TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: Hey.
CLIENT: Not a good weekend; like really not a good weekend.
THERAPIST: I'm sorry to hear that.
CLIENT: It wasn't bad today. I was supposed to read at church and about ten minutes before we were about to leave I went to go change so I wouldn't be wearing sweats to church or have jeans that had holes in them anyway (laughs), I started crying and couldn't stop crying so we were late getting started and then the train was delayed because that's what it does. [00:01:00] They want you to get there like a half an hour beforehand if you're reading which is really stupid, I think, so I got there ten minutes beforehand and they had already told the person who was reading the second reading to do both of them. I was really upset about that. (pause) Mostly like I worked pretty hard to get there in the first place. I wouldn't have gone if I didn't have to read.
THERAPIST: Yeah, I imagine you had to work pretty hard to pull it together when you're in the middle of the train.
CLIENT: Yeah, and then I had to keep it together in church. Yeah. [00:02:03] There wasn't any point where I felt like I needed to call you right then, but things are bad. (pause)
THERAPIST: I guess it's kind of scary to tell me how bad that it's going instead of what happened.
CLIENT: Yeah. I sort of feel like (pause) it's hard to talk about how that is, in part because I don't want to go back to the hospital. (laughs) [00:03:06] Also when I describe my reasoning out loud it sounds stranger, stupider, and bizarre. (crying) There was a lot of, "Well, I will not think about trying to kill myself right now. I'm going to watch this episode of The West Wing first." (pause) I just want it to be over.
THERAPIST: You're feeling, again, pretty done?
CLIENT: Yeah. [00:03:58] And I know that in a day or a week things will get a little easier and I'll sort of get my breath back and in another day or a week I'll get this bad again. (sighs) I'm getting angry at James.
THERAPIST: For what?
CLIENT: Because I think about killing myself and the reason I don't is that I have to think what that would do to James and I think I can't do that. I get angry at you because your way of [sifting things] (ph?) is very slow and I'm really tired. [00:05:23] (long pause) [00:06:45]
THERAPIST: I think one of the things I see as being quite reasonable in your wanting to kill yourself in the first place and also you're kind of pissed off at James for getting in the way and me for not speeding things up already and for being wary or withdrawing in how much you want to tell me about it because you're worried I'm going to send you to the hospital, I have trouble seeing this as your being in a lot of pain and really fed up; but will instead have my own reaction to it, a similar sort of reasonable or wanting to know if this is how it works. [00:08:11]
CLIENT: I do know this is how it works. That's the problem. I just feel like I can't get out of this cycle and I'm really tired of it. (pause) Part of that, also, is that the last few days I've been in that kind of insane place where I'm just in so much pain right then that I just think differently; and now I'm a little bit out of it, but not enough out of it like it's going to come back and so I'm trying to kind of describe what it's like, but I'm not there now and so it's harder. [00:09:56]
THERAPIST: Okay.
CLIENT: but I'm not even sure why I am trying to describe what it's like I think because I feel like that's what I'm supposed to do here? I don't know. Maybe because I'm worried about what I'll do? I don't know. Or maybe it's because I know that I'm not going to try and kill myself, but I'm really angry about that. (pause) [00:11:06]
THERAPIST: My impression, and I maybe talking to two slightly different versions of you here I don't mean in some kind of huge dissociative way, I don't mean it like that. I got the gist of what we talked about before. But what I have in mind is the part of you that's very much in touch with what things were like over the weekend and that is in a lot of pain and wants everybody out and is very angry and doesn't see any point in much of anything, including talking to anybody; and another part that's is a bit healthier and more reasonable or rational, like a conventional way of thinking about that has thoughts of talking or thinks that it can be a good thing. I'm kind of hearing from both of those, in a way. [00:12:51]
CLIENT: Humph. I don't know. (pause)
THERAPIST: I just want to say that what you were just saying was that you said you may or may not kill yourself, but you're really mad about it. Did I get that right?
CLIENT: Yeah.
THERAPIST: I'm not saying you should feel either of those ways.
CLIENT: Yeah. Sometimes that happens. Sometimes I think, "I know I'm not going to kill myself," and sometimes I think that I just might. Both things feel authentic. [00:14:16] (pause) There's a character in the show we were watching, Battlestar Galactica, that just talked about wanting to be dead in the last episode. James was like, "That's a storyline they're going to develop." It's really hard to watch that with James. I have a lot of things to say about that, but I don't want to say any of them to James. [00:15:35] (pause) I don't want him to be scared for me or anxious about me, but maybe he should be scared for me when there's reason for him to be. I don't want him not to be able to trust me. It's like every other thought I think, "What are we going to have for dinner?" and then I think, "I wish I were dead." (laughs) Then I think, "Maybe we should have pasta." "I wish I were dead." (laughs) [00:16:51] (pause) I won a card game with James and Franco. I think that might be the first time ever.
THERAPIST: Congratulations. [00:17:35]
CLIENT: Thank you. I was very proud of myself. And I still wanted to be dead but I was also very proud of myself. I don't know. (laughs) I sort of feel like I should be finding some sort of thread in here, but I don't have one. (pause) [00:18:44] There's not really a good way to kill yourself. [...] (inaudible at 00:18:48)
THERAPIST: What have you thought of?
CLIENT: Apparently the success rate of overdose is somewhere around 2%, so I probably wouldn't do that. I think I want to jump off a building, but that seems not easy enough or easy to tell whether you'd be successful and if you weren't, that would just suck. I have the impulse to run out into traffic, but that seems like a pretty horrible thing to do to the person driving the car, so I'd probably cut my wrists or something. [00:20:37] That's what I think about most; but that, again, is a pretty horrible thing to do to James, because he'd be the one to find me. (crying) I just can't get out. (pause) [00:22:07] The part of me that thinks about consequences doesn't turn off, in some ways.
