TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: Hi.

THERAPIST: Hi.

CLIENT: Yeah. Not much is going on. Just kind of waiting to, I guess, I don't know. I just feel like I have a lot to do before I leave and kind of just wanting to get it done or like... But yeah. I guess and also like start like seeing or like just enjoying myself just kind of taking a break, I guess. Yeah. But...

(PAUSE) [00:01:05]

CLIENT: Yeah.

THERAPIST: We're also not going to be meeting for a while.

CLIENT: What?

THERAPIST: Also we're not going to be meeting for a while.

CLIENT: Right. I think... I mean, I think it'll be okay. I don't know.

THERAPIST: Yeah. I don't have that impression at all like (LAUGHTER) you'll be in any danger. It's not that.

CLIENT: (LAUGHTER)

THERAPIST: More so that it, you know, might be different. [00:01:51]

CLIENT: Right. I don't know. I haven't really thought about it other than maybe I'll be able to, I don't know, build up more like material to talk about, I guess. (LAUGHTER) I don't know. Or... Yeah.

THERAPIST: You... I guess something you're concerned about is not having enough material here.

CLIENT: Right. I guess, yeah, I just like don't know what to say and, I don't know, things that I'm thinking about most times is what I need to do or like... [00:02:55]

THERAPIST: I guess to me it seems like that's a way that the, one of the sort of several problems that you're having, you know (inaudible at 00:03:11).

CLIENT: Right.

THERAPIST: Do you see what I mean?

CLIENT: Yeah. Yeah. Well I guess like not, really not much is happening or, I don't know, not much that I think is worthy of talking about like, I don't know. Or... I don't know.

THERAPIST: Hmm.

CLIENT: I feel kind of... I mean, I do some of my things every day. I don't know so...

THERAPIST: I'm aware that like there's not necessarily much in the way of news and currents events in that like, "Oh my god. Today an elephant came ramping into the lab."

CLIENT: (LAUGHTER) [00:04:05]

THERAPIST: "You wouldn't believe what happened," or...

CLIENT: Right.

THERAPIST: You know, "such and such person had this amazing or horrible or unbelievably happen." I understand. But, I mean, there is like whatever you've been thinking and feeling and even looking at things and stuff like that which one could argue are important things.

CLIENT: Right. I don't know. Maybe... I don't know. Maybe most days I'm just trying not to feel just kind of to do or...

THERAPIST: Oh. [00:05:11]

CLIENT: Yeah.

THERAPIST: What is it that you're trying not to feel?

CLIENT: I don't know. I don't know. I guess I think of it maybe as just being like unproductive or alone or kind of... I mean, it's better to yeah. I always focus on something to do what I need to do or whatever. [00:05:57]

So yeah. Just something I feel kind of in general. Like I don't know if it's something I'm doing or just like how I've been feeling in general just kind of, you know, just kind of like blah or like, I don't know, little bit brain dead or something. I don't know. Yeah.

(PAUSE)

THERAPIST: Wait. I'm a little confused. Like I understand you're talking about kind of trying not to feel things and concerned about the way that the feelings you're feeling can get in the way of being productive. But then you're saying that that can sort of lead to feeling blah instead? [00:07:05]

CLIENT: No. I think it's like one and the same. Like I just kind of feel like not, I don't know, not much. I don't know. Like... Or just kind of like... I don't know. Not knowing what like what to feel or how to feel. Just kind of...

THERAPIST: So you don't so much have a sense of how you do feel but more like...

CLIENT: Not like right now. I mean like I think like... You know, I can tell like when I'm anxious or upset but like I think I'm like at baseline level was kind of like, yeah, just kind of like whatever and just want to I guess do things or get on to the next thing. So... But, yeah.

(PAUSE) [00:08:19]

CLIENT: Yeah, so. I don't know like what's the normal, I guess the normal baseline of how to feel or yeah. [00:09:01]

I often think like, "Oh yeah. Other people feel like when, you know, in the morning when going to work or just...

THERAPIST: What do they feel?

