TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: Well I've been still pretty sick, as you can tell. Yeah, I've developed a couple of other infections, which is kind of why I didn't want to take out the appendix, is because another reason was I knew the other problem was due to the immunosuppressants. So now I just play the game of one high impact antibiotic after another and it's just wearing me out.

THERAPIST: [I can imagine] (ph). What are the affects of the high impact antibiotics, in addition to killing what they're supposed to?

CLIENT: They kill other important digestive things (ph).

THERAPIST: Does that affect what you can eat or make you nauseous?

CLIENT: It does, it does. It makes it so that you have this is one of those deeply humiliating things, about occasionally you can easily lose control of function in your bowels and they (ph) don't smell great. They told me pretty much that antibiotics in general don't work well with birth control, so that's, you know. In general though, I may very well start getting multiple types of yeast-based infections because the bacteria keeps the yeast at bay. So people get things like plastix psoriasis on their skin and things like that, so I've been trying to be really carefully with that. Like, certain types of eczema is actually a yeast-based thing, amongst a variety (ph) of other things like that. Infections in the mouth, that kind of stuff things that are non-bacterial. On top of that (ph), they make you nauseous. They make you do all kinds of stuff.

Apparently I did not know this until about a week ago Cipro also is known for tearing tendons. They don't really know why but the tendons get very brittle and it is really common to tear your Achilles' tendon, amongst other things. That's what's black box but it has to be (inaudible at 02:19). So now I have to go through the horrible experience in January, going and seeing my Rheumatologist (ph) and saying, "Is the mobility worth this kind is this quality of life going to continue like this or, you know, what's going to happen?" Because this is not a socially affected infection. It was different when I was catching things like pneumonia. I could be careful sort of and not (inaudible at 02:46) other people. This is internal infections, so it's nothing I can prevent by washing my hands, you know.

THERAPIST: Right. So the question is are the things that are suppressing your immune system and improving your mobility worth it? Or are you better off letting your immune system recover so that you can fight off infections better [in fact] (ph) making sacrifices on mobility? Is that the idea?

CLIENT: Yeah. But they kind of told me that's one of the trade offs, that and a couple of other really bad things. So just (pause) today I wasn't able to work and I went to work yesterday and Sunday but (inaudible at 03:42) comes from a really devastating (inaudible at 03:45). And so it's been really hard.

THERAPIST: What percentage of your income, your, like, combined income is you?

CLIENT: It depends on how much I'm working. I could have had the chance to make a lot more money, I guess is the big thing. Like, days I would not normally work I would be able to work during the holidays, that kind of thing. And they are increased costs of living in winter time, like heat. We only heat in one room, so. And now. We can luckily (ph) shut it off. In other places we've lived we haven't been able to do that before. But things like that. So, yeah. It's been (inaudible at 04:43) brutal. I'm really lucky it hasn't gotten as cold as it could be or as bad as it could be outside.

THERAPIST: As in the heat in the apartment?

CLIENT: No, like, it would have been a lot more expensive if, like, you know. There's been winters in the past where I mean, we were lucky in that I was able to afford to work more and I had savings. So now I just, like, you know. A couple of times we've had to, like, go through and see what electronics we can live without and sell it. So I have no iPod now, which is fine. I mean, five years ago (inaudible at 05:20) in the world existed, so it's not like I [knew it] (ph). I should be fine, things like that. And this is the time of year where people might want that kind of stuff, like my arm mixer and things like that, that we got from when we got married. Some nice electric stuff in the kitchen. So just sort of finding ways to be able to keep afloat. But, you know, it's (inaudible at 05:52) right now.

THERAPIST: That's brutal.

CLIENT: Yeah. I'm just trying to keep from feeling it right now. I really am.

THERAPIST: What are the options (inaudible at 06:16) short-term disability?

CLIENT: None. I don't work full-time. I don't get short-term disability that's a full-time benefit.

THERAPIST: I see. For long-term disability as well?

CLIENT: Yeah. I mean, if I do something through the government, possibly, but I don't think I can. I don't have a permanent disability at this point. On top of it, I think that would be more than I can handle right now, in terms of emotionally. (pause) I just can't do it or at least not right now. If I get (ph) permanently disabled, maybe, but not right now.

