TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
CLIENT: I'm doing a lot better.
THERAPIST: Good.
CLIENT: I've sort of kind of snapped out of it yesterday so that was good.
THERAPIST: Sorry. The scheduling thing.
CLIENT: Yes.
THERAPIST: I had meant to ask you and forgot. Could you meet at 3:45 instead of 4:30 tomorrow?
CLIENT: Yeah.
THERAPIST: You sure?
CLIENT: Yeah.
THERAPIST: Okay.
CLIENT: (inaudible at 00:00:31).
THERAPIST: Okay.
CLIENT: I don't have anything else that actually has the time.
THERAPIST: Thank you.
CLIENT: Yep. I just have to remember that.
THERAPIST: Do you want me to text it to you or something?
CLIENT: No. It'll be fine. I wrote it down.
THERAPIST: Yeah. I guess I just saw you write it down so I don't know what my problem is.
CLIENT: (Laughter) The problem with having so few appointments during the day is I'm not in the habit of checking my schedule five times a day the way that I used to be so stuff gets lost sometimes. But, yes, I'm feeling a lot better. [00:01:24]
THERAPIST: Good.
CLIENT: And sometimes I feel like... (Pause) I feel like looking at this like a problem really because I like problems. Problems are basically games in disguise. Yeah. I feel like I just kind of snapped out of it. [00:02:04]
(Pause) One thing I don't think you were right about I mean I'm not sure but you said that you thought a lot of my anxiety about going back to the hospital was from part of me really wanting to go back to the hospital. And I actually don't think you're right about that. (Pause) Or at least if that's going on it's not a part of me that I have any access to. Like there wasn't any internal oh right response which happens a lot. It's just like no. (Laughter)
THERAPIST: Good to know.
CLIENT: Yeah. (Pause) I also wanted to ask you I didn't quite understand what you meant about playing chicken. (Laughter) [00:03:12]
THERAPIST: Right. I think I mentioned that.
CLIENT: No. (Laughter)
THERAPIST: You've got to tell me what you did get if anything that I was referring to at all at the time.
CLIENT: It sounded like you were saying that (pause) I'd come in fairly distraught but also distraught, at least, partially you know maybe largely from these kind of fantasies about the monolithic nature of the things that are wrong kind of dominating the way that I was thinking about it. [00:04:15]
And then we kind of spent the session just kind of poking that in ways that as it turns out was really helpful. But it sounded like you were saying that was really confronting pretty directing parts of the way that I think that are kind of dangerous, kind of dark. Yes. That's what I have.
THERAPIST: Okay. We're a lot on the same page.
CLIENT: Okay. Good. [00:05:00]
THERAPIST: So (pause) it can feel to me as though there are times when saying hey this is not just a monolithic awful (pause) accurate perception of reality is or construction of reality is sort of... I mean there are times when I can say something about that or you can say something about that which like yesterday are quite helpful and it seems to sort of deflate some of that. And there are other times I think it has gone badly.
CLIENT: Yeah, I think so. [00:06:01]
THERAPIST: Where it makes you... Where it... I hate this word. But it's like that sort of invalidating, not being believed in your distress or about it as though I don't want to go there with you kind of response. And that's the part that feels a little like playing chicken. It's hard to know which way it's going to go and it can be dangerous.
CLIENT: Yeah.
THERAPIST: And it's sort of like... Go ahead.
CLIENT: I was just going to say so talking about I mean obviously what's in my mind right now is that this works sometimes. So that's the example that's most present for me. But... So I guess one of the things that was really helpful for me yesterday is I talked about looking at it as a problem. But it was actually really, really helpful for me that it was clearly like a problem for you. And this is clearly something that you find interesting. And I'm not going to say you find this fun but maybe you do. (Laughter) [00:07:47]
THERAPIST: That goes back to what kind of person I am.
CLIENT: But that is actually really, really helpful for me in helping me step outside of myself a little bit. Yeah, I thought there was going to be a second half to that but I think that's about all. But I don't think that would work at all if I didn't... You know there's kind of a bank of you being very validating to use the word you don't like that it kind of relies on. [00:08:38]
THERAPIST: Right. Yeah. I think that probably... (Pause) In the ways this has been working I would think probably a lot of how is there's a combination of incurring capital versus credibility and spending it which way. [00:09:20]
CLIENT: Yeah. It's like I'm pretty okay with you doing this because it's something that you find fun. Because I also really know that (pause) when I'm suffering you see that. So yeah.
THERAPIST: And to be correct that part is not fun for me.
CLIENT: Okay. (Laughter)
THERAPIST: That is just part of what we're saying.
