TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
CLIENT: Hi.
Hey.
CLIENT: Well, my Dad's here. He's funny. He's applying for, he's quitting his job and applying for a chaplaincy internship that is, it's an internship. It's the type of thing that you do when you're in seminary. Like train to become a priest. So most of the people who do this are like twenty-three, twenty-four. Like young kids. And he's like, "We'll this is a seventy-five percent pay cut, but if I were in this for the money I would be an idiot anyway."
THERAPIST: (laughs)
CLIENT: So just he wants to -
THERAPIST: So he couldn't just be a hospital chaplain if he wanted to? I mean [without the job training?] (ph)
CLIENT: Apparently not.
THERAPIST: Oh.
CLIENT: Yeah, I wondered about that. Because, you know, he's been a priest for like twenty years. But maybe he doesn't feel comfortable just taking the job. I don't know. So we'll see about that. I got another tutoring job. [00:01:31]
THERAPIST: Good!
CLIENT: So that's good.
THERAPIST: Congratulations.
CLIENT: Yeah.
THERAPIST: What is it?
CLIENT: Teaching a couple of teenage girls study skills. Apparently they just don't do their homework like at all.
THERAPIST: Where are they at school?
CLIENT: They live downtown.
THERAPIST: in the city?
CLIENT: Did I say that right? It's like south. But their Dad is up North and so they're going to make us take the train up there and I'll take the train down and get them to do their homework. So we'll see how it goes. I'm a little nervous considering I have terrible study skills. (laughs) I mean I'm clearly not that bad. Like I, you know, get good grades. So, I don't know. I feel like the biggest thing I can contribute is teaching them to distinguish between what you can afford to blow off and what you can't. (laughs) [00:02:43]
THERAPIST: (laughs)
CLIENT: So we'll find out. (long pause) I've been thinking about Amanda saying we should move back to San Antonio. (pause, sigh) I like it here.
THERAPIST: Mm hm.
CLIENT: Yeah, there's so many things about Boston I just really like. At the same time I'm always a little bit like a fish out of water here. (pause) Yeah. I don't know. (pause) James is going to be finishing up his degree in the next few months, actually. [00:04:23]
THERAPIST: Oh that's great.
CLIENT: Yeah.
THERAPIST: Is that quicker than you anticipated?
CLIENT: Yeah. I think so. He talked with his advisor recently and his advisor said he thought he should finish up the papers they're working on now, one of which has a deadline in two days so he's kind of freaking out about that. No, he's not freaking out at all. James doesn't freak out. (laughs) He's spending a lot of time ignoring me and working. (laughs) So that's just fine.
THERAPIST: (laughs)
CLIENT: But he said that then they should, his advisor thought that they should measure his time to degree in months and that the number should be small.
THERAPIST: Hm.
CLIENT: He also said he was one of the best students he'd ever head.
THERAPIST: Wow!
CLIENT: Yeah.
THERAPIST: That must have been nice to hear.
CLIENT: Yeah, I think so. Because his work, like the projects he's been working on, have not succeeded at all. I don't think he had gotten the kind of results that he really hoped for here. [00:05:36]
THERAPIST: What kind of chemistry does he do?
CLIENT: He does organic, organomettalic. No, not organomettalic. I honestly don't really know.. He works with metals a lot. I don't know. (sound of cell phone vibrating) Sorry. I really should just put it on silent. (laughs) Yeah, I think it was really nice. I'm sure it was nice for him to hear. I mean James is not the kind of person who is going to make a big deal out of that. So he told me once and then I made sure he told Franco. (laughs)
THERAPIST: (laughs)
CLIENT: I think Kevin was trying to say like, "It's okay that [they didn't] (ph) work. Sometimes projects just don't work."
THERAPIST: Right. That's my understanding of a lot of those kind of fields is that you have to be probably good or really good and also just lucky.
CLIENT: Yeah, a lot of it is just luck. Yeah, I mean if you're not good you won't get anywhere. But if you're not lucky. [00:06:54]
THERAPIST: [Being good isn't good enough.] (ph)
CLIENT: (laughs) Yeah. So he's got to figure out where to go after this is all done.
THERAPIST: Uh huh.