Now I'm kind of on my last nerve. Luckily, work was very kind to me. They had me answering phones and things like that [for quite a few] (ph) days. (pause) But it's just not a good quality of life, you know?

THERAPIST: It doesn't sound like an especially tolerable quality of life.

CLIENT: No, plus the customers (inaudible at 08:00) tolerable, so they kind of...

THERAPIST: (inaudible at 08:04) or on the phone or...

CLIENT: Well, I've been working with actually physical customers too and they're more abusive than usual for not getting what they want or what have you and such. [I'm just] (ph) exhausted. (pause) I was really, really lucky yesterday. I had someone basically read me the Riot Act and I actually had one of my regulars saw me and she's like, "Oh my god, you're out of the hospital." She know I had been out for like a week or something like that but she did see that I was just being beaten up. And she's like, "You're out of the hospital finally. You really shouldn't be here," you know, and she like interrupted and interceded so this person would, like, you know. She's like, "Shouldn't you be sitting down or" I'm like, "Don't worry, I'll be OK." But I could tell what that was about. She could see that I was being...

THERAPIST: Yeah, she was running interference.

CLIENT: Yeah and that was just [kind of almost broke down crying] (ph). It was just really tight (ph), you know.

THERAPIST: (inaudible at 09:13)

CLIENT: Yeah. But I was very lucky in that at least quite a few of them most of the time, Microsoft very specifically, they will not tell people what's going on when somebody's gone but I specifically anybody that I could, I let people know or I had other people that were employees tell them that I was out, that way they didn't think that I'd moved on and been fired or just in general haven't been returning e-mails. And also sort of like a vaccine for my flakiness of things (ph) because, like, (pause) being feverish all the time doesn't exactly do a whole lot for your focus and attention on things. And that was actually what I was sort of being yelled at by that customer, because he felt as if I was getting a lecture about how today in society that we don't enough attention skills.

I was looking at what's an Easy Pay device. He thought I was texting my friends. I was looking at my Easy Pay device to find out if, you know, we had something, while he (ph) was talking to me about the problems, to make sure we had something in stock so that we [could just] (ph) swap it out. But he felt as if I was, you know, felt as if I was talking on Facebook or something with my friends, which I'm sure that people do but I could have never imagined I don't even do Facebook or anything of that crap anyways, but I can't imagine doing that at work, much less in front of a customer. I'm one of the few people who doesn't carry my telephone while I'm working because I find as if that's a distraction. [00:10:53]

THERAPIST: He was just being a douche bag.

CLIENT: Yeah. And it is true that maybe I haven't been doing kind of eye contact and riveted attention that I seem to be needing but...

THERAPIST: Well, of course you haven't, because you feel like shit and you're totally overwhelmed.

CLIENT: Yeah, but the alternative is not having any money, you know.

THERAPIST: Yeah, there's no good alternative to (inaudible at 11:20). Just (ph) bad ones.

CLIENT: It's a really bad one and, you know, my poor husband's who's, you know, also very upset because during the whole day he has no family either, you know. It's hard for him and so I've been sort of trying to keep mostly I'm just keeping my head down and going to sleep and not really talking to him about how I feel because there's nothing he can do about it and there's only, like, after the thousandth time of talking about how miserable you are. There's nothing new, there's no new information. So I'm just mostly sleeping, you know. But I can tell he's really upset. I know he's sad. I don't have the (pause) right now I don't have anything I can do or say, so the only thing I can do is minimize his worry about me. Because there's nothing he needs to do, really. There might be the occasional...

(phone rings)

CLIENT: Excuse me while I turn this off.

THERAPIST: Sure.

CLIENT: But, you know, I mean, the occasional rundown to get some, like, Ginger Ale kind of thing but that's really about it, you know. But (pause) I'm actually sort of in favor of him going out to [the game] (ph) tomorrow night because I rather have him have some happiness than stare at me and see how sick I am. There's nothing he can do. He works in the fucking (inaudible at 12:56) and he can't do anything about it, you know? Because he knows what it's like. He knows more than what it's like, you know. I mean, what he does is, you know, early morning testing but he knows how (inaudible at 13:10) certain point [it becomes] (ph) very tricky, you know. It's not cut and dry, in terms of getting rid of infections. And so I would rather have him go and have a good time and sort of pretend like there are no troubles, you know. It's free. They'll (ph) never get a cold if it's the house, you know.

