TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: So there are some very nice things happening. [Jennie] (ph) and I saw the first ultrasound yesterday. That was pretty amazing.

THERAPIST: (Unintelligible)

(Pause): [00:00:56 00:01:02]

CLIENT: I guess the other thing is that I came up with a very diplomatic solution to a problem that we had at work. I'm not sure how important the details are but the upshot is that I invented a major publication that's going to come out in September we hope and -

THERAPIST: Congratulations.

CLIENT: It was quite a bit of fancy footwork and everybody's pretty pleased with how it turned out -

THERAPIST: That sounds terrific.

CLIENT: So that was a good thing. I mean that was something that, I think it was something I had been lobbying for for a long time and the pieces just fell into place yesterday, so -

THERAPIST: That was great.

CLIENT: So that was also very gratifying and I think bought me quite a bit of good will.

THERAPIST: Good.

CLIENT: Now I found out about this at about 4 in the afternoon and -

THERAPIST: Right, you've had the sex of the baby?

CLIENT: No. Much too early. No, we're not going to know I don't think that ultrasound happens until, for several months.

THERAPIST: Where is she at now? Eight and a half gestational weeks. CLIENT: Oh, okay. At any rate -

THERAPIST: (Unintelligible) [00:03:02]

CLIENT: No. No, not yet. Not that far along. (Pause): [00:03:07 00:03:12]

CLIENT: So yesterday morning I was about as upset as I can remember being and I was just kind of freaked and really for the last, well since we got back from Maine for no reason that I can well, that's not true. But I mean, the nominal excuse just didn't add up and my sense was that I don't quite know how to put this that what I was doing wasn't justifying my pay and that people were very upset and they weren't in close enough touch and just sort of classic I don't even know how to describe this kind of cognitive loop. It's very consistent. And the other thing that happened was my report, a one page report to the department for performing a renewal was due on Friday and I brought the five-line guideline to Maine and I intended to do it while we were there and I didn't do it and I didn't turn it in on Friday and I couldn't do it over the weekend and I was not aware that there was an obvious relationship between my becoming increasingly kind of freaked out and this but you know, certainly the coincidence was interesting because there was nothing else really that would have triggered this frame of mind. So, you know, the only things that were happening were good. The only feedback that I had gotten to that point was good.

THERAPIST: When was the ultrasound? CLIENT: One.

THERAPIST: Yesterday.

CLIENT: Yesterday.

THERAPIST: And when did you get back from Maine?

CLIENT: Friday morning.

THERAPIST: Oh, okay, so before the weekend.

CLIENT: Before the weekend. Before like I could have sat down and done this thing even after we got back and had intended to. I don't understand why I really don't understand why. At some level, I guess, I can parse it but it doesn't make any logical sense and you know, because it's so irrational I guess it's difficult for me to respond to it. There's something about performance. There's something about observation, there's something about justifying. I guess that's the common thread and just anxiety in both the New York ambit and the Providence ambit but I was just totally freaked out and [Jennie] (ph) got mad at me as we were like momentarily mad at me as we were going to the appointment because there was this weird snowstorm yesterday and the car was kind of covered in this goopy snow and I was just, it was classic, just completely spaced worrying about all of this. I was just sitting, standing there in the snow kind of dead to the world worrying about it. She's like, 'well, you know if you want to -', I think she said something sarcastically like, not -sarcastically isn't quite the right but she's like, 'well, do you want to go in the car? What are you standing there for?' And I understood her to suggest that I got in the car so I just looked still completely out of it. I got in the car and was just sitting in the passenger seat while she cleared the snow off the car and then she really got pissed off at me so I mean, which is an argument that we have in such moments not infrequently, because, like it doesn't' make any sense to her. And I don't quite know how to explain it beyond what I have already but it's frustrating. So, you know I felt bad and yet I was still completely out of it. I mean it really took an act of will to zone in for the duration of the appointment which was ultimately able to do and it was fine, but I was really out of it. I was just gone. I was not present like at that moment in the car, again was probably classic and maybe more descriptive of what it's like to be in that state than anything else. I was just there. All weekend basically I was like standing there in the snow all weekend. So you know, on the one hand it's really a problem. Like I still have to write the report. And I said this morning I finally sent a note of apology and I'm sure it's fine. It's just to perform a [sedition] (ph) but you know people have to read it. It has to be sent in to Brown and so on and so forth. [00:09:20] So, yeah, what it reminds of more than anything else was my ability to submit job applications, you know, something that has been a major problem for me and for us in general.

THERAPIST: Yeah.

