TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: So, what I thought was this. That, that you might, like, be a good candidate for and benefit from an analysis. What that means is, like, I don't think we talked about this, have we?

CLIENT: No.

THERAPIST: So, analysis is an intensive form of psychotherapy where meetings are usually like four times a week and one generally uses the couch as opposed to the chair. Often, like, to complete one, it's a number of years. However, I think it's quite likely, given, you know, where things are at for you in life you wouldn't necessary finish it out in that, you know, there's a good chance you'd move to school to go to school or you'd go to school around here and would be too busy to continue, but, still, even spending some time doing that I think can be quite helpful. Like, it's really not that different from what we're doing now, except for the frequency. And, I think it could help you. I mean, the chance to sort of work on things intensively in that way can make it sort of over time, easier. [00:02:00]

You know, it can be more frustrating at times and can stir more stuff up, but it can also make it easier to kind of get in to things and sort of stay with it and then you're getting it faster. I guess I've had it in mind as a possibility since we started meeting, but at least for me, like, it usually takes a little while to tell whether it's worth recommending or not. I mean it just kind of depends on how somebody's responding to treatment and how they are making use of it and ways in which it does and doesn't seem to help.

Now, a few other things first. I'm aware that this is direct, what I am suggesting, is directly contrary to your concerns about money related to coming in more often. And, you know, so, what I thought of about that is, and I can explain why I'm wanting to do this. But, I would be happy to sort of forgive whatever's left over or, you know, for, you know, visits three and four each week after what you get from insurance and from the recording. So, in other words, you would have to pay, like, my usual rate, you know, with what you get from insurance and the recording for the first two visits. But, for the other two, I would take, you know, whatever you got from insurance for them. And, what I get for the recordings from them or for them. So, it wouldn't cost you anymore than coming twice a week is my point. [00:04:00]

You know, there are a few reasons I'm willing to do that. One is I like doing analysis and I like working with people intensively. Also, you know, I like feeling like I'm doing something that I think will be helpful. Then there's a slight administrative reason which is, you know, it's a little bit easier because my schedule is I'm seeing fewer more often, but that's not really a big deal. It's mostly really the first two. And, you know, you don't have to answer this now. You can think about it or whatever you want, but, and I guess I should also say this doesn't mean I don't think this can be helpful if you decide not to do it. You know, if you decide you want to come twice a week or come three times a week. Whatever. Come once a week. Like, I think there's still work we can do and this can still help. Like, I'm not saying this is the only thing I think that can help at all. [00:05:00]

I just, you know, in my experience I know that it is often more helpful and often helps a bit more quickly. That doesn't mean, you know, psychotherapy doesn't help because I don't think I would do it if I felt like it didn't help. But, you know, like I said, you don't have to decide now, but I wanted to sort of talk it out or propose it and, you know, answer any questions you might have as you're thinking it through now or later and then go from there.

CLIENT: Why do you think, I guess, I would be a good candidate for analysis? [00:06:00]

THERAPIST: Right. Because, partly from what you've said and partly from what I have seen. So, I guess there are two reasons. The first one is part of it, I mean, you said from what I've seen, it seems like you're making use of this. That it's getting a little easier to talk. It's getting a little easier to think about some of the issues you're describing. I know you're still feeling very stuck and kind of paralyzed. Well, not paralyzed, but like stuck and frustrated and so forth, but I, I have a sense that you, like, there's a little more air in the room. Like, it's a, you feel a little bit freer in some ways and our kind of starting to make use of this in, like, to help with that somewhat.

CLIENT: I don't know. [00:07:25]

THERAPIST: In some ways it seems to me, like, and just kind of the way, I don't know how to say it. Like, sort of the way that you're working with things here and kind of able a bit more over time to like get your hands in to them a little bit and I don't know kind of work on them. You know, to make a little bit, make a little more space for yourself to think. That's sort of like that. And you've said that it's helpful, I guess, is the other thing. So, that's sort of one side of it.

