TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: Wow I wasn't expecting you.

THERAPIST: I would hope not by this time.

CLIENT: Recognizing patterns; they teach you these things in grad school. Yesterday was pretty awful. The session hit me really hard and I'm not sure why; and the rest of the day was really hard. I've been actually applying for jobs today and doing a little better, or doing okay. I'm going to go to the library after this. We've lived here for six months and it seems time to have a library card. [00:01:00] That and I'm getting a new student at the [inaudible] place, a student preparing for the SAT to English, so I have to find out what's on the SAT to English. (pause) I went home and cried for a while and James comforted me and, sure enough, I felt really bad about it. (sighs) [00:02:00] I don't know whether James and I are okay. We're kind of just not really talking about it and pretending it's not there. (long pause) [00:03:08]

I find myself getting into the situation of having a hard time, thinking about suicide, and I'm like, "Maybe I should call Chad," and then I think of reasons not to call you either, "He's still at work," or "It's way too late." Mostly I'm like, "I can handle this, so I will and I'll talk to him about it tomorrow." Yesterday was a little scary. It feels like I'm getting more used to being that much on the edge. [00:04:08] It's like if I'd had a day like yesterday six months ago I probably would have called you, but now it's like, "Well, I've been here before and it will go away or maybe it won't go away, but I know what I'm going to do about it." (pause) [00:04:58]

THERAPIST: It's okay with me to call me.

CLIENT: I know. Thank you. If it is the issue, you're saying that it's okay with you isn't actually going to do anything. (laughs) It's like the 85% of me that knows that it's okay with you knew it was okay with you. The other 15% just doesn't believe you. (chuckles) So thank you. It's like I don't want to call you unless I need to, but the need is a hard thing to parse. [00:06:10]

THERAPIST: Sure, especially when you're in that kind of shape, I would think.

CLIENT: Yeah. I thought about canceling the tutoring session I had yesterday. I didn't mostly because James said he thought it was a bad idea; but I sort of wish I had. It wasn't the worst ever. I didn't start crying in the middle. I just didn't feel good about it; I didn't feel good about myself and I feel like they should just fire me. [00:06:59] (long pause) I think the idea of asking for comfort is something I'm really not comfortable with or I feel like it really upsets me. [00:08:03] (pause) Can I ask you why do we meet so often? [00:09:14]

THERAPIST: Oh, before I forget, I don't know if you got any checks yet, but I got a notice... for about 20 visits.

CLIENT: I did not all of them and not in any order, but I did. Thank you. It seems like they have processed.

THERAPIST: They're starting to roll? Okay.

CLIENT: It was amazing. It was nothing, nothing, nothing, and then our mailbox was full. The mailbox that's not actually locked but that they put newspapers in was also full. (laughs) I was like what's going on?

THERAPIST: [...] (inaudible at 00:09:58)

CLIENT: Actually, it's exactly like that. (chuckles) [00:10:12]

THERAPIST: (pause) I guess I have in mind really two reasons. One is so that during periods where you're having more trouble, like there's more of a chance to check in or evaluate needs, stuff like that. I don't think that's the main reason. The main reason in my mind is that it gives us a chance to work intensively on things you're struggling with. [00:11:28]

CLIENT: Blue Cross did the thing where they say "Your provider billed you $150. We only think he should have billed you $100, so we're going to pay for 80% of that," which is okay because it was a recording, but I'm just worried they're going to decide, "we don't think that you shouldn't be in therapy any more, so we're just not going to pay for it any more," or "we don't think you should be in therapy this often, so we're not going to pay for that." I don't know. [00:12:14]

THERAPIST: I've never seen them do a review of somebody who's in a PPO or POS plan. I've seen many people at this point, three or four or five times a week, who are on those plans for years. It's Blue Cross; I never really know what they're going to do, but...

CLIENT: That is reassuring, though. Thank you. It's like if this is going to have to stop abruptly I want to be prepared for it.

THERAPIST: This will not stop abruptly one way or another. If they said tomorrow, "We're paying for once a week and that's it," we'd need to taper down probably over a period of a few months, but I can't do this for nothing or very little, but I also that just wouldn't be right or fair to you to say, "Oh, well. That sucks for you." [00:13:55]

CLIENT: Yeah, but I feel like just because it's not fair to me to say, "Oh well. I guess that sucks for you," doesn't mean that it's not going to happen.