THERAPIST: It'd (ph) be easier for you at a sometimes, knowing that he's enjoying something.

CLIENT: Yeah.

THERAPIST: Even if you can't.

CLIENT: Yeah. Just before Thanksgiving he was (inaudible at 13:57) information that we really shouldn't have had, but it was really beneficial to him. And I think that he's just been sort of mulling it over in his head, which...

THERAPIST: Do you want to say...

CLIENT: I'll say it. You're a therapist you know this. You're not supposed to diagnose people who you've never met or anything like that. However, you know, he has been his entire adult life (inaudible at 14:23) stress over what the hell's wrong with their mother. And finally the therapist said, "This is not a diagnosis. This is not this and that but you may find some insight if you look up what schizoid personality [looks like] (ph). You may find some solace in it but this is not something unique this is something that is known." And he's actually really pissed right now but he went through ten years of therapy and no one ever told him anything about that. He had no idea that was out there. And so (inaudible at 14:54). I've been watching him but that too, like, being upset. And, like, he really sincerely thought that he was like, there's this unique situation that is so fucked up and there's no label for it and there's nothing like that. And there really was kind of maybe something that gave some insight as to what it is and how there's never going to be a cure. And so he's now, you know. That happened, like, maybe a day before I went down to the hospital.

And so that's just now he's not so angry as much as well, he's angry because he feels as if he had known that years ago, he would have stopped trying, he wouldn't have put himself out there. He would have done something (inaudible at 15:42) himself. (pause) So that's been kind of an ongoing thing.

THERAPIST: That must be awful for you to see him going through that.

CLIENT: (inaudible at 15:59) relief, anger. Like, it's the whole gamma of emotions in terms of that, you know. Whether or not that's really what it is it's giving insight into something for the laymen (ph) would never easily possibly, you know, fathom. And so he's really going through a lot. And so, like, quite frankly, just having him [go out] (ph) and be happy? I'm thrilled. (crying) I actually, disturbingly enough, if he was acting out and that just made him stop thinking about all the bad things in his life right now, I'm thrilled. I just want him to stop crying (ph).

He's really been trying really hard to get out. I mean, yesterday he wasn't at work. He was at home doing things that we needed to do to keep our family together but for the most part, you know, he's been trying to get out and go to work and do other stuff, you know. Like, yesterday was, like, drive me to work. So I'm like, you know, electronics. Be there to figure out why this mask (ph) isn't working right. It was not, like, in his office but it was things to keep us afloat. Because he's been trying (ph) so damn hard right now (pause) and I don't know what's going to come from this but I think it's I don't know. (pause) He went through a really, really bad (inaudible at 17:57) with the last stone but it passed. And I think that...

THERAPIST: He did finally pass (ph) it?

CLIENT: We don't know. It just has not hurt him, so it could be stuck in the bladder. It could...

THERAPIST: (inaudible at 18:08)

CLIENT: Yeah. It could come out later but it's not in a bad place right now. And, you know, I deal with a lot of chronic pain on a regular basis and supposedly that is worse. I don't know but the point though is that I would much rather go through a chronic pain on my own than see somebody I care about, anybody I care about, go through chronic pain. Because it was just brutal seeing him like that, you know. If I had the ability to completely not seem sick (inaudible at 18:49) some sort of worsening of me internally, I would totally do it because I can see that this is negatively affecting him and other people around me. If I had some way of suppressing this a little bit. And so that's sort of a really sincere wish for me. And I can't do that. And things (ph) are just getting frustrating because there's so many times where I've been able to somehow work things out so that I could do that. And because I can't now that I'm (inaudible at 19:23) I'm being a spoiled brat about this. Having to, like, deal with things that I can't control and therefore (ph) it makes me more stressed out.

