TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Hi.

CLIENT: Hi (sighs). I had a performance review today which I've been incredibly anxious about for the last couple of weeks. It went okay, there were no surprises. It was really hard to hear criticism so on other things I don't communicate enough, I don't ask for help soon enough, I spend too much time spinning my wheels and I focus too much on problems that are not high priority. I have trouble distinguishing the high priority items from the low priority items although my boss thinks that's just a matter of my lack of experience and as I learn more the problem will fix itself. He also commented about my use of the Internet and how it's too much and gives the perception that I'm not fully engaged with the work. [00:01:04] There was also good stuff. He approved of the aggressiveness of which I pursue problems once I've sunk my teeth into them and gave me an exceptional rating in the category "Actively improves self and others" which I don't fully understand what that category is about. Yeah… (pause) I actually solved a problem all by myself without help from my mentor today so that was kind of a peak I guess. (pause) So Thursday is Nowruz, which is the Persian New Year, also the vernal equinox which is when the New Year is celebrated in or was celebrated in ancient Persia before the Islamic Empire ended and forced everyone to convert but it's a holiday that my family celebrates, a lot of the Persian traditions got brought to India when the Mongol Empire conquered India and because that's my families ethnic background. [00:03:00] It's what we celebrate even though we're not Iranian and this confuses a lot of people including a lot of Iranians who have no idea that their culture has spread far and wide but anyway I usually throw a big party for Nowruz every year and it's something that I usually look forward to a lot and I started planning about a month ago and then I never sent out the invitation because every time I sat down to write the invitation I kind of got seized by anxiety and couldn't bring myself to type it up and send it out. So I'm not going to have a party this year which I'm a little upset about it because it's just like my own stupid, jerk brain getting in my way, like there's no reason not to other than I couldn't write the invitation.

THERAPIST: Mm hm.

CLIENT: I don't know what's up with that, like why I got so anxious and upset about it. (pause) [00:04:33] I think part of it is that I had asked my work mentor Brian for his personal e-mail address so that I could invite him to the party and then I started second guessing that decision and couldn't think of a way to back out of inviting him after I told him I was going to invite him. Like at first I thought it would be a good idea because in the past I have developed friendships with him and we get along really great at work and we share a lot of the same interests and hobbies and cultural values but on the other hand he's my mentor at work and…

THERAPIST: Is he also your boss?

CLIENT: No.

THERAPIST: Okay. That's what I thought but I wasn't sure.

CLIENT: I mean he has a much higher title in the company than I do.

THERAPIST: Right.

CLIENT: He's the…we're both working on a title and he's nominally the component lead for it but he's not a manager in any sense of the word. [00:06:22] But he's the senior engineer of the project that we're working on together and he is assigned to be my mentor.

THERAPIST: Right.

CLIENT: In many regards when he makes suggestions for things I should look into like those are effectively instructions as if from a boss but he objects vehemently to my addressing him or thinking of him as being my boss.

THERAPIST: Is that all? (inaudible)

CLIENT: Yeah. So there's that and then, I don't know I guess I had a really good time at HudCon and the previous weekend there were three birthday parties I went to and I also had really good times at those also but I was feeling maybe a little bit like I'd been around people too much and the thought of having fifteen to twenty people in my apartment kind of made me panic a little bit. (pause) [00:07:59]

THERAPIST: What makes these things kind of overwhelming? Or have you?

CLIENT: Yeah.

THERAPIST: And? Some of the stuff about the party…

CLIENT: Mm hm.

THERAPIST: And the feeling of "Okay, Brian, I'm overwhelmed, here you go." (laughs)

CLIENT: (laughs) "Take it, only friends please."

THERAPIST: (laughs) "Take it; I'm just going to, you know…" (laughs) That's okay, I'm not (inaudible) but (pause)… [00:09:30] I know you have strong feelings about both things in ways that make them hard to think about.

CLIENT: Yeah. (pause)

THERAPIST: I guess in ways that relate to feeling judged, eventually by your mentor who'd maybe come to the party and really going out on a limb there to suggest that your worries about the performance review may have something to do with pictures of being judged. (laughs) Stretch but…

CLIENT: Not much of a stretch though. (pause) (sighs)

THERAPIST: What's coming to mind?

CLIENT: I just can't shake the feeling that I've just felt so tired and so overcommitted lately and maybe I should drop one of my weekly hard commitments? They're all things that are important to me but…some of them I kind of need like this appointment, like…there's just not enough hours in the day and neither my piano instructor nor my voice instructor do weekend appointments.