THERAPIST: At the same time you're telling yourself how unbearable everything is, but then you've got to be worried [...] (inaudible at 00:22:47) thread. (both laugh) I didn't mean there clearly is a thread in the sense of like think of this dire and yet...
CLIENT: That's what I'm worried about. Yep.
THERAPIST: In keeping with what you're saying about not being able to stop.
CLIENT: Yeah. I may have said this before. I read a poem the other day by Mary Carr about a friend who had killed himself and one of the lines is, "Every suicide is an asshole." (laughs) It's a pretty good poem. I think she's right. (crying) But I'm not sure if I can keep going. I try to. I get down and I say, "I don't have to worry about the rest of my life. I just have to get through the day," every day. I don't think it helps very much. (crying) [00:24:43] I think, "What do I need to do to make it through today?" and then I have to do those things. (crying) (pause)
THERAPIST: I guess I'm also thinking about sometimes it's clear when you're feeling [...] (inaudible at 00:25:40) In addition to that, something else you're feeling that it is too much to hear, which is part of what's making you rather be dead.
CLIENT: Yeah. I'm thinking about that. (pause) I don't know. [00:26:44] I feel useless and like I'm a burden on the people who love me. I worry about money a lot. I don't know. (pause)
THERAPIST: I wonder about guilt, which isn't so far from the things you've said, I don't think. [00:27:37] (pause) It seems like with regard to James, you're not helping more. You're dragging him down, not contributing, but he's usually pretty nice to you anyway. He loves you anyway. You mentioned also, I think, worrying about when the other shoe is going to drop with me; and maybe sometimes it does sort of in a way with you with guilt. In other words, I'm not actually reacting in the ways that you're afraid I will, which is the shoe dropping; but I understand that maybe you will kill yourself anyway. [00:29:10]
CLIENT: I don't know.
THERAPIST: The thought I have that's even more tentative is that maybe it has something to do with being a weekend and we don't meet.
CLIENT: I don't know. (pause) Things got worse over the weekend, but they didn't get drastically or dramatically worse. [00:30:09] This is the way they were going.
THERAPIST: Yes, which I thought was different here, somewhat clear last week.
CLIENT: Yeah, I didn't know how clear it was.
THERAPIST: It sort of seemed they were close to how they were over the weekend last week. I didn't give it a trajectory, but you said that it was pretty close.
CLIENT: I didn't talk about it. When I want to kill myself this much I'm usually hiding from something, but I don't know what.
THERAPIST: [...] (inaudible at 00:31:02)
CLIENT: It's like if I did know, I don't know if that's going to help me stop hiding from it. (pause) I don't know. It seems worse every day. I'm not sure why I felt [...] (inaudible at 00:32:08). I just need to do laundry. (sighs) [00:32:26] (long pause) [00:34:04] Yeah, I keep trying to wrap my head around it and I just keep coming up dry.
THERAPIST: I don't know. I guess you know that you're frustrating yourself by not knowing, and also aware that you're frustrated and disappointed in me if we can't figure it out.
CLIENT: Yeah. I kind of feel like you make some suggestions and I kind of said, "Eh..." like they haven't really clicked. Then I don't have any better, so (laughs) I'm here. [00:35:27] (long pause) [00:36:46] I don't know why James keeps being so nice to me. I don't know why. (pause) I feel like I need to have him not be the only person I see all day. (sighs) Joshua said he wanted to go out for breakfast this week. It's hard. All these things that didn't used to be so hard, but I always hear myself say that it's hard and then I just despise myself. So it's hard; so what? Do it anyway. [00:38:40] (pause)
THERAPIST: I'm also thinking about the stuff we talked about towards the end on Friday, maybe especially about teacher-student, remember?
CLIENT: Yes.
THERAPIST: And your kind of worry and feeling; I think we were talking about it being [...] (inaudible at 00:39:36) and unproductive in a way.
CLIENT: Yes.
THERAPIST: Maybe that hit you pretty hard, the way we were talking about it.
CLIENT: It's hard to talk about. I guess I feel like (sigh) I built up a space or a way of being where I felt secure or I felt like I did well, where I felt proud of myself. I felt like I was valuable. Then that all just kind of went to shit. It felt like it really backfired on me. [00:40:53] Now I feel like that was wrong for me to be proud of being the person in class who was really good at everything or to be happy about having a close relationship with teachers or like it was wrong for me to be okay with being in those relationships. I've been really scared of that.
THERAPIST: Sure.
CLIENT: Yeah. (crying) It's hard for me to talk about. I'm so ashamed of what happened with Dan. I'm so ashamed of it. (crying) I keep trying to rephrase it to make it not quite so much my fault and I just feel awful. [00:42:14] (crying) (pause)
THERAPIST: I think it helps to clarify for me how central what happened with him is to how you think about yourself.
CLIENT: Yeah. Huh.
THERAPIST: [I think that it's just about that you were very close to him and you had some feelings about certainly when you grew up in a way, but also that it was sort of like a part of who you are or a type of relationship you sort of have is central to who you are and that in a way are going to handle with him.] (ph?)
CLIENT: I feel like the type of relationship I had with Dan before it got out of hand was pretty much the same as the types of relationships that I kind of moored myself by, at least since I was in 9th grade; really before then, too. Then I feel like all of this... [00:44:21]
THERAPIST: [...] (inaudible at 00:44:22)
CLIENT: Yeah.
THERAPIST: Well we should stop for now.
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