TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: (inaudible at 00:00:05)

CLIENT: You too. I’m feeling a little better today.

THERAPIST: Good. I think I was a little slow getting back to you on Friday as well.

CLIENT: No, that’s okay. Actually, yeah, no, I was sort of doing pretty badly and like quite badly, and I was like, “You know, I should just call Chad,” like I should just do that, and then we ended up watching some TV and then that like really helped. The thing that’s been like probably the most weird and confusing for me and not weak or through it felt like [00:01:08]

I feel like I’m sort of splitting very efficiently into two completely different people. So, you know, I haven’t really told anybody at church that I’m having a hard time, and I am positive that nobody has any idea because like, you know, I went to this conference on Saturday and like it was great. And I was great and I talked to people and sort of pretended to be extroverted and that was wonderful. And then I came home and it was just immediately awful. Or immediately is probably an exaggeration. But like within a couple hours it was pretty awful. [00:01:57]

I don’t know whether that’s like a reaction to that, or it sort of feels like, it feels like there’s this big chunk of me right now that’s sort of incoherent and out of control and just really unhappy and sort of raging. And I’m trying to sort of mediate between that and other people and like things are hard for me. But I say “Things are hard for me,” in this sort of tone, and so it’s like that mediation is our doom because, does that make sense? But like by the fact that I’m able to sort of talk about it in this calm tone, I feel like it’s hard to me to—

THERAPIST: Represent that part at all, really. [00:03:03]

CLIENT: Yeah.

THERAPIST: Yeah, what seems more like descriptive or expressive of that other side is like how much suicidal thinking you’re having and the cutting. [00:04:13]

And, you know, I sometimes fear, and I’m sure say, “Oh my God,” when you’re really feeling intensely because you’re (inaudible at [00:04:27]). It does seem like the more direct expression of that.

CLIENT: Yeah, it seems like I called you last night and I like I’m scared, and I felt like it might have come across that I was scared in a general sense, but I was like scared about last night, like about what are the next two hours going to be like for me, like am I going to make it through three hours? [00:05:17]

And I don’t, yeah, I don’t really know at this point if, I don’t know how to communicate that, like. [00:05:57]

Yeah, it’s just like, you know, talking with you last week and last night and also sort of talking with Dr. Jannis (sp) today, so like I can, like both of you sort of suggested some, like interpretive models for what’s going on here and why, like I’m so suicidal right now. And they make sense, and I sort of believe them. But it also feels like it’s not, it doesn’t feel like it addresses the things that, the really scary part. [00:07:03]

Like yeah.

THERAPIST: Yeah. But that certainly is how it seems to me as well. [00:07:57]

Like when you said last night that you felt like you’ve got the tiger by the tail, it’s pretty clear who’s talking.

CLIENT: Yeah.

THERAPIST: So no, I, that makes sense to me. Yeah, I’m not yet clear how to understand. [00:09:03]

Like how the other part communicates. I mean, (inaudible at [00:09:20]). I mean, there are, yeah, I’m not sure. [00:09:56]

CLIENT: James seems relatively unfreaked by this. That’s good.

THERAPIST: Good.

CLIENT: I mean, he’s scared, but I think my sort of, my worry is that I’ll recapitulate all this sort of traumatic parts of the last couple of years for him in this. [00:11:21]

That doesn’t really seem to be happening.

THERAPIST: What was Curtis’ (sp) idea that was going on?

CLIENT: He seemed to sort of think that it was a largely coming from like being, feeling more secure and more hopeful about the future, done like as things start to stabilize and get better that I’m reacting against that.

THERAPIST: Is that different from?

CLIENT: Yeah, yeah. Pretty much. Well I sort of suggested, I suggested that it’s one of a couple things that might be going on, and he’s like, “Yeah.” [00:12:02]

I mean, not really, but like he was pretty, he seemed pretty certain. Yeah.

THERAPIST: It’s really not that remarkable that we would agree (inaudible at [00:12:27]).

CLIENT: Yeah. (long pause) [00:13:00]

Yeah, today has been. Talking this morning was frustrating for me, but I felt like I, it was really important for me to talk about like, I sort of, I talk to you about like the suicidality. I want to talk about like how that’s affecting me and James, like I want to talk about how I take care of him in this, and I felt like we didn’t really get to talk about that much. [00:14:06]

And so it was frustrating, but I’m not very good at sort of, I’m not very good yet with him at like staying in the moment, like I don’t think this is working right now, can we talk about something, you know, can we like—

THERAPIST: Table it for now.