CLIENT: I don't know. I just wonder. Like they... If people get as tired as I do. I don't know. Just stuff like that or... I don't know. If they... I think with me I'm just kind of like, I don't know, just trying to go through the days, just try to keep busy or keeping moving I guess. And like no other people feel that way. [00:10:11]

THERAPIST: You mean like other people are sort of working as much to stay focused on what's next and what they're doing and if they feel tired and...

CLIENT: Right. Or... I don't know. It's... I don't know how they feel but I guess I just wonder what, like, I don't know, if they feel... Like at work, if they feel as, I don't know. I don't even know how I feel, I guess bogged down or I guess not knowing what to do or if they're better at, I don't know, spending their time or if they have more interests or, I don't know, yeah. So... [00:11:19]

THERAPIST: Are you in a way kind of wondering if what you're feeling like for you is wrong?

CLIENT: Right. Or not that like I want to feel normal or I just wonder, you know, how, like, yeah, what other people feel or, yeah, in general. Like...

THERAPIST: Hmm. Sort of what they feel or how they are with themselves as they're kind of going through their day. [00:12:01]

CLIENT: Right.

THERAPIST: And you kind of don't know, I guess.

CLIENT: Right or I assume like they're just busier, they have more interests, they're just like... Yeah.

(PAUSE)

THERAPIST: If they're just busier or they have more interests?

CLIENT: Right.

THERAPIST: And that kind of keeps them more afloat. [00:12:59]

CLIENT: Right or they... I don't know. Yeah. I mean, yeah, they take more, I guess, joy in things or... Yeah.

THERAPIST: They're having a better time.

CLIENT: They just don't feel as, I don't know, not knowing what to do with themselves, I guess, or being okay with...

THERAPIST: With how things are for them?

CLIENT: Wait, what?

THERAPIST: They're sort of more okay with how things are for them with the sort of (inaudible) of their lives or how they feel or what they're doing. [00:14:05]

CLIENT: Yeah. I guess, yeah.

(PAUSE)

THERAPIST: I guess I sort of get the impression of you as (PAUSE) like feeling sort of crummy sometimes (inaudible at 00:14:35) but also kind of like (PAUSE) feeling a bit kind of shut down around it or sort of working to keep yourself focused away from it on another thing.

CLIENT: Yeah. I mean...

(PAUSE) [00:15:00]

THERAPIST: Like this could be a metaphor that just occurred to me as like you know the yellow police tape that they put up like, "There's nothing to see here, you know," where like in a way sort of like the loose ends or low or flat or happy with things and then there's also a sense of, "Okay. Let's get focused on work and what's next and wondering what other people are thinking and how they're feeling and are they feeling what I'm feeling?"

CLIENT: Right. Or I'm just... I think I'm more trying to... I'm just like, I don't know, I guess changed to see what it's like for other people to see if there's something I can change in myself.

THERAPIST: Hmm. [00:15:51]

CLIENT: But I think it's more just like, me just not knowing what to do. Like I want to feel productive and like, yeah, I have work to do but sometimes I don't or sometimes I'm just feeling like tired and not wanting to do it. So it's just kind of like what do I do and I mean, yeah. (PAUSE) I don't know.

THERAPIST: I guess for you like in a way sort of the both like the magical yet frustrating question is what do you do. Like if you did the right thing or if you knew what to do, this would be better.

CLIENT: Right or yeah, just be okay with not doing anything or, I don't know. [00:16:59]

THERAPIST: It's like if you could get the right answer to that question at a particular moment, things will be at least better but at least okay, not okay or good. Like you know you can take it easy and that's the thing to do or you know you should be working on A, B, C, D, or E that's good.

CLIENT: Right.

THERAPIST: That's what would help is knowing what to do at any given moment.

CLIENT: Right. I think it's just like feeling like motivation. Like even if I have like (SIGH) something to do... Like I do a lot of art extractions at work and it's very like tedious monotonous and when I had a lot to do I kind of feel motivated to do it and like get it done but like every once in a while someone will bring me a couple samples and it's just like, "I don't want to do this because like..." [00:18:09]

So it's kind of that feeling of not wanting to do it or whatever. So... But, you know, this time I don't have much else to do or like, you know, it's just I guess weird. I don't know.

