TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: Starting a few minutes late than I usually do. Sorry, unusually winded.

(Pause): [00:00:24 00:00:36]

CLIENT: I'll be in town for the next few weeks, so this layoff will happen.

(Pause): [00:00:41 00:00:54]

CLIENT: Can you help situate our conversation in what we talked about last week? I'm having trouble calling it to mind.

(Pause): [00:01:03 00:01:42]

THERAPIST: What's that like?

CLIENT: The calling it to mind?

THERAPIST: [Uh] (ph)

CLIENT: Okay.

(Pause): [00:01:49 00:01:55]

CLIENT: I felt like we were in the middle of something that had something to do with difficulties I've had working, just being kind of distracted. What is it like not recalling it to mind? It feels pretty I know that in the past there's been a kind of thing in this respect. I think I'm genuinely wanting to -

THERAPIST: It doesn't feel like that pain.

CLIENT: I don't think so.

THERAPIST: That's good.

CLIENT: Okay, is that good? You mean that your I guess the premise, your premise is that that thing is not remembering but being upset about remembering. In other words, this idea that things are being repressed or some access problem is less plausible to you than just getting kind of freaked out over not remembering and that's not happening now.

(Pause): [00:03:22 00:03:29]

THERAPIST: I think there's some of both but often when you in the past have had trouble remembering, you describe this feeling of real dislocation and it's really stressful and unpleasant. And in both an immediate and in a sort of (unclear) way, that's good if you're not feeling that way. [00:04:08]

CLIENT: What I feel, I feel kind of dislocated. I don't feel as upset about it as I sometimes do and it's a sort of happy dislocation. I mean just in the immediate sense it is a challenge and maybe this has something to do with my facility with not remembering things that are challenging. But on a week when we meet on a weekly basis I do find it difficult at times not always, at times to just sort of pick up where we left off and 45 minutes is not long enough usually to much more complete a thought if in the best case scenario. Or rather rephrase that is usually not long enough to complete a thought. So you know there's sort of intrinsic challenge, there's a particular personal challenge for me and then there's this whole issue of dislocation. I guess I just have a pragmatic desire to pick up the conversation (laughs) (unclear) if possible [00:05:46] because it seemed like we were talking about something that I actually sort of think about explicitly. I'm sure there's all kinds of thinking going on (unclear). [00:05:46]

(Pause): [00:05:54 00:06:03]

CLIENT: I mean I kind of felt like I had a pretty clear formulation of what was going on in my work blockages.

(Pause): [00:06:24 00:06:28]

CLIENT: I felt there was something about feeling sick, really being sick -

THERAPIST: Right.

CLIENT: that just disrupted me.

THERAPIST: Right.

CLIENT: It's coming back to me now.

(Pause): [00:06:39 00:06:45]

CLIENT: And that disruption was really upsetting in the way we

THERAPIST: Right.

CLIENT: just said really. And that [destruction] (ph) [00:06:57] was very upsetting and scary and led to, you know, a kind of a feedback loop sense of dislocation so that more you know, I felt off. I felt, I felt off kilter and instead of being able to say, 'well, you're not feeling (unclear) because I'm sick,' something else would happen. And I felt like I had a very good grasp on it last week and I kind of want to recapture it. I'd like to kind of make it part of my conscious reaction to these things and I can't quite like I remember the contours -

THERAPIST: Right.

CLIENT: But I can't quite call back the precise formulation.

(Pause): [00:06:57 00:08:02]

CLIENT: And I was thinking along the lines of the idea of balance between the needing to keep going even though I don't feel perfect to kind of get things down on paper and proceed and -

THERAPIST: Maybe needing to sort of recognize things for what they were. In other words, if you were sick and that was making you difficult you were sick and that was making you difficult as opposed to -

CLIENT: opposed to -

THERAPIST: You were anxious or -

CLIENT: Yeah, like unable to deliver.

THERAPIST: psychologically blocked.

CLIENT: Unable to deliver.

THERAPIST: Right.

CLIENT: Right, right.

(Pause): [00:08:49 00:08:56]

CLIENT: [the quadrant] (ph) anyway.

(Pause): [00:08:56 00:09:10]

CLIENT: I feel a lot of it, even now as I think about this, I feel a lot of anxiety about my relationships with people associated with this feeling of not being able to deliver and the consequences of this blockage and my, the kind of feedback loop that I got into when what I produced was delayed by a couple of days. And so I was in this week and kind of interpreting interactions that were probably benign in that -

THERAPIST: I see.

