TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: I am all kinds of a mess; just very scattered and not together. (Pause) I'm very disorganized and confused. That's not good. (Pause) I don't know. [00:01:01]

(Pause) Yeah. I have all kinds of things... Yeah. I don't know. [00:02:17]

(Pause) [00:04:46]

THERAPIST: (inaudible at 00:04:50)?

CLIENT: Yes. I just don't feel like I have much to say.

THERAPIST: It sounds like you did at first and then you didn't. [00:05:04]

CLIENT: Yeah. (Pause)

THERAPIST: What made you feel like a mess?

CLIENT: I'm not sure.

THERAPIST: Have you felt down? [00:06:04]

CLIENT: Somewhat. Not too much. (Pause) I don't feel like I really know what to do. (Pause) Yeah, I don't. [00:07:30]

THERAPIST: Did it start last night or this morning?

CLIENT: I don't know when it started.

THERAPIST: Can you give me an example? [00:08:01]

CLIENT: (Pause) I don't know. I'm sorry. (Pause)

THERAPIST: (inaudible at 00:09:36)? Is it hard to find the words? [00:09:38]

CLIENT: I just feel like I don't have any thoughts. I feel like I literally don't have any thoughts which is not any good. (Pause)

THERAPIST: The most frightening thing to me that you (inaudible at 00:10:00) is that you seem to have some thoughts and it seemed to me you were sort of keeping it more within or more engaged than recently in the last few days. And then from here it looked like I just sort of faded out. You said what you initially had to say and then sort of lost your steam or something. [00:10:31]

CLIENT: (Pause) Maybe.

THERAPIST: I'm a little perplexed because yesterday I thought I knew what was going on. I mean just the (inaudible at 00:10:55). I don't know if finally you describe having been confused and uncertain that sort of conveys having had more internal experience than you've been having this week. (Pause) So that you were saying and then what you said, I guess, gave me that impression. [00:11:37]

CLIENT: Okay.

THERAPIST: But now it seems a lot like yesterday (inaudible at 00:11:47). And I'm not sure what to make of that whether (pause) yeah you kind of had just that one to collect your thoughts or there's something about being here that interferes. [00:12:18]

CLIENT: I don't know.

THERAPIST: Do you know if you had an easier time talking and thinking about it this morning so far today?

CLIENT: I don't think I had an easier time. I mean I seem to recall spending most of the morning just kind of sitting as well.

THERAPIST: Were you doing anything or just...

CLIENT: I was reading.

THERAPIST: Uh huh. You sat all night?

CLIENT: No I had to finish that. A different book. (Pause) Yeah I can now. [00:13:26]

THERAPIST: Did you feel bad this morning?

CLIENT: No, not really.

THERAPIST: Confused?

CLIENT: No. I was just reading.

THERAPIST: Do you know when you started to feel like a mess?

CLIENT: I only remember feeling like a mess when I came in here so go figure. I don't know. (Pause) Yeah. [00:14:10]

THERAPIST: What do you mean? I can imagine if you were even tired (inaudible at 00:14:23) you'd feel like a mess?

CLIENT: (Pause) I don't know. Moving from pretty much just (inaudible at 00:14:49) thing you know keep reading moving from that to having actually to say something about it. I don't know. [00:15:02]

THERAPIST: So it was a very immediate experience?

CLIENT: I guess so.

THERAPIST: I have trouble because that confused me a bit when you said that. In other words, you know most times that you come here you say oh I feel like a mess. I would assume that had been going on for a few hours or it was related to some situation you knew about. But you're kind of saying it was sitting here and knowing you were going to feel some pressure to think of something to say.

CLIENT: Yeah. Yeah.

THERAPIST: And feeling bad about that.

CLIENT: Yeah.

THERAPIST: And, I guess, maybe a bit overwhelmed. [00:16:05]

CLIENT: Yeah. (Pause)

THERAPIST: I mean for what it's worth it does seem like this is almost certainly related to the ECT in that the doctors make whatever changes they're going to with it and then so you'll improve a lot.

CLIENT: I hope so.

THERAPIST: It will be much easier to find things to say.

CLIENT: Uh huh. (Pause)

THERAPIST: I guess you still feel pretty responsible for having things to say?

CLIENT: Yes. [00:17:06]

THERAPIST: (Pause) What's it like when you don't have much?

CLIENT: I just feel awful when I don't know there's nothing to say.

THERAPIST: Do you know what about that is awful?

CLIENT: No, not really. (Pause)

THERAPIST: That seems to be bothering you more today than recently. [00:18:10]

CLIENT: Yeah I guess so. (Pause)

THERAPIST: Do you want to (inaudible at 00:18:49)?