I kind of lost it on my doctor about a week ago when I asked him if he thought that the stressed and anxiety was a component of this. And he's like, "Yeah, you don't seem like the nervous type." He)ph) basically was like, "Is it possible that, like, you know, stress and anxiety could be, like, fueling this because of those things, like" "Well, it's possible but you just don't seem like that type of girl." Although it's nice not to be dismissed as being a person that's not [all in my head] (ph), but that didn't give me any insight as to whether or not. That just means that I can act like I'm not a nervous wreck all the time. But people that have a lot of anxiety, like, a lot of present anxiety in their lives all the time do tend to have digestive disorder problems more often and, you know...

THERAPIST: Sure and there's stress that's independent of what type you are. [00:20:31]

CLIENT: Well, yes and no. But there really is. Like, having done some brief research to find out some things, there really is a strong type, you know. And it is almost always women with, you know, irritable bowel-related things. It is almost always people that are just nervous personalities and they're very, you know, they wear their heart and sleeve all the time about everything. And it is true that I don't fit and as a, you know, as any (ph) surgeon of the bowels, I guess that's pretty much all he knows, is how to look for that personality type. But, you know, the kind of things I would think, like air traffic controllers or something like that, which you think would fit into that category, don't really and so it's like you know, I'm not qualified to be doing differential diagnosis but this guy isn't qualified either. So I just happened to decide, you know what, I'm going to play that card later on if this doesn't get any better.

They know that the infection bad but there is other things that are making it worse, you know, but they don't know why. And (inaudible at 21:44) sort of claiming it's a fluke right now but we're just not sure.

THERAPIST: That the infections are a fluke?

CLIENT: No, the fact that I'm not getting kind of usually, the digestive motility that is supposed to be able to at least flush out the parts that are infected faster than anywhere else would be is not happening the way it should. And therefore I was trying to find if it is stress-related that is...

THERAPIST: I follow.

CLIENT: Does that make sense?

THERAPIST: Yeah.

(crosstalk)

THERAPIST: The question is whether stress if affecting your ability to flush out your, like, GI tract, which would help you clear the infection.

CLIENT: Yeah.

THERAPIST: Which is the primary source of (inaudible at 22:27)

CLIENT: On top of it, what also will help me clear out what is left over from the antibiotics, which, you know, later on are precursors for things that are not real great for your body, you know. But right now apparently I do not fit the criteria for that and that's OK. But, you know what, I really almost...

THERAPIST: I mean, you're under incredible amounts of stress. I mean, your health is shot. You are selling, you know, looking to sell the mixer you got for your wedding because you're so short of money. You're heating one room in your house. You don't know how you're going to sort of balance out pushing yourself to work, which, let's be clear, in the right kind of world you wouldn't have to do, given your state of health. Your husband is depressed and just got told his mother, you know, probably has had schizoid personality disorder and he's wrestling with that as well as pretty severe long term addiction. You have very little local support. [00:23:52]

CLIENT: Even when (ph) we do, we don't want to tell because we don't want to scare them off. I mean, that's a very valid reason to do that people get very scared when they they're emotionally prepared to handle a little bit of the Christmas blues, but not like this.

THERAPIST: I understand. You're under tremendous stress, unquestionably.

CLIENT: And the big thing is that, you know, there are people in my life that I've tried telling them about it and they're so powerless that it's not even (ph) comforting. All it's doing is upsetting them, you know, in my life. And so I don't really I mean, I'm not trying to keep it a secret or anything but I'm not really overly talking about it too much because it's like all it does is make them upset, you know. And (pause) yeah. [00:25:17]

THERAPIST: Well, you're certainly welcome to come in and talk to me about it as often as you'd like.

CLIENT: I know (inaudible at 25:23) chase you away. I'm just talking about the happy families who would want to, like, "Hey, come over for dinner" kind of thing, you know.

THERAPIST: Yeah, I know (inaudible at 25:31).

CLIENT: You have to keep it floppy (ph) or else it's just not working (ph).

THERAPIST: No, it's one of the worst things about really having this hard of time, is that it alienates you because, you know, unless the people around, like close friends you've known a long time or family or something, it's often, you know, causes problems to talk about it.