CLIENT: frame. Maybe they weren't but I mean -

THERAPIST: (Unclear) [00:09:49]

CLIENT: I'm finding that just on a moment basis kind of this cognitive loop, it's kind of open, it's activated as we talk about it.

(Pause): [00:10:06 00:10:22]

THERAPIST: (Unclear) part of why you want to kind of get back to where you were on Friday when you felt like you had a better handle on it.

CLIENT: Maybe. Maybe that's it. That's true.

(Pause): [00:10:30 00:10:35]

CLIENT: I guess I'm struck right now by the fact that's it's really all about relationships. It's translation in my mind, I think translation of this anxiety is an anxiety about the durability and reliability of relationships and a sense of my responsibility for them. You know, to the extent that the relationships are feel transient or unreliable, it's my fault. There's a sense that if I would orchestrate them right, they would be sustainable and people would respond in the way that would reassure me about them. Does that make sense? In other words, what has meaning when I'm sick, when I'm feeling sick and I'm feeling disrupted by that, and engaged in the process of translating this in a different way that leads to a kind of -

THERAPIST: Trouble.

CLIENT: It leads to trouble. The way that it's being translated is in a sense of a certainty and fear really about -

THERAPIST: You're putting (cross talk) (unclear)

CLIENT: durability of certain kind of relationships. That's the way that I see them like the map in my head that's created by whatever, that's created by this sense of disruption, or is triggered by this sense of disruption is a map of uncertain relationships. I feel they're uncertain. I feel I'm responsible for them. I feel that the fact that I'm unable to proceed for I think or reflect, on reflection completely independent reasons I feel that that inability to proceed is responsible for uncertainty of the relationships. The more difficulty I have doing what I would like to be doing, the more uncertain they become, the more fearful I become for their durability. And that's what diverts me, really, in the end is that sense that I'm at the mercy of that I'm about to be cut off. And I'm about to be cut off because of something that I'm doing and that something that I'm doing is being dislocated.

THERAPIST: (Laughs) Yeah.

(Pause): [00:13:31 00:13:42]

CLIENT: You know there's a funny confluence I guess between the relationship to the work and a sense of dislocation at work and a sense of dislocation to the people.

THERAPIST: Yeah, that's -

CLIENT: Very, very consistent probably (laughs) psychologically interesting.

THERAPIST: Right.

CLIENT: Or at least meaningful.

THERAPIST: Yeah, the way they go together. CLIENT: Always, always. There's always something about production and something about people. You know, in one way or another, yeah, I think that that analysis is probably true across the board.

THERAPIST: Yeah.

CLIENT: Sometimes the production is just "hello," at the time.

THERAPIST: Right.

CLIENT: It depends on what kind of interaction we're talking about but there's always something about my production.

THERAPIST: Right.

CLIENT: But maybe that's true of relationships in general, right? I mean there's always an excuse I mean there's always like a venue for them and both sides are used to a relationship contribute. And they don't just like exist in the ether or like we're having a conversation and our relationship is dependent on my giving to it and you giving to it.

THERAPIST: I see, yeah. Like (unclear) [00:15:01]

CLIENT: That's right.

THERAPIST: is kind of intrinsically harder transacting in a relationship.

CLIENT: So in that sense producing like the relationship to the work is the relationship for certain kinds of interaction.

THERAPIST: Right.

(Pause): [00:15:13 00:15:43]

THERAPIST: You seem to have gotten yourself to a more comfortable place.

CLIENT: Yeah. Thought it through and haven't completely back in my head and picked up the main part of the thread.

(Pause): [00:15:56 00:16:01]

CLIENT: I didn't panic.

THERAPIST: Right.

CLIENT: Like I did feel a little cut off and dislocated. On that occasion I didn't.

THERAPIST: Right.

(Pause): [00:16:08 00:16:24]

THERAPIST: And you were able to reconnect. CLIENT: Yeah.

(Pause): [00:16:27 00:17:30]

CLIENT: I have a memory, kind of a disembodied recollection, I think it was of our last conversation but maybe earlier of just sitting here for 10 minutes or so quietly as if, I don't know, something something had been resolved or it was untroubled and there was not maybe it was the week before last.

