TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: So... rough weekend. Today is going a little better. I got sick again. (therapist responds) It’s just like, a cold or like (therapist affirms)... I’m just tired of being sick. I don’t know. So... I’ve been whining about it a lot. (pause) Yeah, James and I talked a lot this weekend, most of which was good. You know, sort of like... hard to get back in the way of talking well, not so much in terms of agreeing, but in terms of like... having the conversation be productive, or feeling like we’re both being heard, and feeling like we’re both getting to talk (therapist affirms), and feeling like... things are going in a way that is, I guess... I don’t know. I... I have a very clear idea of what I want to say, but not so much with being able to articulate it. (pause) Yeah. James spent a fair amount of time yesterday and the day before reading about a religious group that he grew up in. [00:01:45]

THERAPIST: What’s it called?

CLIENT: Religion Together. (therapist responds) He was like, “Yup. Definitely a cult.” He was sort of like... He sort of has been like, telling people that he was raised in a cult, I think as sort of like, both sort of a “F*** you!” to that religious organization, because he’s pretty angry at them, but also... (sighs) definitely (ph) not sort of seriously believing that that’s what it was. (therapist affirms) But he sort of read up on them, and read up about, on like, the practices of cults, how they are defined, and what do they do, and they work. He was like, “Oh, yeah! Yeah, that was my childhood.” So that’s led to some interesting conversations. [00:02:37]

Yeah. (pause) You know, we talked some about... I think for him it was helpful to... to realize that like, oh, well in a lot of ways, your experience in scholarsh , in the world of scholarship was like, remarkably similar and in many ways like... so... I think that was sort of helpful for him to see that parallel. It was nice for me, for him to see that parallel as something I already sort of pondered, and I’m like, “Yup, that makes sense.” [00:03:41]

THERAPIST: How do you mean, like the cult-ishness of academia?

CLIENT: Yeah, yeah. Or at least... you know, definitely biblical scholarship, but I feel like the humanities more generally. I don’t know enough about the sciences. You know, I think it’s different in different places, but... (therapist affirms) But like, the pyramidal power structure, where you sort of are promised that you’ll be able to move up, but you’re not actually going to be able to move up, and the sort of... “you’re in or you’re out,” “us versus them” mentality of like, if you leave, it’s not just that you’re leaving, it’s like, your whole identity is gone, and that you’re seen as betraying your community by leaving.

THERAPIST: I see.

CLIENT: So... (pause) You know, I’m not sure the parallel is as strong as... he’s sort of making it right now. But, I think it’s really there. (therapist affirms) (pause) Yeah, so there is a lot of me... being like, “Well, this is a time for us to have these conversations, and I really want to be having these conversations and so like, I am just going to pull it together in order to have them.” [00:05:14]

And... (pause) about which I have mixed feelings. (chuckles) (therapist affirms) Like... you know, I think... honestly, like... I think James would have been hurt if I had said, “I’m sorry, I don’t feel like, I feel I’m too sad to talk about these things. Like, I can’t connect with you today. I just, I’m too sad.” You know, I think it would have been really hard, hurtful for him.

THERAPIST: I see.

CLIENT: And so I’m glad that I didn’t say that.

THERAPIST: Right.

CLIENT: But it also sort of felt like... in some ways like... I was doing the thing that was not the best for me in order to take care of us (therapist affirms), to take care of him. I don’t really feel that good about that. [00:06:13]

(pause) But on the other hand, I’m a lot less sort of exhausted and being down today than I was expecting, so... (pause) Yup. I made bread. And... which is something that I like, I like to do, because I really like homemade bread, but I have to sort of trick myself into it, because I always think of it as this like, big enterprise that’s going to be hard. (whispers) It’s really not hard; it takes like, ten minutes, if that. But, so like...

There are a lot of days where I’m like, “I should make some bread. Like, I should cook something,” and then I just don’t do it. Like, I just don’t... have the energy. (pause) yeah. Cooking this weekend has been like pulling teeth. I have... (chuckles) Like, yesterday... we got up and it like, quickly became apparent that like, we were going to have to cook breakfast like, that was, because we just didn’t feel like we didn’t have anything that we could just snack on. And I was like, “Okay. I have to do this, like I just have to do it.” Like, I could have asked James to, but I didn’t want to, and so I made pancakes. Took about an hour. (chuckles) Mostly because it took a long time with me like... It’s like, “Okay! (chuckles) Let’s do this!” So, I don’t know... [00:08:03]

THERAPIST: I guess some of the other things that you’ve been saying about, I’m wondering if... like in that case, it wasn’t between you and James or between you and part of you. Like, “I really don’t feel like making pancakes (chuckles) right now.” (client affirms) Like, not feeling that’s where you’re at, to do something to take care of yourself. (client affirms) And constructive. (client affirms) And... (pause) kind of forcing yourself to do it.