(PAUSE)

THERAPIST: I guess to me it seems like things going on in your emotional life interfering with your motivation or you're having a clear sense of what to do.

CLIENT: Right. (PAUSE) Yeah. And they... [00:18:53]

Yeah, I guess I get mad that I don't want to do it well or, I don't know. Whatever. You know? I'm not productive or efficient or something and, yeah. (PAUSE) Yeah, I guess I get angry that I am, I don't know, not motivated or tired or, I don't know. I just can't do it I guess or do it well and...

(PAUSE) [00:20:00]

(CROSSTALK)

THERAPIST: Oh.

CLIENT: Well I was just going to say.

THERAPIST: Yeah, go ahead.

CLIENT: Like I've described it this way before but like say like I was at work but I need to study tonight. I'll imagine like this perfect, not perfect but like ideal study session where I'm engaged and learning and just like I don't know. Just, whatever. But then when I go to do it, I'm tired and distracted and just kind of like, "Oh, I'll do this tomorrow." So I guess I get like angry that like that I have something to do and that I should do but I don't do it well or I don't have the motivation or... [00:20:57]

THERAPIST: Wait. I guess when... It seems to me that you... (PAUSE) I know you're, you get sort of very frustrated by that, by having something like that in front of you to do that you know you should do and not sort or getting to it in the way you feel you should or in the way that in any way matches up to the vision you have of how it should be.

CLIENT: Right.

THERAPIST: I guess I think that in part you're avoiding something there which is sort of how do you actually feel and what's going on with you? [00:22:09]

Which is kind of responsible for why you're not doing things the way you want to. Like in other words, again with the goofy metaphors, if there's what's going on in front of the curtain and what's going on backstage. What's going on in front of the curtain is like the performance, you know and what's going on backstage is everything that's sort of is involved in, leads up to, is required for performing. [00:22:55]

You get focused on what's going on in front of the curtain and whether that's what it should be or not. I think in part, because there's something certainly more familiar probably also a bit more comfortable even if it feels crummy which I know it does, as compared to looking more behind the curtain. Like, in other words, okay. So, you know. Why don't you feel like studying? Why are you distracted. I'm sure you're just feeling tired. You probably had a long day and you probably had to do a bunch of art (inaudible) extractions which are boring and monotonous and, you know, you're not really sure about this med school thing in the first place and that fucker of a dean last year told you that, you know, you weren't, you know, going to be a good applicant and so it's demoralizing and you're nervous because what if you put in all this work, you know, and it doesn't pan out? [00:24:01]

And you're screwed either because you really don't know what to do or you've stuck money into a post doc program or just time and energy into this. I mean, I don't know if these are... Obviously I don't know if these are sort of what's going on but I, you know, it's something we've talked about it and could be contributing and it seems to me like... (PAUSE) On one hand, I can imagine you could be worried that you could get mired in those and that could take you even further away from getting your homework done and doing any studying you were intending to do. At the same time, it seems to me you kind of almost feel like you shouldn't feel them or you should sort of closet them because, you know, you should just be able to suck it up and do the work.

CLIENT: Right. [00:24:53]

THERAPIST: But I guess I sort of feel like after a point it kind of doesn't work like that so much any more. I mean, once you've been sucking it up for long enough and there's enough has kind of built up back there, it really gets in the way.

(PAUSE) [00:25:05]

CLIENT: I don't know.

THERAPIST: I guess it's sort of a concern I had about something that's happening to you or it seems to me it could be happening.

CLIENT: I don't know. I don't think I know about those things or I don't consciously. I don't think I think about them like when I was studying the class. I think it's more like why am I not encoding these things more perfectly. Yeah. It's more like, yeah, why am I not like smart enough or like not have the knowledge to kind of like encode what I'm studying better in a knowledgeable way or remember it forever or something. [00:26:09]

It's like I'm just being critical of every step or something or maybe like I resent like that I didn't study better when I was in college or something like... I don't know. Just kind of like criticizing my method or something.