(Pause): [00:17:58 00:18:01]

THERAPIST: I don't remember a silence that long.

(Pause): [00:18:02 00:18:15]

CLIENT: I remember sitting here and thinking to myself, '(unclear) you know, I've really figured it out, maybe we're there, maybe that's it. Maybe that's' which is funny because I don't feel that way right now. But, yeah. It's interesting.

(Pause): [00:18:32 00:18:37]

CLIENT: I mean I think in that moment I felt like, I felt satisfied. I felt like we'd kind of gotten somewhere and I almost I was like turning over the thought in my head that, 'well, maybe we should just end on a good note we should just, this feels good, it feels like I've gotten somewhere. That's it, it's done.'

(Pause): [00:19:00 00:19:06]

CLIENT: It seems rash now. So it really was like the last three days because it really was hard. I really was struggling with the sense of fear about, you know, my place and my place is uncertain. I'm a consultant but not staff and -

THERAPIST: You mean in the last week.

CLIENT: Yeah, yeah. These past few days.

THERAPIST: Oh, this week.

CLIENT: Yeah.

THERAPIST: Okay.

(Pause): [00:19:34 00:19:42]

THERAPIST: I wasn't sure because I know there was the that thing you had to work on last week that caused (unclear)

CLIENT: Yeah. (Cross talk) (unclear). [00:19:48]

THERAPIST: this week being -

CLIENT: Yeah, no, I mean, no, I'm just like this is just what's freshest in my mind.

THERAPIST: Sure, of course.

(Pause): [00:19:55 00:19:59]

CLIENT: Yeah, it's not a thought that would have occurred to me last week so it's probably from the previous -

(Pause): [00:20:02 00:20:13]

CLIENT: Anyway.

(Pause): [00:20:13 00:20:20]

CLIENT: I don't know, I mean I guess it's a feeling that I'd like to preserve, right? In some sense. I mean I would like to be feeling as if I had figured it out.

THERAPIST: Sure.

(Pause): [00:20:31 00:20:40]

CLIENT: Certainly the sense of equanimity that I'm feeling at the moment would be something nice to have in the moment.

THERAPIST: Yeah.

CLIENT: Like I would have appreciated having it around 1 o'clock yesterday afternoon. I held it together fine.

(Pause): [00:21:01 00:21:37]

CLIENT: It really would have been nice to have it around 1 o'clock yesterday afternoon.

THERAPIST: Yeah.

(Pause): [00:21:40 00:22:40]

THERAPIST: But I imagine you felt it a little bit when you first came in here this morning and kind of weren't sure where we were and kind of feeling out of touch with where we had been though it was somewhere that you knew had felt good and you know, I guess were feeling a little dislocated and then was able to reconnect with that.

(Pause): [00:23:16 00:23:29]

THERAPIST: Whatever happened last week with an understanding of things with the depends on what you think is right for you would be -

(Pause): [00:23:34 00:23:44]

CLIENT: Yeah.

THERAPIST: I wonder if you know maybe there was sort of a combination of the kind of work product and relationship thing going on there you know where what you thought of a person's work okay, 'I had these thoughts you know, I had some helpful ways of thinking about it but I guess I'm not you said there was also the relationship that's like, 'hey, I haven't seen you in a week,' you know, feeling a little more disconnected and maybe those went together.