CLIENT: You know, and he's talking with Franco (sound of cell phone vibrating) as though he was just going to do the next thing for an academic career which would be -
THERAPIST: It would be post doc.
CLIENT: Post doc. Yeah, at a top research university. But then he was talking to me and he said he doesn't know that that's what he wants to do. He doesn't know what he wants to do.
THERAPIST: Yeah.
CLIENT: So, I don't know.
THERAPIST: Is the stuff that he does close to industry? Or is it -
CLIENT: He could go into industry pretty easily. Yeah. Probably about half of the students end up going into industry, at least. I think he really doesn't want that though.
THERAPIST: I see.
CLIENT: (pause) You know, it's looks pretty idealistic in some ways. I mean he's a little to idealistic for the academic world, really. (laughs)
THERAPIST: Uh huh. Does that make him way to idealistic for industry (inaudible at 00:08:19)?
CLIENT: (laughs) So, yeah, in some ways there just isn't anywhere that sponsors the kind of research that he would want to be doing.
THERAPIST: Hm.
CLIENT: So he will just have to find the best place for it. I don't know. I don't know. You know, I think he'd be really good teacher.
THERAPIST: Mm hm.
CLIENT: But I don't know whether he'd get bored teaching. I don't get bored teaching but he might.
THERAPIST: Yeah.
CLIENT: Or at least I haven't gotten bored yet. (pause) Yeah. I don't know how to help him with this (pause) because I don't really know what his options are even. I don't think he does either. (pause) You know it's not like a PhD in chemistry is going to hurt him ever but, you know, I guess maybe I'm just a little bitter. But I feel like I'm increasing realizing that a graduate degree doesn't necessarily get you anywhere either. (laughs) Like people say, "Oh that's nice, but do you have any skills?" (laughs)
THERAPIST: Well who would say that to him? (inaudible at 00:10:38)
CLIENT: I guess I'm just thinking like if he wanted to change careers. Although I don't know what he would do. I think he'll be okay.
THERAPIST: I've certainly heard of people with [his kind of] (ph) PhD doing things like teaching at public or private secondary schools. The private ones especially seem to like to hire.
CLIENT: Yeah, they like graduate degrees. (laughs)
THERAPIST: Or going into like consulting, which he probably would not want to do. I don't know that that's for the idealistic, but [I heard he was doing it]. (ph) Or, what was I thinking of? Well there's the industry academia but there's also (pause) (inaudible 00:11:53) like legal stuff.
CLIENT: Yeah. Yeah. (pause) I don't know. (pause)
THERAPIST: Is he sort of struggling or angsty about the decision, or he's just not sure?
CLIENT: He's just really not sure. He doesn't seem to be worrying too much about it.
THERAPIST: Are you worried?
CLIENT: I'm a little worried. I'm probably worrying about it more than he is. But you know, I worry.
THERAPIST: (inaudible at 00:12:45) Sorry. Like teach at, you know, small liberal arts colleges.
CLIENT: Yeah.
THERAPIST: You know where it's more of a teaching job than research.
CLIENT: Yeah. You know, I think that if he decides to stay in academia I think he'll want eventually to be teaching in probably, yeah, a smaller liberal arts college. He'll want to be something that's more teaching.
THERAPIST: I don't know of those folks are post-doc or not or like if his post-doc depends on whether it's like (inaudible at 00:13:21).
CLIENT: Yeah. I think he'd want to do a post-doc first. If he was going to be in academia I think he would want to do post-doc first. Just because it's almost impossible to get a job at a decent school without a post-doc.
THERAPIST: I see.
CLIENT: So like he could teach at like -
THERAPIST: Like a small local college.
CLIENT: Yeah, he could teach at like a local college, but not -
THERAPIST: A little more prestigious liberal arts college.
CLIENT: Yeah. Not anyplace where he'd have students that were paying attention. I think. You know I don't really know. And I think he'd want to keep his options open.
THERAPIST: Mm hm.
CLIENT: So. (pause) But I don't know. (pause) (laughs) On his a paper he's working on right now he said that he really wishes his advisor would just not make changes after a certain point because after a certain point about thirty percent of the changes that Kevin makes make the paper worse or introduce errors. (laughs) So then James has to go in and clean it up. And he's already spent a lot of time on this paper trying to clean it up. And he said it's very frustrating. [00:15:12]
THERAPIST: Is it for a journal or a conference?
