Client "K", Session March 17, 2014: Client discusses her plans to go to grad school after she receives an offer. Client thinks she should be happy about it, but is instead anxious and worries that all the work she's done in therapy will fall apart if she leaves. trial
TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: Good morning. Happy belated birthday, I think. [00:01:03]
CLIENT: Yep. Friday [ ] (inaudible at 00:01:27) and Vicki and her brother was looking at schools in Philadelphia and he had never been to Philadelphia before, so we went with him. I went back to Delaware with Vicki just for Saturday, just to hang out. [00:02:07] It was nice out, so we just went for a hike. Other than that, there is not much going on. I’m starting to think about options for what I want to do for grad school. It looks like UNC is my best option. [00:03:01]
THERAPIST: Did you get in?
CLIENT: I got an offer.
THERAPIST: Congratulations.
CLIENT: Yesterday I was thinking about that – moving and if I should save money and live with my parents, but that doesn’t sound like it’s the best thing; and then finding a place to live. I have to think about it a little longer. [00:03:56]
THERAPIST: That’s big news.
CLIENT: I guess one of Vicki’s friends from school is going there for residency, so she’ll be there pretty much the time that I’ll be there; so that’s nice. We’ll both be on [ ] (inaudible at 00:04:30) campus. (pause) I also kind of see it as more of a hassle with having to move. [It brings all these things out.] (ph?) It’s hard for me to get excited about it and not immediately go to what am I going to do about moving? Stuff like that. (pause) [00:05:56]
THERAPIST: So it hits you pretty quickly and then you start to think about it?
CLIENT: Right. (pause) Everyone seems to have an opinion about it in terms of “you should take time off” or “you should go somewhere” or “you should live with your parents” or “don’t live there.” We’ll see. (pause) [00:07:06] I don’t know. I think I just kind of want things to stay the same because I feel I can better control myself and do the things I want to do and not be lazy, not be stressed out. With the kind of routine I have now, I know things that make me feel better. [00:08:03] Even this weekend, it’s hard for me to relax and not be anxious about what’s next or my energy levels. (long pause) [00:09:32] I guess I just knew what I wanted and was wanting to be more flexible and not so anxious about everything, kind of a feeling of not wanting to do anything. (long pause) [00:11:01]
THERAPIST: I guess I’m thinking about it, but I’m not sure yet what to say. (pause) I guess part of what seems like it’s frustrating is how, in a way, this is what you wanted; and yet it’s also making you feel anxious and stressed. [00:12:10] (pause) It seems like you’d rather be able to think about it a little bit or get excited that you’ve gotten a good offer and have a little breathing room from all the decisions that then come next. [00:13:01] (pause)
CLIENT: The feeling is like I’m doing this alone, so I want to do whatever is easiest in terms of finding a place. I’m not excited about it because it’s just like whatever. [00:14:02] It’s kind of like me; I just want what’s easy, that I don’t have to sit and stress about or feel anxious or worry about. (pause)
THERAPIST: This isn’t about feeling good, it’s more about not wanting to be super stressed out.
CLIENT: Right – or just not excited about it. [00:15:05] (pause)
THERAPIST: It’s more like wanting to deal with all the things that it raises that are stressful, like basically these big to-dos that add to your to-do list; and also the opinions everybody has about decisions you should make. [00:15:58] (pause)
CLIENT: I don’t know if I’m just being whiny, but I can just leave easily. I don’t have to do this and that and that – train someone and other things that would be so much work. [00:17:05] I feel like I just want to be working on myself and concentrating on that. Any little change throws me off. I don’t know if I’m being stubborn or inflexible. (pause)
THERAPIST: I guess, apparently, at least my part in this, when you say that you’re being stubborn and should be more flexible, I guess in a way, that reflects a burden that feels like I’m sort of putting on you – you probably, as well – but I guess I imagine mostly from you and a little bit from me, in your mind, not only do you have stressful things to deal with, but really you should be more flexible and you should be dealing with this in the right way. Do you see what I mean?