THERAPIST: I understand. Either from Blue Cross or from me. [...] (inaudible at 00:14:13), but for the moment.

CLIENT: I guess the other thing I want to put on the table, which I think I talked about before, is looking for a job might make Mondays and Wednesdays harder for me to do. That, I feel like, is a different thing than to say, "I just can't do this at all."

THERAPIST: I guess your hours would depend on what job you got. If you got a teaching job you'd be working school hours and I assume that in any job I guess that could vary. [00:15:09]

CLIENT: They really vary. That's what I was applying to today. A lot of them are noon-ish to afternoons, but a lot of them are more flexible.

THERAPIST: With something like that, depending on the hours you had, it might take me a little while to adjust, but I probably could.

CLIENT: Okay. Thanks. I guess I did bring that up to change the subject, but it also was something I wanted to talk about. (laughs) [00:16:01] (pause) This ends up being different than most people's therapy, I think. I don't know. It's like a couple of times I've been trying to talk over a problem with James or, realistically I've just been talking at James about something that's bothering me, and he'll say like, "What does Chad think about this?" And I'll be like, (laughing) "Chad doesn't really tell me what he thinks." [00:17:24]

THERAPIST: What sort of problems do you have in mind?

CLIENT: I actually don't have anything in mind. Whether I should look for a nanny job is one. The only reason I can think of that I shouldn't is pride and that's a terrible reason. Also, I don't want to do other people's laundry, but I can just say, "I'm not going to do your laundry." (laughs) I have that power. [00:18:48] I just get attached to people. I really should be charging more for both of my tutoring jobs, but I am attached to the kids and I don't want to lose the job. (pause) [00:19:43] I'm having a much harder time with leaving school than I expected to, I guess. I still pretty much think of myself as an academic, with all the trappings that entails, but I'm not any more. (pause) [00:20:42] I think of myself as an academic on good days. (laughs) Like this is [...] (inaudible at 00:20:48). Those are not the days where I think I just can't do anything. I just don't know what to tell people when they ask about my life. "Yeah, it's kind of a shit show," is usually not what they want to hear. (pause) [00:22:00]

I finally got my thyroid tested. Now I have hyper-thyroidism so I have to make an appointment with the doctor and get that figured out. Dr. Vaughn (sp?) said she hoped that fixing that would help with the emotional stuff. I'm not going to hold my breath because I had hypo-thyroidism and they told me, "When we fix this the depression will get better." (laughs) (pause) [00:23:04] I feel like I've tried enough things and had them fail, like tried enough physical things and different medications and so forth, and that did not do anything that I'm kind of aggressively resistant to the idea that anything could do anything. I don't really like being like that. It pisses James off and I'm not entirely sure why. Maybe I'm just angry about getting my hopes up so many times. I feel like instead of seeing an invitation to be hopeful, I see it as an invitation to be disappointed. [00:24:17]

THERAPIST: [...] (inaudible at 00:24:29) I think in which you feel I can see why really cruelly treated. Like, "Here, try these 15 different things that could help and all of them have different side effects. You're going to have to wait awhile to see what the side effects are and see if it helps. But maybe the next one or the next treatment." I can see, too, how awful you felt yesterday and how I don't help with reasonable, practical issues. I mean I know that you know why. I don't really think...

CLIENT: I know.

THERAPIST:... but still I'm sure there are some moments like "What the fuck?" [00:25:55]

CLIENT: Yeah.

THERAPIST: That's hard to say because then I'm going to get mad and you're going to feel really guilty because you're going to sort of start to think about the other side of it where people around you are trying. That sort of then strangles the frustration and the anger and, I think, criticism.

CLIENT: Yeah. It's really hard for me to be frustrated with you because you are the person who does help. It's like, "How dare I be frustrated that it's not helping more?" I feel really guilty about that, which is basically just restating what you just said. [00:27:03]

THERAPIST: It also, I think, speaks to a feeling of tenuousness about being helped or sort of what I will put up with.

CLIENT: Yeah. There's that other shoe, you know? (laughs)

THERAPIST: But barely. Yeah.