CLIENT: And had dictated, I think some of my decisions over the last few years to the detriment of just about everything. Like there's a deadline and there's an evaluation and it's not just that like I don't want to do it, or that I feel anxiety about it. That's not the experience. The experience is that I can't think. Like I can't put it together. I can't put it into so,

THERAPIST: More like standing in the snow.

CLIENT: It's like standing in the snow. I can't put it together. I just, like there's something is not able to engage. So, you know, while it is true that it feels bad, I feel distress, the experience of it is just of not being able to get whatever executive function is necessary to move on something, you know to get it underway. Which feels a lot more difficult somehow. I mean, ultimately it's the same thing, but somehow that aspect of it makes it difficult to either intervene or despite feeling lousy, to kind of go through with it with what I'm trying to do because there's just like some basic prerequisite for acting that is undermined.

THERAPIST: Right.

(Pause): [00:11:38 00:12:27]

CLIENT: One more thing.

THERAPIST: Yeah, yeah.

CLIENT: One final, final thought.

THERAPIST: Sure.

CLIENT: The only coherent thought that I remember having with regard to the reappointment, again it's pro forma, it's like -

THERAPIST: No, I understand.

CLIENT: You know, the only coherent thought that I remember having is, 'well,' is, you know, like a rationalization beyond saying it's some kind of vague fear that I wouldn't be reappointed and that I didn't fulfill the requirements which is totally not true. I mean it's like, not that it's a very high bar, but -

THERAPIST: Right.

CLIENT: It's not true, was (Pause): [00:13:14 [00:13:26]

CLIENT: It's time for me to go. Like it's time for me like this system is not recognizing me and I just need to make a break. You know I'm kind of locked in an unfulfilling cycle where I'm not being recognized and whatever and that is why I'm doing this.

THERAPIST: Right.

CLIENT: And at the end of June then the relationship will be at an end. Now, you know, it may be that there's some either some emotional truth to that or it may be that there's even some plausible rationale that that expresses, but that's not why this came about. In other words I had every intention of doing so and I wasn't really conscious of this particular motivation. I don't know, maybe it had crossed my mind from time to time but -

THERAPIST: But it's certainly out of whack very much so with what you (cross talk) (unclear) [00:14:52]

CLIENT: I mean I would have just, if I really wanted to do that I could have just written to them when -

THERAPIST: Right.

CLIENT: ` I found this e-mail, you know, I noticed this e-mail a month and a half ago, like I'd been aware of it for a month and a half. They gave two month's warning for this.

THERAPIST: Right. (Pause): [00:15:08 00:15:16]

THERAPIST: Yeah, one thing it makes me wonder is whether

(Pause): [00:15:17 00:15:35]

THERAPIST: that sort of not being able to make it work there at the institution could be the institution not looking out for you and not being able to make a place for you is sort of like unconsciously terribly upsetting and -

CLIENT: Yeah! Oh, you know, partly unconsciously and partly consciously. And I'm pissed.

THERAPIST: Yeah.

CLIENT: Like I'm really mad about it and hurt and yeah, I don't even think it's that unconscious. And I'm conscious of it, you know, clearly but, and the fact that I it rose to the level of consciousness and it has occurred to me this scenario in which I just fail to renew the appointment, has occurred to me, that scenario.

(Pause): [00:16:35 00:16:39]

THERAPIST: Well, I get -

CLIENT: In that context. So I'm aware of it. You know, it's not like it's very far under the surface and yet, like this process, you know, if that's where you are, then you do it. You know, you don't engage in this very strange -

THERAPIST: Well, I guess there must be much more to that than there's ever been. In other words, like -

CLIENT: Keeping this connection is actually a great convenience. It means, for example, like we can apply for Brown daycare. It's something that you can keep almost indefinitely like you just renew it year after year. It's kind of no skin off anyone's nose so long as you stay minimally involved and engaged and you know, you get library access, you get all kinds of stuff. So it's free, basically it's free access to Brown's resources. It's very, it's a very convenient thing. So, rejecting it out of pique is really what I'm talking about at some level, or I don't know, maybe that's unfair to myself. But you know, rejecting it would be a significant statement. It would mean something meaningful or something just kind of self-defeating.

THERAPIST: Well how you feel about it is incredibly meaningful. I'm not, look I'm not trying to argue that you shouldn't renew it, but I -

(Pause): [00:18:20 00:18:39]

THERAPIST: It seems to me kind of minimizing to refer to it as "pique". I mean when you describe sort of how angry you are and how upset and maybe also, hurt, that's a lot more than "pique." CLIENT: Yeah.