CLIENT: Yeah. And then I feel sort of like, I don’t feel very good about like then after the fact, telling you that, because that’s not really addressing the problem, but I do feel like that it helps me like go back the next week and say, “I do want to do this.”

THERAPIST: Right, right.

CLIENT: That’s just [00:15:02]

I’ve been sleeping a lot. I just get really tired. I feel like the last several days have mostly consisted of me like deciding once every five to ten minutes, the entire time I’m awake that no, I’m not going to kill myself today, and it’s tiring, as it turned out. [00:16:02]

I don’t know what to say. I’m not feeling it right now, so I don’t, I can’t, but I also think this is the thing that is going on for me, and so I don’t.

THERAPIST: I think, what you can get into I think, because you’re talking today, is the difficulty of like communicating these sorts of things. [00:17:14]

I mean, striking away when you say that last night you didn’t know how to make clear that when you said you were afraid, you were afraid of making it through those few hours, it was two hours, I think you said. And I guess in my mind that you were, or that you were afraid you weren’t going to be able to kill yourself and carrying out a plan to kill yourself. [00:18:02]

And I just imagine that like you’re very worried about saying that explicitly.

CLIENT: Yeah. I seem to be, because I don’t say it.

THERAPIST: And your feeling is, I don’t know, what you said earlier today was, you know, you don’t know how to say it, but feeling it and not knowing how to say it. But what it looks more like, from a little on the outside, is that you don’t want to, you know. [00:19:07]

Or you’re frightened to say it. Maybe there is another reason that you don’t want to say that you’re frightened, I’m not sure. [00:20:04]

CLIENT: I don’t know. I feel like in some ways. This is maybe something sort of related, but think, in terms of not telling friends and family that I’m having a hard time. I feel like it’s, I feel better about being isolated if I’m sort of isolating myself than if I’m telling people about it and then I’m still isolated.

THERAPIST: Yeah.

CLIENT: Like the thing I am, the thing that seems really devastating to me is to tell people about it. Maybe nothing they can do, or nothing they care to do. [00:21:16]

You know, James asked me last night, like if there’s anything I can do. I tried to come up with something because it makes me feel better when I can do something. And so I sort of said, “Well maybe you can sort of like tell family about it,” but then I was like, “No, I don’t actually really want you to.” But I don’t know. There is really something weird about talking about it right now that I don’t quite know what’s going on.

THERAPIST: Yeah.

CLIENT: But it’s sort of looming large for me. [00:22:00]

THERAPIST: (inaudible at [00:22:00]). I think, I think that on the one hand you are really worried. You know, I think when you, depending on how open you are, how direct, you really put yourself in someone hands and tell them how you’re doing. You know, last hour you said, “I’m not doing very well,” moreso than your saying, “Yeah, I don’t know if I’m going to deal with (inaudible at [00:22:57]) in the next hour, same or different state. [00:23:05]

CLIENT: Yes.

THERAPIST: And the second one says, (inaudible at [00:23:09]) I think. I think you’re putting it in its own hands and I think there’s in some sense, like the real worry that the other person won’t, I guess he won’t respond helpfully or there won’t be anything they can do as you said. But I think there’s something else too which is like [00:24:08]

(pause) (inaudible at [00:24:19]), but someone like I think to some extent you feel like the other person being sort of open to what you have to say, listening, taking it in, you know, being sort of pretty clearly supportive about it feels like doing something, and (inaudible at [00:24:54]), which I think you’re probably doesn’t. [00:25:00]

CLIENT: Yeah.

THERAPIST: And maybe that’s where some of the complexity is, that it’s hard to know if it’s going to feel like the other person can do something about it or not. I think last night on the phone it probably did feel like I did something, or was there, you know, like—

CLIENT: I don’t know. Actually, it felt pretty bad, I think. [00:26:02]

THERAPIST: It’s about the same. No, I’m glad you’re letting me know. I had to say it, only because you mentioned you were better today.

CLIENT: Yeah, but yeah.

