TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: There we go.
CLIENT: I've been thinking about anger a lot and talking about it with James some.
THERAPIST: Sorry. I think I blocked it.
CLIENT: Oh, okay. I'm just, you know, having a tough time with job hunting because it just pretty much sucks. I was talking with him, with James about this and, you know, talking about how I just feel terrible and just really upset with myself. I just feel like a failure, etc. James was wondering why I'm not more angry about this. You know? Just that I've done things pretty much right. I've, you know, done what people ask me to do. I've tried to live my life according to what I have been told would make me successful and I was saying well, I am angry. I really am. You know, I really do feel like I've been let down in some way. [00:02:00]
Like, you know, I should be able to find a job having prepared myself, having gotten the degrees and all of that. But, I feel like if I, I feel like I just can't bear to be as angry as I am. I feel like I just want to kill myself when I think about that. I just can't stand it, so it's much easier to just think I'm a failure. So, yeah, that's what I have been thinking about. [00:03:00]
THERAPIST: So, there is something, which is at least not clear to me or maybe both of us, that feels awful in some way about being as angry as you are that it makes you want to kill yourself?
CLIENT: Yeah. Yeah. It's just unbearable. (pause) You know I sort of want to kill myself when I feel like a failure also, but slightly less, which is weird, but yeah. [00:04:10]
THERAPIST: That it's slightly less you mean?
CLIENT: Yeah. It's just a lot easier to live with hating myself than it is to live with, you know, hating the world.
THERAPIST: That is one of the reasons people often do.
CLIENT: Hate themselves?
THERAPIST: It's not the only one, but one of them.
CLIENT: Yeah. (pause) [00:05:00]
Yeah. I mean I really have done most things right most of the time. Yeah. You know? I get good grades and I have been successful academically. And, you know, I feel like I was led to believe that that would matter and it really doesn't. It really doesn't. [00:06:05]
So, I feel betrayed and let down and I just can't handle that. Yeah. I, it's just unbearable to feel this betrayed. (pause) So, it's much easier to think well, I should have known better. I shouldn't have been taken in like this. I shouldn't have been a fool. [00:07:10]
THERAPIST: I see. That's how it comes back to you?
CLIENT: Yeah. (pause) Yeah, I mean it's hard for me to talk about it even with you because I feel like you're going to think I'm a fool. Oh well. [00:08:20]
THERAPIST: It's going to be so obvious to me that should not have been taken in?
CLIENT: Yeah.
THERAPIST: So, it also feels kind of humiliating that you were?
CLIENT: Yeah. (pause) [00:09:20]
THERAPIST: Yeah, I think often I sort of get the sense that the self hatred that you feel involves like feeling terribly ashamed of yourself?
CLIENT: Yes. It's big.
THERAPIST: Yeah.
CLIENT: Yeah. It's a lot of where the wanting to cut myself comes from too. Just feeling ashamed of myself, which I still haven't been. You know. I don't feel good about that. (laughter) [00:10:30]
THERAPIST: Yeah.
CLIENT: It's really hard. (laughing)
THERAPIST: Yeah.
CLIENT: But...
THERAPIST: I mean I'm glad for your sake that you haven't, but sort of related to what you're talking about; I certainly wouldn't think any less of you if you did or had.
CLIENT: Yeah. See, the thing about cutting is that I, I do it because I'm feeling ashamed of myself, but it also makes me feel ashamed of myself.
THERAPIST: Right.
CLIENT: So.
THERAPIST: Yeah. (pause) [00:11:45]
CLIENT: Yeah, I miss it, but oh well. (pause)
THERAPIST: I wonder if it also like in addition to being both the cause and effect of feeling ashamed if I mean you're probably having some of that, but it's also fuck you.
CLIENT: How do you mean? [00:12:50]
THERAPIST: I like being bad. You know, like, not the one who gets the good grades and works hard and does everything she's supposed to and then gets fucking nowhere from it.