CLIENT: Right. [00:18:57] (pause) It’s hard for me to enjoy things if I’m just anxious or out of my comfort zone. I wish I could just relax. (pause) [00:20:07] I don’t know if I’m just always so focused on the negative or whatever. I don’t know. (long pause) [I think this because I’m not enjoying myself at all and don’t feel good.] (ph?) (pause) [00:21:08]
THERAPIST: I clearly did have the wrong idea when I mentioned something about that a couple of minutes ago. It does sound like this is causing you a lot of stress and anxiety. (pause)
CLIENT: I just wish I wanted to deal with it or was excited about it and that it trumped the normal anxiety about everything. [00:22:05] (long pause) [00:23:09]
THERAPIST: Instead, is it a little bit the opposite? I guess I’m thinking, that said, at least when you’re here you kind of know the things that you can do that will help.
CLIENT: Sometimes.
THERAPIST: Whereas there are just so many unknowns with going to grad school. It’s the unknowns that make it harder to deal with, the stressful things about the decisions and figuring out what to do? [00:24:07]
CLIENT: Right. All these worries about whether I’m doing it right or getting the most out of something. I don’t know. (long pause) [00:26:07] I guess I don’t want to fall further into regret or keep doing the same things that make me hate myself. I just want time to get better, time to actually change.
THERAPIST: I would imagine you are probably referring to losing this. [00:27:01]
CLIENT: Right. (long pause) [00:27:38] I just want to not be consumed and to change [ ] (inaudible at 00:27:55). (long pause) [00:28:53]
THERAPIST: I guess it sounds like you’re worried that the things we’re working on will get lost or overridden; kind of drowned out by . . . I guess I can’t tell. (long pause) [00:30:06] Are you saying partly you’re worrying you’ll regret leaving the work that we’re doing and feel very caught up in the kind of stuff that, after you leave, you’re often caught up in there that we talk about at work and stuff and you’ll have less hope of feeling better? [00:31:09]
CLIENT: A little bit. It was more because I don’t feel better. I don’t feel like I’m in a good state or change or that I’m just going to go and do all these things or be so worried about the wrong things and not take advantage of what I need to do. [00:32:01] I’ll be so worried about being socially [ ] (inaudible at 00:32:11) instead of networking and taking advantage of opportunities or something like that. (pause)
THERAPIST: I guess it’s like what you describe from college somewhat? (long pause) [00:34:04]
CLIENT: I guess I just kind of want change or want to feel better. I want to feel capable. (pause)
THERAPIST: I think also safer. (pause) [00:35:01] I think a lot of this is terribly frightening.
CLIENT: Right. (long pause) [00:36:20] I’m just not sure what to do because the more I do things, the more I try, they kind of weigh me down or make me feel worse. (long pause) [00:38:44] I guess it just feels like I’m going to have to keep pushing myself, just doing it. (long pause) [00:40:56]
THERAPIST: I have the feeling that at other times I don’t think you want advice or for me to tell you what to do. I think you want me to somehow protect you from all the worry and, I think, isolation that go along with the specter and starting grad school; and I guess probably by helping to reassure you a little bit about the ways you feel you’re going about this so badly or that you will make a bunch of crucial mistakes where you’re not handling things well. [00:42:45] Things can feel so bad and overwhelming, I think, that it’s helpful if I sort of reassure you in a way about those things. I don’t mean to make them go away or that you don’t have them the next time, but in the moment, I think it assuages things a little bit. I think it makes you feel a little bit protected, but it does sound like you are in a period of being really pretty distressed about all this. [00:43:37]
CLIENT: Right. I don’t know. I think I’m just focused on wanting to change or wanting things to be different or feel better. (pause)
THERAPIST: Are you, in essence, also seeing your time here as also being kind of a failure? Maybe a bit on me, but I would guess that you probably see it more on you because you don’t feel better? [00:44:50]
CLIENT: Right – or I can’t control or let go of things. I’m just always consumed by or affected by things and the outcome is always negative instead of positive how it affects me. (pause)
THERAPIST: I see. So in a way, the two big efforts that you’re talking about and, in a way, are making you feel worse are, I assume, in a way that assumes to both applying to grad school and getting in and deciding to do this. [00:45:52] (pause)
CLIENT: I guess I feel like I’m just doing it wrong and am not excited or am not seeing it the way I’m supposed to. I’m preoccupied with the wrong thing or something.
THERAPIST: We should stop for now.
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