THERAPIST: And I guess, one way I've found myself thinking about it is that -

(Pause): [00:19:13 00:19:23]

THERAPIST: what I sort of get is that some of those feelings are you're kind of aware of them, maybe some much more than others. I don't know maybe they can also be somewhat distant at other moments or you know when you're thinking about it in more practical terms you sort of lose some touch with them and the way that they're trying to kind of speak up or sort of really like raise their hand is to keep you from doing this thing.

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

CLIENT: Except that, okay, so I think that's true. I think that there's a layer of truth there. The other thing though is that deadlines freak me out in general and simultaneous to this sense of significant distress and deferment and delay and dissociation, really, associated with this particular deliverable and having an identical process, you know, equally disturbing and upsetting with these other things to which none of this applies. Quite the contrary, in fact. You know, I am being validated. I am being supported very lavishly. Any time I feel like going down to New York I can. They're fine with it. So, and it's working. And yet, the same anxieties apply, the same sense of terror really at not performing or not submitting or not engaging obtains. So yeah, there's truth to the rationalization, in other words, like the rationalization of this anxiety is not fictitious. It doesn't come from nowhere. It's not I don't deny that I'm angry and that's relevant to something, and yet the process or trajectory of my engagement with this deadline for this completely trivial deliverable is identical to my process of engagement in deferment in all of these other deadlines that don't have any of this associated. There's a very kind of neat control here and the obvious conclusion, although maybe not complete it's not a thorough going truth, maybe you know there isn't an element to which this isn't as descriptive as it might be but the conclusion that I would draw just as an outsider looking at this particular quasi-controlled experiment is, 'well, you know you have one situation in which you don't have any of this emotional complexity and one situation in which you do have an emotional complexity and you're behaving identically so it's not the emotional complexity that's at issue.'

THERAPIST: Well. There is emotional complexity. Like, I think you're always super-worried about how much of a home you have in whatever institution you're working for.

CLIENT: Sure.

THERAPIST: And you may be sort of at different places along the spectrum of how much you feel you do or don't, but anywhere no matter where, like (unclear) doesn't seem to preclude a similar level of or some considerable level of anxiety. I mean, you're one place with Brown and partners which is in the, 'they didn't I'm pissed, I'm upset, I'm hurt,' and in another place with the [thank] (ph) [00:24:22] which is, 'they have so far; it's going well.'

CLIENT: It's not permanent.

THERAPIST: They like me and I like them but it's not permanent and I think, on top of that, like there's a reality of it not being permanent and I think there's a kind of important psychological reality to the feeling of it not being permanent if that makes sense.

CLIENT: Yeah! Oh, definitely. I'm aware that's conscious.

THERAPIST: Yeah. True.

CLIENT: That's conscious.

THERAPIST: But I think there's still a feeling of there is kind of more hopeful and excited but it's so tenuous I think you're really anxious, not hurt and pissed but worried.

CLIENT: (Whispers) That's true.

THERAPIST: And I think it's also, I mean, there may be things we're leaving out but it's not all the same. I mean you've said that you felt as upset yesterday as you can ever remember having been, which is not what you've been saying about the sort of glitches and difficulties with getting things done for the bank. I mean they've been -

CLIENT: Oh, this weekend I felt those. I felt like I was about to be cut off. Very specifically.

THERAPIST: I (unclear) they're both in relation to the bank you think and in relation to Brown. [00:25:44]

CLIENT: Yeah. It was very comprehensive, this anxiety. It was extremely comprehensive and I felt, I mean I felt like I was about to be, you know, cast out. I had very specific fears about this. You know for nonperformance, for inadequate it makes sense. You know I've been trying to finish this article, a kind of review article for a couple of weeks now. I don't know.

THERAPIST: I wonder if you were also really worried about the ultrasound.

CLIENT: I was, at the moment it happened, like you know, the one they look for the fetal mass, or embryonic mass and they look for a heartbeat and when the technician who is this very maternal, woman, probably a physician, wherever she trained, when she mentioned one of the things she was looking for was the heartbeat, I got worried all of a sudden. I'm not aware of you know, and I remember being a little worried that she wouldn't be able to find anything and that it was all like a false pregnancy or something, whatever that means. So I had some anxieties but I wasn't aware of being super upset about that.

THERAPIST: Well, there are a few other things that are making me wonder about that. CLIENT: Okay.

THERAPIST: One of which is, or for me to see another reason why this would be such a difficult few days, in other words, like you have not talked recently in such strong terms about how bad you've been feeling. You've talked about difficulties you've had getting things done and delays and so forth and struggling. But I don't know you're language seems stronger today than it has recently. So that's one thing. The thing is, what I would imagine similar things happened through the weekend. You could on this incident such as standing out in the snow which was on the way to go there and you said, you seemed to suggest, although I'm not sure about this, that you felt quite a bit better afterwards. I know the other thing that felt really good was the coup at work which you said happened a little bit later in the afternoon. But my impression from the way you were talking was that it was both the ultrasound and the coup that made you feel better.

