TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

(pause)

THERAPIST: I actually had a thought as we were wrapping up on Thursday that I was going—or on Wednesday. That I was going to then tell you Thursday, but then, I had to be out.

But maybe I’ll mention it now. I mean, first of all, sorry, again, for having to cancel for Thursday. Everything is fine.

I mean, it (inaudible at 00:00:47) to me like this. So, it seems that we wound up on Wednesday that, at times, we do, where I don’t know how well you remember what we were talking about, but I . . . (inaudible at 00:01:04) you can say it was something that has come up fairly often. [00:01:08] Which is about the way that you feel stuck. Having to be focused on things, pushing hard a lot of the time, always getting a lot done, active, busy. And how maybe other people have their who or they are who do things differently and who, at times, encourage you to do things differently.

And that’s where you get stuck, because even though it conceptually, it seems like something more in the middle or something allowing more flexibility would be better, in practice, it actually doesn’t work like that for you. What happens is if you say, “Okay, I’m not going to the gym today,” or, “I’m going to slow down at work and only do 80 percent of what think I should get done,” you feel crummy. [00:02:02] Or you get anxious or frustrated with yourself.

And so even if it, in a way, it seems like a sensible idea, it just doesn’t work. And so it leaves you . . . uncertain about what to do. And then, the way that it seems to me you’re saying that comes up here is I seem to have some ideas, however precise or vague, about some alternative way this could get better. [chuckles] Although you’re not real clear what that is.

And so, in a way, that doesn’t really help matters much, either. [00:03:00] And you don’t necessarily, I think, see me as somebody who’s telling you, “Well, just slow down,” “Take it easy,” or, “That’s really what you need to do.” So I’m now failing to be helpful in that way, that people often do when they’re trying to be helpful to you.

I’m still not being all that helpful in that you still feel quite stuck in the same dilemma and unsure what to do about. Which, mostly, I think, as we’ve talked about, feels to you like a failure on your part, because you’re struggling with this. You don’t know what to do. People tell you things, but it doesn’t really help. So it’s on you. And yet, in a way, it’s on other people or on me, because nobody’s really doing that much to make it any easier for you or move things along for you at the same time. [00:04:03]

So, I have a thought about all that, but first, I want to make sure that I’m more or less getting the situation right.

CLIENT: Yeah.

THERAPIST: Yes, you said?

CLIENT: Yeah.

THERAPIST: Okay. That seems like a pretty central thing to you, too? This [kind of thing] (ph) that I’m talking about, yeah? All right.

(pause)

THERAPIST: I’ve had a little bit—right. [00:05:02] So, then, I guess I’m pretty aware that what I’ve just described . . . is really what it’s like. I have an alternative point of view on it, which goes like this: So, for example, apply to things here. Your experience is, in a way, of being faced with a practical problem. Namely, what do you do about this? Both, in a way, while you’re here and more broadly. (inaudible at 00:05:57) come if it feels like . . . we’re not getting you through this impasse? [00:06:09]

I mean, I imagine there are others ways that you could find this helpful or supportive or whatever and I’m not—I’m just putting that off to the side for now. And as you’ve not said anything like, “Well, it’s get through this right now or bust.” (inaudible at 00:06:29) [chuckles] But I think it’s important. And I think this impasse figures large in your thinking about this and how you’re doing, in general. Is that right?

CLIENT: Yeah.

THERAPIST: Yeah. So, that’s a practical problem. And it’s an important one.

I think, in a surprising turn of events, I think that that practical problem, which is a real one and one that deserves serious consideration. Also conceals an emotional issue or you could say problem. [00:07:14] Which is that what the impasse feels like, what the stuckness and passivity and uncertainty all feel like . . . particularly . . .

(pause)

THERAPIST: . . . when you’re here with me and . . . you know that I see it and you also, I think, feel some sense that we’re helpless in it together. [00:08:00]

So, like I said, from one angle, there’s a practical side of this. And from another angle, there’s an emotional side of it, which involves what it feels like, what the experience is like of being stuck, helpless, not knowing if it’s on you or on me or how much it’s on you or me. Or if it’s somehow on us together, in the way that we’re trying together to deal with it.

