TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
CLIENT: Hi.
THERAPIST: Hey.
CLIENT: So I made the mistake of looking into my voice mail yesterday. (laughs)
THERAPIST: Sorry to hear that.
CLIENT: I hadn't realized how long it had been since I really listened to it, and I all those, I was going to delete a whole bunch of messages and so it made me listen to them before I could listen to anything else. So there were two messages from this guy with the ambulance company. There's been this whole thing where Blue Cross said they weren't going to pay for any of the ambulance from one of the times I was in the hospital because it was like a nonemergency thing. And even though, so we had to write a grievance to them to say, "Well I didn't have the option of refusing to take the ambulance." [00:01:17]
THERAPIST: This is like an ER to a hospital, or something?
CLIENT: Yeah.
THERAPIST: Yeah.
CLIENT: And so that's been sent in and they've received it. Hopefully, they'll pay for some of it at least. But I had forgotten that that was sent in, that we actually did that, because I can't remember anything. (crying sounds and strained voice) So I just thought I had been ignoring this guy from the ambulance company. And then another message was I actually didn't make it through all of the messages because I was freaking out too much. Yeah, I had to hang up. (pause, crying) [00:02:05]
So I had applied for this job as a substitute teacher in the city wit the Public Schools like back in January or end of December. And so I had a message from when I was in the hospital in January offering me a job interview. So that didn't happen. (pause and sniffling) So, you know, I'm sort of freaking out just telling you about it. (sniffling) I was really freaking out listening to it. I got home and kind of fell apart and you know James comforted me and everything.
And that was the rest of the day. Like this happened right after my appointment with you yesterday. and all I could do for the rest of the day was sit and read my book because every time I stopped and, you know, tried to actually get some work done or do anything, I would just fall apart again. (pause, sighing and sniffling). Yeah, I don't know how to live like this. [00:03:22]
(long pause, sniffling)
It's like I spend so much of my energy not thinking about things. Well, I mean I can't deal with problems and then I don't have (sniffling) the attention that I ordinarily would have because, you know, a huge portion of my energy is going toward staving off this panic that's there all the time. [00: 04:17] (pause, sniffling)
This morning was going okay then I talked to Amanda on the phone and that was going okay. And she said she really thought that James and I should move to San Antonio and made a pretty good case for it. Just in terms of having a community. But I just couldn't handle that. (long pause) I'm kind of trying to talk about anxiety and I feel like I've been trying to act like it's not as much of a big deal as it is, but it's just really devastating for me. I feel like it's crippling me. [00:05:38]
THERAPIST: Uh huh.
CLIENT: (pause and sniffling) I'm so scared. (crying)
THERAPIST: Uh huh.
CLIENT: (crying) I don't even know what I'm scared of, I'm just so scared.
THERAPIST: Yeah.
CLIENT: (crying, sniffling, long pause, labored breathing)
THERAPIST: I think some of what you're scared of is like an intensity of your anger at yourself for not being able to handle things you feel you should be able to handle. [00:06:55]
CLIENT: Yeah, I do. (pause)
THERAPIST: I think now sometimes you do want to kill yourself for that or kill yourself so you don't have to feel that.
CLIENT: Yeah. (pause) I feel like I'm constantly on the verge of just getting into huge trouble over something. (crying) I never know what it is I all have forgotten about that turned out to be really important. [00:07:58]
(long pause)
THERAPIST: Well, you probably don't remember this because it was sort of in the throes of the (inaudible at 00:08:39) stuff, but we had talked about how not being able to remember things can feel like not having control over things in the way you feel you should.
CLIENT: I don't remember talking about that.
THERAPIST: Yeah. And so it can be something you blame yourself a lot for, I think.
CLIENT: (whisper) Yeah. Yeah. (long pause) James, you know, at the end of the day thanked me for taking care of myself. (sniffling) You know, for actually just saying, "Well, I'm not going to be able to get anything done today. I just need to take a day off." [00:10:26]
THERAPIST: Yeah.
CLIENT: But I felt so bad. I hate that. (long pause) Yeah, I hate myself when I'm like that. I don't know why I can't just get over it (pause) or push through it or something. (long pause, sniffling) Yeah, I don't know what's going to happen the rest of today. (long pause) (crying) I really hate this. [00:12:09]
(very long pause, sniffling, crying) [00:14:33]
And I hope. I mean at some point I have to listen to the rest of my messages. (laughs) I hope I'll be able to do that soon, but I don't know. (long pause) I know it's not that much to deal with, but it feels like too much.
(long pause, crying, sniffling) [00:16:18]
My Dad's coming tomorrow. We'll see how that goes.
THERAPIST: Mm hm.
CLIENT: (long pause) Like I just want to hide. (long pause) [00:18:17]
THERAPIST: I think you might worry that I won't react well if you hide for a little while.
CLIENT: Yeah. (pause)
THERAPIST: And then I'm going to say something to you that puts some other demand on you or limitation (ph) or burden that you can't bear.
CLIENT: No, not really. I just don't really have anything to say. (pause) I don't worry too much about you. [00:19:40]
THERAPIST: Mm hm.