CLIENT: Yeah. That's about right.
THERAPIST: She does what she feels like doing who tells, you know, in the act of cutting herself, a lot of people, certainly including the medical establishment, but other people too, that they can go fuck ourselves.
CLIENT: Yeah. Yeah.
THERAPIST: Or we can go fuck ourselves. (laugher)
CLIENT: Yeah. I mean the main reason I haven't is because there's really no way for that not to be a fuck you to James and I don't want to do that.
THERAPIST: Yeah. [00:14:00]
CLIENT: You know, I don't want to hurt James. Even though I kind of do. (laughter) Yeah. (pause) I don't feel like it's right.
THERAPIST: To cut yourself? [00:15:00]
CLIENT: Yeah, but I can't really get out of that. That it's just really important to me to do the right thing. It's really important. Even though that just hurts me, it gets me nowhere. (pause) [00:17:00]
THERAPIST: Well, I'm sure you're right about that, but that doesn't do away with the fact that you also have a wish to do the wrong thing.
CLIENT: Yes.
THERAPIST: And, it's hard because you're really mad about having to do the right thing.
CLIENT: It gets me nowhere.
THERAPIST: Yeah.
CLIENT: Yeah. No, but you're right.
THERAPIST: Yeah. They're both probably there. The sort of strong, and in a way kind of taking the focus on doing the right thing, and a wish to do something else and being really angry. [00:18:10]
CLIENT: Yeah. Yeah. I feel like it's just, I feel like that wish to do the wrong thing, I think of it as very childish. Like, that's what I mean when I say it makes me ashamed. It's just sort of embarrassing. Yeah. But, I can't say, I can't say that it's not really powerful and very much there, because it is, so there's, yeah. [00:19:20]
THERAPIST: You know the image I got in my head was not because I thought that you were trying to sort of get out of that, but because I had the thought that like and the wish to do the right thing is so much more critical.
CLIENT: (laughter)
THERAPIST: Now, look, to be clear, I mean I think, you know, in both instances there's kind of multiple levels of operating that evoke more primitive aspects of the wish to do the right and wrong thing and more unsure ones. In other words, you want to be compliant and honest and do the right thing and also basically kind of see like that's just the better thing to do and it sort of works in that way, probably on both sides.
CLIENT: Yeah. (pause) [00:20:45] People ask me how I'm doing.
THERAPIST: Sorry to hear that.
CLIENT: (Laughter) I've been telling them. It's probably not very nice of me, but, oh well.
THERAPIST: That's your way of getting back at them for asking you.
CLIENT: (laughter) Yes. Yes. No, I mostly tell people that I think actually do want to know.
THERAPIST: Yeah. (pause) [00:22:00]
CLIENT: Yeah. Things are hard. [00:23:00]
THERAPIST: Yeah. (pause)
CLIENT: That doesn't get me anywhere to say that things are hard. Yeah. It doesn't matter in some sense. I would like it to matter, but it just doesn't. [00:24:15] (pause)
THERAPIST: I wonder if that's an example of one of the many kinds of things that can sort of add to this feeling of betrayal. Like, when you say things are hard or you say things are horrible and it doesn't make a difference, if that's what you're telling me, that's horrible. [00:25:30]
CLIENT: Yeah. That's about right. (pause)
THERAPIST: And I think people mostly lie about that in a way that probably also feels like a betrayal.
CLIENT: What do you mean?
THERAPIST: Well, not that it even matters explaining why it's going to get better. [00:26:30]
CLIENT: Yeah. Yeah. Things like so it's sort of helpful to be in the hospital, but it also really just sort of makes things worse because they just can't do anything. They can't do anything.