CLIENT: Yeah.
THERAPIST: Like it's good if I feel I can be helpful even if that means just sitting here with you with it which is not sort of acting, fixing. You know whatever kind of other helpful it may be. But (pause) it's not exactly a happy thing. [00:10:40]
CLIENT: Yeah. I mean a lot of this is me constructing why you do this job out of why I do jobs.
THERAPIST: I have a hunch it's more too. Like in that (pause) I think most of the time you felt (pause) like either nobody could or wanted to be anywhere near your feeling these ways. [00:11:26]
CLIENT: Yeah.
THERAPIST: It must make you wonder what the hell I'm doing here?
CLIENT: Yeah. A little bit. You know seeing even my closest family members they burn out you know.
THERAPIST: Who do you have in mind?
CLIENT: Well my dad. It just became pretty clear that he just didn't really want to talk about the depression. But also James, I think, is working really hard to be there for me but it's a really, really hard job. And just a couple hours ago I (pause) started talking about something I was worried about and he kind of snapped at me because in his mind it's not a reasonable worry. And I think he just couldn't deal with it right then. [00:12:45]
THERAPIST: And I think (pause) this is sort of a complicated What you're referring to is complicated in my mind in that there's the (pause) expectable sort of typical amount of energy it takes to deal with a loved one who's depressed and that's just always how it is. [00:13:32]
But there's also not being able to go there with somebody who's depressed or not wanting to. To me it's different you know if it's James and you guys are together all the time and this is my impression what you said like he does a lot. I think he listens a lot, clearly works hard. It gets to a point where there are some things that's very hard for him to tolerate like your suicidality because it just scares the shit out of him. But he would probably acknowledge that and I would imagine (pause) could be fairly honest about like here's what I can handle and here's where I just have trouble that's one thing. And your dad who comes up to visit you because you're depressed and doesn't bring it up until a half an hour before he leaves town that's different. [00:14:41]
CLIENT: Yeah. And a lot of my friends and family fall into the latter category.
THERAPIST: And...
CLIENT: Yeah I mean such that (pause) just the ways in which James has been there for me has been kind of inexplicable to me.
THERAPIST: Like how my doing this job is in a way inexplicable?
CLIENT: Yeah. Yeah.
THERAPIST: That comes partly from growing up with someone like your dad. [00:15:28]
CLIENT: Yeah.
THERAPIST: And developing the belief which is really more of a certainty that this stuff cannot be talked about, people cannot tolerate it, people want nothing to do with it.
CLIENT: Uh huh. So the thing that was interesting about growing up with my dad is that his job was to be a counselor. He was a priest. His job is to go visit people who are in trouble and talk to them. And it's a job that he really loves and is really good at. So (pause) I mean I still don't really know what to do with that. [00:16:18]
THERAPIST: Sure.
CLIENT: (Pause) And maybe I have this idea of some sort of disconnect between work and personal life with them. It's easier to be with people that you have to be with all the time. (Laughter) Yeah, there's that it's easier to be with people when you can go home at the end of the day. I don't know. [00:17:00]
THERAPIST: (Pause) You're thinking about (pause) how was your dad able to do it with other people and yet not do it really at all with you?
CLIENT: Yeah.
THERAPIST: Okay. And both of those things seem true? That's my impression.
CLIENT: That he was able to do this with other people and he was not... Yeah, I think so.
THERAPIST: And you're thinking maybe sort of having the kind of removed and sort of boundaries work (pause) had a lot to do with it? I'm not necessarily doubting you. [00:18:25]
CLIENT: Yeah, I'm not sure (pause) because at this point I have been married to James for a couple of years and I have gotten to know his family pretty well. I've kind of gotten the chance to see a whole bunch of people who work very differently than my dad. (Pause) So... So I don't know. (Pause) I mean I think the other part of it is that (pause) I think I tend to idealize work in some ways because I use it as such an escape and I have for a long time. [00:19:41]
THERAPIST: And so (pause) in that way (pause) that might help to account for how he could be different at work or maybe even in a way how it's a relief to you when I'm clearly here at work. In other words, like yesterday sort of (pause) interested, and stimulated, and problematizing.
CLIENT: Yeah, because that's something that I can understand really well. [00:20:23]
THERAPIST: I see. Well I think it also takes the charge out of what the hell I'm doing here right?
CLIENT: (Laughter) Yeah.
THERAPIST: Which, I guess, is just a very scary thing for you.