CLIENT: It's for a journal. Yeah. It's almost out the door. Almost.
THERAPIST: Yeah.
CLIENT: He's really, really sick of it. It's not even He's an author on the paper. It's based on some really old work. He's an author on the paper because Kevin got him and another of his students to try to replicate the results because they weren't sure about them. But he didn't come up with the original results. Like it's not something that he's that interested in, I think. And then, of course, they were unable to replicate all of the results, so. (laughs)
THERAPIST: Right.
CLIENT: I don't know. (pause) Yeah, I think the most important thing for James is just having somebody to talk to. I'm really glad he's here, but he doesn't have that many people to talk to here. I'm really glad Franco's here because at least he's got somebody. (pause) But even at his other school one of the things that was very frustrating for him and I think one of the reasons that he doesn't want to go into industry. You know, this is a top ten school. It's a very, very good school for chemistry. And he said just nobody wanted to talk about ideas. There just wasn't anybody. (pause) [00:17:30]
I think, I don't know, I feel like that's just sort of a problem in the sciences is that (pause), I don't know, I guess I feel like at these Ivy Leagues and everywhere I've ever been, the problem is really that finding people. Everyone's just up in the clouds all the time. Of course, I love that. But I don't know. Maybe that's not fair. (pause) Yeah, I worry about taking care of him. I'm not doing a very good job of it. (long pause) [00:19:01]
The memory loss. I feel like I expect it to get easier and it just gets harder. I feel like the more I'm coming back to myself and the more I feel like myself, the more upset I am getting about -
THERAPIST: I see.
CLIENT: And even more I realize what I have lost and stuff is not coming back. Some stuff is, some stuff is not.
THERAPIST: I think I asked you this. I assume you're referring to stuff not coming back not only from the last few months but even from well before that. [00:21:01]
CLIENT: Yeah. Like my stepbrother has a baby. I've completely forgotten about the existence of this child. (laughs) Completely forgot that Miro has a baby. It's gone.
THERAPIST: How old is the baby?
CLIENT: Around a year, a year and a half.
THERAPIST: Okay. Not five months.
CLIENT: No. (laughs) Not a really recent baby.
THERAPIST: Yeah. Yeah.
CLIENT: You know it's like I have to re-watch all the TV shows that James and I have watched. (laughs)
THERAPIST: (laughs)
CLIENT: So I don't know if you heard, but Veronica Mars, they're doing a Kickstarter campaign to make a movie for it and they raised the money for like forty eight hours.
THERAPIST: What's Veronica Mars?
CLIENT: Veronica Mars. Oh it's a really good show. (laughs)
THERAPIST: (cross-talking at 22:00)
CLIENT: It's okay. It's a TV show about a high school girl detective that was made like eight or nine years ago maybe. It's got Kristen Bell in it as the lead. And just a really good show. Very clever, very fun. And it's one of James's favorite shows and James and I watched it all together. And it's gone. I don't remember anything. I didn't even remember the basic premise of the show which is that her best friend gets murdered.
THERAPIST: Oh.
CLIENT: Like nothing. It's just gone. You know, that's not so bad because, oh wow, I have to watch more TV. (laughs)
THERAPIST: (laughs) Right. You get to enjoy watching it for the first time twice.
CLIENT: Yeah. (laughs)
THERAPIST: But still -
CLIENT: Yeah, other stuff (pause), yeah I get upset about. I feel unborn (ph), you know? [00:23:28]
THERAPIST: Yeah.
CLIENT: Yeah. We went over to Franco's for dinner to play this card game that he really likes that we've played with him a lot. Like we've played a lot of this game.
THERAPIST: Mm hm. I think you mentioned it to me. You got the hang of it like last time you played, or something.
CLIENT: Yeah, but I had to ask him again. "How?" You know, I had to ask what the rules were again. And then, you know, I picked it up again. It's fine. Then I kind of remembered some stuff. But, yeah. It really, really bothers me. (pause) Yeah, I think James doesn't think it should bother me as much as it does. (pause) Yeah, and then I feel like it's my fault that I can't remember things. [00:24:56]
THERAPIST: Mm hm.