THERAPIST: Yeah. [00:27:30]
CLIENT: You know, it is helpful to have some official stance of caring that things are so hard, but you can't poke that too hard because then you discover that that official stance doesn't mean anything. (pause) [00:28:40]
When I was talking with the ECT doctor, you know, he was saying well, yeah it's fine if you don't want to come in tomorrow, but let's schedule it for next week and he said because, you know, of this whole business with suicidality. Like, we want to pay attention to that. We don't want you to slip through the cracks. I mean, like, that's nice. You know.
THERAPIST: It's incredibly trivializing, yet his role, I'm not actually trying to be critical of him personally or whatever.
CLIENT: Oh, it's okay.
THERAPIST: But, saying you don't want somebody to fall through the cracks, like, he wants to get, invite them to something or... [00:29:45]
CLIENT: Yeah. It's like well, I mean I am glad that you don't want me to fall through the cracks, but in order for me not to fall through the cracks, what you were doing would have to be helping (laughter) and would have to not be making things worse in the way that it is. But, I do fall for that. I don't know. I just, I never expect to matter to people even that much, so it makes me feel good for, you know, in that moment and then I think about it later and then it makes me feel worse.
THERAPIST: I see. Yeah. [00:31:00]
CLIENT: But, it's still a little bit flabbergasting for people to care, even that much.
THERAPIST: You really don't expect that they will?
CLIENT: Yeah. I really didn't expect that they would. (pause) [00:32:45]
That and I just have no want to do what people tell me to do. I just really want to please people. So. (pause) [00:33:45]
THERAPIST: So, I'm not saying this because I think it's going to make you feel any better right now, but more just to kind of flag it and we can talk more about it at another time, but the things you're saying are, I imagine what you are describing about how things feel now probably tracks pretty well with some things you felt pretty strongly when you were little. Like the sense of being mad at the world and betrayed by the world and sort of taken in by like seeming kindness or concern, but quickly let down and, you know, turning that inward in this kind of very sort of shaming, self-hating way. [00:34:45]
I mean it sounds like, you know, a little kid looking for help or a response or something from the parents or the people who might have looked like they were there, but really weren't there. I don't know whether I'm trying to figure out if it's your mother or father or both of them or, you know, as much in your head isn't really it. I don't know, but something about your experience and, again, you know, my point in saying that is not that in any way you feel better now, it seems to sort of...
CLIENT: Yeah. I mean I would buy that, but I don't.
THERAPIST: Right.
CLIENT: I don't know. [00:35:45]
THERAPIST: Yeah. It's kind of out of context now.
CLIENT: Yeah. It's not something I remember.
THERAPIST: Yeah. Sure.
CLIENT: Yeah, I don't remember that, but I don't remember it not going on. It's more like there are big gaps.
THERAPIST: Sure. Yeah. Yeah. Yeah. At the moment it's very much a reconstruction about it.
CLIENT: Yeah. (pause) [00:36:45 to 00:39:00]
Yeah. Mostly what I remember being afraid of my dad and missing my mom. Those are the big ones.
THERAPIST: Yeah. (pause) [00:39:15 to 00:41:15]
CLIENT: He's not very good at listening these days. Yeah. I mean my mom just doesn't ever call me and I'll never call her either, but she doesn't ever call me. My dad calls an awful lot. He calls and then he kind of chatters for a while about whatever's going on in his life and then he hangs up. (laughter) So. Yeah. I wish it were important that things are so hard for me right now or critical. [00:42:30]
THERAPIST: You can't really talk to him about it?
CLIENT: Not really. You know, I try to talk to him about it. He's just not very interested.
THERAPIST: It's pretty striking.
CLIENT: It sucks, but on the other hand, I mean he does a lot better than he used to. Like a lot better. A lot better. So, I sort of feel bad presenting that. [00:43:30]
THERAPIST: Or, maybe it's hard to be so angry at him?
CLIENT: Possibly. (laughter) Yeah. Yeah. Yeah. I just don't have anywhere for that to go.
THERAPIST: Well, we should stop for now.
CLIENT: Thank you.
THERAPIST: Sure.
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