CLIENT: So, you're saying something useful, relevant. I'm thinking about something else, or at least whether it's because you provoked it or I was wool gathering, or what what I'm thinking is you know that at some level the way that I've been scheduling the trips to New York which were kind of a dialogue between me and Jack has been motivated at some level by just a feeling of disconnection and a desire to reconnect with people because it's hard for me just for obvious reasons really, but unusually it's unusually the case for me, I think, that what other people might take as just kind of a normal part of doing this kind of business is really troubling for me, it really makes the work process difficult where I can't just see people but kind of be reassured about my connection with them. Those connections feel tenuous and capable of being alienated at any particular moment and that fear of alienation; the impulse is to find them reassured by some kind of tangible connection. What I discovered this week, you know sometimes it works I guess I suppose sometimes I feel reassured by it. This week I didn't feel very reassured by it and that's what I was thinking about the extent to which I didn't feel reassured by it or maybe there's reasons for me not to be reassured by it. Who knows? Like I don't feel I don't have enough faith in my ability to separate the fear from the reality to know whether it wasn't the case that people were distracted or that there's a kind of professional structure and hierarchy that led, for example, Kevin to defer to Jack and not to acknowledge me as like as an active part of the team. You know, like Jack is the primary [turlick eater] (ph) [00:27:05] and that, you know in theory that's fine. There's no particular reason why and there's some delicacy in being a high paid consultant retaining some distance from the executive. So, whatever. There are alternative scenarios but this scenario that keeps on presenting itself to me is that somehow by being a couple of days late last week I alienated something. That's the I mean if I follow it back, that's the kind of construction and I was unable to reassure myself even with my tangible presence over the last few days about the durability of the relationships when confronted with that scenario. You know, of four possible scenarios that would explain the sort of interactions that I had, some of them probably are more plausible at some level I don't know. That's the one I want to and over the course of three days I couldn't shake it and so as you were talking about (unclear) [00:28:30] it was the fact that and the week intervening and my ability to call it back, what I was thinking was, well, you know I was like the analogue of meeting twice a week, I was even there and it still didn't help. I think. It was kind of the opposite. Yeah, it doesn't always help.

THERAPIST: Right. CLIENT: I guess that's my thought.

THERAPIST: Yeah.

CLIENT: Just to close the loop there. I guess that's the thought. It doesn't always work. Even then it doesn't always work.

(Pause): [00:29:09 00:29:43]

CLIENT: And that's, I guess, I mean I guess in one sense that feels troubling and in another sense it's kind of instructive. You know it's not really about being there. It's not really about the tangibility of the connection. You know at some level it's really about how I'm feeling. You know, it could be that we're meeting every two days or every day or what have you and I'm still having trouble calling things to mind, or I'm still having trouble calling things to mind which I think we've been talking about as maybe this was something you said last week or a couple of week ago it's really about the tangibility of our connection (unclear) the tangibility of our relationship. (Pause): [00:30:29 00:30:41] CLIENT: Unless it's something I did, something I was able to do just now in calling to mind our conversation on Friday, right?

THERAPIST: You weren't able to -

CLIENT: I wasn't able to do the analog of that even though I was actually on site, in town, in New York.

THERAPIST: Right.

(Pause): [00:31:00 00:32:22]

THERAPIST: I wonder if there's something about a sense that you have that the other person is kind of there with you. Like when you couldn't remember when you came in earlier today and I didn't tell you but you asked me to (laughs) but I did ask you a different question and I did sort of try to think with you yeah, go ahead.

CLIENT: What? No, no. Interesting. I was just actually scratching -

THERAPIST: And I did what I did was to try to stay with how you were feeling at the moment. You know, unsure, dislocated, kind of anxious, wanting something from me.

CLIENT: Yeah.

THERAPIST: And I would wonder if there was something about that I would certainly like to think, but I also do genuinely wonder if there were something about that that helped you to kind of right things.

CLIENT: Yes. I think that there's no question that that's true and I appreciate it. Thank you. That was a good, that was a good play. (Laughs). Something else just -

THERAPIST: Okay, yeah, yeah -

CLIENT: Sometimes I stare at my running shoes. I have not been running at all. Like this month I've almost completely not been running. And I really had to run hard to get here more or less on time. I wonder what role that kind of physiological aspect plays in some of this.

(Pause): [00:34:21 00:34:28]

THERAPIST: The thought that you jogged and jogged your memory?

CLIENT: Oh.

THERAPIST: I'm just goofing around here.

CLIENT: Yeah, that's cute. But, yeah, I mean I guess at some level like you know, the feeling of I mean I was ruminating in a very kind of ignorant way last week about the kind of neurophysiologic component of feeling dislocated and you know, that question presents itself to me again a little more concretely and may be usefully here, like what part of that state of mind or state of relation is really what makes it up? What are the components of my reaction to it and what are the components of the thing itself?

(Pause): [00:35:29 00:35:37]

CLIENT: You know there's an actual state of feeling and some mental state associated with it and then there's the reaction to that mental state and then there's the interaction between the mental state and the reaction and I guess I'm just wondering what that would (unclear). [00:35:51] And I don't know, like part of what we're working on is you know really about figuring out more constructive strategies for dealing with how I'm feeling at any given moment. Part of it is probably am I doing things to feel better at any given moment and one of them might be exercise but I'm just wondering what that could -

THERAPIST: I guess I CLIENT: Maybe that's not your department.