THERAPIST: I see.

CLIENT: That would make my life easier if I could just go home after work but… (pause) [00:11:39]

THERAPIST: Neither does your shrink.

CLIENT: Huh?

THERAPIST: Nor your shrink. I can't offer you weekend appointments…because I don't have them. (pause)

CLIENT: Sometimes I can stack things if they're on the same day but you know usually my Monday's are come here and then go from here to voice lessons but for the last month that hasn't been possible because there's this kind of adult formation program for my church that's on Monday's that I go to instead which means I go to voice lessons on Friday's and that's just one more day of the week where I'm going somewhere after work.

THERAPIST: Mm hm.

CLIENT: Yeah. (pause) [00:13:10]

THERAPIST: It seems to me your thinking in kind of a supportive way about yourself which is good.

CLIENT: Meaning?

THERAPIST: Your saying like "I'm tired, I've got a lot to do, I love doing all of it which is great but it's wearing me out!"

CLIENT: It really is.

THERAPIST: And you know "Maybe I…maybe it's okay to think about doing less in something?"

CLIENT: Yeah. (pause) But I don't know where I can relieve the pressure in my schedule and still be reasonably happy? (pause) I think if I had, if sleep weren't such an issue then maybe I could get up earlier and get to work earlier and not spend so much time in the morning just lying in bed, staring at the ceiling, being exhausted and unable to get up. Right? Because that's at least thirty to forty-five minutes a day. If I could get to work thirty to forty-five minutes earlier then you know, I could have a dinner break between getting off work and getting to wherever it is I need to get to in the evening. I would get to those appointments earlier and get home earlier or (sighs) but…[00:14:54] I mean both Saturday and Sunday I took three hour naps in the middle of the day and I still felt exhausted and unable to get out of bed this morning. (pause) It's scary because Dave wants children, I want children, but I really, I can't imagine being any more tired than I am now and surviving in any way. It's scary. (pause) [00:16:12]

THERAPIST: I imagine you're a little worried saying something like that to me, that I'm going to…Your saying you're having a hard time with something and you're afraid about it and I imagine you're worried that somehow I'm going to bring it back to being your fault or tell you you shouldn't be afraid about it, not to make you (inaudible) you know, I'm not?

CLIENT: Right. No that hadn't occurred to me.

THERAPIST: No? (pause) [00:17:27] Is it more that it's kind of overwhelming to think about?

CLIENT: No.

THERAPIST: Okay. (pause) [00:18:33] What other thoughts do you have about it?

CLIENT: I don't know. (pause)

THERAPIST: Is it that you're looking for guidance or reassurance, guidance on how to think about it or reassurance about…?

CLIENT: I think I'm always looking for guidance. You've made it pretty clear that that's not how you work so…

THERAPIST: Is that annoying?

CLIENT: A little bit but you know…if it were really that annoying I would find a new shrink. (sighs) I guess it's just seems to me like it's an intractable problem because like sleep has been an issue for so long and so many approaches to fixing it haven't worked. [00:20:07] Even when I was not as scheduled in the evenings didn't have…over the summer when there wasn't choir because choir was out of season, we only sing from September to May and we take the summer off, before I started taking lessons, then all summer was voice lessons, I was still exhausted all the time and I still felt overwhelmed. But at least now I'm doing enjoyable things that make me happy so…I don't know what to do and I don't know that there is anything I can do. (pause) [00:21:20]

THERAPIST: Are the sleep issues pretty much unchanged?

CLIENT: Mm hm. They're not as terrible as they were at their worst but still it's hard for me to get to sleep and I still wake up fairly frequently. (pause)

THERAPIST: I have a couple of thoughts. One was if we did something more intense, more analysis, we might be able to get more traction on the issue with sleep but A. It could take a while, it usually takes a while and B. That would involve more of your time.

CLIENT: Yeah.

THERAPIST: But you know, it's certainly something to think about.

CLIENT: Mm hm.

THERAPIST: Um (pause) [00:23:06]

CLIENT: It's gotten to the point where I dread going to bed because it feels like a failure, that I can't get to sleep.

THERAPIST: Like you're fucking up because you can't fall asleep?

CLIENT: Yep. Which I realize is probably only exacerbating the problem and is certainly not helping but once the negative self-talk begins it's really hard to shut it down. (pause)

THERAPIST: Is it at all correlated, either way, like positively or negatively with how well things are going or how stressful they are?