The other side of it is, you know, there are some people who have bad reactions to intensive treatment. Not many, but sometimes it really makes people like, you know, fall apart or it can make the problems much worse. Somebody can have just like a bad reaction. That's not somebody's fault. It's not their fault. It's not necessarily my fault. But, that can happen and I've, I've seen no evidence so far that that's likely to happen. You know, that doesn't mean it's going to be the most helpful thing in the world, ever, but, you know, you never know for sure that's not going to happen, but I'm sort of confident enough that that's not going to happen to recommend something like this. [00:09:10]

I, I, tend to want to take a little time to get a sense of that with someone. It's not something that may be apparent in the first couple of weeks or months. You know, you sort of, I tend to want to wait a little bit longer than that to know. But, yeah, I've, and again, that's, that's not a lot of people, you know. It's a smallish percentage of people, but, but I've, like, seen no indication that that's likely to happen to you. So, you know, kind of the short answer to your question is because it seems to me, from what I've seen and from what you've said, that you are, like, making good use of this and it's helping and to that, you know, I'm confident enough in ruling out sort of a bad reaction to the treatment, but, no, I'm not real worried about that. [00:10:30]

CLIENT: I guess how is the method different?

THERAPIST: It's not.

CLIENT: It's not. Okay. It's just the frequency?

THERAPIST: Yeah. So, yeah. I mean I tend to practice, like, pretty more intensive psychotherapy more than once a week and the psychoanalysis is pretty much the same way. [00:11:30]

CLIENT: So, who would, I guess, like what would be some, I guess, like who is a person who wouldn't benefit from psychotherapy? I really wouldn't know. Sorry.

THERAPIST: No, that's alright. Like, well, either somebody who's likely to have a, kind of a bad reaction to a more intensive treatment or analysis. You know, somebody for whom it's likely to stir up things that, you know, that in a way that has become quite counterproductive. I mean, anybody in intensive therapy is going to have upsetting things come up at some point and it, you know, might suck for a few days or a few weeks or something like that. But, you know, then you kind of work through it and that's part of what the work is that you're doing. Do you know what I mean? Some people, you know, stuff gets stirred up and it really is just too overwhelming. It's not something that you can kind of work through and then like be the better for it in a way. But, it's something that just sort of knocks you over and it's kind of a bit more destructive than helpful. So, that kind of person probably does better through therapy than analysis. [00:13:15]

Also, people who, you know, analysis or sort of intensive psychotherapy tends to benefit people who can, you know, like, be there and think about their feelings and talk about it with somebody else and, like, you know, sort of take in to some extent what the therapist has to say or, like, I don't know, begin to form a relationship with a therapist that can be talked about and looked at and I feel like I'm being quite vague about this. [00:14:15]

There are some people who have a harder time, like, thinking and talking about their feelings or their worries or ways they're stuck. Like, an extreme example would be somebody who's sort of more Asperger's like in a way. You know, where, it's like, you're treating somebody like that. You know, I don't mean to be critical of people like that, but they sort of don't have a kind of psychological mind in this. Which is helpful in a more intensive psychotherapy or analysis. Like, it's a kind of sensibility that somebody like that doesn't have so much. And they probably wouldn't benefit particularly from something like an analysis. There are people like that, you know, who aren't as interested in kind of introspecting or talking about how they feel or how to react to things or sort of making connections. You know, about things in their lives and what they feel. You know, stuff like that. There's, there are people who just aren't inclined that way particularly. It's not necessarily a lot of people, but, you know, I'm trying to answer your question. [00:15:45]

So, somebody like that probably would benefit more from the psychotherapy and an analysis and a therapy is sort of geared in particular ways. And, that's just sort of a partial answer to your question, but does that, is that helpful?

CLIENT: Yeah. I mean I'm willing to try. I mean, I don't. I think my worry is something I haven't even thought about. Yeah. I mean, okay. [00:17:00]

THERAPIST: Okay. Sure. Well, I will, in that case, keep the Thursday time and then I can look for a better time and additional time starting next week?

CLIENT: Sure.

THERAPIST: Yeah. Try it out and see what you think and see what happens.

CLIENT: Okay.

THERAPIST: And, let me know if you have other questions. Either now or whenever.

