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CLIENT: Hi.
THERAPIST: (inaudible at 0:00:06).
CLIENT: So I'm on for 9:15 tomorrow?
THERAPIST: Yea. That's...
CLIENT: Yea.
THERAPIST: That's good? OK.
CLIENT: OK. (pause) So yea, I don't know. It's seems clear that the ECT is doing something. It's just not clear what it's doing. I hope it helps. But yea, I don't know what to do to make it this far. [0:01:13] (pause) James (inaudible at 0:02:07) expecting me to feel better every day on top of that.
THERAPIST: On the ECT or just in general (inaudible at 0:02:18). (pause) [0:03:00]
CLIENT: I think I had a bunch of really horrible nightmares last night. So...
THERAPIST: Do you remember anything from any of them?
CLIENT: Not really. (pause) I guess I have (inaudible at 0:03:44). (pause) [0:04:07] I just remember being really distraught.
THERAPIST: I see. (pause) [0:05:00] Does the a feeling being distraught remind you of anything?
CLIENT: I just feel (inaudible at 0:05:40). (pause) I just feel uncomfortable for the most part. [0:06:02] (pause for two minutes) Yea, I'm just scared of everything. [0:09:00]
THERAPIST: Like what? (pause)
CLIENT: Like putting anything away in our house. We had just closed on the storage unit so we have kind of stuff everywhere. I just don't know how to tackle it. I really ought to. I am usually very good at this. I'm just kind of frozen. [0:10:00] (pause)
THERAPIST: I feel like you're scared you'll find you really can't handle it at all.
CLIENT: Yea. (pause)
THERAPIST: And then you might carefully even have any more suicidal (inaudible at 0:10:56).
CLIENT: It seems like an option.
THERAPIST: Yea. (pause) Maybe it's like you've found somebody who's explosive and angry and extremely dangerous. And then maybe you could be easily set off. (pause) [0:12:00] (pause for two minutes) Are you afraid of saying things here?
CLIENT: I don't know. Probably.
THERAPIST: What's clear is that you're just not sure what to say?
CLIENT: Yea.
THERAPIST: Because things aren't coming to mind, you feel blanked out or...
CLIENT: Yea. I just I don't feel like I have much to say. [0:15:05] (pause)
THERAPIST: Do you have a feeling of not wanting to be here?
CLIENT: No. No, I really don't.
THERAPIST: Just a feeling of not having much to say.
CLIENT: Yea.
THERAPIST: OK. [0:16:00] (pause for one minute)
CLIENT: Yea, I do feel like I'm doing something wrong.
THERAPIST: In general here?
CLIENT: Here.
THERAPIST: Here? Oh. (pause) You have before felt very like uncomfortable and self-critical when you haven't had much to say. [0:18:05] Because you felt like that?
CLIENT: I guess so, yea. (pause) [0:19:00]
THERAPIST: Well, one possibility that occurs to me is that, in general, being able to work I guess in here probably feels related to having things to say helps to make things look and I think also give you the feeling that things are OK.
CLIENT: And nothing that intense as long as I have nothing to say.
THERAPIST: Something like that.
CLIENT: Yea. (pause)
THERAPIST: Usually when you sort of can't pull it together enough to do whatever the work is at hand is you get really scared and really angry at yourself. [0:21:04]
CLIENT: Yea. (pause) I'm not sure if James would even be here. (pause) [0:22:01]
THERAPIST: You might be doing it by not having much to say. (inaudible at 0:22:26).
CLIENT: (chuckling) No, you're probably right. It's just I'm very uncomfortable with that thought. (chuckling)
THERAPIST: Oh. [0:23:00] (pause for two minutes) I wonder if part of what makes you uncomfortable what I thought is that the work whatever work you're doing is always like a little bit of a sort of displacement from work a little bit of distance from you.
CLIENT: Yea.
THERAPIST: Like generally easier to focus on whatever work is at hand which like is kind of you but not exactly you. [0:25:59] And if you can sit there and not doing anything and that's the work, then it really doesn't put a whole lot of distance between you and what you're doing. I feel like I'm getting a little convoluted. What I mean is it really puts the focus on you and what's going on with you. Or how you're really struggling and scared, I guess. (pause)
CLIENT: I guess I have. (pause) [0:27:01]
THERAPIST: Are you worried I'm going to decide it isn't working because you don't have much to say?
CLIENT: I don't know. It could be. (pause) (inaudible at 0:27:27). (pause for two minutes) I worry about how hard this is on James (inaudible at 0:30:11) I guess. (pause) I just feel like he's bound to feel tired of taking care of me. [0:31:01] (pause for two minutes)
THERAPIST: How has the last holidays been between you?
CLIENT: I think that (inaudible at 0:33:20). It's not been immensely easy for me to take things easy. But I've been doing it. (pause) I feel like I can't be around people. Like there's I don't know ideas. I just... it's very scary for me. (pause) I just feel like I'm not entirely (inaudible at 0:35:01). (pause for four minutes) We just had Amanda here.
THERAPIST: When did she go home?
CLIENT: Sunday (ph). A couple days ago James and I took her to the airport.
THERAPIST: On Sunday?
CLIENT: Yea, I think so.
THERAPIST: You went out on Sunday?
CLIENT: On Sunday afternoon. Yea, we took her to the airport and then we went to church. (pause)
THERAPIST: Enjoys (ph) coming out here?
CLIENT: Yea. She's the best.
THERAPIST: OK. (pause) How is she the best?
CLIENT: (chuckling) She's just... she's a very easy guest. And she always has been plans big projects. And she's like, "No, this will be easy. That is no problem." Yea, she just kind of gets stuff done. She's just kind of wants to part of everything which is pretty easy. That's OK. [0:41:04] (pause) And James really liked having her here also which is nice. And it was a kind of an automatic thing. Like I could see it being difficult but it's not.
THERAPIST: Is that so?
CLIENT: Yea. [0:42:00] (pause for two minutes)
THERAPIST: What time is the appointment today? Do you know?
CLIENT: About 10:00, I think. It's twenty-five after.
THERAPIST: [All right. Feel free to call me if something changes.] (ph)
CLIENT: OK.
THERAPIST: And I will see you tomorrow morning.
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