TRANSCRIPT OF AUDIO FILE:

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THERAPIST: Good morning.

CLIENT: Good morning.

THERAPIST: What's on your mind?

CLIENT: Not much this morning. I think I mentioned maybe last week I've been kind of wishy-washy with my decisions. It kind of bothers me because I'll want something but then I start second guessing myself and talk myself out if it. It's kind of hard because I don't have a register of how I'm acting or are my decisions good or normal or if they're a product of something else. It's really hard to check in with myself, I guess. [00:01:52] (pause) When people you know are deciding, "We should do this," or "We should do that because of this reason," are rational reasons; but, for me, I feel like I've lost my ability to judge and I guess I just deny a lot of the those decisions I make or immediately regret them or change them later. It's just a little weird of how I register things for myself. (pause) [00:02:55]

THERAPIST: It's sort of related to lacking a feeling of confidence about what you want or factors decisions that matter and the ones that are you and the ones that aren't?

CLIENT: I question why I want something or I did something. Yeah I guess it's confidence. I don't know if it's some non-committal thing. I don't want to make the wrong decision. Yeah, it's weird.

THERAPIST: Are you feeling muddled about it? [00:03:44]

CLIENT: Yeah. I get frustrated because I feel like I should do this and talk to other people and then I'm like "Uhh," and I end up changing my mind anyway. I don't know. I wish I just stuck with things and did them. (pause) [00:04:48] It's like a weird I don't know. It frustrates me because it's like I don't have a personality or wants or needs. It's just kind of like everything is like, "Yeah, I could do it either way," or if I want it or something like that. It bothers me because I wish I had more conviction of what I want. (pause) [00:06:00]

THERAPIST: You feel a little sort of blurry or like jello or something like that, as opposed to something with clear edges and more solidity?

CLIENT: Right. I think I do want to have more solidity, but I also want to register that I want the thing because I'll use it just being able to register. I don't know how can I say it? [00:06:55]

THERAPIST: I guess one way of saying it is I hadn't thought about this quite as well before but you're saying that there are almost two aspects to a decision, one of which is to decide what you want. There's a firm grasp on the obvious there. The other says something about you and sort of what matters and how you see things. In other words, there's something kind of self-defining about making a decision.

CLIENT: Right.

THERAPIST: It sounds to me like you're talking as much about not feeling the second part as about the first part. In other words, it's in a practical sense pretty helpful to be able to make decisions easily. But there's also a way in which being to make decisions easily helps to clarify things about you or things about what matters to you. [00:08:02]

CLIENT: Yeah. There is not much or I'm not very picky. I don't know what the word is.

THERAPIST: I guess that would be an example of it. Do you know what I mean?

CLIENT: Yeah. I wish I had stronger feelings or was more opinionated or maybe just had more of a personality. I just don't always want to be second-guessing myself or letting other people decide. (pause) [00:09:52]

THERAPIST: I guess it sort of relates to some way that you feel inside yourself?

CLIENT: Yeah. (pause) I just wish that there were more to me just wanting things or enjoying things or be interested in things. I wish there was more to me. I feel like I've tried to get into things but it's always just boring or disappointing or something. Or second-guessing myself for even liking or wanting something.

THERAPIST: If I follow, it's like feeling moved strongly in any which-way.

CLIENT: Right. And I don't know if I have this weird ideal, but I want to be authentic or not want something because it's materialistic or what everyone else is doing. So I just kind of question everything or remove myself from it. (pause) [00:11:56]

THERAPIST: You mean like you don't know if it has to do with your standards?

CLIENT: Right. But then I feel like my standards are whacked or guessing what my standards are so I end up having bearings. (pause) I don't know if it's because I've been trying to change myself or being someone else for so long, I feel like there's nothing left. There's nothing behind just wanting change or wanting to do something else. I just feel like there's not much there. I think I'm just kind of guessing if I want this because I actually want it or (chuckles) some other... [00:13:52]

THERAPIST: I see. There's this whole condition effect even your thought about being different or wanting to do better.