CLIENT: Okay. [00:19:00]

THERAPIST: I guess one other thing I could think to say, because I didn't, you might worry about it. I hope not, but you might. Is I don't think my impressions of your suitability for analysis are likely to change. In other words, like, I don't think in a week or two I'm going to think oh, shit. You know, geez, yeah. God, boy was I wrong about that one. She really, yeah.

CLIENT: Right.

THERAPIST: So, you don't have to, this may not help. You don't have to worry about, like, about that. [00:20:00]

CLIENT: Yeah. I don't know. Just, I guess, for some reason, I was just thinking about, I don't know, how, like, Woody Allen jokes about it. It's like I don't know. Yeah. I don't know. Other than that, I don't really seem to like coming out to something.

THERAPIST: Yeah.

CLIENT: I feel like I kind of forgot we're here. Not so much. Yeah. I guess, the worry that I have or something that I think about is that I still have this like, I guess, image or of like I'm trying to do everything I can or, like, to become, like, I don't know. Like a, someone who's like, you know, perfect and who can handle, like, I guess, emotional things or like, you know, have the, the right thought at, you know, the right time or something like that. And, so my worry is that like, I don't know, that you're not seeing like, I don't know. Like, I used to think, like, therapy was like, you know, the key to, I don't know, perfection or whatever. I don't know, but it's like, like, you know, a cure all, I guess. [00:22:30]

THERAPIST: You're can't see actually?

CLIENT: Right. But, you know, so, I have been. I don't know how to have, like, the right mindset about this whole thing other than maybe it's just helping I guess or, you know, changing the way I think, I guess. You know. Or, yeah. Me not being, you know, so destructive in my thoughts. I don't know. I don't know if my father will be like well, I'm going four times a week. Why am I, you know, too? I don't know. Right.

THERAPIST: I feel like why isn't everything awesome.

CLIENT: Right. [00:24:00]

THERAPIST: And why I can't sort of handle whatever emotionally comes at me or whatever? Sort of stressful things that you're having to deal with. And it's not quite clear what, what idea about how therapy or analysis helps to substitute for that.

CLIENT: Right.

THERAPIST: And, one possibility is well, it helps you deal with, I don't know, some of the more negative kind of view of yourself or the way that you're thinking about things or the ways you feel about things. It helps you deal with those.

CLIENT: Yeah. [00:25:20]

THERAPIST: Yeah. My impression is you're sort of partly explaining something, but you're kind of confused about or unsure how to think about it at this point and partly asking me how do I think about it?

CLIENT: Right. I don't know. I mean, I don't know if this is like, you know, just like, how like, you know, like magazines describe like this person or something. I don't know. There something to write on a locker or so they, I don't know. So, maybe that's just a hope, I guess, or something, instead of seeing it as work or... [00:26:20]

THERAPIST: Well, there are a lot of ways to think about how sort of therapy or analysis can help, and it can be different for different people. And, you know, sort of other than at the end of the day you will decide how it's helpful to you and sort of what's beneficial from it and what are the ways in which it doesn't help or the things that haven't been helpful for you. But, well, I guess I do have some thoughts. Let me ask you first. I'm not really sure I thought. How would you describe how this has helped so far? I mean, clearly, it has not solved the problems you came in to solve. I don't mean it like that, but what's your impression? [00:28:00]

CLIENT: I don't know. I mean it's just like, like, I just kind of, like, the feelings that I've hated, like, being really low or, you know, kind of frozen and not knowing what to do. Just kind of, like, I don't, like I still feel that way sometimes, but it's not as, I don't know, intense or I don't know. I just kind of have more knowledge about it that I'm not so I don't know, helpless, maybe? I don't know. Just maybe a better understanding of some of like the perils and thoughts or just like, I don't know. [00:30:00]

THERAPIST: Yeah. That, that kind of story goes together about it seems like. Yeah.

CLIENT: You know, emotional, like, I don't know and like. Yeah, it's helped, but I don't know. Being just, knowing more about what's going on instead of being, you know, just kind of, I don't know, over powered by whatever it is.

