Client "Ma", Session February 26, 2013: Client is frustrated with her lack of improvement both emotionally and cognitively. trial
TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
1004967702 Mda 2-26-13
CLIENT: I'm going to go right at time because I have ECT (ph) today, so James's going to come pick me up.
THERAPIST: Okay, I think we're coming right over tomorrow, so
CLIENT: That doesn't matter. Yeah, it doesn't matter. It's just, I don't know. I kind of really don't know what to do about ECT I don't know. I guess I should do it.
(pause from [00:00:57] to [00:01:27]) So my friend Gerry visited this weekend. It was good.
THERAPIST: Is this Gerry, of Gerry and Ashley?
CLIENT: Yes. (pause) Yeah, it wasn't the best visit. (pause) But I don't know. She and I get along really well. So that's good.
(pause from [00:02:24] to [00:04:28])
I feel like I'm just a mess. I need to be looking for a job more. Like, a lot more, and I don't, I just don't know what to do. I was supposed to, I was supposed to be at our church on Sunday, and somehow I just didn't get the schedule, like I didn't know I was supposed to do it, and missed it, and just all of this stuff.
THERAPIST: That's really unlike you.
CLIENT: Doesn't feel unlike me though, feels pretty much exactly like me. (chuckles)
THERAPIST: I see.
CLIENT: I just feel like I can't get it together. But, (pause) I feel like I've...
(pause from [00:06:23] to [00:07:52])
THERAPIST: I see, so (pause) you feel like such a complete disaster on the inside that you can't function and you just kind of (inaudible) in a respectable way on the outside?
CLIENT: That's what it feels like. (pause from [00:08:18] to [00:10:30])
THERAPIST: So, (pause) what I'm thinking is that, you blame the kind of, the incompetence or like, messiness on feeling bad. I mean like, you've got these sort of very painful, depressive feelings. Sort of sad and angry and want to kill yourself and all that stuff is making you a screw up. You can't sort of do the things you are supposed to do.
CLIENT: I guess. I don't know. (pause from [00:11:47] to [00:16:49])
THERAPIST: Do you know what you are thinking about?
CLIENT: (pause) Not really. (pause from [00:16:59] to [00:17:14]
THERAPIST: Are you feeling frustrated and sad?
CLIENT: Frustrated.
THERAPIST: With not being able to function better? Do more stuff?
CLIENT: (pause from [00:17:48] to [00:18:43] I wish I were a lot less, (pause) together. Or a lot more together.
(pause from [00:19:03] to [00:19:44])
THERAPIST: Seems a way to put it, I guess what I have in mind is, you know, because like having it together, which I assume is getting to be like, you know practical things, and directed and stuff like that. I guess, I wasn't shocked by you saying that. But that's in a way just like, in a kind of a literal way your mind is not together. In that you can't really remember stuff, you can't find words easily, it can be hard to describe what you are feeling sometimes. These things are very separated, not together.
(pause from [00:21:08] to [00:21:26]) My point being, I imagine you are referring to that too, when you say you wish you were more together.
CLIENT: Yeah. I don't know. (pause from [00:21:36] to [00:22:57]) Yeah. (pause from [00:22:57] to [00:25:05])
THERAPIST: I think, first let me close the shade, I think it's, very disturbing to be so not together in this way. I mean both in terms of like, in terms of your life but also in terms of memories are over here, your words over there and your feelings are over there, they are not really, well connected, like the search board is not reading well. I think it's probably much more so to feel like that's being done to you by the ECT.
CLIENT: It's not fun. [00:26:50]
THERAPIST: And I think, I do think it probably recapitulates and experience you had, an experience you've had over and over in your life, which is began like, you know, you are getting the message, sometimes explicitly, and sometimes by well-intended people, inadvertently that what you feel is not okay. It can't be handled and has to be pushed away, it has to be packaged, it has to be hospitalized, it has to be split apart, it has to be kept under wraps or under control. It can't be part of conversation.
CLIENT: Yeah. That's about right. [00:28:04]. (pause)
THERAPIST: Obviously, I'm not intending to say that ECT is inherently bad or the people doing it are malintented. But for you, it's just got to feel like, you know, let's exile that stuff again.
CLIENT: Yeah, it's not very much fun.
(pause from [00:28:44] to [00:29:13]) I don't really know what to do about that.
(pause from [00:29:16] to [00:29:50])
THERAPIST: Let's say for the moment, we're going to go all the way to making a decision about what to do about it. And go with what it was like.
CLIENT: Okay, yeah.
THERAPIST: What comes to mind?
CLIENT: That it's just miserable. (pause) It just feels like I'm being pushed out very firmly. Yeah, (pause) yeah. (pause from [00:30:53] to [00:32:19])
THERAPIST: Okay, then what's that like?
CLIENT: (pause from [00:32:32] to [00:33:12]) I don't know. I,
(pause from [00:33:13] to [00:33:57]) I don't know. But (pause from [00:33:59] to [00:34:17])
THERAPIST: This is where it's bad.
CLIENT: What's that?
THERAPIST: This is where it's bad.
CLIENT: Yeah, yeah. (pause from [00:34:22] to [00:34:44])
THERAPIST: I would imagine that it's shaming and it's isolating.
CLIENT: Yeah, it's (pause) yeah, it's pretty lonely. (pause)
THERAPIST: Do you feel like you've been sort of locked away inside yourself by this?
CLIENT: I don't know. (pause) Something like that. (pause)
THERAPIST: Have you been having suicidal thoughts again?
CLIENT: Yes. I've been really wanting to hurt myself. So, that's been fun.
THERAPIST: Is it pretty hard not to?
CLIENT: Yes.
THERAPIST: Hard not to kill yourself as well?
CLIENT: Hard not to hurt myself.
THERAPIST: Not to hurt yourself.
CLIENT: But I've been not.
THERAPIST: I'm happy to talk a bit longer, but it is 8:30, I just don't want you to
CLIENT: Okay, thanks. I know, I should go. Thank you.
THERAPIST: You have 4:00 tomorrow.
END TRANSCRIPT