CLIENT: I haven't really thought about it much but maybe so. (Pause) Yeah, I think so. (Pause) Yeah because I also have very clear internal ideas about what I'm allowed to ask you and what I'm not allowed to ask you. It's like why the hell are you here is not something I would ever ask you. (Laughter)
THERAPIST: Although you did once. Remember? [00:22:07]
CLIENT: No.
THERAPIST: (inaudible at 00:22:10).
CLIENT: Oh that was like the first thing I asked you.
THERAPIST: Why do you do this job?
CLIENT: Yeah. But you didn't answer it did you?
THERAPIST: Probably not.
CLIENT: (Laughter)
THERAPIST: But I remember being (pause) struck by the question not so much by the content of the question but that moment was a very different moment than the moments we had had previously. It really felt like you kind of very clearly started shifting the focus onto me in a way that I remember being a bit taken aback by it sort of surprised by and unsure about it which is probably partly why I didn't answer because I felt like I didn't know what was going on. [00:23:02]
CLIENT: Yeah. I think I was trying to decide whether to trust you.
THERAPIST: Yeah.
CLIENT: (Pause) Yeah. Because now that I remember I remember that as being very important for me. And you didn't answer, but I don't remember what you said, but whatever it was it was clearly okay. (Laughter) I was like oh okay. That's good enough.
THERAPIST: Great.
CLIENT: So...
THERAPIST: The part of the issue of trust must have had to do with what's coming up now as well though neither of us knew it at the time. You were looking... You were so scared to talk to somebody about some really bad overwhelming things that you were feeling that you have (pause) been quite sure nobody would want to hear anything about. I mean if somebody was going to say they were going to hang around they better have a damn good reason because you wouldn't want to get into that and have them (pause) walk away. [00:24:51]
CLIENT: Yeah. (Pause)
THERAPIST: What are the other questions that you can't ask?
CLIENT: Oh man. (Pause)
THERAPIST: You don't have to right now.
CLIENT: I don't think I'm ready to do that. (Laughter) Also I can't think of any right now. [00:25:23]
THERAPIST: (Laughter)
CLIENT: (Laughter) Which might be cheating.
THERAPIST: That's why I'm laughing.
CLIENT: What?
THERAPIST: (inaudible at 00:25:31).
CLIENT: No, not at all.
THERAPIST: Oh okay. I thought you were saying I don't want to say that and anyway I can't think of anything.
CLIENT: (Laughter) That's okay. That was kind of my thought.
THERAPIST: Yeah. Right. (Pause) We all do that at some point.
CLIENT: (Pause) Yeah. That's the only area I'm really uncomfortable with. (Pause) Well here's a question although it's not really a tough one. Why are you always late? I mean I'm always late also so it's not like I'm going to give you a hard time about it. [00:26:55]
THERAPIST: So you are late?
CLIENT: No, but I'm always late. I've gotten much better at being late because I'm so obsessed about being... I get so upset about being late that I make myself be early for everything. But I used to be always late.
THERAPIST: Right. (Pause) Well there are aspects that I'm happy to answer. Do you have any thoughts or have you wondered particular things about it? [00:27:43]
CLIENT: I mean I guess I just figured that either you're just somebody who's always late like you have trouble being on time or you have other stuff going on in your life that makes you late like maybe you have kids. Nothing makes you late like kids. We have these friends who used to be 20 minutes late to everything and then they had a baby and now they're like an hour and a half late. (Laughter) [00:28:19]
THERAPIST: Yeah. A lot of it is just the way I set my schedule. And the way I used to set my schedule was I did 50 minute hours on the hour through the day pretty much; sometimes on the half hour. And I switched to doing 45 minute hours a few right after so that I can take a longer break because I was learning that I could run over a little bit. But those five to ten minute break between was silly. (inaudible at 00:28:59) break and then do a longer break. But what that really does is it makes my schedule more aspirational than anything else. I'm often running a few minutes over here or there. And I guess I could make those five minute breaks (inaudible at 00:29:13) but at this point... So it's sort of somewhat structural that way. [00:29:23]
CLIENT: It really doesn't bother me to be clear.
THERAPIST: I think clearly it feels (inaudible at 00:29:30).
CLIENT: (Laughter) Clearly. Yeah, it's funny how I mean I'm really not bothered by other people being late at all. I'm just really bothered by myself being late. Thanks.
THERAPIST: Sure. (Pause) And there are probably other things to do with me and that's the part I will be less forthcoming about.
CLIENT: That makes sense. [00:30:10]
THERAPIST: (Pause) Which is to say it's not (inaudible at 00:30:22).
CLIENT: (Laughter) Yeah.
THERAPIST: Well who's to say it's not about questions.
