TRANSCRIPT OF AUDIO FILE:

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CLIENT: Hey.

THERAPIST: Hey.

CLIENT: So I'm really not (inaudible at 0:00:10). (crying) I just feel like there has to be a way out of this. But I don't know what it is. (pause)

THERAPIST: It's really bad.

CLIENT: So bad. (crying) (pause) [0:01:00] I don't know how to deal with it. I don't know how I got like this. And sort of do but it's not workable. It doesn't... (pause) (crying)

THERAPIST: My impression is that when you feel this bad, there's kind of nothing else. [0:02:07] There's no limit to it. There's no reason for it. There's no way of dealing with it. There's just how awful you feel and how it's always going to feel that way.

CLIENT: Yea.

THERAPIST: And how there's no room for anything else at all.

CLIENT: Yea. It's been... I pretty much decided, yea, I'm just going to have to keep it to myself. And I just want to have (inaudible at 0:02:58). I didn't know what else to do. Just kind of not be in myself.

THERAPIST: This is after you left here?

CLIENT: Yea. And anyway, I mean the therapy (inaudible at 0:03:14) which I was just not really looking forward to it.

THERAPIST: Yea.

CLIENT: Felt bad but it'll...

THERAPIST: Yea.

CLIENT: (crying) It was like it goes away just enough and then it comes back worse. (pause) Today I wasn't... I woke and I just didn't just feel awful. [0:04:04] I also didn't get anything done yesterday. And I felt horrible (ph) about that. And... (pause) (crying) I know it was that... I know that horrible (ph) stuff was going on but I can't see it. (sobbing) I have like all of these things that make me feel so bad aren't real necessarily. But...

THERAPIST: But they sure are.

CLIENT: I can't get out.

THERAPIST: Yea. [0:05:01] (pause)

CLIENT: An image of Paul (ph) and my mom (inaudible at 0:05:32). It's like when like you cooked a chicken and you like take the leg off. And it just comes apart. I feel like this comes apart. (pause) (crying) [0:06:00]

THERAPIST: Well, I could be wrong but I suspect you feel somewhat that like this was a bit something I did to you yesterday. [0:07:01]

CLIENT: I mean, sort of. I was sort of holding it together before our meeting. I don't know. (crying) Yea, but if it wasn't you, it would be something else. But if it wasn't you, it would be just be the process of trying to apply jobs. (pause) I don't know. It's bad enough that causality isn't really something I can distinguish very well. I don't know. It's just there. (pause) [0:08:00]

THERAPIST: I guess you feel like there is worry by that prospect.

CLIENT: By what?

THERAPIST: Of feeling like I was partly responsible.

CLIENT: Yea, I guess so. (pause) (crying) Yea, (inaudible at 0:08:48).

THERAPIST: But boy, is it a bitch. [0:09:00] (pause for one minute)

CLIENT: (crying) And (inaudible at 0:10:36) I must be doing something really wrong or I must have done something really horrible for my life to be like this. But I don't know what it is. I can't make the changes I need to make. I can't make it stop. (crying) [0:11:01] (pause)

THERAPIST: You (inaudible at 0:11:10)... well, all you really have room for is how awful you're feeling, I think.

CLIENT: Yea. I keep thinking I should be able to fix this. I should be able to do something to fix me (ph). (crying) (pause) [0:12:02]

THERAPIST: Yea, I imagine that you're terrified about that.

CLIENT: I keep expecting you to tell me that this is my fault or something. [0:13:01] (pause)

THERAPIST: I sort of want to quip I'm not going to be that reassuring.

CLIENT: (chuckling) Oh, yea. I'm definitely not satisfied until I get that this is absolutely your fault.

THERAPIST: (chuckling)

CLIENT: I mean, that's one of the big draws (inaudible at 0:13:28) is the inference I brought kind of like this. You should be able to fix it. (pause) [0:14:01]

THERAPIST: Yea, I mean, this isn't your fault. I mean, it's that you're helpless. In a lot of ways, I guess entirely helpless. (pause)

CLIENT: Yea, I hear you. (pause) [0:15:00] (crying) (pause) I want to give up. But I'm not allowed. [0:16:00] (pause) And that's the thing. I can't be entirely helpless because I continue to do it. I continue to be here.