And I think it’s very easy for that emotional angle to get obscured by the practical considerations. But one reason I think the emotional piece isn’t—there are a few reasons I think the emotional piece is an important one. One is I think the way you feel it in here and in terms of how we’re trying to work on this is pretty—I’m guessing it’s pretty similar to what it feels like when you’re lab, struggling with the parallel problem. Or at home on a weekend. Or trying to think through something social that happened. That there’s the practical question of what’s your judgment going to be about what happened between you and somebody else. Or what are you going to do on a Saturday morning when you have some flexibility in your schedule or some time and you’re not sure what you want to do? Or the analog (ph) at work?

I mean, the practical question, again, it’s important and it’s one you’ve got to figure out. [chuckles] [00:10:00] But there’s also what each of those situations feels like. And I think that’s pretty much all the same. I think the feeling in each of those situations, including the one in here, is pretty similar. I think in here . . . pretty clearly, in a way that is a little different from in your life outside of here, we dwell on it. [chuckles] I don’t mean it doesn’t stick with you, but we talk about it and we fuss over it. That sort of thing.

But my point is . . . I think the actual problem you’re having has to do more with the emotional side of this. [00:11:04] And the pitch of anxiety, vulnerability, confusion you feel . . . in this stuck situation that I’m referring to, that passivity and helplessness via (ph) confusion. And I think you really . . . I think you have a very intense emotional reaction to it that’s hard to be clear about or aware of or think your way through when you’re in the middle of it, because it’s so overwhelming. [00:12:00]

(pause)

THERAPIST: And I think it—you . . . I think that’s really where you have trouble, is with the emotional side of all this. And I think you get a little focused on the practical side. Which is very real and very important, but I think you do it a little bit . . . in an effort to help settle yourself down, because just staying with the emotional side is so God damn overwhelming. I mean, I really think it’s horrible. I mean, what I mean is (ph) it feels really bad. [00:13:02]

I think however often you’re coming here, I think a significant amount of the work will involve our looking at that, you’re getting a little more used to tolerating that, understanding it, metabolizing it, in a way? Does that make sense, what I mean?

CLIENT: Yeah.

(pause)

THERAPIST: I don’t think my laying it out this way is any kind of solution or procedural manual . . . for how to deal with these situations. [00:14:09] I’m saying I’m trying to reframe a little bit where I think you get stuck and why. And how I think you—and I think the kind of things that we can work on to help make it better. Which involve . . . gradually coming to tolerate and . . . deal with the anxiety of and get more clarity about or understanding of what’s going on when this happens. [00:15:04] Why it’s so overwhelming. Getting used to that in a way that helps you feel more settled when it’s going on, so that you can think, in a sense, where you’re actually at in any individual situation where you’re stuck and this comes up.

CLIENT: Right.

THERAPIST: Yeah. I guess I thought it might be helpful for me to . . . at least, in a sort of conceptual way, provide a kind of overview, a (inaudible at 00:15:51) of what I think you’re having trouble with.

And this is often the way that psychoanalysts (inaudible at 00:15:56) analysis work is that you wind up stuck in the same place in the treatment with the analyst that you are everywhere else. [00:16:10] And you don’t find an answer or a solution or a strategy so much as you come to get used to gradually think your way through, become less anxious and churning and paralyzed by the feelings that come up in the situation or around it, so that you can think and operate and get a sense of how you feel and where you’re coming from when the problem comes up, in a way that you couldn’t before. [00:17:03]

(pause)

CLIENT: Okay.

(pause)

THERAPIST: So, I guess, first, is that . . . am I being clear? Do you have questions about what I’ve laid out? Are there parts of it that either don’t make sense or don’t seem right or? [00:18:00]

CLIENT: It seems right. I guess . . . I don’t know. I guess it makes me a little anxious to, I guess, because I’m immediately drawn (ph) to—I don’t know. Problems that—I don’t know. Being stuck in a situation—I don’t know. I was thinking, “Oh, I’ll never know what the right thing to do,” or . . . or, I don’t know. I don’t want to be wrong in my conviction. I don’t know. That’s just what I was thinking of (crosstalk at 00:18:52).

