TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
CLIENT: I really, really didn’t want to go to work this morning and didn’t want to get out of bed. As soon as I went outside I felt a little better, but I’m not very excited about the week. I went to bed at like 9:30 last night and I was still really tired this morning. I tend to wake up ten minutes before my alarm goes off and lay in bed; ten more minutes – I go back to sleep for that ten minutes because it’s easy for me to do that. This morning I woke up at 4:00 and looked at the alarm and was like, “Please tell me it’s not 6:25.” (laughs) Yes! So that was good. [00:01:00] (long pause)
I read an article at some point over the weekend. Apparently, San Francisco is really into toast right now. This café is selling big slices of toast for like $3 and it’s a big deal. [00:01:58] I thought it was ridiculous. (both laugh) What’s going on here? They had to track down where this was coming from and they sort of went from one café to the other and the café that it turns out had started it was run by this woman who is like 35 and has schizoaffective disorder. She spent most of her life in periods of having an apartment, alternating with periods of not having a place to stay, alternating with periods of living with friends and then friends kicked her out and then she would be homeless – sort of back and forth and back and forth. Eventually, she sort of pulled herself together enough to start the store in which she basically just knows everybody who comes to the store and makes an effort to be really, really recognizable to a whole lot of people so that when she has a psychotic episode, people know who she is and will take care of her. [00:03:15] It was very sweet, actually, and also seemed like yeah, that’s a really good plan. (both laugh) I think at some point within the last five years she actually was diagnosed and put on medication for it, which helped, but she started selling cinnamon toast because it was this comfort food for her. It was good. It was a very sweet article about sometimes crazy food crazes have something real under them. [00:04:00] I had cinnamon toast for breakfast this morning. That’s what made me think about that. (both chuckle) I have that like once a week because I really like it. (pause)
Kim makes fun of me because I regularly propose something as a breakfast food for the kids that she really considers a dessert. (laughs) I’m like, “Well . . .” We sort of blur together. Caleb (sp?) especially is very strict with himself about eating healthily. I feed them really healthy food, but I think it sometimes is a little bit hard for him to take in. He is like, “You eat really unhealthily.” [00:05:04] I’m like, “Yep. Yep. I really, really do.” I weighed myself last night. That was a mistake. I usually don’t do that. It’s not like I’ve gained much weight, it’s more like I just feel bad about myself and there’s not really any point to it. I’m not going to lose weight. I’m not going to try to lose weight. Every time I weigh myself, I feel like I ought to and that way lays sadness.
THERAPIST: Is that something you think about much? You hardly mention it. [00:06:04]
CLIENT: I think about it a whole lot less than I used to. (pause) Yeah. It’s almost like I’m surprised that I got out of high school without an eating disorder, in terms of wanting to have control over my life and also all the body image stuff that comes along with being in high school and being 5’9”. (laughs) Regardless of what weight you are at 5’9”, I was just huge. I don’t know. Yeah. Yeah. (pause) [00:07:00] It used to be something I thought about a lot, even as an adult, but I sort of had weeks where I’d really hate my body and then I’d just forget about it. Part of that, Dr. Hoffsteder (sp?) suggested doing dietary changes as a possibility to control stuff, and I just couldn’t do that. Once I start limiting food, it just turns into a body thing. I tried cutting dairy out of my diet for a week or so and I made it about my body and I just felt really bad about it the whole time. Then I just said that I just can’t go here. [00:08:01] (long pause) So I just walk around it, if that makes sense. It’s funny though, because I look at pictures of myself in high school and I was probably about 20 pounds lighter than I am now, so not a whole lot, but a noticeable amount. [00:08:58] It’s like the way I look in pictures is just so drastically different from the way I thought about myself then. It’s amazing. (laughs) I actually look pretty good, and now I feel like I look pretty good and I’m a lot heavier than I was then. I don’t know. I just remember thinking of myself as this horrible, fat person. (sighs) It’s awful. [00:09:59] One thing that’s really helpful is that as you get older, someone around you settles into a more normal weight anyway. I just stand out less now than I used to.(pause) I was really self-conscious about being tall for a really long time. The whole wanting to be attractive and not wanting to take up space really intersected for me. It wasn’t just that I felt ugly or felt unattractive, I just felt like I couldn’t hide anywhere. [00:11:00] (pause) I’m not really sure how I ended up being so tall. I’m the tallest woman in my family by a lot and I’m taller than my little brother. Yeah, I don’t know where that came from. [00:12:00] I think at least one of my mom’s sisters is almost as tall as I am. (pause) Yeah, I don’t know. (long pause) [00:12:52] It’s weird, because Kim will say stuff to me about the way that she feels about her body and I think she’s significantly heavier than she was before she had kids and she hasn’t been able to lose that weight yet. She has kids and she works full time and it’s a lot harder to lose weight than it is to gain weight; and I don’t know what to say about that. I usually just don’t say anything. It’s important for me not to participate in that whole sort of [self-shading] (ph?) ritual. I just don’t want to be part of it. But even if you don’t participate, she talks about herself and it makes me feel bad about myself. [00:13:58] (pause) I sort of almost but not quite feel comfortable saying, “Can you just not say things like that because it makes me feel bad about myself?” I feel like that would be fine, but she is my boss and it’s sort of weird and sort of a hard thing to ask of somebody anyway. (long pause) [00:15:18]
THERAPIST: So she’ll say something self-critical about how she looks and that will leave you uncertain how to handle her and also it’s a little contagious, like you’ll start thinking critically about yourself?