CLIENT: Yeah. I feel like it’s hard to predict, for me... You know like, one of the sort of standard things that people tell you is like, “Do the things that make you feel better or are good for you.” Like, practice self-care, even when you don’t feel like it, you know. Like, go for a walk, and eat good food, and get enough sleep, and like, take care of yourself in those ways. But you know like, sometimes doing that is actually helpful, and sometimes it really backfires, because I just feel like I’m... becoming my own tyrant. (therapist affirms) So... I’m sort of right on the edge (ph) today. (chuckles) (therapist affirms)

(pause 00:09:28 to 00:10:05)

Similarly like, going to church last night, and going to dinner with some friends afterward, it’s like... really just sort of right on the edge between like, “Oh, it’s nice to see friends and like, have social interaction.” Like, that’s a good thing for me. And then like, (whispers) I’m really tired and I don’t want to do this. (therapist affirms)

(pause 00:10:26 to 00:10:48)

Yeah, I feel pretty low. (therapist affirms) I’m sleeping a lot in bed. I’m just like... still tired.

THERAPIST: Yeah, and it’s part of...

CLIENT: ... just feel sad. (therapist responds) Sorry.

THERAPIST: (pause) Well... it seems to be something that’s, it sounds like what you’re describing is that... like, some of the stakes or the intensities actually feel... in a way like, higher than from what you’re saying would suggest. You know like... just about (ph) anybody can say, “Well, I was sort of torn between seeing people and going out and doing stuff last night and not. You know, and just taking it easy.” But I guess, the fairly pedestrian sort of conflict in a way, but I think... you know, you’re not like a tyrant, tyranny. And... in some way, it seems the stakes are actually quite a bit higher (client affirms), that it’s not so much like, “Oh, would you be happier if you do this or do that, or you know if you like, push yourself a little to do this.” It’s more like... (pause) “Hey, there would be pretty like, crushing and self-abnegating to... push yourself to do something or like potentially... disastrous... to... let yourself be.” I mean like, what you sort of started out talking about, the conversation with James. (client affirms) I guess there it was obvious, in a way, that the stakes were very high. [00:12:58]

CLIENT: Yeah, yeah. I mean... right now at least like, sort of like... whenever like, James or I reach out to one another like, those are very high stakes. (therapist affirms) I can’t just say like, you know, “Not today.” (chuckles) I then like, when it’s like... yeah... (pause) you know (sighs), I’m sort of slowly and painfully coming to realize that like, when I don’t eat like, that’s really bad for my mood and like (therapist affirms), potentially like, disastrously bad for my mood. (therapist affirms) Yeah, I felt sort of very... (pause) I guess like... pretty vulnerable with those choices (therapist affirms) that like... either one could work out really badly for me. [00:14:04]

THERAPIST: Right. (pause) This reminds me a little bit of what we were talking about, too, on Friday, about your feeling... I guess both suicidal and also like you want to cut yourself. I imagine... you might feel a similar dilemma kind of getting into that sense (ph) we were talking about, edge (ph).

CLIENT: Yeah. No, I thought about dying a lot this weekend. (therapist affirms) At the same time, so it’s sort of like, others have it like, when there is like... I felt like in some situations, I would sort of make the decision to like, do the thing that was hard, that took care of myself. In some situations, I would make the decision to like, just let it go and rest. And it just sort of was bad either way. Like, I’m not sure that there was a right decision there. (chuckles) I’m not sure there was actually a lot riding on the decisions (therapist affirms), so much as like, things suck. (chuckles) So... I’m not sure whether that makes me feel better or worse. (pause) I think better. [00:15:28]

THERAPIST: (pause) Yeah, actually... trying to think of it, um... I bet... like... I’m (ph) really going to turn things on their head a little bit like... Oftentimes, you feel really sort of stressed and desperate are times where you’re in just that sort of dilemma, where it’s impossible, because neither choice seems tenable. (client affirms) And you’re totally stuck. But I bet most of the time, it’s like what you say. Neither option is all that good. I mean, more accurately, they’re both pretty, they are awful things about both. (client affirms) [00:16:42]

(pause) And maybe that idea that you, you know, it’s really important to pick the right one is mostly about having the idea that you can get out of how awful either one is (client affirms), which I think can be really hard to swallow, less so now, clearly. (client affirms) I mean like, with James, for example... that things are shaky enough, that if it’s possible you really connect, you really have to... do what you can to like, take that opportunity. I guess the really tough thing there is... how shaky things are (client affirms)... and how hard it’s been to connect in the ways that matter. (client affirms) Or on the other side... how awful you’re feeling and... yeah, I mean, just how... difficult and dangerous it is to... have that in a relationship. (client affirms)

(pause 00:18:29 to 00:19:03)

CLIENT: Yeah, I guess the... here is something like talking with James. I mean, I think there is definitely like, a right choice there. (therapist affirms) Something like, “How do I take care of myself like...” Maybe there is a right choice, but there are not really a choice that makes me feel better like, those are... or that will necessarily make me feel better like... (therapist affirms) I don’t know.