CLIENT: (Laughter) Yeah. (Pause) Yeah, I guess I'm intensely curious about you but also it's really, really important to me to respect your privacy; like really important. So you know... But obviously you can take care of yourself in that regard. I just... I don't know. I say I don't know when I don't mean I don't know at all, all the time. (inaudible at 00:31:16).
THERAPIST: (Pause) So (pause) it sounds like you're worried there sort of on an emotional level that you would ask questions or start a discussion about things you wonder about, about me and somehow that would broach some boundary of mine, or I would talk about something I didn't really want to or something like that. Which then at a kind of more intellectual level you imagine I probably wouldn't do and that I could take care of myself but somehow there's still a worry that that would happen. [00:32:20]
CLIENT: Yeah.
THERAPIST: Is that's what's coming?
CLIENT: Yeah I think so. (Pause) You know I don't want to make you uncomfortable. (Pause)
THERAPIST: Yeah, in a way I guess that's a lot of what we're talking about today relates to.
CLIENT: Yeah I guess so. [00:33:02]
(Pause) Even though part of your job is to make me uncomfortable. (Laughter) I should probably just get over it.
THERAPIST: Well I think this is a central issue for you is (pause) kind of like being able to find a certain solidity in a person that you're talking about something that matters to you. And not to be worrying about how they're going to be fragile. [00:34:40]
(Pause) Lately, I also have an idea in mind that you imagine that (pause) again, maybe on an emotional level I guess I could call it my anonymity you know not talking about things in my life is significantly about protecting myself.
CLIENT: Yes. Yeah, actually that's exactly right. [00:35:23]
THERAPIST: Which (pause) mostly isn't true. Like whether I have kids or not or (inaudible at 00:35:42) or whatever. I don't... For me, or therapist in general, not talking about those things (pause) is especially sort of protective. There are some things that are. I'm not trying to say otherwise. But something like that which isn't a sort of (pause) talking about things that aren't particularly sensitive, or don't feel sensitive to me, or protecting myself so much. It's more to do with (pause) giving your (inaudible at 00:36:42) more room to maneuver or... [00:36:48]
CLIENT: That makes sense.
THERAPIST: Allowing you to feel (pause) freer to have opinions or reactions without worrying so much about me. In other words, if you find people with kids really annoying or people who don't have kids ridiculous... You don't know one way or another it kind of doesn't come up. If I do then maybe you would worry as much but maybe not depending what your opinion was. [00:37:42]
CLIENT: That's really interesting. (Pause)
THERAPIST: Again, I'm not trying to say there aren't sort of things about my life or things that it would make me feel quite vulnerable to talk about. But a lot of the anonymity isn't about that.
CLIENT: No. I mean that makes a lot of sense to me. I just hadn't thought of that.
THERAPIST: Sure. I mention it because, again, it seems (pause) related that (pause) my safety or stability was at stake in all of that. [00:38:52]
CLIENT: Yeah. I mean, I guess, the way that I have kind of (inaudible at 00:38:58) is wanting there to be, at least, some level of reciprocity in that like you really take care of me. And so I want to be taking care of you in whatever way I construct this; being some way that I can. [00:39:27]
THERAPIST: (Pause) Well there may worries there but that's also kind so thank you.
CLIENT: Thanks. (Pause) But I mean clearly I don't exactly know what that looks like. [00:40:31]
THERAPIST: What taking care of me looks like?
CLIENT: Yeah. (Laughter) (Pause) It's important to me. One of the things I worry about with James right now for a while back is I can't take of him in the way that he takes care of me. I feel like I'm not. I don't quite know to do about that. [00:41:25]
THERAPIST: (Pause) Was that much of an issue during the period where you were not as depressed as you've been over the last couple of years?
CLIENT: Less so. You know when I'm not depressed it's easier for me to recognize that the things that James needs from me are not the same things that I need from him and that's harder for me to see. (Pause) If James wanted to marry somebody who was just like him... I mean I guess it'd be a little bit hard. He's pretty special. But there are a lot of people who are a lot closer; a lot of people. (Laughter) We dated for a long time. He knew what he was getting into. (Laughter) [00:42:52]
But yeah I just get into this mode of worrying about all the ways that I can't do things the way that James does them. (Pause) Even at the best of times I can't and then I have a hard time just taking care of myself basically. [00:43:46]
(Pause) He says he's doing okay.
THERAPIST: Great.
CLIENT: Yeah. It's hard for me to kind of trust him in that, but that's what I need to do.
THERAPIST: (inaudible at 00:44:19).
CLIENT: Okay.
THERAPIST: (inaudible at 00:44:23). [00:44:23]
END TRANSCRIPT