THERAPIST: Right. Yeah, I think . . . [00:19:00] Yeah. It sounds like you immediately went to feeling disarmed. Anticipating dealing with situations that are overwhelming.

CLIENT: Right.

THERAPIST: Which . . . is the very anxiety that I’m referring to. And that is so difficult. [00:20:00]

(pause)

THERAPIST: I guess at the . . . at the end of the days, there’s something more immediately interpersonal in this that I’m having a little trouble yet getting ahold of.

(pause)

[00:21:00]

THERAPIST: But that I think we can—we will learn more about as we continue to investigate.

(pause)

THERAPIST: Tell me more. So, you were immediately thinking of—because I think I missed something, here. You were immediately thinking of situations where you need to have answers or you need to decide what to do.

CLIENT: Right. Or I don’t—I don’t know. I don’t want to be wrong or arrogant or, yeah. I don’t know. [00:22:00] I don’t know. To me, it seems like a lot of times where I get stuck, it’s a problem of—I don’t know. Battling knowing what I want and knowing what I think I should do. I don’t know. I get scared to make a—I don’t know. Choice or—I don’t know. So, I think (inaudible at 00:22:38) just (inaudible at 00:22:38), I don’t know. But I guess it’s hard for me, I don’t know. I guess to trust myself or to, I don’t know, make a decision. [00:23:00]

(pause)

CLIENT: I guess when I ask, I guess, whoever, “What do I do?” or—it’s not (ph) like—I don’t know. [00:24:09] It’s not what decision do I make. It’s more like how do I think about the situation or—I don’t know. (inaudible at 00:24:24) one, don’t get stuck, or two, I know what the answer or something. What do I do to prevent (crosstalk at 00:24:33)?

THERAPIST: Well (ph), yeah. It often seems like more, “How do I get oriented to this?” or –

CLIENT: Right.

THERAPIST: I mean, if you were sitting in front of a math problem, it’s not so much like you’re asking what number or equation (inaudible at 00:24:52) the answer, but what kind of a problem is this? And what, in general, is the way to work on a problem like this? [00:25:00] Something more like that?

CLIENT: [Uh uh] (ph).

(pause)

CLIENT: I don’t know. (inaudible at 00:25:16) I don’t know. It boils down to . . . not that I’ll never get out of this or I need a new way of thinking, so—or a new, I don’t know, awareness or something so I don’t get in these situations. I don’t allow myself to be in these situations. That’s what I think of. Or I think I want (inaudible at 00:25:54). [00:26:00]

(pause)

THERAPIST: I feel like there’s a way in which, both with what I’ve said and—about we just stick with that. That I’m often throwing you into those situations, in a way, here. [00:27:02] Like when I say more about the—what comes up emotionally and the anxiety and the overwhelmingness. I know you know what I mean. I mean, you said (inaudible at 00:27:21) did that make sense to you?

At the same time, I think there’s a way that it also throws you in it, because it doesn’t really tell you exactly how to go about that. And what you most immediately want in these situations is, “How do I deal with it?” [chuckles] “What do I do?” or “How do I get oriented?”

CLIENT: Right. [00:28:00]

THERAPIST: And saying, “Well, actually, it’s about . . .”

(pause)

THERAPIST: “. . . looking at how it makes you anxious and what is getting screwed up and all that. It’s not a lot to hold onto, I imagine.

CLIENT: Right. I don’t know. It’s pretty much crippling.

THERAPIST: It’s crippling? [00:29:01]

CLIENT: Yeah. I don’t know. I don’t know. Yeah, like when I’m trying to decide or going back and forth or trying to analyze it. And just asking, “So, what do I do? What do I do?” It’s just (inaudible at 00:29:35). I don’t do anything or it’s just sitting there, stewing. And I feel that (inaudible at 00:29:51) get out of it is to (inaudible at 00:29:53) I don’t know, be super-strict and push myself. I don’t know. Or get someone else to distract me or push me (inaudible at 00:30:05). [00:30:05]

(pause)

THERAPIST: Yeah. That feels like somebody really reaching their hand out to you. Grabbing ahold of you while you’re in the midst of all of this. Whereas what I’m saying (inaudible at 00:30:43) though it feels much like more leaving you in it.

