TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: Good morning.
CLIENT: Good morning. Today is my birthday.
THERAPIST: Oh, happy birthday!
CLIENT: Thanks. Yeah, I'm not sure I much want to think about that. Let's see. I don't need to go into work for a couple of hours. So I might go home and make pancakes with James. (Pause)
THERAPIST: Sorry I got you out of bed early on your birthday. I didn't know.
CLIENT: It's really okay. I got up at the same time I would have anyway. I just spent less time staring into space before I came over here. [0:01:00] Staring into space time is very important. (inaudible at 0:01:08). (Pause) Yeah, I don't know what to talk about today. I usually say that in hopes that it will prompt me to talk about something. But sometimes that works, sometimes it doesn't. (Pause) I really need a bag that's not from (inaudible at 0:01:56) conference. [0:02:01] I just need to get a new tote bag. I got rid of the other one (inaudible 0:02:08) I didn't want that (chuckling). (Pause) It hasn't been my first (inaudible at 0:02:32). (Pause) [0:03:00] Having four days off every week, I sort of thought I would get things done. But that was very foolish of me. I still kind of struggle to run errands I need to run and do things I need to do. [0:04:04] I still haven't gotten my haircut, for example. For three weeks I've been like, I'll go get my hair cut this weekend. Anyway, I think this weekend I did everything I really had to do, most of which was fill my prescription. But I let a couple of days go by. I had a couple days' gap between running out and filling it. So I probably should care. I really don't care (chuckling).
THERAPIST: (Chuckling) (Pause)
CLIENT: I think James cares. [0:05:00] But I don't know.
THERAPIST: James cares?
CLIENT: As in, I think James got irritated with me when I was like, I have... I let it lapse and missed a couple of days. (inaudible at 0:05:17).
THERAPIST: What is it?
CLIENT: Oh, it's just Synthroid. So it's not a big deal in that my overall thyroid levels will go down. But I think it takes a while to get out of your body.
THERAPIST: I see. (Pause)
CLIENT: I feel like James spends a lot of time having to take care of me in fairly basic ways and now can't get out of the habit. [0:06:09] And that's starting to bug me (ph) a lot. (Pause) And I don't think he's very happy about that either. I don't think he wants to feel like he has to take care of me, but I think he does feel like that. (Pause) [0:07:00] I just don't want to be complaining about it all the time. I just don't like that. But I'm really feeling like I complaining about it all the time (inaudible at 0:07:34). It's funny. I really just block it out, but it drives James nuts. I think the ambient noise is one of the things about living here. And I didn't notice that until I realized that I couldn't quite hear what I was saying (chuckling). [0:07:56]
THERAPIST: Uh-huh (chuckling). (Pause)
CLIENT: Yeah. I got an e-mail back from Kirsten, my former roommate Kirsten. Did I tell you that?
THERAPIST: I don't think so.
CLIENT: Okay. Well, I e-mailed her, and she (crosstalk).
THERAPIST: (Crosstalk)
CLIENT: Then she wrote back and was like, yeah, that's great. Maybe some time in July. She's studying for comps right now. [0:09:02]
THERAPIST: So you (crosstalk).
CLIENT: Oh yeah, I think I did. So, anyway... (Pause) It's harder to say, I need to find a community in this city, where I'm living, when I don't know how long I'll be here. So there's a class at church that I'd like to sign up for. But I haven't because it's a three year commitment. So even if we were going to be here for a year or two, if I knew we were going to be here for a postdoc, then I would probably sign up and say, nobody knows what's happening in three years, so whatever.
THERAPIST: Right. [0:10:02]
CLIENT: But... (Pause) Yeah, I mean, I'm so terrified by the idea of having to find another psychologist. It's like I... (Pause) [0:11:01] When I sit down and think about it, I say, oh, of course. It would be bad, but it wouldn't be the end of the world. I would survive this, that would be fine. But I'm just scared.
THERAPIST: Uh-huh. (Pause) [0:12:00]
CLIENT: We...
THERAPIST: Yeah.
CLIENT: Apparently we went to the mountains last year or maybe the year before?
THERAPIST: Yeah. I think it was last year.
CLIENT: Okay. Yeah, it's gone. Completely gone. I forgot that we took the trip. And then I remember now taking the trip. But I look back at all the pictures that I took, and I don't remember anything.
THERAPIST: Uh-huh.
CLIENT: It's a little strange seeing yourself in pictures and not remembering the context of the pictures (laughing).
THERAPIST: Sure, yeah. (Pause) [0:13:00]
CLIENT: One other thing that's really hard for me right now... and I'm not sure how much of it is the ECT and how much of it is just the forgetting that happens when you don't do something for a while, but feeling like I've lost most of my biblical studies background. [0:13:59] I don't remember the things that I did in grad school. I remember William & Mary pretty well, but I don't remember what I learned.