CLIENT: Yeah and [even friends] (ph) did things that they just it's very difficult to talk about, like, what's my prognosis because I don't know and, quite frankly, the doctors don't know really what's going to happen. And so it's very anxiety building to even talk about it because it's like, you know, they're doing it because they want to hear if you're getting better or worse but the answer is, "I don't know."

THERAPIST: Yeah, so you're really pretty completely in the dark about it.

CLIENT: But I did do something that I haven't done in a well, which is that I made myself Saturday night I was invited to my old boss, who just left (sp?), she had a party and I spent about an hour or so there. And I never really go out for that kind of thing and it was really important for me. Everybody knew that I was kind of frail, [the way that I was there] (ph), but understood that because everyone was there till, like, 3:00 in the morning, like, I was there between 9:00 and 10:00 pm or something like that. They all understood that, you know, that I'm just there because I wanted to see people, wanted to be around people. And I think it did help. And I definitely felt like it was better than not going at all.

Usually when I make decisions not to go for (ph) things it's for the best, but this time I really needed to do it. (inaudible at 27:08) do it but, you know, it's just been really exhausting. Like it's been awful, awful, awful, awful, awful, awful, awful. But...

THERAPIST: Should I bug you about asking your parents for help?

CLIENT: (laughter) Well, the problem is that they're right now in a couple different things, one of which is that I don't think that (pause) I love them very much. I love them very much but they have both been through much worse times than me without help and therefore I think that I don't feel really comfortable with that kind of weakness, so...

THERAPIST: Well, excuse me for saying so because that's completely bullshit. Here's why. I am sure they would love to help you and there's probably nothing they would rather do with money they have. And this is where you got it from, I'm sure. In other words, like, you do the same thing you give your last whatever to help whoever that you are (ph) close to and go without whatever you have to go without to do that. And I'm guessing you probably got it through (ph) them (inaudible at 28:35).

CLIENT: Probably, probably.

THERAPIST: And, you know, my understanding is they're not going to have to give their last or whatever to help you. I mean, I understand that they're not completely flushed (ph) but...

CLIENT: They've been doing so much philanthropy and other types of readjusting of income that, you know, they're not super flushed right now.

THERAPIST: Yeah, but they have enough to help you pay the heat.

CLIENT: I do feel guilty though because my mom's been doing so much. About a year ago my aunt died from an overdose and she's been doing a tremendous of things, but financially and with their time, to make sure that this kind of stuff doesn't happen to other people. And so...

THERAPIST: Also, [this is something else you said that I have a particular issue with] (ph). It does not make you one iota weaker to ask them for help. It doesn't make you stronger to have a colder house or fewer electronics or more suffering from this (ph). Like, (inaudible at 29:36)

CLIENT: (inaudible at 29:38) mentality, do you?

THERAPIST: Well (laughter) yes.

CLIENT: No, but it does, it does. I understand. It's just that (pause) I truly do understand.

THERAPIST: There will be plenty of things that will be incredibly difficult and painful in your life and that you'll have to struggle with and will be overwhelming challenges, like, without your help making them more so.

CLIENT: I am. I think that it would be easier for me if I just find some way to make it not even, but there is some sort of equivalent exchange of sorts. Like, you know, I will do this, this and this in exchange for this. It makes me feel better (ph).

THERAPIST: How about you be a loyal and loving daughter and let them be helpful, supportive parents. How about that in exchange?

CLIENT: I know. But then also there's the other question of having to explain to them why it is that, you know, that they're the only ones that help. (inaudible at 30:43) answer. I don't like to have to explain that. (pause) I do (inaudible at 30:57)

THERAPIST: You don't have to explain that. Here's why. "There are reasons that we can't ask Mike's family for help, which for his and their sake I really don't want to go into."

CLIENT: I've been thinking about describing that she's broken inside and there's nothing that we can do. It seems to be the only easy way to explain it without inviting more questions.

THERAPIST: They're your fucking parents. You can just tell them you don't want to talk about it because Mike doesn't want to talk, you know, or because you don't feel like you want to be talking about your in-laws that way, whatever. You know, like, just tell them you don't want to say hey (ph). Like, they'll probably be worried but they'll probably completely respect your saying (ph) that.

