TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: I want to mention a couple of things, first off, I won't charge you for yesterday. I don't think we've talked about it, but generally, I do need to charge for cancellations that are like sooner than 48 hours. I think, I don't always charge for like if somebody is sick, I usually won't charge them, but for other things I usually do. And also, I happen to have a cancellation this week, at 8:30 on Friday, if you wanted to come in then?

THERAPIST: I can do that.

CLIENT: Okay. Then I will see you then. (pause)

THERAPIST: I've got, I guess nothing really new, it's just been a more of a same, worries, and just kind of feeling like, I don't know, that what I want to kind of stop, so I can just sit and think, I don't know. (chuckle) [00:01:22]

Just to think about, I don't know, what I should change. I don't know, like make a schedule for myself or something, I don't know. I think I was feeling better, in like, in terms of like, I was in a better mood and I felt more kind of like in control, but, I don't know. I think it seems like, the end of last week, I don't know, I feel like, I don't know, yeah, I just feel, I don't know, I don't have control anymore, I'm just more skeptical of myself. I don't know. It's like, take for example, like, I'm starting classes this week, in which I'm excited about. But yesterday I was kind of making a schedule for the week, and I should probably work out you know, at this time and you know, coming here and you know going to classes at this time. But I felt so like, ew. Like I don't know if I should I think my (inaudible) comes to like when I should work out, or when I should study or should I go to yoga.[00:02:57]

I don't know, it's just always, so I felt, I was like, I should just think about it, I don't know. I'm just, you know, feel stuck and I want to like, you know, I don't know. I ask people, but I don't know, again, I just feel like, you know, I don't want to I guess come off as like, needy or I don't know, just crazy. Like when should I (chuckle) work out, when should I eat, I don't know. So I just kind of like feel a little, I don't know, more than just a thing, I'm just like stuck and[00:03:57]

THERAPIST: Yeah it's like you are sort of more anxious and wound up about it in a way. And maybe a little bit more kind of concerted feeling?

CLIENT: Right, it's so silly, because like, all the things that I want to do like, coming here, and going to class, and working out, all the things I like want to do, and like, I don't know, it's just, I don't know why I like, I don't know. My feelings of anxiety is of planning them, I end up just kind of like shutting down and just doing nothing. I don't know.

THERAPIST: And I follow like, why when you are trying to plan a bunch of activities, that you have like wanted to do and chosen to do, that it gets so stressful.[00:04:54]

CLIENT: Right, and I have time for them. I like the things. You know, it's just kind of, I don't know.

(pause from [00:05:06] to [00:05:19])

And, yeah I just kind of get, I don't know, I think I get in the mindset that I should think about it, and like, I don't know, (pause) research or something. I don't know, it's just like I have this sense of, like I hate to sit and think and research about it or something like that. And then, I don't know end up just kind of getting like, exhausted or just kind of I don't know, a pity party or something. I don't know. Like why me (chuckle), like why can't I make a decision, I don't know.

THERAPIST: Why me as in why is this so hard for me, when other people seem to manage this, when you are like -

CLIENT: Or, I get caught up in like, I don't know, should I write an e-mail to (chuckle) like asking her for advice, or like her input or whatever. Then I'm like, no, yes, no, yes, oh just do it, and then I'm like no. So. [00:06:34]

And then, I hate, this is a problem, I don't know, I just like, I don't know.

THERAPIST: Oh I imagine it's incredibly frustrating.

CLIENT: (chuckle)

THERAPIST: And that you feel like you are making problems out of things that don't need to be. I mean, it's one thing if, you know, I would imagine it feels like it's one thing if you are trying to decide if you want to go to Medical school, or Graduate school or something else, I mean that's big decision and you have trouble with that. And I know you are very frustrated with making that decision. But, you know, I would imagine you would have more sympathy with struggling with that, than with, you know, should I work out at this time, or at that time? Or, you know, do you want to go, or do you not want to go. [00:07:31]

CLIENT: I don't know. And that I know that if I have, like, or I think that I might have like weird like like in strength in myself, like, (pause) I guess I can't go with the flow, and I have these constraints, like if I don't get (pause)

THERAPIST: What are the constraints?

CLIENT: Like if I don't workout before five (chuckle) I'm not going to do it, I don't know. It's like I can't just not do it later, I don't know.

THERAPIST: And why?