THERAPIST: That's true. That is something that you have some control over.

CLIENT: And I hate it. (crying)

THERAPIST: Yea, I'm not saying it's a sad thing you should be in the hospital now. But I could imagine that's one thing that's reassuring about being in the hospital is that that somewhat less in your control.

CLIENT: Yea. [0:17:00] (pause) (crying) It feels like the only thing I have control over it is to choose to continue to go through hell. And I don't like that. It's hard. (crying)

THERAPIST: It's awful. (pause) [0:18:00]

CLIENT: (crying) I don't know how people get through this. [0:19:01] That's what I don't know. (pause)

THERAPIST: I really don't either. (pause)

CLIENT: (inaudible at 0:19:17). (pause) (crying) [0:20:00] (pause for one minute)

THERAPIST: Well, I think you are like showing what it's really like.

CLIENT: I guess.

THERAPIST: I don't think it's because you decided to because you feel like you don't really have a choice that (inaudible at 0:21:38).

CLIENT: Yea. There's not really much that I can talk about that's real other than that. (pause) [0:22:00] (crying) It sort of feels like I'm trying to get you to do something about it. But I have nothing to say (ph). (pause) (crying) [0:23:00] (pause)

THERAPIST: I do think there's an aspect of this that has to do with you and me. Probably other aspects that aren't really other aspects that aren't but I think one kind of strand in this. It is a kind of reaction to what happened yesterday which I gather you moved away from in a sense pretty quickly on your way home thinking that the thing you had to do is really to kill yourself which was better than thinking about, I guess, some of the things we talked about. And also the way it felt like I did something very hurtful to you, which I know you know in another sense is not true in saying some of the things that I did. And I guess I feel like one thing that probably is exceedingly hard for you here today is like letting me know that. [0:25:12] And...

CLIENT: The thing is I guess it was hurtful. But it felt more like... it felt like a relief at the time, honestly. For you to be like, "Yea, no wonder you're not doing very well with this. You're not equipped to do very well with it." So it was sort of like getting my feet knocked out from under me. But I'm also like bad in this situation and so it is a relief to have it acknowledged. [0:26:02]

Yea, but it certainly did not make me feel better in other ways. Certainly did not help my project of keeping it together. I'm not giving up. (pause) Yea. I guess the part that is hard or hurtful is being expected not to give up in the face of how bad things are.

THERAPIST: I see. [0:27:01] (pause) I hope you won't give up and kill yourself. [0:28:04] But I also want to make it clear, I could understand and wouldn't think it was like the craziest or wildest thing in the world if you did.

CLIENT: Thanks. (pause) Yea, because holding on seems to be increasing just more senseless thing to do. (pause) [0:29:00] Thanks.

THERAPIST: Sure. It's true.

CLIENT: Yea. That people would say it (inaudible at 0:29:30). (pause) I feel sort of like when both of your feet ache and you keep shifting weight from one to the other. But it doesn't help because they both ache. [0:30:06] But I can't figure out a way to keep moving forward. And I can't figure out a way to stop.

THERAPIST: (inaudible at 0:30:20) it just hurts in each way you try and do it. (pause)

CLIENT: And I can't do that to (inaudible at 0:30:43). But...

THERAPIST: It's really hard to do this to yourself.

CLIENT: Yea. (pause) It's not like this is even being fair. I find myself going crazy by rationalizing to killing myself trying to find ways to make it OK. It's too easy to tell emotionally. (crying) (pause) [0:32:00] (pause for four minutes) Yea. (pause)

THERAPIST: What are your thoughts?

CLIENT: I'm wondering what happens to the transcripts if I kill myself.

THERAPIST: What things do you imagine?

