Client "Ma", Session March 11, 2014: Client discusses the expectations of therapy and the feeling of being unable to meet them. trial
TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: Hey.
CLIENT: Hey. (pause) I’m really tired. (pause) I don’t know what this week’s going to be like. (pause) They asked me to be on this – religious committee. Which I – is actually a real thing, even though it really doesn’t sound like something that has any meaning at all. [00:01:05] (pause) (background noise)
But basically it is sort of to talk about like (pause) religious education for adults in the church, and how to be better at that. So the first the meeting that I was able to go to last night, and it was really nice; like really good.
THERAPIST: That’s great.
CLIENT: Yeah, especially since I didn’t really want to go. It’s not a well time to do it. (pause) That is something that I am looking forward to being a part of and I think it will be good.
THERAPIST: Well good.
CLIENT: Yeah. (pause) [00:02:05] (pause) Yeah, I’m just really tired. (pause) Papa left his bike by the clinical office at my friends’ apartment. Or if he thinks he did it, I’d never actually asked her if she’s seen them, because like I would have recognized them, so it occurred to me that they were going there. (pause)
I (pause) I had a bad dream that woke me up in the middle of the night last night. (pause) So it sort of surprises me, but on the other hand, then I get to sleep for like two or three more hours; that’s always a nice night. Or worse is waking up like two minutes before your alarm goes off. [00:03:51] (pause)
Yeah, I really don’t know what to talk about. (pause) I really need to get new socks. (pause) (inaudible at 00:04:33). It’s while they’re awesome, I feel like I need new socks. (pause) James would say, “Why did you put on a different pair?” And just like, I just didn’t know; I’d be like, “They’re cold.” (pause)
And I’m – I am very ready for James to at least be applying to jobs. I don’t think he’s applied yet.
THERAPIST: Yeah. (pause)
CLIENT: I feel like I’m sure that my being in the hospital has made him feel more like he needs to – like me to stay at (school) (ph), and I don’t think he’s very happy about that. And I think that sort of makes it harder for him to get off the ground. (pause) I don’t know what to tell him. [00:06:00] (pause)
It’s like, I feel like the current situation is a really bad one for me. (laughter) (pause)
THERAPIST: What, about the current situation you mean, right?
CLIENT: Oh, just not being able to make plans or look more than two weeks or a month into the future. (pause) [00:07:00] (pause) Yeah. (pause) I am trying to be patient. It’s not like I actually want to move, but (pause) I think (pause) I (inaudible at 00:08:11), so I think I’m going to work more hours for the (inaudible at 00:08:19) for a couple more –
THERAPIST: Oh. I don’t think I know them.
CLIENT: Okay, the chief of staff at Kim’s office is going to be out on maternity leave, so Kim’s going to be active chief of staff. And she said, they sort of said that she didn’t have to come in more days, but she really does have to come in more days. (pause)
So she asked whether I wanted the hours, and if I don’t want them, like there’s somebody else who could do it. But I think I could; I could certainly see and all of that.
THERAPIST: When will you be working?
CLIENT: I don’t know yet; Monday or Friday. You know I want to do it, but I’m not willing to – like I need to work around like these appointments, and also figure out how to keep doing the tutoring, because I don’t want to drop that. [00:09:27]
THERAPIST: Yeah.
CLIENT: So probably Friday.
THERAPIST: Yeah, let me know if changing our Monday or Friday times would make things easier, and I can always stay on the lookout.
CLIENT: Okay; thanks. (pause) Thanks. Yeah, if anything came up at like the end of the day on Monday, that might be helpful.
THERAPIST: Okay.
CLIENT: But – (pause) Please tell James that I (inaudible at 00:10:26). It’s still hard. I think it’s getting easier though. (pause) For awhile, I was taking a lot of my energy (extension) (ph), (pause) and it still is, but maybe not quite as much. (pause)
And I’m trying to be, I don’t know, optimistic, but I just feel so beat. (pause) [00:11:34]-[00:12:34] (pause) It just occurred to me that I haven’t talked about that in like two weeks. (pause) I haven’t thought about it. (pause) I think like most of friends knew I was in the hospital; my friends who I know from (school) (ph). (pause) I talk to them. (pause) It was like – really awkward, it was like we were having a conversation about something else entirely; it was almost like time for us to go our separate ways; we were having a weird like [g time] (ph). [00:13:42]
I was like, “Oh, by the way,” (laughter) “it happened.” (laughter) (pause) It was like in – there’s a hyperbole and a half comment, of course, that “Tanya, you’re just trying to figure out how to tell people that she might be suicidal.” And she like goes through all of these – she’s like, “This is a (stupidly) (ph) awkward conversation to have.” And so one of the options that she puts forward is like shout it, and then run away. (laughter) (pause) I think knock joke would be one. (laughter) (pause) Yeah, it’d be. (pause)
THERAPIST: Yeah. (pause) [00:15:00]-[00:16:00] (pause)
CLIENT: Things with James are pretty okay in the day to day. (pause) We did talk for awhile yesterday about the sort of e-mail updates that he sent to my family. (pause) So like, we did a pretty good job there; it was hard, but like we I think both wanted to talk about it with Dr. Jannis (sp?) and we just didn’t get there. So we just sort of talked about it afterwards. (pause)
Yeah, we just like [beat the job] (ph) listening to each other, and saying (pause) yeah, as he said like have any space for both of us to get upset. (pause)
THERAPIST: How was that?