(Pause): [00:28:4100:28:50]

CLIENT: Yeah, I don't know. I mean we did the ultrasound and we went back to the car and I forgot my laptop. It actually turned out to coincide with the call in which this was all decided with the work issue so I actually missed it. I missed the whole thing and the reason it took until the afternoon was that I had scheduled a chat with Jack, my collaborator on this, so you know, I had and I had wanted to finish this research article that I had been plugging away at before this conversation. So it was really wonderful and they gave us these kind of photographs of the embryo and we were pretty excited and [Jennie] (ph) [00:30:00] wanted to go to copy them and I was kind of stressed out and I wanted to work on this article. We went to the copy store and, downstairs actually, come to think of it. And you know, their equipment is kind of, I wanted to scan it and she wanted to Xerox it and I couldn't understand why she wanted to Xerox it and I'm feeling really anxious and kind of distressed so my recollection is that, yeah, in kind of a rough interaction we apologized to each other afterwards and it was fine, but we had my experience of it was that there wasn't that much change after the ultra I mean I feel kind of bad saying that, you know, I would like it to be the case that the catharsis was partly provided by the ultrasound itself, and the fetal heartbeat was 165 which was exactly where it should be and I mean, it was a very encouraging event and both of us were very happy and yet what I really seemed to be worried about was this thing at work. I was still, you know, not, maybe not quite so acutely in that state but I was still in that state when it was all over. Now, once I was able to kind of touch base with Jack and get this feedback and feel as if I was kind of embraced by everybody and so on and so forth, then the combination of that and the ultrasound was great and we called our parents and I mean all of these things were, I could -

THERAPIST: I feel like that helped you enjoy it.

CLIENT: That helped me enjoy it. Yeah, it was just a wonderful evening.

THERAPIST: But it didn't feel like that was central in the particular drama.

CLIENT: I don't, I'm not aware that it was. I'm just not aware that it was. That kind of thing you know, I'm anxious about it. I was anxious about it. It would have been a really horrible disappointment. Both of us would have been obviously devastated by it.

THERAPIST: Sure.

CLIENT: The anxiety that we're talking about here does not apply to that.

THERAPIST: I see.

CLIENT: You know, it's specific. I think you hit the nail on the head and we've talked about this ad nauseum from your point of view I'm sure, it's about having a home. You know we want to bring this child into our home but my anxieties on this score are prior to that, are separate from that.

THERAPIST: Yeah. I guess part of the way I had been thinking about it was in terms of stuff like that, in other words, they didn't seem unrelated to me.

CLIENT: No, they're not.

THERAPIST: I do also. That doesn't mean they're necessarily connected.

CLIENT: They don't function the same way and I just don't, you know, maybe it's possible to understand them kind of coevally but -

THERAPIST: Yeah.

(Pause): [00:33:43 [00:33:51]

CLIENT: I mean when you think about it rationally, the cause for anxiety about this ultrasound should have been like 300 times the level of anxiety about this fucking report or this stuff at work or whatever. I mean like, who gives a shit, right?

THERAPIST: Yes.

CLIENT: I mean this is the real, this is life. Literally. And yet, the proportions were completely reversed.

THERAPIST: I see.

CLIENT: I guess I feel ashamed about that to some degree. That's the way it is.

(Pause): [00:34:23 00:34:39]

THERAPIST: So what has seemed much more on target is the sort of ongoing worry that like, the ongoing worry about sort of your uncertainty of having an institutional home and you know, this kind of varied reaction to that, having varied reactions to that sort of like that this has kind of the same spectrum before. In other words, what seems on target is that you're having this one reaction to the renewal letter because of how you're feeling in relation to not having a home made for you at Brown and yeah, certainly more positive but in a way, no less worried about things at the bank for not having a home that feels secure there either. I mean you're clearly hopeful about that and (unclear) optimistic about it, but there remains a kind of tenuousness, at least it feels like, and that sort of comes up around getting things done. CLIENT: Yes.

THERAPIST: With the particular worry that if you don't get something done or it doesn't work out well enough, you know, you're going to blow it and lose the chance and they're sort of ready to kick you out or something like that.