CLIENT: And I know it's not my fault. I know it's not my fault. (laughs) But I feel like it is.
THERAPIST: Mm hm.
CLIENT: (long pause) Yeah. My Dad says it will come back. I think he's seen a lot of people who have had ECT.
THERAPIST: Hm.
CLIENT: I think he's worked with a lot of people who have had ECT. But, you know, he also likes to try to make me feel better. So, it really doesn't feel like it is. [00:26:25]
THERAPIST: Mm hm.
CLIENT: You know, some things I'll ask about and somebody will tell me and that kind of triggers a memory.
THERAPIST: Right.
CLIENT: And then it comes back. But some things, it's just gone completely.
THERAPIST: Mm hm.
CLIENT: (pause) I don't know where I am. It's alarming.
THERAPIST: Yep.
CLIENT: (laughs)
THERAPIST: Yeah (inaudible 00:27:08) is very disturbing and that like the sort of anger at yourself and holding yourself responsible is kind of a way to at least feel like you should be more in control of this.
CLIENT: Yeah. (laughs)
THERAPIST: To help stave off how disturbing it is.
CLIENT: Yeah. If it were my fault then I would have some control over it.
THERAPIST: Yeah. Instead of not.
CLIENT: Yeah.
THERAPIST: And I think part of the reason that's so frightening is because (pause) the people around you, I think you probably feel you can't rely on people around so much to help to orient you in some important ways. [00:28:38]
CLIENT: I mean I do, but I feel like they're going to get tired of it.
THERAPIST: Hm.
CLIENT: And I've gotten pretty okay about just saying, "I don't remember that."
THERAPIST: Mm hm.
CLIENT: Just saying that.
THERAPIST: I guess I'm thinking about two things. Partly you're starting with both your Dad and James's sort of professional uncertainty. A sense that they're not quite sure where they're going or they're figuring it out or something. And a sense of like your Dad trying to cheer you up. Like, and in that sense, you can't quite trust where he's coming from or like you can't trust how he's trying to orient you to what's going on. [00:29:47]
CLIENT: Yeah.
THERAPIST: Because he may have an agenda that gets in the way of it.
CLIENT: Yeah. Yeah. James's pretty good about just telling me, "This is what happened here. This is what we did here."
THERAPIST: Right.
CLIENT: "This is what this is."
THERAPIST: Right.
CLIENT: But you know with James I feel like I'm not allowed to get upset about it. You know, I'm not allowed to show that I'm upset that I don't remember things because that bothers him.
THERAPIST: Mm hm.
CLIENT: So. (pause) Yeah, and you know I'm really upset about this. I get more upset as time goes on rather than less. [00:31:00]
THERAPIST: Yeah, I have the impression that there is a piece of it that so far we're missing or at least I'm missing about what's making it as disturbing and upsetting as it is.
CLIENT: Yeah. Hm. (pause) Also a lot of things I don't know that I've forgotten about them until somebody else brings it up.
THERAPIST: Mm hm.
CLIENT: So it's sort of like, oh, I had this whole piece of my life that got taken away from me and I really don't know it's gone. [So there's that.] (ph) I don't know exactly why. You know I also I guess, now being told both from you and doctor Vaughn, also my sister and other people and James. They're like, "Yeah, you..." I guess I didn't realize how much of a zombie I really was when this was going on. [00:32:42]
THERAPIST: Yeah. I don't think you did.
CLIENT: I really didn't at all. It didn't feel like I was that different. And I only sort of realize it by contrast because I really feel like I'm on my A game now or something. (laughs) Like, "Oh, I can put sentences together. This is great!"
THERAPIST: (laughs)
CLIENT: But not -
THERAPIST: Do you remember when James came in here?
CLIENT: No I had forgotten that James came in here.
THERAPIST: Did he mention something recently?
CLIENT: No, I don't think so.
THERAPIST: When you said now, "I forgot that he came in," was as though you had forgotten previously but also remembered.
CLIENT: Yeah, something reminded me of it.
THERAPIST: Yeah?
CLIENT: I think he mentioned, I think he made some reference to like knowing what this room looks like or something.