CLIENT: Because I like, feel like, I know myself and the when I get late in the day, I'm more exhausted and I just want to go home and not do very much. I don't know, just kind of, I don't know. (pause)

THERAPIST: So it's just like a practical consideration? Because like, if you don't schedule it before five, it might, it's not likely to happen even if it's on your schedule.

CLIENT: Right. [00:09:07]

THERAPIST: That's another thing that you have to take into account.

CLIENT: Again, it's just so silly, because I have time, I don't know.

(pause from [00:09:33] to [00:10:14])

(inaudible phrase) I don't know. (inaudible) that I can't just to do it, I don't know.

(pause from [00:10:25] to [00:10:42]).

THERAPIST: I guess that it would seem that you sort of have to put yourself through this fairly torturous, kind of anxious, like planning and scheduling process, for no clear, sort of realistic reason in some sense. But for other reasons that you really don't know about yet.

CLIENT: I think, like I'm just wait like I think I must like I feel that I know myself. And I feel like I will work at like, get a better workout in in the morning, or like before five or whatever. I don't know, just like, I'm waiting for the ultimate like, optimal time. I don't know, and trying to balance that with I don't know, when I (inaudible) (chuckle) I don't know. It's been rough. So, [00:11:57]

THERAPIST: So some of it is optimization?

CLIENT: Right, I guess it's like, I want to go when I have high energy and I want to do it, not just doing it because, I don't know. (sighs) I don't know. (pause from [00:12:21] to [00:13:03]).

THERAPIST: Is this something about really being at your best?

CLIENT: Yes, or just making the effort worthwhile or something like that. I don't know. You don't want to go to the gym and not (inaudible) and not run what I want to run, I don't know. Or I don't want to go, and just be, get more tireder, or more bummed out, I don't know.

THERAPIST: Ah, okay. So, what's the part about getting more bummed out?

CLIENT: (pause) I think it's just like, I'll be harder on myself because I, I don't know, I didn't (pause) you know, (pause) do, I don't know, I didn't, yeah, do it at the time I was not supposed to, but would be like I would think the optimum, like I would run more, or feel better, or I don't know. [00:14:41]

THERAPIST: So, okay, you get to the gym at 5:05, and you had planned to run five miles, but you make it three and a half, and you know that if you had gone four, you would have gone all five? Or maybe you went five but you were going slow. And, then you would be like, pretty annoyed with yourself? Because you know, if you had planned better, or gotten there you know, at a more peak time for you, you would have actually been able to do what you had wanted to do? [00:15:32]

CLIENT: Yes, but I think also it comes down to like, again (inaudible) scheduling (chuckle), like oh no, like should I shower, or should I just take the bus home in my gym clothes. I don't know, it's like I just get more like, tied up in, I don't know, if I don't do it at a time that you know, I'll do something after-wards I don't know. Just...

THERAPIST: Like it creates further complications as well. If you are going to shower, and then you have to figure out a bunch of other scheduling things around that.

CLIENT: And I mean it's also just my, I don't know, my mood at night or something. (pause) I feel like, I just kind of have less, will power or control at night to like, I don't know, push my not push myself, but want to do good things for myself I don't know what it is.

THERAPIST: It's harder to get motivated and be disciplined and initiate things?

CLIENT: Right. (pause from [00:17:06] to [00:17:28])

THERAPIST: I think a lot of this may be a kind of elaborate ritual geared towards protecting you from yourself. In other words, towards, kind of being safe or protected from beating yourself up. It seems to me that is kind of the danger lurking around every corner. Is that you will get angry at yourself and beat yourself up for not doing well enough.

CLIENT: Yeah I think so. And like, by that time of day I just kind of go along with it, or turn off, or yeah. Which is, I don't know, it's weird because, I don't know.

(pause from [00:18:51] to [00:19:08])

It's like I should, like I'm thinking I should be able to cope, and give myself a break. Like I should just work all day and I don't know, whatever. But then I'm like, what would make me feel better and feel happier would be to work out, but then I don't do it because I concoct some weird, I don't know, scheduling issue. So, I don't know.

(pause from [00:19:36] to [00:19:52])

THERAPIST: What was the first thing, before the scheduling issue? You think the thing to feel better would be to work out but -

CLIENT: Yes, like I, create so much anxiety around the idea of me working out like, you know, like, when do I shower, how do I get home, blah, blah, blah, I don't know. I don't know if it's like excuses or like, (pause).