THERAPIST: Yeah it sounds like you sort of have this like internal tough softball coach or something like that who's saying like... This is what you're describing I think like, "Why aren't you smarter than this? Why aren't you remembering this better? You should, you know, this should be this hard. You should be able to learn this better."

CLIENT: Right.

THERAPIST: "What's going on?" [00:27:01]

CLIENT: It's just kind of like, I guess, you know like they say like, "Oh, you have to have the mindset." Like why don't I have the, you know, the mind for this where I just kind of...

THERAPIST: Yeah, see. I guess, you may be right but I'm going to take some convincing. In part because like my understanding is that in college you did pretty well with fairly similar or at least analogous material at times.

CLIENT: Right. I mean, I did do well but, I don't know, I just. Yeah. Talking to other people, they have like more like larger grasp of things and I'm just good at memorizing details like... Yeah.

(PAUSE) [00:28:11]

CLIENT: Or maybe I'm better at recall, I don't know, without reasoning or, I don't know, higher process thinking. I don't know. So...

THERAPIST: Again though, I imagine there are times when you've done that pretty well. I mean, the papers or the experiments.

CLIENT: I guess. I think it's harder for me. Yeah I could, yeah loss what I want to say or something. I don't know.

(PAUSE) [00:29:07]

THERAPIST: Well I'm going to still take some convincing because I think what you're describing... I think your style is a little more on the obsessional side. I don't mean you're OCD. It's nothing like that. I mean, that particularly when you're sort of under stress or feeling lower or more anxious, you're inclined to sort of focus on the details and the small picture and like are pushing yourself and thinking about your standards and so forth. [00:30:11]

Rather than, you know, I'm sure other people are kind of opposite like under pressure or when they're feeling low or anxious tend to be more impressionistic like forget about the details and just step back from everything or, you know, kind of avoid things, like avoid the particulars. My impression is that's probably more in response to emotionally what's going on than to a sort of like fundamental lack of capacity to think quicker or to put details together. But I guess I'm not sure because that's not something we talked a lot about but I guess I have a little bit of a hard time imagining you could get through, you know, like a really good school doing pretty well just because you can... [00:31:05]

I mean, I believe you can memorize things well and you're good at sort of learning details like that but... And I'd be willing to believe that some of the more, some of the higher level thinking stuff or more synthetic stuff, you know, is relatively more difficult for you. But I guess I'm really just not willing to believe that you're not good at is so much as there's something emotional going on that interferes with your ability to do that when you're having a harder time.

CLIENT: Yeah.

THERAPIST: I'm not saying I could never be convinced otherwise but...

(PAUSE) [00:32:00]

CLIENT: I don't know. I think it's just the wish that, you know, I was better at it or like or like things came easier or something. I don't know.

(PAUSE)

THERAPIST: Well how much, how much variation is there in the extent to which this was the case? Like were there classes or semesters or even times through high school where or for that matter, you know... Well, let's just stick with school for now. That this kind of thing was easier and other kind of things were harder or has it been pretty consistent? [00:33:01]

CLIENT: I think in high school I was fine. Like I, I don't know, had more of an opinion or something or... Yeah, I was fine at writing. I don't know. In college... I don't know. Maybe it was more daunting or something. I don't know. (PAUSE) Yeah.

(PAUSE)

THERAPIST: You were more intimidated?

CLIENT: Right or I think it's always like I missed my window. (LAUGHTER) Like, I don't know. [00:33:59]

Like I always felt, you know, if I was better educated when I was younger, these things would be easier like I missed the, the window or something. So...

THERAPIST: I see. Like there's a sensitive period to learning how to write a thesis and develop and argument in a way.

CLIENT: Right or I missed the, some of the basics, kind of just like I jumped forward into school and, you know, it's hard to make up for lost time or like things that I...

THERAPIST: I see.

CLIENT: ...didn't know or something.

THERAPIST: Like if you didn't crank out a lot of five paragraph essays in middle schools and then write a bunch of, you know, short term papers in high school then by the time you get to college and you have to write, you know, a twenty page term paper, if you don't have the right foundation skills to do that? [00:34:55]

CLIENT: Right? I think there was a lot of thinking that the window's gone or something but I could always, I guess catch up or do fine with, you know, science or, you know... Or, I mean, I liked it so I could memorize it or I could learn it or...