(Pause): [00:36:22 00:36:31]

THERAPIST: I think that's a reaction to what I've said and in a kind of move away from sort of the relationship part.

CLIENT: (Laughs) Okay.

THERAPIST: And here's one reason that struck me as you were talking. You know the chicken and the egg might go the other way. You talk about you often talk about it sort of in terms of the cause going in another direction like -

CLIENT: True.

THERAPIST: Maybe, sure I can appreciate that physiologically, you know, you've been running, something, whatever, like and put you in a better head space, more relaxed and one that (unclear) [00:37:20] but what you tend to talk more about it how being in a better head space allows you to run.

CLIENT: That's true.

THERAPIST: And I

(Pause): [00:37:28 00:37:38]

THERAPIST: Yeah, something about like the way you so immediately when I said like, 'yeah, something about the relationship, and you know I'm sitting here with you feeling uncomfortable and like ah, maybe it's because I went running.' (Laughs) You know, I'm kind of (unclear) right now.

CLIENT: (Laughs)

THERAPIST: And I'm like, 'yeah, you may be right' and go right into (unclear) the relationship. [00:38:01]

CLIENT: It's a fair question. It's a fair play.

THERAPIST: Okay.

CLIENT: Fine. So we can (unclear). [00:38:12] Yeah. I mean what you did was helpful because what? Because you're not not, it may well be that you remembered what we talked about on Friday (laughs) and a lot of things that intervene for you between then and now and that's fine, too. But it was helpful, it was helpful because I had to manage the uncertainty. I didn't get it out. You didn't give me a 'get out of jail free card'. Actually, I did kind of navigate and try and avoid the kind of panic that would make it impossible to remember anything and just kind of talk it though and talking it through is really kind of the strategy that I think I've been looking for in general.

THERAPIST: Right. And which I kind of invite you to do and sort of I hope would try to be a part of in a way and like -

CLIENT: But it also sustains the relationship.

THERAPIST: Yeah.

CLIENT: You know so when you did that, when you did that at least my interpretation of that was not, well our relationship is actually tenuous well, I suppose one interpretation I could have made of that, something that actually crossed my mind at the time was, 'well, Josh doesn't remember.'

THERAPIST: Um, hmm. Sure. CLIENT: You know, he's just sort of playing for time or, like (laughs) (unclear) they're not mutually exclusive but you know instead of feeling kind of upset and dislocated as a result of that you know and thus, again, not able to remember even more, unable to remember, I was able to just see it as you know, an offering, an invitation to (unclear). [00:40:28]

THERAPIST: I can't it seems to me there's something to your thought that it's not justified that I didn't remember, but also that I (laughs) didn't want to say so.

CLIENT: (Laughs).

THERAPIST: And I wonder what's going on. In other words, like

(Pause): [00:40:49 00:41:02]

THERAPIST: Yeah. I wonder why you imagine that if I didn't remember -

CLIENT: You would not say so.

THERAPIST: I did sort of want to be correct or up front or something like that. I wouldn't have said so and it is your thought that I was concerned that you would be offended if I didn't remember, or hurt, or something else?

CLIENT: I said once that I'd had a fantasy and always have a fantasy of recording these conversations, these sessions, but actually listening, you know like saving them.

THERAPIST: Right.

CLIENT: Like a library of (laughs).

THERAPIST: Right.

CLIENT: Like the last thing you want to have (laughs) but you know just the imperative of having somebody in charge of remembering, in charge of remembering has often felt urgent especially at times when I felt most dislocated and so I remember when I first started going to see a shrink I was really put off that he wasn't taking any notes. (Laughs) like, 'wait a minute, you need to get all of this down.' And so you know, you know I think I kind of figured out a little bit better how it might work and even were that not too happen, but maybe at some level it is kind of built in to my expectations so that if you weren't remembering it would be I really would be offended -

THERAPIST: Yeah.

CLIENT: to some degree. I think it was just, anyway. I think that we're coming to the end of the therapy (unclear) [00:42:48]

THERAPIST: Yeah.

CLIENT: So Wednesday.

THERAPIST: Wednesday.

CLIENT: All right. Good. See you then.

THERAPIST: See you then.

END TRANSCRIPT