THERAPIST: I see, like, you can't tell if you make a fuss over eating and showering, and timing in getting home and all that. Kind of as a way of working out, or whether if somehow that stuff actually matters. Well, so, let's get into it a little bit then. [00:21:01]

What are the issues with eating and showering and stuff (chuckle) like, you don't want to eat right before you work out, I understand. And -

CLIENT: I think it's just like, I have these (inaudible) days where it's like, it's 5:00 and I haven't eaten since noon. I just want to go home and like you know. And yeah, it's just more of like, okay, if I work out, at night, then I take my shower at night. But then I want to just get up in the morning and with out it and I just don't want to take multiple showers. It's so stupid. (laughter)

THERAPIST: (laughter) All right.

CLIENT: (pause)

THERAPIST: I gather that you are feeling a bit uncomfortable just getting in to it. And I gather that this stuff kind of takes on a degree of cosmic importance when you are in the middle of it. That you don't entirely believe at other times it should have.

CLIENT: Right, but even though, when I try to go and schedule it so I'm not driving myself crazy. But even, I can't do it. Like I can't, even like now, I'm like, oh. I don't know.

THERAPIST: Because it becomes hard to think through or because there really becomes so many constraints that it's hard to satisfy them all? [00:22:57]

CLIENT: (pause) I think that, yeah, just too much constraints. Like, I was feeling like, (pause) I don't know. Like, I get out of work, I'm just like, I'm really putting pressure on. I'm like, oh I'm not coming here til like 9:15 on a workday, I should just get up and go in the morning when there's plenty of time. Then I'm like, oh, I'm cold, and then I'm like, well when am I going to have my coffee. (laughter) It's hard to do. And, I don't know, it's just like, oh, then I'm like, well should I just do it and you know, I'm like, I don't know. (inaudible) (laughter) What the hell?

THERAPIST: But that's part of the impulse is the like, AAAHHH. I need to talk to somebody about this, this is overwhelming. [00:24:07]

CLIENT: Yes. And I want to do it, and I thought I should do it because I would feel better like later in the day you know, I would be like proud that I did it. It's like, I don't know. (pause)

THERAPIST: It's like, yeah, okay, I come here, I have (inaudible) I should have time in the morning, I should work out, and I know I'll feel better if I've done that. And I'll feel like of proud of it during the day, but if I do that, then when am I going to have coffee, and if I think about having to do that and arrange a shower, and I have to eat beforehand, but not right beforehand. Is it stuff like that?

CLIENT: Yes.

THERAPIST: (chuckle) Okay.

CLIENT: I don't know, it's so, yeah, I'm just kind of thinking about like, what, like in high school, I would do so many things, get up before school, workout, go to school, then have softball, and then I'd have like lessons later. It's just like it didn't seem to bother me. Like why should I worry about those things.[00:25:27]

I don't know. (pause)

THERAPIST: I would imagine you had very little say then, of when you do each thing.

CLIENT: Right, yeah, it was more structured. Yeah, everything had a time. (pause) Yeah, but, so I guess I try to, limit myself, I can't just do it and work, you know, eat and shower. (chuckle) (pause) I don't know, it seems so, (pause) it seems so, it does feel like so frustrating. And then, I don't know

(pause from [00:27:04] to [00:27:27])

It just, I guess it frustrates me that I think so much about this when that, like the other things that I want to think about are like, you know, what I should do with my life, and how do I get better. It's like, I don't know. (pause) Yeah, like right now I just feel I'm just go home and just not do anything. I don't know. Sit and think and figure it out. (pause)

THERAPIST: Yeah that was the kind of impulse you mentioned before, I guess that I was understanding, just step back. You know just sort of think about it, think it through in your head. That kind of thing?

CLIENT: Yes. I'm so, I think I'm very confused, when I'm like, I don't know.

THERAPIST: I think there's a lot going on. [00:29:00]

There's a lot listening to this I think. I'm not quite sure what yet. But (pause) but I do think there's a lot in that.

(pause from [00:29:14] to [00:29:36])

CLIENT: Yes, now, I just feel kind of angry and confused and yeah.

THERAPIST: Angry with yourself? Angry because of what I said?

CLIENT: I think, angry I feel out of just, I don't have control, I can't just do it, I just feel out of control with all this. I can't.

THERAPIST: Yeah, I would imagine that is in response to that, that the wish emerges to just push everything aside, sit down and think about it. I suspect that times when you feel that, it's immediately in response to some kind of feeling of being work up and out of control.