THERAPIST: You sound (pause) to me (pause) angry or kind of bitter about all these things that have been taken away, I think, or could be?
CLIENT: Hmm.
THERAPIST: But I imagine if that's true that's not a very comfortable thing to begin with (chuckling). [0:14:59]
CLIENT: I don't know.
THERAPIST: You worry... I mean, I guess even starting with what you said about James, I think what he's taking away in looking after you is your sort of... part of the way you cope with feeling bad, which is to not notice things you could do to take care of yourself.
CLIENT: Hmm.
THERAPIST: And you tune it out, like the noise. And he waves his arms about it or points it out. And...
CLIENT: I hadn't thought about that.
THERAPIST: And I think it can... and that's what's... maybe he's kind of interfering with the way you're trying to deal. [0:15:59]
CLIENT: Hmm.
THERAPIST: Yeah, and I think tuning out the noise is maybe... fits pretty well as a kind of... sense of that or metaphor for that. And [it's interesting that way] (ph). And he wants to move, and there's worry over that. And then there's memory, things that you invested in and that meant something to you, like a trip or all those years you spent studying stuff. (Pause) [0:16:57]
CLIENT: Yeah.
THERAPIST: I think it's people taking things away.
CLIENT: Hmm. (Pause) It's really hard to bear in mind that [if I'm forgetting] (ph) things it's probably not my fault.
THERAPIST: Uh-huh. (Pause)
CLIENT: Whether it's... (Pause) [0:17:57] Whether it's just you shouldn't forget things (inaudible at 0:18:01), or you should... thinking I shouldn't have left my program, or I shouldn't have taken so much time away from thinking about the stuff that I left (ph). I don't know. I wasn't feeling angry. I wasn't aware of feeling angry. (Crosstalk)
THERAPIST: Yeah. (Crosstalk)
CLIENT: Maybe (chuckling). (Pause) Just feeling sad and kind of trying to cast around for why that might be. (inaudible at 0:18:56). [0:18:59]
THERAPIST: [What I said was] (ph) (pause), I picture it either way, because to me what you did was to say, well, I feel like it's my fault, with the remembering. It's not that somebody took it away. It's that I feel like I've screwed up because I feel like I should be able to remember that stuff. And one way or another it's my own damn fault I can't. (Pause) And... (Pause) [0:19:59] I'm not sure. On the one hand I think we could open (ph) and that could be a way you'd respond to feeling angry at something or someone else. It could be other things, too. You know what I mean?
CLIENT: Yeah. Yeah. (Pause) I hadn't considered that... what you said, that I cope with feeling bad by ignoring or letting go of things that I could do to take care of myself. I hadn't thought about it that way. [0:20:56] (Pause) Hmm. (Pause) It feels more like... it feels like there's a struggle between saying, if I don't take care of myself perfectly, then if I feel bad it's my own fault, and... represented in my head by James at this point, which is not good. [0:21:57] And that's impossible (laughing).
THERAPIST: (Chuckling) (Pause)
CLIENT: Yeah. (Pause) [0:23:00] I'm not sure what the difference is between losing things and having things be taken from you. (Pause) Right now I'm focusing a lot more... I'm framing it as losing things.
THERAPIST: Mm-hmm. (Pause)
CLIENT: [I guess my thinking is] (ph), that, if things are taken away from me, then I have to get upset. I can't have that. I don't know. I feel like I'm not (inaudible at 0:23:54). [0:23:58] (Pause) Yeah, things aren't clear in my head, anyway. I don't know what I'm saying. (Pause) [0:24:56] It feels like I worked very hard for a few months to find a job and find some stability. And now I sort of have that stability, whatever it is. I can kind of look around, and I say, oh, this isn't actually very good (chuckling). I don't actually want to be here like this. (Pause) And I can't tell how much of that is things in my life that I would like to change and that can change, like having friends who live in Providence. That would be nice...
THERAPIST: Mm-hmm.
CLIENT: And how much of it is just me not being happy. [0:26:02]
THERAPIST: As somewhat independent of circumstances like (inaudible at 0:26:08)?
CLIENT: Yeah. (Pause) If it's the circumstances, then I can just (exhaling)... it makes it easier to deal with.
THERAPIST: Sure.
CLIENT: Even if I don't actually fix the circumstances, I can say, well, if you could do... if you did do these things, then that would fix it. [0:27:06] [I don't know] (ph).
THERAPIST: You mean it's on you again?
CLIENT: (Chuckling) Pretty much. (Pause) But I feel like it's on me either way.
THERAPIST: Yeah. (Pause)
CLIENT: I just don't know how to change it. (Pause) [0:28:00] Yeah. [0:28:57] I don't know. I'm feeling unhappy and really scared about something, and I'm not... or it's not entirely clear what it is. (Pause) And then I wonder, well, how much do I just look for things to be unhappy about, because that's how I feel more comfortable? I don't know that either. (Pause) [0:30:00] [0:31:00] (inaudible at 0:31:46). I'm supposed to send that to Monica (sp?). I finally did send it to her yesterday. [0:31:57] But it took me a couple weeks, I think (chuckling). I mean, it took her a couple of weeks to send it to me, so whatever.