CLIENT: Yeah, I think so. It's just (pause) this is something we've (ph) been sort of indoctrinated into me and this is something in no way from them, which is that I have been born strong, there are many people who are not and that I can handle adversity better than others. And therefore it is my job to make sure that others get things that I don't. [00:32:10]

THERAPIST: Go for it.

CLIENT: Not because of, like, just me. Like, that we are able to. That's why we need to make sure.

THERAPIST: Go for it. You were born strong. You can handle adversity better than a lot of people. You can make sure that other people have things that you don't. But I don't really see how that applies to this situation of asking your parents for help. It doesn't make you any less able to deal with adversity. It doesn't make you any weaker. Like, it just doesn't. You're not getting anything out of this. In other words, like, if this was you doing some problem set in college or graduate school and not wanting to ask for help because you want to figure it out because if you figure it out you'll learn it better. OK, you get something out of toughing that out, you know. You're not getting anything (ph) out of toughing this out.

CLIENT: Well (pause) I think that's the wrong analogy to use because I could say, "Well, I should have been do something during the summer, taking what I could and making sure that I did something so that in the winter things were not as bad." But yes, you're right, you're right. I probably will. It's just it's hard for me.

THERAPIST: I know [it is] (ph).

CLIENT: I can't take things from (inaudible at 33:29)

THERAPIST: I know, I know, I know. Absolutely.

CLIENT: And it's not like (pause) I don't know how to explain it but it's just for me there are different rules I guess because I can think through these things, you know? I mean, so far I haven't sold anything I need and I'm not going without antibiotics. I want you to know that I'm not turning off my heat. You know, I'm not doing anything dangerous yet. I'm just being...

THERAPIST: That's wonderful.

CLIENT: ...extremely I just want to make sure you know that I'm not doing anything extremely foolish probably foolish but not extremely foolish. But yes, I am...

THERAPIST: I'm not hearing you do things that are self-destructive exactly. But...

CLIENT: I'm not selling my plasma or anything.

THERAPIST: Well I'm glad to hear that. (laughter)

CLIENT: There are many people that do that. But yes, I understand. I think I will try (ph) that but it's very hard for me and... [00:34:34]

THERAPIST: I understand.

CLIENT: I guess of what I'm afraid is that if start that I just won't be able to stop, you know?

THERAPIST: You are not I understand, I think, that you're worried about that and that probably at some level I can imagine you feel that extremely strong temptation, which you would never really succumb to, to get whatever help you can because things have been so bad and so desperate for so long. But I don't think this is going to be a slippery slope. I don't think you're going to, like, you know, sort of give up, you know. I don't think you're any less of a fighter about this or any less able to handle adversity, you know. You're not going to go soft by getting some help. You might become a little more flexible in this way but (inaudible at 35:39).

CLIENT: I guess (inaudible at 35:46) the unnecessary.

THERAPIST: (inaudible at 35:50)

CLIENT: Because I want to make sure that if I'm going to turn this card and show that I'm really weak that not really weak, but I am suffering a momentary point of weakness that I am going to (inaudible at 36:05).

THERAPIST: Illness is not weakness (inaudible at 36:08) reasonable sense of the word as we're talking about. I mean, yes, you're physically weak. Like, if you had to lift weights today as compared to a year ago you couldn't lift as many. I understand that but that's not really, I don't think, what you're referring to. I mean, you're sick. You have a horrible illness and you have, like, a lot of life stress and various other, like, you know, sort of family and financial problems that fit together with that. That's not weakness.

CLIENT: The biggest problem I have and I think I would be able to get past this if I didn't work in retail is the fact that I yield (ph) so many really shallow people who it's like, wow, don't buy things you can't afford to break, that kind of thing. So I get this reinforced everyday that, you know, that you're only as good as you're only not (inaudible at 37:05) good but don't take on more than you can handle. Don't do this, don't you know what I mean? I guess that's reinforced all the time, seeing people's bad choices. And so it sort of reinforces the ability of being able to be self-sustaining all the time, you know?

THERAPIST: I see, like, you see people who are so irresponsible in that way that it leads you to really not want to be like that and kind of be afraid of becoming like that.

CLIENT: Not just that but also, like, having to turn inside and saying, "How much of this is my own problem?" You know? Like...