CLIENT: (pause, sighs, sniffling) I don't know. (banging noises, sniffling) Kind of not having much to say I think is working pretty hard not to lose it right now. So, I'm not really sure why. (pause) I mean it's just because my nose runs so much. (laughs)
THERAPIST: (laughs) [That's okay.] (ph) [00:20:39]
CLIENT: (pause, sniffling) (sobbing) Just why is this happening to me? (pause) Why is this my life? [00:21:36]
(long pause, sobbing)
THERAPIST: I'm so sorry that it is. [00:22:33]
CLIENT: Thanks. (long pause, crying, sniffling) There's no reason for me to be so scared of everything. (pause) I just am. [00:24:10]
(very long pause, sniffling, nose blowing) [00:29:35]
Here. I really don't want this. (pause, sniffling) I'm going to go home and I'm just going to keep going. (pause) That seems pretty bleak right now.
THERAPIST: Mm hm.
CLIENT: (long pause, sigh)
THERAPIST: Well. [00:31:03]
CLIENT: (long pause, sniffling)
THERAPIST: I think (long pause) as far as sort of the dilemma that you're in, which is on the one hand to be inclined to say things like, maybe not in an existential sense, but in other senses know some of why things are like this now and some of what's making you feel so, so bad.
CLIENT: Yeah. Yeah.
THERAPIST: And some of how when particular sorts of things happen they affect you in pretty (inaudible at 00:32:31) ways. But on the other side I'm inclined not to say so much about because you seem pretty maxed out with what you can bear. And I think that probably pretty well reflects the dilemma that you're in, which is (pause) the things that could help, whether it's understanding or task (ph) sort of things, or work, often feel like way too much.
CLIENT: Yeah. We went to dinner with Franco. [00:33:54]
THERAPIST: Mm hm.
CLIENT: And Franco's friends. And it went really well and I felt better while we were there. But I really didn't want to go. (laughs)
THERAPIST: Uh huh.
CLIENT: (long pause) Yeah. (inaudible at 00:34:33) Yeah, I really do want to hear the reasons because that wasn't really a rhetorical question, and I feel like I want to know. And in other ways I feel like they're not going to give any reasons that are good enough.
THERAPIST: Mm hm.
CLIENT: Yeah. Nothing adds up. So, I just want to stay away from it. (long pause, clearing throat, sniffling) I must have read four-hundred pages in the last twenty-four hours. [00:36:07
THERAPIST: Mm hm.
CLIENT: (long pause) And in other ways understanding doesn't necessarily help. (pause) So... (long pause) It's interesting. It's distracting sometimes. (long pause) It's hard for me to think about just the possibility that greater understanding wouldn't be helpful. I mean I feel like it's kind of one of the foundational principles of life that like knowing is better. (laughs, sniffles) Yeah, knowing will help. [00:39:10] (pause)
THERAPIST: I think when it comes to this stuff, I think you want to think knowing won't help, because I think you don't want to know. (pause) We kind of know where a bunch of the bodies are buried at this point. I mean, there's a lot more to learn.
CLIENT: But, no, you're right. (pause)
THERAPIST: I feel like we sort of (inaudible at 00:40.27) a bunch and a number of things that have become really intolerable for you and some of why. And it's really hard to keep that in mind, I think. I mean (pause) like, the phone messages I think are actually maybe just the right metaphor. Like, you know they're there, and it's terrifying because you know you may not be able to bear hearing them.
CLIENT: Hm. [00:42:15] (pause)
THERAPIST: And if we wanted to think about it for a few minutes, because probably getting much more particular about what would be hard about hearing them. The message that you had a job interview, you know, and you never got (inaudible at :0042:50). Not far from stuff we've talked about. Again, I don't have a complete understanding, or I'm sure that there's a lot of important context that I don't have.
CLIENT: Yeah.
THERAPIST: But (pause) yeah, I think you also I have no doubt that in moments when you're totally overwhelmed and upset, it feels like you have no idea what's going on or why this is happening. But -
CLIENT: No, you're right. I know. (pause) I know why I react the way I do.
THERAPIST: Mm hm.
CLIENT: Yeah. (pause)
THERAPIST: (inaudible at 00:44:30).
CLIENT: Yeah.
THERAPIST: If you pretend you don't, you don't. And then anybody who does or who thinks that there could be reasons, clearly doesn't know.
CLIENT: (laughs) Yeah. Yeah, but I don't want to be like that. (pause) Hm. (pause) Thanks.
THERAPIST: Mm hm. (pause) I really want to run with that. I don't think you do this (inaudible at 00:45:52) to mention intentionally, but I think it's sort of related. I think that a lot has happened recently and more historically in your life that sort of, in reality, adds to the impression that anybody who thinks they have reasons doesn't know what they're talking about. Like (pause) it may not be (inaudible 00:46:43). I'm just going to throw it out there though anyway and we'll think about it.
So there may be times when your feelings are so intent and you come on, in your kind of subtle way, so strongly with them that you (inaudible) or kind of nearly empty reassurances from people who are sort of anxious and have a sense of your need and don't know what to do.
CLIENT: Hmm.
THERAPIST: That then confirms your impression that they clearly have no idea what's going on or what to do.
CLIENT: Have no idea. I can't say you're wrong. (laughter)
THERAPIST: And certainly a lot about the mental health establishment plays right into that too, completely apart from you.
CLIENT: Hm. Yeah. I mean, yeah, I want people to tell me it's going to be okay and I'll feel better, but you know, "How dare they." Hm. (pause) Hm. [00:48:01]
THERAPIST: Well, we should stop for now.
CLIENT: Okay. Thanks.
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