CLIENT: Right. [00:31:00] I guess I’m just explaining, I don’t know, why—yeah, I’m so—I don’t know. Or keep asking me, “What do I do?” I guess I feel like—I don’t know. (inaudible at 00:31:27) I’m just lost, I don’t know. I don’t know. It affects everything (inaudible at 00:31:33), or I don’t know. I’m less productive or (inaudible at 00:31:41).

(pause)

[00:32:00]

(pause)

CLIENT: Yeah. I mean, I guess I’m going to set some kind of—I mean, I agree with you, what you say that (inaudible at 00:33:05) you don’t think—I don’t know. [00:33:12] (inaudible at 00:33:13) or understanding more what’s going on, but (inaudible at 00:33:16) too critical and too—I don’t know. Shut down or (crosstalk at 00:33:25).

THERAPIST: I’m thinking about I wonder why. I’m not exactly posing this as a question for you to answer, but it seems like it’s a central question. Why it is that . . . the thing that works is having somebody step in and tell you how to look at something or tell you what to do? [00:34:00]

(pause)

THERAPIST: I mean, there’s a way in which that . . . limits somewhat how you might choose to approach something or what you might feel is right. But I understand that sometimes, that’s not what matters immediately so much as getting unstuck or unlost. But the question is, through my mind . . . [00:35:00]

(pause)

THERAPIST: I wonder why that’s the thing that . . . helps. And I guess what it must be is . . .

(pause)

THERAPIST: . . . once you have moved forward a bit, you can think again. And you feel a lot less anxious. [00:36:00]

(pause)

THERAPIST: And another way to say it, I guess, is that there’s something having a very decisive, controlling figure . . . who really takes over. [00:37:04] And that . . . makes you feel much better.

CLIENT: (inaudible at 00:37:23)

THERAPIST: What went with that, that’s in a way the person you need when you’re feeling lost.

CLIENT: [I don’t know] (ph). (inaudible at 00:37:53) [00:38:00] I mean, I don’t know that’s because they may have an opinion or—[I don’t know] (ph). Because they have that opinion, I don’t know, there’s some weird—I don’t know. I don’t know. Know it’s right or something like that, or . . .

(pause)

THERAPIST: Well, I guess you can have confidence in it. I mean, I would imagine in reality, there are times you look back and later on, felt like maybe most of the time, the advice was good. Maybe sometimes it wasn’t. But what really mattered was how it got you unstuck. [00:39:03]

CLIENT: Right.

THERAPIST: But in the moment . . . I guess you can hold onto that advice. And you can feel—because you can feel confident of it. Or have some faith in it, in a way.

(pause)

CLIENT: (inaudible at 00:39:48)

THERAPIST: Yeah. Right. It can’t be just anybody off the street. [00:40:00] I mean [chuckles] it’s somebody like—I don’t know. I think the person comes to mind is Vicki. Somebody you know very well and knows you.

CLIENT: Right (ph).

(pause)

[00:41:00]

(pause)

CLIENT: I don’t know. I’m just thinking as, I don’t know, I need to push myself or I need to . . . I don’t know. [00:42:07] Yeah. I mean I need to, yeah, just—because I know what I could (ph) do to let go of myself. (inaudible at 00:42:20) more productive. But I get stuck. But I don’t know.

THERAPIST: I imagine it’s (inaudible at 00:42:30) pushing yourself to come here, actually. I don’t mean every day, you go, “Oh my fucking God, I have to go there again.” [laughs] Although maybe you do. I don’t know. But more like . . . not in all ways, but in some ways, I mean, it really puts you right in the kind of thing you struggle with, where you just say whatever. I give you advice. [00:43:00] You’re often in this uncertain or confused place about what to do.

(pause)

CLIENT: [I am] (ph), a little bit.

THERAPIST: I think that you’re in that place a lot in a lot of places. Sorry, go ahead.

CLIENT: (inaudible at 00:43:49) I don’t know. It’s not as hard. I don’t know. [00:44:00] It’s not as—I don’t know. I’m not walking in and out of the door or (inaudible at 00:44:07), I don’t know. So it’s easier just to (inaudible at 00:44:09).

(pause)

THERAPIST: Well, we could stop (inaudible at 00:44:23).

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