CLIENT: Yeah. Yeah. I don’t think that she’s seeking reassurance. [00:16:00] At one point I was like, “You look just fine;” and she was like, “No, I don’t.” Not like “please reassure me more,” but like “no, you’re wrong;” (laughs) which is just sort of very Kim.
THERAPIST: Stay in charge.
CLIENT: Yeah. (laughing) I don’t know. She doesn’t want me to contradict her, but it feels like she wants me to listen to her – but that’s one thing that I really don’t feel good about listening to. (pause) [00:16:58] I’m just glad that most of my friends who are women don’t do that because I think I’m pretty lucky in having a circle of friends who are women who have said, “No, that’s not what we want our culture to be.” (pause) I think about Heather Kate and my other friends who have had eating disorders, people who have been in the hospital and have had treatment who have had eating disorders and that shit just doesn’t let you go. That stuff is just awful. (laughs) (pause) [00:18:10]
THERAPIST: Maybe what you share with them is the intensity of the self-hatred that they feel.
CLIENT: Yeah. Yeah.
THERAPIST: Maybe that’s probably why, also, it feels dangerous for you to hear.
CLIENT: It feels like it could very easily become something for me. It could very easily become a way that I try to mediate that self-hatred. It’s there and it does (inaudible at 00:18:47). It’s sort of insidious and pervasive and doesn’t let you go. [00:18:55] (long pause) [00:20:13]
THERAPIST: It makes me wonder about you worrying about you putting me in an uncomfortable position if you’re more vocal or expressive about your own self-hatred.
CLIENT: Hmm.
THERAPIST: Or that you imagine it will feel for me like it does for you, in some ways, that way; kind of like you think it will be the same, but you know it could be uncomfortable and it’s something I could imagine you really wanting to avoid.
CLIENT: Yeah. I guess I don’t really think about it in terms as clear as when I hear other people expressing self-hatred, that sort of triggers my own self-hatred. [00:21:06] I just know that it feels super uncomfortable and bad for me and that I could relate. Yeah.
THERAPIST: It’s as simple as it just makes you hate yourself. I sense also that you kind of immediately imagine their hating themselves in the way that you do, like they’re in front of you getting a kind of horrible beating and you don’t know how to stop it or help them. I would imagine it may make you aware of your own self-hatred, but also a kind of helplessness and sort of horror of what it feels like you’re watching.
CLIENT: Yeah. [00:22:02] It’s like Kim doesn’t really have many problems with lack of self-confidence. She seems to pretty much just seem to think that she can do things and then she does them; and so it’s very weird for me for her to be saying these things. It’s not surprising in that I don’t know any women who don’t, on some level, hate their body – at least I can’t think of any. But it’s just weird. [00:23:00] I think I do sort of picture it as being this awful, awful thing and there’s nothing I can do about it. There are sometimes things that I can do to alleviate it or help in the moment, but there’s nothing I can do to fix it. [00:23:59] I don’t know. I wonder about that in like maybe I feel that way about you, but there is nothing you can do to fix it. I imagine that’s frustrating for you when I know that’s frustrating for me, so I just keep us both out of that. (long pause) [00:25:25]
THERAPIST: I think you have a pretty strong sense in both instances, whether you’re watching somebody else express their hatred towards themselves or imagining me sitting here while you do that. I think you have a pretty strong sense that the other person is feeling the way you would, like when Kim is being very self-critical about her weight or how she looks, that it’s like when you do that about how you look or whatever else and similarly with me.