THERAPIST: Either that, whatever, you said after you got off the phone last night. Yeah, I think it feels like telling people about it sort of puts myself in their hands, both in terms of like that, in that moment, like will they be able to help? [00:27:25]

In that moment, will they respond in a way that’s not totally appropriate, but then also like I don’t know. I feel like it sort of leaves me vulnerable down the road. Yeah, I mean, I sort of keep going back to telling the clergy at my church and asking for, you know, support in some way and in general they’re good at offering support in the moment but then like it’s just gone. [00:28:14]

Like they don’t follow up, and that’s sort of like long-term pretty devastating. And so, which I mean, it’s hopeful that I’m thinking about the long-term consequences of it, but—[00:29:02]

THERAPIST: But I think of you always, always being worried about sort of driving people away like that. I guess it feels like it’s often not just about driving them away in that moment, but like (inaudible at [00:29:43]).

CLIENT: Yeah. My conversation with (inaudible at [00:29:50]) this morning sort of boiled down to him saying, “Don’t worry about it.” Just, he didn’t actually say, “Don’t worry about it,” but just said that—

THERAPIST: Meaning “Don’t worry about how I react to how you’re feeling now?”

CLIENT: Yeah. Like don’t worry that I’ll feel abandoned, or rather he’s saying, “Don’t worry that I’ll feel abandoned.” [00:30:15]

Which, shockingly enough, does not help me not worry.

THERAPIST: Yeah. I think it also makes you mad.

CLIENT: Yeah, a little bit. I guess I sort of felt like I have a lot to carry right now, can I not carry you? And he said, he’s tried to say yes, don’t worry about carrying me, but in the way that makes it, that he’s saying like, “No, you still have to keep worrying about me.” [00:31:11]

(Long pause) [00:32:00]

(Long pause continues) I know what he said about, he said he really doesn’t want the rest of our life to be a repeat of where we are now in the last two years, but that’s not something to worry about right now, which that goes for me. Like the thing that I think about, or when I think about suicide, you know, I can see like making through, like I can always see making it through the next twenty minutes, and sometimes through the next hour, sometimes through the next two hours. [00:33:16]

But then when I think about like a week or a year or like it’s when you stretch out the time that I can’t see it. I just feel like “Well yeah, I also don’t want our lives to be like this for the rest of our lives.” [00:34:08]

THERAPIST: Maybe that is a way in which no one is really there for you. Like with the possibility that this could go on like this for years and years. [00:35:00]

CLIENT: Yeah. It can then confuse me and like can sometimes people get through. It’s hard to believe. And like I know that it’s not always something that people go through.

THERAPIST: Do you mean sometimes with it for a long time and then sometimes (inaudible at [00:35:53]) before that.

CLIENT: I mean, yeah. [00:36:00]

Like both, sometimes they live with it for a long time and yeah. (inaudible at [00:36:13]). Yeah, so when I talk about it with James, I talk about it as though like it is something that one day I will be (inaudible at [00:36:49]). Yeah. [00:37:03]

And how much I believe that.

THERAPIST: So he is kind of abandoning you there that, when he says, “I don’t want to live with this the rest of our lives, but now is not the time,” when you think about it that way. And it sounds like that is part of how you’re thinking about it.

CLIENT: Yeah, yeah. And there’s sort of this, it’s like this sort of side of me that is very hopeful and optimistic and is doing things. [00:38:15]

Like I’m starting to make plans, starting to think about five years ahead, I’m starting to think about ten years ahead. And that, but then it’s like the way that I can get through the day with the other side of me is just to not think about further than a day ahead or a week ahead, and so yeah. I’m not sure what’s going on. And a lot of the time like I deal with it by like talking about the future, but with the sort of unexpressed caveat that we all that’s not really going to happen. [00:39:04]

So like I could make all kinds of plans because there will be no five years from now, so I can do whatever I want.

THERAPIST: It’s just a pretend future.

CLIENT: Yeah. (long pause) [00:39:59]

(Long pause continues) [00:41:00]

(Long pause continues) I find that going to church really helps. I’ve been going a lot. That’s like a half an hour or an hour where I think this is okay right now, this is okay. [00:42:00]

Talking to people afterward, (inaudible at [00:42:06]), but, or it’s like, you know, social things. (Long pause) [00:43:00]

THERAPIST: (Long pause continues) It seems to me that you (inaudible at [00:43:48]), and the feeling that (inaudible at [00:43:52]), whatever failure, but like abandonment, really. And more or less a form like talking to the other person. [00:43:52]

CLIENT: Yeah.

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