THERAPIST: Well, that makes sense, but like, just because it’s a tough choice doesn’t mean one is not actually better than the other. (client affirms) You’ve been pretty clearly towards you... did do the right thing, as far as talking to James.

CLIENT: Yeah, I think so. Yeah.

(pause 00:19:50 to 00:21:07)

So on the way to couples’ counselling this morning (or on the way back, actually), we passed a bakery that had some little like, cutesy advertisement in the window. It was like an apron or something that had on it like, “The voices say to have cupcakes for breakfast,” or something. James (ph) was like, “That is in spectacularly bad taste!” I’m like, “Oh, gosh! Wow!” (whispers) Because he knew. Psychosis is fun for everybody! Um... So I sort of... pointed it out to James and that got us into a conversation of like, what exactly like, a psychotic episode is like, what is it. So I was like, “This is how I understand it,” and we talked about it. [00:21:58]

(pause) He was like, “Do you have psychotic episodes? I was like, “As far as I know, no. Like, nobody seems to say that that’s something that happens for me.” (therapist affirms) (pause) I’m not really sure why I’m thinking about that. (pause) I think it’s just like... it’s just difficult to explain what things are like for me to James. And I’m sort of moving away from trying to... get him to understand it exactly in the way that I understand it (therapist affirms), because I don’t find that A) that actually (inaudible) happened and B) that that’s super helpful. I think, “Maybe James just doesn’t need to know how much I (chuckles) think about killing myself.”

(pause 00:22:59 to 00:23:18)

I did talk to him about... saying well, you know, what does happen for me is that like, when I feel suicidal, I get (sighs)... like, my reasoning gets just messed up and I can’t see any of the things that are good. All I see is the things that say that I should kill myself, and that’s all I can really be aware of. So the key for me is to like, remember that I can’t remember these things, but... I’m like... that’s hard. (therapist affirms) And it doesn’t feel as real as... the situation is just really bad. (pause) You know like, I think he got that, but I don’t know.

(pause 00:24:10 to 00:24:40)

It’s sort of a lonely, scary place. (therapist affirms)

(pause 00:24:43 to 00:25:05)

(whispers) God, being sick is the worst! (pause) And I’m just like really grumpy about it. (chuckles) Like, aside from being, you know, very low, and suicidal, and wanting to self-injure, and all of that stuff. I’m just like, (inaudible) sick! (therapist affirms) Son of a b****! (chuckles) So...

(pause 00:25:30 to 00:25:58)

THERAPIST: I mean, it’s like... when you’re feeling... suicidal, the rest of the world... like, everybody else feels, in a way, like a part of a... totalitarian regime in that... we all seem to think it’s worth living, or we seem to find good things. (client responds) And you’re so sure it’s not, and there aren’t, or at least a part of you is... which, I guess, is kind of a dominant force, you know, the lead vocal. (client affirms) And also, clearly, very separate from other people, I think. (client affirms) [00:26:53]

CLIENT: (pause) Yeah, I think one of the hardest things is though like, it’s... it feels like... it sort of feels like, if James loved me, he would just not make me keep living. (therapist affirms) You know like, all of the things that people do, to take care of me, you feel like the opposite.

THERAPIST: I see. Really. All of us, and especially James, should just be letting you go.

(pause 00:27:47 to 00:28:18)

Yeah, it makes me think of like... one of those patients with a terminal, I don’t know, cancer or something, who are... you know, terrible quality of life, but, you know, there is all this life support and all this... sort of effort of whatever kind to... I mean, it’s not almost like this but, you know, keep him alive for those two months or something. (client affirms) Painful procedures and, you know, whatever medication, and...

CLIENT: Yeah, maybe that’s how both of my dad’s parents died.

THERAPIST: Oh.