CLIENT: Maybe it is part of this fear that I just don’t know, like I don’t have much of a way of knowing. [00:27:04] I know how intensely I hate myself and am hard on myself and I know from talking to some of my closest friends – like Ashley and Jerry both really hate themselves. Candace, I don’t think, does, but you can’t tell from just talking to them – or I can’t. It sometimes comes up in conversation. I always sort of imagine it as this worst-case scenario of at least as bad as it is for me. [00:28:02]
THERAPIST: I think this is also a way you feel connected to people – or a sense of camaraderie and I imagine this kind of mostly under-the-rug self-hatred that other people have and that you imagine is like yours, but that they’re not saying too much about either. [00:28:59]
CLIENT: That makes sense. It sounds kind of sick when you say it out loud, but I remember in high school I wanted to think that was transformative for me in being able to feel connected to people was making friends who also struggled with depression, making friends who knew what my life was like.
THERAPIST: In my mind there are two aspects to this, one in which, in a way, there is something shared and, of course, there is a sense of self-camaraderie and people being able to understand. But I think that’s not the only ingredient in there. I also think there is something a bit more about projection and identification. [00:30:05] For one thing, it reminds me a lot of the way your mom is, but it also has that feel. For example, [it may be a little foreign] (ph?) from the way you talk about Angelie, I don’t get the sense that her self-hatred is like yours.
CLIENT: I know. I don’t think so.
THERAPIST: I’m not saying it doesn’t hurt her or make her feel awful about herself, but it just doesn’t sound as virulent or pervasive or [withering] (ph?) for her.
CLIENT: I see that, but I also continue to imagine that it is. [00:30:58] (pause)
THERAPIST: And then with me as well. Maybe it is a way we’re connected. Like I’m sitting here, mostly feeling frustrated and that my hands are tied watching you struggle and take it out on yourself, unable to do much except feel helpless and terrible and uncomfortable and wishing I could do more. It sort of puts us in similar boats. [00:32:02] (long pause)
CLIENT: That’s really interesting. (pause) [00:33:00] I don’t really know what to do with that. (long pause) [00:34:39] [Yeah, I don’t know where to go from there.] (ph?) (pause) [00:35:27] It is sort of in my mind to see that as a failure on my part, which I know is not having (inaudible at 00:35:43) which I know is not really true.
THERAPIST: It’s like you’re making assumptions and being accurate and still doing something wrong.
CLIENT: Pretty much. [00:36:00] (pause) I also think of how painful it is for me when my mom insists that the things that I need are the things that she needs and not the things that I’ve told her that I need. (long pause) [00:38:44]
THERAPIST: These feelings are ones that it’s pretty exciting that you’re starting to think of yourself being like her in this way, and the other is there seems to be some important difference there in that your reaction to me tends to be, how I think when this happens with people, is to either be “Oh, well. I’m upset and confused and that does happen. I just want it to stop.” [00:39:26] Or it’s one of the ways of putting people in that position that you’re in, which is different from what you’re saying she does to you. She’s not, in one way or another, saying, “Gosh, I wish we could change the subject. This is making me uncomfortable.” She’s saying, “Oh, you must be like me so what you need to do is this.” [00:39:57]
CLIENT: (pause) Yeah. (pause)
THERAPIST: She seems to want to control what the other person does in order to manage what things are stirred up for her; whereas you feel like a little more like being held hostage to the other person, in a way. [00:41:00] (pause)
CLIENT: I feel like I’m more likely to try to very intensely control what I did to the other person or what I say to them to try to manage that.
THERAPIST: I see. It’s more like you and your mom kind of agree that what you need to do is manage yourself very carefully. (both laugh)
CLIENT: Yeah. (long pause) [00:43:20] It’s very funny, when he said “Belinda Harris, Jerry, and Ashley’s mom, which is pretty much her entire mode of operation with other people. (both laugh) That’s sort of an interesting thing to think about.
THERAPIST: We should stop. See you tomorrow.
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