly with him, I'm going to his wife's birthday party on Friday, you know what I'm saying? But I don't feel like the stakes are that high, it's more us kind of senecteching (ph?). [00:39:42]

THERAPIST: Do you feel like it's the group of people, the institution, that he stands for?

CLIENT: Yeah. Which has ironically basically cut his budget down to our grant, the one that I wrote. That's the only budget he has left.

THERAPIST: Yeah. (Twelve second pause) But I got you feel like (inaudible at 00:40:14) matters quite a lot to you.

CLIENT: Yeah.

THERAPIST: (Six second pause) And what in that moment feels like perfectly (ph?) unreciprocated.

CLIENT: Yeah I guess that is the feeling, that is the fear, that is where the energy for this totalizing picture of the world comes from. [00:40:50] It's not true! Really, I mean maybe, I don't know, but my sense is that it's not true.

THERAPIST: What's not true?

CLIENT: That Phil doesn't care, that others don't care, Jack didn't, I mean you know. That's an incomplete story, but that's the way it feels in the moment.

THERAPIST: Yeah. And that's really what's interesting about this and important is how intensely it feels that way. In the moment, all the and, how get granted themes later.

CLIENT: See that's what I don't have access to in those moments! What I don't have access to is the memory of this social and emotional connection.

THERAPIST: Yeah.

CLIENT: That's what's forestalled to me, it's not the other stuff about meaning, causation, and all of that. It's not even necessarily a lack of awareness that I'm feeling abandoned, it's that I don't have any access to the long, apparently obvious history of connection that would

THERAPIST: Right. {00:42:08]

CLIENT: just divert me from this train of thought.

THERAPIST: I guess to me I don't see that as being so different, it's only the meaning that has been (inaudible at 00:42:16, voices overlapping).

CLIENT: Sure, sure. So putting more specificity to your formulation there.

THERAPIST: Yeah.

CLIENT: It's meaning about emotional connection to something. It's meaning about historical access (ph?) with somebody, it's meaning about some kind of relatively intimate social relationship.

THERAPIST: Yeah. We've got to stop.

CLIENT: Yeah, okay. So I'll see you on Friday. Hopefully with a full voice.

THERAPIST: Yeah I hope you feel better.

CLIENT: Thank you. Alright see you then.

THERAPIST: Here, just don't forget

CLIENT: Oh yeah.

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