THERAPIST: Right.
CLIENT: I don't know. I think. [00:33:51]
THERAPIST: Right. Yeah. I was alarmed at how out of it you were.
CLIENT: Oh.
THERAPIST: And, I mean you know I talked about and we had him come in because I wanted to sort of compare notes with him about how you seem because it was a little hard for me to tell whether there was anything therapy related about it or whether it was just the ECT and it was happening everywhere.
CLIENT: Yeah.
THERAPIST: And so, yeah, he came in and the three of us talked about it a little bit and he's like, "Yeah, it's happening everywhere."
CLIENT: (laughs)
THERAPIST: And then I called a doctor there and I left a message with him and [he did] (ph).
CLIENT: I mean, do you think this is normal? Does this happen to everybody who has ECT?
THERAPIST: I don't know. I know that it (pause) You reported at the time that the doctor doing the ECT did not seem particularly concerned, and he also did not seem particularly concerned in his message back to me. [00:35:02]
CLIENT: Yeah. And I mean when I talk to him about stopping it, the thing that he was concerned about, he was saying suicidality is something that we need to be concerned about for you, so I don't think you should stop.
THERAPIST: Right.
CLIENT: That was basically what he said. But no, he didn't seem to have any Like he didn't seem to understand what I meant when I said that I felt like it was really affecting me cognitively.
THERAPIST: Right. Yeah. I still have his message so I can listen to it. But I think he said, he was reassuring about your sort of memory and intellect coming back in short order, on the order of weeks, I think.
CLIENT: Yeah, you know, I feel like my intellect is coming back but I don't feel like my memory is.
THERAPIST: Right. It also seemed very clearly dose dependent. I mean all that stuff we were just talking about happened during a week where you had like a more intense dose or a higher dose than you had before (ph). [00:36:20]
CLIENT: Yeah, but I mean I don't think They went up. They started me off at like the absolute lowest dose and they went up one step and that was as high up as they got. So I never got much.
THERAPIST: Wow.
CLIENT: (laughs) Yeah.
THERAPIST: [I didn't.] (ph)
CLIENT: Yeah.
THERAPIST: I don't feel like you were well prepared for this by them at all.
CLIENT: Oh.
THERAPIST: Like they should have I mean, you knew there might be some memory loss going in, but -
CLIENT: Yeah, I knew that I was going to lose my memory.
THERAPIST: Yeah.
CLIENT: But I didn't know. They told me it was going to be short term memory. You know, they told me basically I was going to have trouble making new (ph) memories. They didn't tell me I was going to lose everything.
THERAPIST: Mm hm.
CLIENT: Nobody ever mentioned anything about cognitive impacts. [00:37:36]
THERAPIST: Right. Yeah. I mean you interviewed, I remember, at the partial at the hospital after you were on the inpatient unit?
CLIENT: Okay.
THERAPIST: And they called and left me a message and said that they didn't think it was appropriate because you weren't cognitively intact enough.
CLIENT: Yeah. Oh yeah.
THERAPIST: Remember that?
CLIENT: I mean, no. But I think we talked about this before, like a couple of days ago. (pause)
THERAPIST: I really think they should have sat down both with you and James and said, "Look, here's what's likely to happen."
CLIENT: Yeah. Well what I'm wondering is what happens to me. Because the thing is, like in the hospital there were a lot of people who were doing ECT in the hospital with me. And I talked with a lot of them, and nobody You know, I never really, I didn't know these people before they were doing ECT so it was hard for me to tell, but I don't feel like I noticed them being particularly slow. And nobody said they felt like they were slow. So I'm wondering like is this just something that happened to me or is this something I don't know. [00:39:09]
THERAPIST: Yeah. I wish I did and I don't either.
CLIENT: I mean I can call the doctor. I've got his number.
THERAPIST: Mm hm.
CLIENT: (pause) Maybe that's something to do. (pause) Yeah, because if I had known that it was going to be anything like this I wouldn't have done it. (laughs) Dr. (ph) said, "Well, here's one good thing about it. You found out there's something worse than being suicidal." (laughs) [00:40:10]
THERAPIST: (laughs) Okay.