THERAPIST: Yeah. Yeah. I think that like probably through the process of having it come up in here, and having the opportunity for both of us to sort of look at it, reflect on it and talk about it. You know, then when you're sort in your life and you start to experience being stuck or feeling really low, you know, you can sort of instead of like kind of half knowing what's going on, or what you're feeling being knocked over by it. You know, you sort of have some more context for it and more of a story about it. And, it's not quite as over whelming. Is that -

CLIENT: Yeah.

THERAPIST: Pretty accurate?

CLIENT: Yeah. [00:31:30]

THERAPIST: Yeah. I kind of think that it seems to me a reasonable way to look at how this works and over time, you kind of get further in to the story you kind of see in in sort of deeper and broader ways, you know, like, what the context is and while you're feeling the way you're feeling and how to understand it and become sort of more able to, like, manage it. Think your way around it or overcome it. Be less affected by it. [00:33:00]

Clearly when you read a novel, and, you know, you may pick up fairly quickly in the first few chapters about, you know, what some of the themes are likely to be and what some of characters are like. But, you know, you get half way through and you kind of have a much sort of fuller, richer view of the meaning of what happened earlier on in the story and what the characters are like and what their parts are and things like that. And, and, you know, it's kind of is like this. Having that kind of understanding, you know, tends to free you up to make decisions, to think things through and do with it what you want. [00:35:00]

CLIENT: So, yeah, I don't know. I think, yeah, like I can, I mean yeah, personally, yeah, I mean all helps but, you know. Yeah. I guess the hope that the yeah. I don't know. Yeah. I see others people and not much to do.

THERAPIST: So, let me try to follow it. So, you mean that like, so partly you have had a question about kind of how does this work and how can it help? [00:36:30]

CLIENT: Right.

THERAPIST: You're also saying, kind of apart from that, that you have a fantasy about what this is going to do for you. That, it sounds like a pretty strong one. You know, though you know it's not accurate in a way.

CLIENT: Yeah. I mean, I don't know. Yeah. Like, I could see how, yeah, it helps, but I don't know. It's just, I don't know. I mean it's just part of my mentality of like, you know, if I exercise and, you know, eat right, like, I'll I don't know. You know, be someone, you know, I want to be or someone like her. You know.

THERAPIST: Did the things you're doing then become more like rituals? Probably like OCD rituals. I mean, like, in that if you follow them, then kind of quasi magically you will be perfected? [00:38:00]

CLIENT: No. I don't think it's a ritual. I definitely see them as like work. I don't know. I mean it's the prompt really. Why didn't I give them so much emphasis is because like, you know, like, there's so much. Like, you know, just like articles and like things on the Internet that are kind of like, oh, you know, exercise. Blah, blah, blah. Like, it helps with memory and, and like all these here.

THERAPIST: You've done some aging and memory and you need to function.

CLIENT: Right. I don't know. I guess, I don't know why I guess, I don't know choose all these things. I mean I like doing them, but not putting too much emphasis on like what they're doing for me. You know. [00:39:00]

THERAPIST: Yes.

CLIENT: I'd rather. I wish that I could be done with this and think my problems through. You know, things I can't do well. Like, exercise or cooking or something. So, so, yeah. I guess, like, another example is like, like yoga. Like, I used to do it all the time and I haven't been in a while, but I don't know. It's kind of like when I first started going I thought, you know, like, this is great. I guess (inaudible). I thought this is great. Like, I feel better. I changed which I like doing. I guess the magic of it kind of wears off. Yeah. And, so, now I don't really see it as like a something for, I don't know, mental health or whatever just to work out or. [00:40:40]

THERAPIST: I see. It doesn't have the promise it did for a while.

CLIENT: Right.

THERAPIST: It's not bad things, but it's, it's you're not going to fix everything.

CLIENT: Right.

THERAPIST: And, are you in to this being something like that?

CLIENT: No. I'm just kind of looking at how I think about all the things that I'm -

THERAPIST: I see.

CLIENT: Or helping me. Just give me something to do and I'll try and do it the best. I mean. [00:41:10]

THERAPIST: I see. Yeah. Yeah. Well, we can finish up for now.

CLIENT: Okay.

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