CLIENT: Yeah. (pause) [00:18:00] (pause) I’m really excited about the weather. (pause) Yeah. I’m just really excited about being able to go outside with the kids again. (pause)
THERAPIST: Speaking of more space making it easier between people. (pause)
CLIENT: Yeah. (laughter) Exactly. (pause) [00:18:59]
THERAPIST: I think maybe there is (pause) a way that that’s kind of what you’re wanting with me in a way now as well, in that (pause) I imagine you feel (pause) like some pressure to be talking about how bad things are, or like these bad feelings. And then they’re sort of, [what it is to like not going off to work] (ph); you don’t want to. And (pause) I don’t know that I could be wrong, but my hunch is you feel that little bit of split between you and me, where it’s sort of like what came up yesterday, where it feels like some of the pressure comes from me to be talking about the deep dark awfulness. [00:20:03] (pause)
Or that you’ll be talking about something else, and I’ll say something that points back to it. And that (pause) it feels like if you had a little more breathing room, (pause) in that way, you feel more at ease. (pause)
CLIENT: Yeah. (pause) I don’t know; I don’t feel particularly cramped this morning. (pause) I guess it feels like, I feel pressured to be talking, and it feels like every avenue of conversation’s just going to lead bad places. And I sort of know that’s going to happen; (pause) somehow really going to hurt. [00:21:11] (laughter)
THERAPIST: I see.
CLIENT: I don’t know. (pause)
THERAPIST: I also get the sense when you say that it feels more as though that comes from you than from like some pressure from me, or -
CLIENT: Yeah, I think so. (pause) It’s just why – (pause) it’s just where I am right now. (pause) I’m just so tired. Like (pause) yeah, I’ve just been so exhausted.
THERAPIST: Yeah. (pause) You’re really wiped out. [00:22:10]
CLIENT: Yeah. (pause) And as I tried really hard not to be, (pause) I tried really hard to structure things that this wouldn’t happen, and didn’t make it that far.
THERAPIST: What do you mean?
CLIENT: Like I cancelled everything I had to do, and tried to be able to rest this weekend.
THERAPIST: Oh, with your dad coming in town? (laughter) (pause)
CLIENT: Yeah. I don’t think I did a very good job, but I’m just like, that was the hope. (pause) [00:23:00] (pause).
THERAPIST: I’m trying to figure what the other things that you – (pause) like had on your schedule to do, that you said you that you cancelled. (pause)
CLIENT: Yeah. I guess I’m just frustrated and feel like – I feel like there are too many things that I couldn’t cancel. (pause) [00:24:00] (pause) I feel like I can’t, (pause) but I feel like I just need to not cancel things. I don’t know where like the completely arbitrary deadline is like, I need to be better now. But (pause) [00:25:00] (pause)
THERAPIST: Well I can see why. I mean probably most people are emotional is that you’re totally wiped out. I mean (pause) your having been in the hospital, and then work last week, and then seeing your dad is totally exhausting and overwhelming a lot of the time, among other things certainly.
But that, and then yesterday, this was my impression, was no picnic either with a (inaudible at 00:25:29), I mean towards the end, and you know, then you had another appointment with Dr. Jannis, then moved to having conversation, which is great that it went well. But I’m sure it’ll come out of you. (pause) [00:26:00] (pause)
You haven’t had a lot of time to recover, and catch up. (pause)
CLIENT: (crying) (pause) I don’t know what to say. (pause) (crying) [00:27:00]-[00:30:00]
It’s just like -
THERAPIST: No, go ahead.
CLIENT: trying to – like it’s just trying to (pause) transfer what I’m thinking into words; it’s unbearably hard. (crying) And I’m tired.