CLIENT: Not that I can tell but I haven't been tracking that so I don't have good data. You know another thing that's incredibly frustrating is that I'll be awake doing something like in the living room or in my study, on the Internet or reading a book or working on some project and I'll start to feel really, really sleepy and really, really tired and I'll think "This is great, I'm really tired" and I'll get up and brush my teeth, put on pajamas, go to bed and as soon as I lie down I'm wide awake and can't get to sleep. [00:24:45] That happened last night actually. I was at a friend's house for St. Patrick's day, so we had dinner and watched a movie, you know played a drinking game while we were watching a movie, called a cab to go home, I was literally falling asleep in the cab, it was like "Fantastic, I'll actually get to sleep tonight." I paid the cabbie, walked in the door, crawled into bed, wide awake. Not able to sleep. The last time I remember noting on the clock last night was 3:34 a.m. and I'm not sure if I was actually awake until 3:34 or if I slept and then woke up again at 3:34, it's not clear to me but…(pause) [00:26:01] (coughs)

THERAPIST: It sounds like your feeling terribly overwhelmed, I mean each of the things you've brought up today is something that is big or points towards very big things.

CLIENT: Mm hm.

THERAPIST: And each of which is also I think very hard to like sort of think about?

CLIENT: Yeah.

THERAPIST: And (pause) I imagine you do really want some guidance with this stuff and my hunch is that part of what you want is…part of what would be helpful with the guidance is it would make you feel more like I was really on your side with it and I'm not saying you feel like I'm not on your side, but that I was like, not in the trenches, at least kind of…I don't know, more like that. [00:28:14] It would probably feel more like I wanted to help and really had a sense of how much you were suffering with this.

CLIENT: What is it that you called it? Instrumental solutions?

THERAPIST: Yeah. I don't have anything against instrumental solutions actually. I'd just rather take…more than I do or like there's more that (pause)

CLIENT: My boss actually made a comment to my performance review today about how I often seek, you know, specific solutions when really I should be looking at underlying causes to technical problems with the project that I'm working on. This is a critique he also made of the two senior engineers within our project, all three of us, our background is in hand place design and this new tool flow has got all of us practically thrown off balance but yeah (laughs) it sounded very similar to your objections too, in my particular case, using instrumental solutions and how that is probably not helpful to me. (pause) [00:30:00]

THERAPIST: Yeah I guess I'm…with the sleep stuff in a way it's a little easier in that I'm sure you've tried umpteen instrumental solutions so there it's sort of easier and sort of an issue I'm sure I couldn't think of anything anyway but I do think this issue of the ways in which it…I guess it probably seems very obvious to you that of course that's what you want.

CLIENT: Right.

THERAPIST: Like "What the hell?"

CLIENT: Yeah.

THERAPIST: "I have a problem. I want some help!"

CLIENT: Right.

THERAPIST: Usually that involves suggestions or at the very least more help talking about it. I could be sitting here not making suggestions but asking you questions about the performance review, the sleep, the party, you know in a way that would help you to think it through.

CLIENT: But you do do that.

THERAPIST: Sometimes.

CLIENT: There's also the issue that you start suggesting instrumental solutions to me even though that's what I want, I know myself well enough to know that as soon as you start making those suggestions I'll start digging in my heels and be "I don't want to, you can't make me" part of my brain will kick in and …

THERAPIST: I see.

CLIENT: Yeah.

THERAPIST: It's good to know that's where we'd be headed.

CLIENT: Yeah. So I'm actually glad you're so stubborn about not providing any solutions because it would end badly.

THERAPIST: (laughs) [00:31:48]

CLIENT: But I can't stop wanting them.

THERAPIST: Sure.

CLIENT: Right?

THERAPIST: Sure.

CLIENT: Even though I know, that's kind of like I know eating that bowl of ice cream will upset my stomach and I'll regret it later, but I do it anyway.

THERAPIST: It's probably a good analogy again in that I imagine you do both, feeling for something kind of concrete to help you with your anxiety.

CLIENT: Yeah.

THERAPIST: Like a comfort in this…sometimes those things can help. And you probably do that at times when you're anxious and not that you to some extent lose the capacity to think which I think indicates how scary this stuff is.

CLIENT: Mm hm.

THERAPIST: And like also how very alone you can feel with it, I mean to me there really is this feeling, I don't always have this feeling when somebody's asking me for instance what the solution is, the feeling for you is there really is something about it would make it feel like we were on the same team more so and that would mean a lot. [00:33:20] Like you wouldn't feel you were shouldering the burden so much on your own. (pause) We should stop.

CLIENT: Yep. (inaudible)

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