CLIENT: I mean on a much smaller level I have that same anxiety in every situation where there's a deadline at which I get some kind of a read on whether I have a home in that particular place. Like here. Right now what's on my mind is 45-minute therapeutic hour and every time that moment asserts itself in our exchanges I have anxiety. Are you beginning to wander in your attention as we approach the moment of separation? Am I being appropriately respectful of whatever? You know, all of the things that one can possibly consider. So here, micro-cosmically we really have many of the same dynamics and the level of anxiety is not quite so high although you know at some times when I really do feel, am in distress, it's actually quite high.

THERAPIST: When you say you have anxiety of all the (unclear) one might, about that.

CLIENT: Well, I might, I suppose.

THERAPIST: And what sorts, I am interested in the particulars there. One is that my attention is beginning to wander at the end of that hour, I'm sort of not really here anymore anyway.

CLIENT: And so that, and yet the way that it sort of occurs to me is that you know there's some kind of you know I have to not care, or I have to not be invested. I'm fumbling for something. You know, somehow it's not on you, it's on me. And yet what the measure of it is your engagement or your level of engagement. So, I'm at the moment where this though occurs, or this sensitivity to time in our interaction occurs I begin to very, very intently consciously and unconsciously sort of parse our interactions to see the moment at which your attention begins to wander and it may or may not become incumbent on me to separate, I guess. What's

(Pause): [00:39:32 00:39:39]

CLIENT: I don't want to over stay in a way that would lead to some kind of breach I guess to your disengagement.

THERAPIST: Maybe it's (unclear). [00:39:51]

CLIENT: Yeah, maybe.

THERAPIST: Maybe it just hurts, (unclear) and you're not, in a way you're not exactly sure when the moment is that we stopped. Is it, you know, my checking out at some point? Is it the actual time? Are you over staying? I mean it seems to be like -

CLIENT: Well, I don't like it. I mean like I don't like the reminder that this is, that I'm sharing these very intimate experiences in the context of a professional interaction and you know in this very weird fictitious description of time and at moments the stupidity of my insurance company enters into it and I mean, not really stupidity, but bad faith and depending on where we are in the billing cycle, or our billing cycle, so I don't know. Yeah, there's definitely hurt there and the anxiety is driven by hurt over something enforced by the regularity of separation. I think there's something there that speaks to these larger more general issues. I'm feeling it right now, of course. (Laughs).

THERAPIST: Sure.

CLIENT: At any rate.

THERAPIST: What is it that you're feeling? I mean I know what (cross talk) (unclear) [00:41:40]

CLIENT: No, I appreciate that. I'm parsing very assiduously. I'm extremely attentive to your behavior, looking for change, looking for some evidence that you're withdrawing or disengaging concerns to avoid precipitating some kind of breach by presuming too much, by demanding too much, by being excessively presumptuous. I mean I think the construction is somehow that if I do that then you know, the breach could be permanent as opposed to just a kind of separation that is temporary. And yet, it's like there's something that I could do that would make this disengagement that hurts permanent. I'm fumbling a little bit. If I presume too much, if I press it, if I pull it too far, or push it too far, then it won't only be a kind of momentarily painful separation, a separation that enforces the limitations of our relationship, but it will really begin to develop into a breach that's really serious and more difficult to I think that applies frankly to the appointment letter, it applies to many of these interactions -

THERAPIST: Yeah, and one thing that certainly is similar in all of those is that in another way, like there's a tremendous weight.

CLIENT: Yes.

THERAPIST: More to -

CLIENT: Given to interactions that -

THERAPIST: You were not worried 10 minutes ago that, 'oh my God, if I say the wrong thing,' CLIENT: No.

THERAPIST: then that might be the end, but it's something about like pushing the boundary or envelope -

CLIENT: It's something about the boundary. It's something about this deadline.

THERAPIST: Yeah.

(Pause): [00:44:13 00:44:26]

CLIENT: And it even applies to deadlines with people I've never even met before. I guess that's the really curious thing, although, you know -

THERAPIST: Yeah.

CLIENT: These are prospective homes and prospective relationships.

THERAPIST: Right.

CLIENT: So maybe they're even worse just because I don't have any information at all but, yeah. The dynamic is very consistent.

THERAPIST: True.

CLIENT: Yes. (Laughs) I was smiling.

THERAPIST: Yeah.

CLIENT: Okay.

THERAPIST: A week from today? CLIENT: A week from today. Yeah. No, wait a minute. No, not a week from today. Hang on. Yeah, I'm in New York the end of this week and I'll see you on Wednesday.

THERAPIST: Yeah, that's right.

CLIENT: Okay. All right.

THERAPIST: All right.

CLIENT: Bye-bye.

THERAPIST: Congratulations, again.

CLIENT: Thank you very much. Thank you.

END TRANSCRIPT