CLIENT: Right, and then like, I guess I feel like, it's me. Like I don't have any control over my energy or my emotions or like, my, something, I know that I am preventing myself from doing something, is just not disciplined. Like, I'm not out of time, I know it's just me. [00:30:50]

So, it's I don't know, I hate that like, yeah, I'm not in command of my tiredness or emotion or whatever. I just don't know. (pause) So yeah. (pause)

THERAPIST: I also wonder about the piece where you want somebody to step in and help or tell you what to do. Like where you are almost, okay wait a minute, alright, fuck, I need to tell somebody about this. At least that's kind of how I heard it.

CLIENT: Well I think that yeah, I'm aware that yeah, I just kind of wind myself up and I can't really register, like, exactly how I feel, or like what I want, or, so I can just ask for like, asking for input and so on. I don't know, I guess I just see, the way, I guess, yeah, the way they think about and what they say and you know, somehow, that's more valid to me, or less insane than what I think. [00:32:39]

THERAPIST: I see.

CLIENT: It's kind of a supportive, thought process. It's usually like, do it, or like give yourself a break. Talking to someone, yeah. Weird, like I'm tired, or whatever.

THERAPIST: You mean it sort of, it could provide kind of a respite from sort of the little tornado that you are in the middle of?

CLIENT: Yes. (pause) And like, maybe like, they like, I, yeah like chatted with Sascha or whatever, and was like should I work out tonight, or should I like take it off or whatever. And I guess she would like ask questions of like, are you busy, are you tired, like, I don't know. Just like simple things, and then she would be like, oh just go. I don't know. [00:34:01]

THERAPIST: Quick.

CLIENT: I don't know, then that would just convince me.

THERAPIST: I have the impression there is something appealing about being able to put yourself in someone's hand like that. When you are feeling that way. I mean in addition to the kind of practical value of getting you out of the dilemma and sort of making the decision. That there's something that maybe feels good to be able to rely on someone that way. Or get that kind of help.

(pause from [00:35:00] to [00:35:13])

I appreciate that you probably don't want or need it. But I guess I also imagine that it feels good. (pause)

CLIENT: Yeah, I think it's, I don't know, it's a, like, I don't know. Because like, someone outside gives me input into my world, like I think it's just kind of like, I don't know a way of sharing I don't know, or communicating. I have nothing else to talk about, (chuckle) but the sexual drought I'm on. (chuckle) (pause) Yeah, and I just, I think I'm -

THERAPIST: I'd say in a way it's the point you (inaudible) want to pick, but it is sort of a way I think of feeling close to people. I mean this is what's really going on with you. I mean that's what occupies your mind I gather a lot of the time, and energy and thought. And it's nice to have somebody there with you in it. [00:36:52]

CLIENT: Yeah, yeah.

(pause from [00:36:59] to [00:38:08]

I mean, I'm just thinking about examples and how it felt like, yeah. I guess talking about it, also I think it just also turns off the chatter. Like, I even work out better when someone tells me to work out. Because I'm not, then I don't, I'm not going to the gym to keep me on it, that's not the whole, whatever. That's not still going on and I don't feel like, so exhausted by the idea of having to shower (inaudible).

(pause from [00:39:02] to [00:39:32]

Yeah, I don't know. (pause)

THERAPIST: If somebody else has sort of told you to work out, then you don't have to think about so much other stuff. Like, what you should have, worrying about showering after-wards, stuff like that. (pause)

CLIENT: Yeah, and I wonder why it is like causing so much anxiety like, or (pause) exhaustion. I don't know. (inaudible phrase at [00:40:30]). I don't know, it's weird.

(pause from [00:40:33] to [00:41:00])

I want to ask, I guess I was confused, it comes back to me being angry and why it's hard for me.

(pause from [00:41:12] to [00:42:00])

THERAPIST: I wonder if there is something precisely about it all in some sense being manageable. Like, whether there's something about letting yourself do what you want or have the things you want, that (pause) has something to do with this reaction. I mean I guess, like in contrast to high school, where you didn't have a lot of choice I gather, and input in to what, and input in to when. I wonder if, if there's something about how now you do and actually you have the time to do things you want, and they are all sort of very feasible. That, you know that makes you feel anxious and feel guilty and feel something. That that means you kind of get worked up about it. (pause) But we should finish up for now.

CLIENT: Okay.

THERAPIST: (inaudible) Thank you.

END TRANSCRIPT