THERAPIST: Sure.
CLIENT: I think because I was asking her to change a couple of things, and so I was having a hard time writing her and e-mail. And James was like, did you just not remember it, or do you not want to do it? Well, I didn't want to do it, so I didn't remember it (chuckling). (Pause)
THERAPIST: Well, I'm not sure about this, but I wonder if (pause) part of what you're so scared of is losing touch with yourself somewhat. [0:33:22] I think that may be the big thing that you're sort of worried about losing or having taken away. I think, as awful as things were a few months ago, you felt often pretty much in contact with yourself, how you felt, what was actually going on with you...
CLIENT: Yeah.
THERAPIST: Where you were really at in a way that I think you rarely have in your life. [0:33:57]
CLIENT: Hmm.
THERAPIST: And I think you may be sort of anxious in this new regime, the way things are now, with that being different and particularly if you moved. (Pause) And at the same time (pause) you're working pretty hard in many of the usual ways not to know or not to be in touch...
CLIENT: Yeah.
THERAPIST: With things you feel. Go ahead.
CLIENT: Oh, just... and it's very strange to... it's like whenever I sit down and I'm not doing anything else or I'm just talking to you or at church or thinking about myself, I just get really sad. [0:35:12] And it's very scary because (pause), how sad will I get?
THERAPIST: Uh-huh.
CLIENT: (Teary) How bad will it get? But you're right. So it makes me feel like the rest of the time I'm not (pause) paying attention. [0:35:58] Or I'm not in touch with myself.
THERAPIST: Mm-hmm.
CLIENT: Then it's, how in touch with myself can I really afford to be? (Pause) Yeah, I think so. (Pause) When I really know what's going on, will I just kill myself (teary, chuckling)?
THERAPIST: Mm-hmm. (Pause) [0:37:00]
CLIENT: Well, then I wonder (pause) if that kind of feeling in touch with myself is... I wonder how real that is, because most of the time I don't feel good about it (chuckling). It's not... I don't remember very many times (pause) feeling really present with myself and having that be, I am so happy. [0:38:04]
THERAPIST: Sure. That's usually...
CLIENT: Falling in love with James basically, stuff like that.
THERAPIST: Yeah. More recently it's generally been pretty horrendous.
CLIENT: Yeah. (Pause) And it's like (pause), do I draw out the horrendousness in order to...? Or do I encourage that in order to feel in touch with myself? [0:38:58] (Pause) And maybe to feel like it's okay to be... I want to say, close to myself, but I don't know if that's right, because (pause) I feel less guilty about it when I feel like I can't help it. [0:40:08]
THERAPIST: Mm-hmm.
CLIENT: I mean, I feel like things are bad, and I can't help it. (Pause) It's pretty grim.
THERAPIST: I'm trying to figure out what you mean. When you are closer with yourself, you feel less guilty about things you can't do because it's kind of clear that you just can't do them or sort of... [0:40:53]
CLIENT: No, it's more like, I feel less guilty about paying attention to myself as opposed to paying attention to how I am feeling as opposed to just doing what I need to do when it's clear to me that I'm feeling overwhelmingly bad...
THERAPIST: Uh-huh.
CLIENT: When I can't manage myself. Does that make sense?
THERAPIST: Yeah. I'm not sure if this is exactly what you are referring to. It reminds me a bit of when you go into the hospital, and it's at the point where, okay, somebody else is going to take care of me. And I've given up.
CLIENT: Yeah. [0:41:56]
THERAPIST: And there was relief in that, probably partly from the guilt, at least for the time... sort of for the time being at that time.
CLIENT: Yeah. (Pause) [0:42:53]
THERAPIST: Yeah, in a way I guess your sort of fear about being sort of more [in time] (ph) with what's been going on with you in a way is sort of fear that you really won't be able to contain it, that you'll either kill yourself or, because of how sort of painful and horrific it is, how sad, or how guilty you feel about it, that either those feelings themselves or feelings that occur in reaction to them will be so strong that you'll kill yourself.
CLIENT: Yeah. [0:43:58] Unless I also want that to happen. (Pause)
THERAPIST: And you get... [I think there are certainly some points] (ph) where you're worried that the other people around, mostly James and me, won't be able to or won't want to help you with it or help you while you're with it.
CLIENT: Hmm. [0:44:58]
THERAPIST: It'd be too much trouble for me. James would be really angry with that whole thing. I mean, these are the things you worry.
CLIENT: Yeah. (Pause)
THERAPIST: We should stop. [Bye, Tanya] (ph).
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