CLIENT: Right. I don't know. (pause)

THERAPIST: You try to kind of put a stake in the ground or just say something and then have this experience of sort of feeling yourself crumbling or dissolving.

CLIENT: I don't know. [00:15:01] (pause) I just think there's nothing there. (pause) Maybe it's just wanting to be something else or where I regret and I'm wishing I could go back in time. (pause) [00:16:53] It's weird, I guess, the whole idea of self and I think I just have a lot of hate towards myself and I don't know. I guess it's just hard to know. I guess I get mad at myself for what my wants are or why. It's hard. I feel like it's guess it's coming out (chuckles) in simple decisions. It's affecting my perception of everything. (pause) [00:18:35]

THERAPIST: It does make sense to me that there is something about the intensity of your self hatred that makes it very difficult for you to assert yourself in any consistent way. (pause) [00:19:27]

CLIENT: So, yeah, (chuckles) what do I do? I guess this reminds me of in college I was a part of a lot of a lab that did the effects of meditation on attention in average children. My PI said if you can't accept yourself you can't accept that you can't accept. (both laugh) He was like, "Well, where do you go from there?" (pause) Like I say, I don't know what to do then if I should be fine with what I'm doing or I don't know. [00:21:26]

THERAPIST: I think what you're telling me is that you really don't know how to get any kind of help for this.

CLIENT: Right.

THERAPIST: And that you don't have much confidence that anything will help.

CLIENT: I feel like I've been at it for years in every direction and working out, meditation therapy. Hit it from every angle, and it didn't work. [00:22:29]

THERAPIST: I think there is sort of a question and maybe a frustration and maybe also a worry directed towards me in what you're saying, in that your PI and the communication from him, I think, was something like in order to get better you're going to need to do the thing you can't do in the first place. I know my impression is a light-hearted exchange. But I imagine that may be something you're wondering about with me; like am I going to convey something similar to you about it, or maybe it feels to you like I already have. I don't have a way of helping you with where you actually are. I'm going to insist that you are only going to be able to be helped if you can already do something that you can't do and that you're coming for help for in the first place. [00:24:44]

CLIENT: I'm just frustrated. I think it's just because [...] (inaudible at 00:24:58) any good. I just feel kind of hopeless. [...] (inaudible at 00:25:09) or thought that much about it.

THERAPIST: What thoughts have you had so far about this and me? I want to sort of explain quickly and hypothetically that have you ever read anything or has anybody blathered to you about transference before? When I ask questions or make comments that relate to things in here between us, it's in part from the belief or from the point of view that you will sort of unconsciously and without meaning to, in a way, bring things about the problems that you are having into the therapy process and into our relationship because to my mind and this is the way it works, that often happens and can be useful to look at. It's possible I'm not quite as self-involved as I may come across (chuckles) when asking these questions about reactions to me or talk about things here; at least, not necessarily, because I'm so focused on this in a personal way but because I have this idea that this displacement or projection happens where things that you're feeling about the problems that you're having will kind of come into the room here in ways that can make them easier to get a handle on or get a hold of. Exploring that is part of how this can work. I don't want to sidetrack us too much, but I also think it was probably useful to say at some point and it's just come up now. Is that clear? [00:27:44]

CLIENT: Yes.

THERAPIST: So with that said, what thoughts have you had about this or how we've been talking or whatever?

CLIENT: I don't know, kind of what the negatives are because I'm in the waiting stage, just waiting. Not negative just waiting. Wait and see. Sometimes I wish I had said things differently or when I leave I'll remember something I wish I had remembered when I was here. [00:29:13]

THERAPIST: Things that are positive?

CLIENT: I guess (chuckles) it's kind of like practicing talking; things that I think of. I think I notice a little bit of difference with problems in just talking. If I just don't know what's going on and you restate things, I kind of go polite and kind of feel it's not those messages are wrong, I think I'm just kind of I don't know. I think it's more of an emotional reaction or it's kind of like yeah, this sucks. Then bringing up the problem... [00:30:34]

THERAPIST: You say something, I sometimes will reframe it, and then you go blank?