THERAPIST: Sure. (pause) Well it probably is, because (pause) (crying) I can imagine, I don’t if this is quite how it is, but that it would feel very heavy to say some of the things that you’re thinking, (crying) and describe some of the things that you’re feeling. (pause) [00:31:00]
CLIENT: It’s not like I’m scared to say them, it’s more like it’s hard to articulate, like I can’t -
THERAPIST: It sounds more like it’s work and onerous. I don’t have the impression that you’re scared more than (pause) you’re like feeling kind of crawling across the finish line.
CLIENT: (laughter) (pause) (crying) [00:32:00] (pause) (crying) (background noise)
THERAPIST: I’m sorry if it’s more of the same thing. (pause)
CLIENT: That’s okay. (pause) [00:33:00]-[00:35:00] (pause) Do you feel like I’m letting you down?
THERAPIST: No.
CLIENT: It feels like it. (pause) (crying) I don’t know how, I don’t – (pause) I don’t know. (pause) [00:36:00] (pause)
THERAPIST: My impression is that maybe because I said (pause) that you’re supposed to be some kind of work here, I have the idea that you’re supposed to be doing some kind of work here to make things better by talking about things, or by having things go better in your life, or in terms of how you feel; something like that. And that, you know, those are my expectations.
CLIENT: (crying)
THERAPIST: And I’m sure, but it seems to me that what you’re feeling is grief. [00:37:17] (pause) I’m guessing, but I’m not sure you think about it this way for things you’ve been through, maybe recently, maybe longer ago.
CLIENT: (crying)
THERAPIST: Certainly there’s been a lot recently, and that that feeling that for you usually doesn’t bring with it the sense that things are going to get better, or there’s even much of a point. (pause) It’s just grief. (pause) And it’s about you. And that’s at odds I think with the sense that I think you’re supposed to be doing something, or renewing something ahead. (pause) Or doing some work. (pause)
I guess that’s sort of my impression that maybe has you feel you’re letting me down. (pause)
CLIENT: Yeah.
THERAPIST: Sure. (pause)
CLIENT: (crying) (inaudible at 00:38:40)?
THERAPIST: Sure. (pause)
CLIENT: (crying) (pause) [00:39:40] (pause)
THERAPIST: Also I think that this idea that I have expectations for you, or that I think you’re doing some kind of work is complicated. I mean, you know, I don’t think I really stated anything. At the same time, there’s either like when I do make comments, or point things out, (pause) I can see how there’s a way in which in itself, that sort of puts a certain burden on you.
I mean not in a bad way exactly, or not like badly intended, but (pause) maybe it gives you something to think about, or something to look at, or to doing something while sitting, right? There’s a kind of [00:40:44]
CLIENT: Sometimes I can see what you’re doing.
THERAPIST: Yeah. (pause) Well what do you mean? (pause)
CLIENT: I – (pause) I don’t know, it just feels like (pause) it feels like sometimes I can – (pause) sometimes I can tell what you’re trying to do. And I don’t (pause) (inaudible at 00:41:32). (pause)
THERAPIST: I guess what I had in mind is, you may be right about what I’m trying to do, and you may be right (pause) when I am aware of trying to do something, or when I’m not. But you might not be ready. (pause) In other words your idea of what I’m trying to do might not actually be what I’m trying to do.
CLIENT: Yeah.
THERAPIST: You know, it might come from your expectations. (pause)
CLIENT: Yeah.
THERAPIST: So I don’t know. (pause) [00:42:30] (pause)
CLIENT: Okay. (pause)
THERAPIST: I think it’s partly what I have in mind is like, (pause) I sort of think you may have the idea that I think you should be working on things, and I’m not so sure I have an idea that there may be a way that I do that I’m not aware of; I don’t know [what that is] (ph).
CLIENT: Yeah. (pause) It feels like (pause) the things that you say (pause) often sort of nudge me into taking a step that I would not have taken on my own. (pause) And it feels like that’s sort of the point. [00:43:46]
THERAPIST: The point.
CLIENT: (laughter) Or, yeah, my intention. (laughter)
THERAPIST: Yeah.
CLIENT: I agree.
THERAPIST: Yeah. (pause) Yeah I mean if you had an example in mind, (inaudible at 00:44:21) like I would probably tell you in the interest of sorting this out. (pause)
CLIENT: I don’t think I do.
THERAPIST: Yeah sure.
CLIENT: Right.
THERAPIST: Yeah. (pause) We should stop.
CLIENT: Yeah.
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