CLIENT: You know, just... a lot of family who really didn’t, weren’t ready for them to die and (therapist affirms)... yeah. You know, I heard my dad got pretty upset about it like (therapist affirms), and so of course, then he was like fighting with his siblings over it. (therapist affirms) (pause) Yeah, that’s sort of what it feels like. (therapist affirms)

(pause 00:29:18 to 00:29:48)

THERAPIST: Well, in some ways, it’s probably worse for you, actually, because... you know, with them... it’s probably pretty clear that like, at least everybody could somewhat see the other side, or that there was another side. You know what I mean? Like (client affirms)... even if his siblings weren’t ready to let them go, they could at least appreciate that it wasn’t crazy to think (client chuckles) “Okay, you know, let’s stop and think about this.” (client affirms) Whereas...

CLIENT: And for me like... I have to... like, it seems very important to maintain the understanding that like, “No it is actually crazy to be thinking this way.” (therapist affirms) Like... both in terms of what other people think like, and I have to believe that, or I have to tell myself that. (therapist responds) (pause) Because you know, if I stopped, (whispers) then I might just kill myself.

(pause 00:30:51 to 00:31:26)

THERAPIST: I see; so that really is pretty impossible like... um... (pause) like... (pause) like that part of you that wants to kill yourself pretty much just has that one demand. (pause) And I guess maybe like... (inaudible) are arguments for it. And the words like, “You’ve got to think of all of that as crazy.” (client affirms) (pause) Or... it’s in charge. [00:32:38]

CLIENT: Yeah. Yeah. (pause) A lot of the time, the things are like, worst sort of later at night... (therapist affirms) And so like, one of the things that I do is I will just say like, “Well, why don’t you just go to sleep instead. Just go to sleep. We’ll just... do that...,” which works pretty well. When I can’t go to sleep, then it gets really bad. (chuckles) (therapist affirms) But it sort of feels like... yeah, it feels like... trying to compromise with this like... very insistent and uncompromising desire. [00:33:57]

THERAPIST: (pause) Like the way an addict would want something?

CLIENT: How do you mean?

THERAPIST: Well, I guess I’d think of somebody who, you know, wants a drink or... cigarette... or wants whatever else and... um... It doesn’t feel like it’s about anything else. You know, it’s not about... (client affirms) “Oh, I’m just feeling so awful and I need to drink, you know, to make it go away.” I mean, I guess it could be that, but it’s more like, “I just want, I just need a drink it right now.”

CLIENT: Uh-huh. Yeah. Well, and the thing that makes me think of is like... so, you know, people will like, drink soda or chew gum or like, all these things are not in any way the thing that they actually (therapist affirms) want, but it’s like, “Well, I’ll take it.” (therapist affirms) Yeah. [00:35:09]

THERAPIST: (pause) But it’s different from... (pause) I mean, I guess I have heard like, I could talk about a different lead on it (ph). They might say, somebody might say, you know, “Oh, my God! I just need a drink or a smoke or whatever.” Somebody else might say, “Well, my head just feels so bad,” or “I had to get something done and I knew I just was not going to be able to do it unless...” (client affirms) or “I was just feeling so awful and whatever, I mean, the only thing that will make me feel any better” (client affirms). Just a little like, just sort of a step removed from... (pause) you know... “All I can think about or all I want... is to have a drink.” (client affirms) You know what I mean? [00:36:26]

CLIENT: Yeah, I do.

THERAPIST: And it sounds like that’s more what it’s like for you.

CLIENT: I don’t know. (pause) Because I mean, the reason that like, I do go to sleep, the reason that I can is like, you know, I need whatever is going on in my brain to stop. (pause) And so... yeah. I don’t really know.

(pause 00: 37:04 to 00:37:25)

(inaudible) of them like... sometimes I have bad dreams or like, dreams that sort of, even if they’re not like nightmares, they’re sort of like, continue the same cycles, if you know what I mean? (therapist affirms) Um... You know, and I have to get up the next day. (chuckles) (therapist affirms)

(pause 00:37:44 to 00:38:50)

In some ways it probably is good to like, our apartment is so small, you know, that... (therapist responds) somebody is always there... you know. It’s both like intolerable and it keeps me from dwelling on it, somehow or another. (therapist affirms)

(pause 00:39:09 to 00:40:25)

Because it’s really, you don’t want to do this.

(pause 00:40:27 to 00:41:39)

THERAPIST: Yeah, I don’t think you feel like... anybody... I think (inaudible) shown that not just sympathy or understanding about...

CLIENT: (pause) I think that I don’t... I sort of don’t want to hear any sympathy or understanding or like (therapist responds)... it... you know. If I listen to that, then I, you know, I would just do it. Like, I feel like... I feel like the way to sort of keep myself safe is to just be hard on myself about it.

THERAPIST: (pause) (inaudible)

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