CLIENT: I was wondering whether you pulled them or not. I don't know.

THERAPIST: You wonder would I pull them or not? [0:37:00] (pause)

CLIENT: I don't know. I think (inaudible at 0:37:12) people. I don't know about that. I guess it seems like the sort of thing I could imagine there being some possibly legal clause. But...

THERAPIST: Being that they have to be pulled?

CLIENT: Yea. But that doesn't really make sense.

THERAPIST: So in that case...

CLIENT: What?

THERAPIST: ...I guess I was wondering if it's related to that that would be protective of me somehow. [0:38:11] Or protective of me or reflective of like a failure in my work or some kind of privacy issues?

CLIENT: I was thinking of it in terms of a privacy issue. (pause) Yea. (pause) [0:39:00] It's difficult mental exercise to imagine what would be like to kill myself. So I don't know what I... it was just indicative that I'm trying to get control over this in some way or another. That I feel like wow, I'm going to kill myself. I might as well know what I'm getting into, right?

THERAPIST: Right. (chuckling) I can see.

CLIENT: It's really, really...

THERAPIST: But that's why I was smiling. A minute ago you said that they have some [fussy legal clause] (ph). But that doesn't make sense. Well like OK. Well, the fantasy doesn't make sense and I don't want pursue it because...

CLIENT: (chuckling) Yea. Because it better make sense. (pause) [0:40:02]

THERAPIST: I think it feels pretty touch and go. (pause) Are you sleeping?

CLIENT: Yea. (pause) (inaudible at 0:40:41) to talk to you about this. I like to keep my options open. But it feels like cheating not to tell you. Can't be a cheat. Could be dead, but... (chuckling) As long as I'm probably fair about it.

THERAPIST: (inaudible at 0:41:03). Yea. (pause) Well, I guess then I imagine probably what's (inaudible at 0:41:17) there is like a little you feel like you have to hold on to in a way that sort of being trustworthy like that is something.

CLIENT: Yea, yea. I don't know. It feels like a relic (ph) in some ways. I like the image of myself as somebody trustworthy is left over from when I had a lot more resources. [0:42:00] [And I don't want to deal with it] (ph). (pause)

THERAPIST: I am also wondering under the (inaudible at 0:42:17) were there. (pause) The upcoming break from our meeting is scaring the shit out of you.

CLIENT: Yea. It's scary and that's when I'm home alone, I'll think about it. I just don't know what's going to happen. So I can see it being not a problem at all. I can see it being very problematic. I just don't know.

THERAPIST: Yea. [0:43:00] What's going on the rest of the day?

CLIENT: I have an appointment with Dr. Vaughn at 5:15. Afternoon it's kind of going to go to coffee shop (inaudible at 0:43:12).

THERAPIST: Then you (inaudible at 0:43:14).

CLIENT: Yea. No. But I do get picked up a (inaudible at 0:43:21). So that's good. I need to schedule a time to meet with that guy.

THERAPIST: I see. So they like sort of accept you.

CLIENT: Yea, yea. I applied to them and they... yea.

THERAPIST: And you're not working today.

CLIENT: No. I work tomorrow morning early. I told the guy I'd be OK until (inaudible at 0:43:48) with him.

THERAPIST: Why is that?

CLIENT: It's unclear. He went to the library because he's got allergies from the building. [0:44:02] So maybe I will talk to him after my meeting with Dr. Vaughn. Maybe before that.

THERAPIST: Will you be home before the meeting?

CLIENT: Probably but not necessarily. (pause) It's probably safer for me to be at (inaudible at 0:44:26) than at home especially home alone.

THERAPIST: Yep.

CLIENT: I wouldn't want to make a mess in public.

THERAPIST: Why don't if you're going to go home why don't you send me a text and let me know how you're doing.

CLIENT: OK. I can also just call James (ph) and ask him to come home with me. [0:45:03]

THERAPIST: OK.

CLIENT: I will do that.

THERAPIST: We'll stop for now.

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