CLIENT: Right, or I agree with you and then yeah. Or I just don't know what to say about it. Maybe it's just me trying to focus on analyzing it and not what's coming to my mind. I think I'm just trying to [...] (inaudible at 00:31:07) or maybe it feels like [...].

THERAPIST: Something's happening there. I imagine it's some anxiety immediately that's the cause of blanking out is usually like unconscious anxiety between being anxious about something and in a way that you're not really aware of; like if somebody blanks out on a test, you know? There are sort of conscious things that one might feel for a test, like a textbook high school thing where palms get sweaty and you feel butterflies and you're like "uhhh" or whatever. If you feel that intensely enough, it can make it harder to focus after a point, but something like a blank is usually more unconscious anxiety where you might feel the usual sense of butterflies or your palms are kind of where you're like something is getting geared up but then you go blank. That usually means that there's some kind of anxiety that you're not experiencing in a physical way or not aware of having, or like there's something scary about it, the nature of which is unclear and kind of unknown. There's probably something like that going on with your blanking out in response to my saying something, redefining what you said. [00:33:48] The thing that occurs to me: I wonder if it happens at moments where it feels like I'm connecting with you or something that you said there's something about that occurring that makes you feel anxious?

CLIENT: Yeah, maybe. Maybe I'm embarrassed or I don't know. I think I'm just not explaining myself well. I think you reiterate, at least for the most part, fairly well. I'm sort of embarrassed.

THERAPIST: You feel sort of exposed?

CLIENT: I guess. I think it's more like what I was talking about is so theoretical. It's all the same thing, this feeling of bullshit. (chuckles) [00:35:45]

THERAPIST: Actually, I have another hypothesis, then. Somehow this looks to me like this sort of arms race and you are trying to say something or have an opinion about something and then it kind of falling apart or your being unsure and feeling muddled or getting hung up as you're trying to say it. I realize that as I'm talking in reframing things I'm sort of getting pulled into that a little bit without really realizing it myself, trying to help you establish a beachhead; then I wonder if that actually exacerbates it a little bit for you; and the other side fights back and blanks out. [00:37:11]

CLIENT: (pause) I don't think so.

THERAPIST: Okay. (chuckles) Okay.

CLIENT: I think when you reiterate things it's clear and precise where I'm just rambling. I feel like I'm just repeating certain things over. It's more just me criticizing myself and then when you say it, [...] (inaudible at 00:37:52) (chuckles)

THERAPIST: And then you feel crummy about yourself because you said it earlier, or something like that?

CLIENT: Yeah, a little bit. But I feel like I've felt this way for so long. Another thing is I'm just so unsure of myself or of what I'm feeling or how I'm analyzing or perceiving it in my thoughts. [00:38:32] (pause) I guess I just don't like that I can't give you a clear picture or hand you (sniggers) how I feel.

THERAPIST: That makes you feel bad? (pause)

CLIENT: Yeah. I feel like it's my fault or whatever. (pause) [00:41:16] I guess [...] (inaudible at 00:41:22). She couldn't feel what it was like because she would always say she couldn't understand but she didn't know how to help. Not that I wanted to hurt her, but I just wanted I don't know. I just wanted her to feel what it was like. [00:42:12]

THERAPIST: Feel what things are like for you as an adult? What's going on with you? I guess oftentimes that can be so hard to convey.

CLIENT: Right.

THERAPIST: I guess that would make you feel pretty bad about yourself and also pretty sad.

CLIENT: Just the way I am is like uggh. Just the way I am is really isolating. I think it really ties into being like an observer.

THERAPIST: We have to stop for now. I'm gone Monday, Tuesday next week, but not Thursday.

CLIENT: All right.

THERAPIST: Take care.

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