THERAPIST: Really none. I mean, you know, you probably have some issues and we've probably talked about some of them but taking two little responsibility for things? Not so much. I mean...

CLIENT: I'm especially proud that I'm not spending any money on booze anymore, because I can't. (laughter) Not that I really was spending an awful lot of money, you know, on wine but...

THERAPIST: I'm sure you weren't.

CLIENT: I was spending all of about 40 bucks a month but, yes, you know. But yeah, it's like these little things like I don't know. I agree. I [want to go through with it] (ph) but I have to really explain to you why it is that it's really hard for me because it's like I deal with people who make extremely poor choices everyday of their lives, you know, where, you know, like, I have somebody who like and this just happened yesterday again. Somebody who just spent every cent that they had on a brand new iPhone 5 but they also gave it to their child to keep their entertained and now it's broken. They're completely unemployed and they're hoping to get a phone call so they can get a job, so that they can be able and they're telling me all about how they need to have, like, you know. This phone is the only phone that they have, you know. And I'm just like, "Why did you just spend 700 dollars on a telephone then that you didn't have, you know? And then you give it to the child and now that it's broken and now you're mad because the broken phone cut your child too." You know what I mean? It's all becoming, like this really reinforces (ph).

Like Rocko (ph), you know, having to deal with some people putting responsibility on so many people that if not themselves, it really self reinforces not wanting to ever (inaudible at 39:34) help for anything else. Because it just (inaudible at 39:38) it's really hard to deal with. And so you have to sort of, when you see that around there, you sort of reflect inside. I would assume that, you know, if you're around people that are constantly sick you start to wonder, like, OK, is this normal? You know, whatever. You start to see whatever you're around. And so it's like, you know, and that's [part of the] (ph) biggest reason why everyone makes fun of me my phone is four years old, you know. It's like, you know what? I know that if it breaks I can replace every part in it and I can afford to replace the phone well, I can't right now but, in theory, I know how to replace the screen on it. It's an iPhone but I can do everything I can because if I were to (inaudible at 40:20) or something that if it broke I couldn't do anything with it. And, like, I don't know.

It's not even like on some level it is, like, puritan. It is something that I want to make sure that I can responsible for everything I have but part of it's also just not having to worry about it, you know. Like, having something that the maintenance on it could (ph) be more than I can handle.

THERAPIST: Being independent and in control of things helps to manage anxiety.

CLIENT: Yeah, you know. For example, I miss my dog really. I really miss my dog and I'm hoping to get her back soon but, you know, people are like, "Well, maybe you should get a puppy. A puppy would really, like, make you feel better." And I'm like, yeah and, you know, the shear concept of everything that could wrong with a puppy right now would be more than I can handle because I know dogs get in (ph) stuff. It's not that the happiness about being around a puppy wouldn't be great it just happens to be if the dog ends up (inaudible at 41:27), which is not uncommon with puppies, I couldn't afford to go to the vet. You know, that's (inaudible at 41:33) irresponsible. So, I don't know.

THERAPIST: For what it's worth I don't know if this helps or not, but I see plenty of people on the side of what you are describing of being kind of irresponsible or (inaudible at 41:48) what they don't have. And I tell people stuff like that all the time. So, like, in other words, I think you're (inaudible at 41:56) or I think, you know...

CLIENT: So you would be telling me if that's being irresponsible (ph)?

THERAPIST: Yeah.

CLIENT: OK.

THERAPIST: It probably comes across like I'm trying to be nice god forbid. Maybe a little bit. But that's not why I'm saying what I'm saying. I would not consider it nice for me to bullshit you with that (inaudible at 42:16) quite unhelpful too (ph).

CLIENT: OK. I appreciate that.

THERAPIST: For what that's worth.

CLIENT: I'll do it. I just...

THERAPIST: (inaudible at 42:28) it's very hard and it's very uncomfortable. (pause) We're going to stop for now. Are we good for tomorrow?

CLIENT: I believe so.

THERAPIST: [Yeah, sure, that's fine] (ph).

CLIENT: OK. I'll probably see you same time tomorrow.

THERAPIST: OK, sounds good. Take care.

CLIENT: (inaudible at 42:53)

THERAPIST: Bye.

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