(PAUSE)

THERAPIST: Did you not go through very good schools growing up?

CLIENT: I mean, a public school was good for Idaho but I think Idaho is low on the education list. (LAUGHTER) So... No. Compared to, I think, like (inaudible) or like my roommate freshman year my school was not on par, I guess. [00:35:57]

But I was, I guess my freshman year, I was very surprised how well I did or and I guess (inaudible) I was talking to my softball coach (inaudible) I mean, it's still hard but it was easier than I thought it would be.

THERAPIST: Huh.

CLIENT: But...

THERAPIST: And what were you taking?

CLIENT: My freshman year or just in general?

THERAPIST: Your freshman year.

CLIENT: I think I was taking chemistry, math, like Neuro, you know, 101 and Bio 101. They were like introduction courses or whatever. Even though we have an open curriculum, we still had like requirements for our major so neuro has a ton of requirements like math classes or... [00:37:01]

THERAPIST: You have to do a fair amount of reading (inaudible at 00:37:03] I could be wrong. I did not study neuroscience at Brown but I would guess (inaudible) "Okay, here go memorize all this stuff."

CLIENT: Well right, yeah. I was also, yeah, I took maybe the hard core like neurobiology stuff but yeah.

THERAPIST: (inaudible) you've got to know all that stuff but I guess there's also a lot where they actually, I mean, are interested in thinking too. (LAUGHTER)

CLIENT: (LAUGHTER) Right. I mean, yeah, definitely there is discussion classes. I took a lot of cog neuro (ph) classes which is...

THERAPIST: Yeah. [00:37:57]

CLIENT: ...a lot more writing than memorizing. I don't know. Yeah. (PAUSE) Maybe because I didn't talk as much in those classes as other people did. I didn't think... It wasn't the same caliber.

THERAPIST: I bet you often did well in them.

CLIENT: Yeah. I mean, I can do well at exams or if I have time to write a paper but not, I guess, discussion or something.

THERAPIST: Although... I mean... Right. I think I'm, you know, on a different side from that. You're like, "See Ethan if I was actually good at this kind of stuff and smart at this kind of stuff, I'd be able to talk in class." And I'm saying I think, you know, there's something about being kind of anxious and the way that that tends to shut you down that strongly contributed to you're having a hard time talking in class. [00:39:15]

CLIENT: Yeah, I mean, yeah, sure. Yeah. There's a lot of times I wanted to say something... I don't know. Yeah but I guess always second guessing...

THERAPIST: You second guessed what you were going to say?

(PHONE RINGING)

THERAPIST: Oh shit. I'm sorry.

CLIENT: No that's okay. (LAUGHTER)

(PHONE RINGING)

THERAPIST: Sorry about that.

CLIENT: No that's okay. Right. Yeah. I get, yeah, anxious, yeah, want to say something but rarely would.

(PAUSE) [00:40:09]

CLIENT: I think that, yeah, that's normal. I've always just been quiet and I mean, I was, I'm that way now with friends. I'll want to say something but yeah. [00:41:01]

THERAPIST: Yeah, I'm not saying there's anything wrong with being quiet. I'm just saying it doesn't mean you're not smart.

(PAUSE)

CLIENT: I agree. I think, I think I was praised for being quiet because it meant I was smart or mature when I was younger or something. I don't know. But it's not helpful now.

(PAUSE)

THERAPIST: Who praised you for that?

CLIENT: Family, teachers... I don't know. Yeah.

(PAUSE) [00:42:07]

CLIENT: Yeah and people still say that now. Like that, yeah, I meet someone and they say like I don't say very much or I don't know. But... I don't know. Most of the time I don't have anything to say.

(PAUSE) [00:43:17]

THERAPIST: Well we'll stop for now but I hope you have a good break.

CLIENT: You too.

THERAPIST: Okay. See you in January.

CLIENT: Okay.

END TRANSCRIPT