CLIENT: I don't know. I don't think so but I don't know. [00:19:08]

(Pause) Yeah I don't think so. [00:20:03]

THERAPIST: (Pause) Can you think anymore about talking to the doctor tomorrow? (inaudible at 00:23:29)?

CLIENT: I don't know. (Pause) I don't know. [00:23:38]

THERAPIST: (Pause) Yeah, it seems like you're really blank.

CLIENT: Yeah, I really am. I hate that. [00:24:17]

THERAPIST: What do you hate about it?

CLIENT: I just feel at a loss. I feel like I should be having things to say and I just don't.

THERAPIST: And this seems effecting you more how you've often been or have been in the last few weeks.

CLIENT: Yeah.

THERAPIST: It's like I have nothing to say and this is a problem. [00:25:06]

CLIENT: Yeah.

THERAPIST: (inaudible at 00:25:08) to say.

CLIENT: Yeah. (Pause) Yeah. (Pause)

THERAPIST: Have you been able to have conversations with James?

CLIENT: Sort of. They've been small. (Pause) Yeah. Mostly I've been not having conversations. [00:26:03]

THERAPIST: So just mostly reading?

CLIENT: Yeah. Yeah.

THERAPIST: (inaudible at 00:26:16) or was it just reading?

CLIENT: No, just reading.

THERAPIST: It must be a lot of reading.

CLIENT: Yeah. I read a lot.

THERAPIST: Yeah. A different book every day?

CLIENT: Something like that. Somewhere around there. (Pause) If I can I read.

THERAPIST: Anything recently that you especially liked? [00:27:04]

CLIENT: I really like the (inaudible at 00:27:13) death, that trilogy. It's really good. Yeah. Yeah. I read a lot of crap too though.

THERAPIST: Yeah?

CLIENT: Yeah. Some really good stuff and some really, really terrible books.

THERAPIST: Why do you keep reading them?

CLIENT: I'm not sure exactly. I like them. (Pause) Yeah. [00:28:17]

THERAPIST: (Pause) Have you been less in touch with people?

CLIENT: Not really. My friend Gerry's going to come visit in a couple of days, but I haven't been in touch with her. I've been kind of hiding. [00:29:44]

THERAPIST: (inaudible at 00:29:57).

CLIENT: Good one. Yeah.

THERAPIST: It's nice to have some time to yourself?

CLIENT: Yeah. Yeah. I like it. I probably should (pause) get out more but or not hide as much, but I like it. [00:30:42]

THERAPIST: How have things been with James?

CLIENT: Pretty good. Yeah. (Pause) Yeah. He's been very affectionate which is nice. (Pause) Yeah. [00:31:29]

THERAPIST: (Pause) Do you feel like you sort of have been in a bubble? [00:33:23]

CLIENT: All day (pause) unfortunately.

THERAPIST: I take it this is the first time you haven't felt really awful in a long time.

CLIENT: Fair enough. Yeah. It's good to not feel really awful.

THERAPIST: Yeah. Do you notice that much?

CLIENT: Not that much.

THERAPIST: When you stop and think about it but...

CLIENT: Yeah. I have to really stop and think about it.

THERAPIST: Yeah. It's not like you're a kid on school vacation and summer vacation is like oh. (inaudible at 00:34:13).

CLIENT: Yeah.

THERAPIST: Not until you stop and think about it. [00:34:17]

CLIENT: Yeah. But then it's good. (Pause)

THERAPIST: And then (inaudible at 00:34:36) as well like be aware of your safety.

CLIENT: Yeah I think so.

THERAPIST: And how you're feeling all the time.

CLIENT: Yeah. Yeah I think that's good. (Pause)

THERAPIST: Have you had many thoughts (inaudible at 00:36:00).

CLIENT: Not really. [00:36:02]

THERAPIST: No?

CLIENT: No. (Pause)

THERAPIST: Does this feel a little like being in the hospital at all in that kind of being in a bubble sort way? [00:38:24]

CLIENT: I don't know. Not really.

THERAPIST: How is it different?

CLIENT: I guess it's more that it doesn't call up any similarities to me. Like it doesn't strike me it doesn't seem massively similar.

THERAPIST: I see. Let I ask did your mom ever do ECT?

CLIENT: Yeah I think so. [00:39:12]

THERAPIST: Oh.

CLIENT: Yes. I don't remember when but I'm pretty sure she did. I don't know whether it was successful or not. (Pause) Yeah. (Pause)

THERAPIST: I'm going to stop for now.

CLIENT: Okay.

THERAPIST: And I'll see you tomorrow at 11:10.

CLIENT: I'm sorry?

THERAPIST: Tomorrow at 11:10.

CLIENT: Okay.

THERAPIST: I think you wrote it down yesterday.

CLIENT: I think so. Yeah.

THERAPIST: Okay. [00:43:35]

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