CLIENT: Yeah. And it's true. I'd much rather be myself and miserable than just not myself. (pause) I mean I don't like that those are choices. (laughs)
THERAPIST: Right. (ph)
CLIENT: Yeah. (long pause) I've been thinking.
THERAPIST: Mm hm.
CLIENT: I've been thinking about this kind of off and on a lot, but really I think yesterday more intentionally. You know, so I did the ECT because medicines don't really seem to work for me and the ECT sort of backfired. Which I guess just means that if I want not to be like this I'm just going to have to work really, really hard. I don't really know in what way. Like I don't You know, I can work hard but (pause) I guess I really don't know what direction to go in from here. [00:42:46]
THERAPIST: As in what else to do?
CLIENT: Yeah. Yeah. So, you know, I was saying yesterday I don't know why this is happening to me. And you said, "No, that's bullshit. You know." (laughs)
THERAPIST: (laughs)
CLIENT: And you're absolutely right. (laughs)
THERAPIST: You know, some things. Yeah.
CLIENT: No, but you're right.
THERAPIST: Yeah. Yeah.
CLIENT: I do know a lot of how this works. (pause) And so I think two things kind of stem off from that. The first is that the stuff that I say "I don't know," so often, not because I don't know kind of how it works but because the huge, "Why me?" question in my head that doesn't really go away. Like, okay, so this is what my life is like. Like why am I the person who has this life? [00:44:05]
THERAPIST: I see.
CLIENT: And that's not really going to get answered so, oh well. And the other is that I do feel like, though sometimes it is a comfort to see how things work and just to be able to say, "Okay I got here." (pause) You know so I find that I think about killing myself a lot of the time. Not because I actually want to kill myself but because thinking about killing myself makes me feel better. Like that is a relief for me.
THERAPIST: Yeah.
CLIENT: And knowing that that's how that works, you know sometimes that helps. But a lot of time it feels to me like it doesn't help. [00:45:17]
THERAPIST: Well (pause) I am. How can I put this? Like (pause) I don't think the problem is that understanding isn't working. I think the problem is it can be too hard or too overwhelming to look at sort of some of the things that we half understand. For example, you say, "Well, I know that I'm thinking of killing myself because it's reassuring. But knowing that doesn't make me feel better," is what you said. But knowing that, "Eh, doesn't get me that far." Which, that makes sense to me. But what it points towards is what's making you feel so awful at that moment that then thinking about killing yourself is a relief. [00:47:15]
CLIENT: The thing that makes me feel better? (laughs)
THERAPIST: Right. And I think that's usually something like a sense of rage or betrayal, a terrible anxiety that comes from feeling like you don't have control over what's going on.
CLIENT: And you think that's the thing that's hard to look at?
THERAPIST: Yeah.
CLIENT: Hm.
THERAPIST: I don't think at the end of this story that's like a chapter, but yeah.
CLIENT: Okay.
THERAPIST: And I know that probably because you told me the other day, "I just can't think about that. Like I feel betrayed and angry and it's just too much."
CLIENT: Hm.
THERAPIST: And I think that's what it is every time.
CLIENT: So what do you think the thing to do is? You know? Do I just make myself look at that every time? [00:48:35]
THERAPIST: Um.
CLIENT: You don't have to answer that? (laughs)
THERAPIST: Okay.
CLIENT: That's not really a fair question.
THERAPIST: Okay. (laughs) Well, I think that's the sort of thing we're kind of chipping away at over time.
CLIENT: Okay.
THERAPIST: For example, yeah I guess I can leave it there. But yeah. (pause)
CLIENT: Okay.
THERAPIST: For example, a way to say it. I think (pause) you know like yesterday, yeah you know a lot about this and you just don't want to because you feel like shit and it's dangerous to know these things. And you know and you're like, "Yeah, yeah, yeah." [00:50:08]
CLIENT: (laughs) Phone. (ph)
THERAPIST: Yeah, right. I don't know that you would have agreed with that a few months ago.
CLIENT: Hm. Okay.
THERAPIST: Like maybe, but yeah, I think that's the sort of stuff we're working on, at least some of it.
CLIENT: Okay. Okay. Thanks.
THERAPIST: Sure. We can stop for now.
CLIENT: Okay.
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