CLIENT: I feel like I keep pushing a little harder and a little harder and it's exciting (laughs), shall we say. [00:28:08]

THERAPIST: It makes me think that things historically, too, that sort of worry, I think, about pushing your dad and the ways it sometimes did go very badly when you did. And maybe also the other shoe is kind of your mom. I mean, she took off.

CLIENT: And sometimes she was there and she was really wonderful and then sometimes she just wasn't there and I didn't know. Yeah. [00:29:04] I didn't know if she was going to kill herself. (pause) I don't talk about it very much. (pause) In some ways I think about her more when I'm thinking about suicide. I feel like I understand her better. [00:30:08] (pause) She always said that she loved us more than anything and I believed that, but what that meant as it played out was that we didn't spend very much time with her and a lot of the times we did we were playing second fiddle to her boyfriend, whichever boyfriend it was, so that's odd. [00:31:14] Now I just think, "You don't really know me very well. I believe that you love me, but you sort of love this person that you think is still eight years old." There was a long time where, in the couple of years after my parents split up, where my therapist would ask me what I wanted and I would just say, "I want to be with my mom all the time." [00:32:16] (pause) It's harder to be angry with her now and saying, "Yeah, I absolutely know why you tried to kill yourself multiple times. I absolutely know." Part of me is like she can't have been trying that hard. (laughs) She never calls me or gets in touch with me first. I'm not sure whether she feels like she's not welcome to, but that's sort of [...] (inaudible at 00:33:57). (pause) [00:34:25]

She got me a kitten once. My dad was really upset. (laughs) It was a disaster. He's allergic to cats, although I don't think he's really that allergic. I think he just doesn't like them because my step mom has a cat now, has always had a cat. The cats die and he thinks, "Oh, no more cats," and then she gets another cat. He's always surprised. I think he just says that he's allergic to cats. That was, I think, a unilateral decision on her part but, since it was going to be my cat and I lived with him, he was going to have to be over there. [00:35:24] It ended up having some horrible G.I. disorder. I'm pretty sure he gave it away. (pause) [00:36:21] He sent me a text at like 11:30 last night with a picture of him holding this cat. "I have to be nice to the cat otherwise he'll run away and Joanne will have no reason to come home." (laughs) Who are you? I'm not sure how I feel about that. I'm not sure how I feel about him saying he was allergic to cats when we were growing up because he just really didn't like them. I mean he genuinely doesn't like them. [00:37:35] I don't know. Mostly I just think, "Good for Joanne." He keeps saying, "No, we don't need any more cats," and Joanne is like, "Yes, we do." (laughs) It's not something I could have done. (pause) [00:38:20]

I was so lonely. I wanted a pet because I was just so lonely. (crying) I didn't have any friends. It felt like I didn't have anybody that loved me, so I wanted a pet.

THERAPIST: That makes a lot of sense.

CLIENT: Yeah. I say I didn't have any friends, but I'm not sure how accurate that is. I think pretty accurate. I would kind of like form temporary alliances with people in my grade, but I never [...] (inaudible at 00:39:43). It was like, "Oh, both of us are getting picked on by everybody else. Let's be friends." When you don't actually like the other person much, it's hard to be friends. (laughs) [00:40:04] I got in touch with one girl over Facebook a year or two ago did I tell you that? Maybe. This was the other girl in the class that was getting picked on even worse than I was. I apologized to her. She was kind of like, "Why are you apologizing?" (laughs) But I felt better. (pause) [00:41:05]

THERAPIST: You do seem to me much more in touch with and able to talk about ways things were sort of bad and very painful...

CLIENT: Than what?

THERAPIST:...than when you talk about things from the past, six months or a year ago.

CLIENT: Humph. I would not have said that. Like I don't notice that. [00:42:13]

THERAPIST: Your version of that, anyway, doesn't feel in a way I think it probably used to more so, like it's going to cause the other shoe to drop, talking about things having been bad.

CLIENT: Yeah. I feel like I'm invested in some way saying, "Things were really bad and look how much better they've gotten," which I don't feel like I have much to base that narrative on any more. (laughs) Like things are really bad. Yes, things are pretty bad right now. I don't know. Jed Bartlet on The West Wing is really like my dad. Even the funny yet irritating non sequitur conversations where he'll be like, "Let me tell you all about the National parks." That's my father. [00:43:51] I have no idea how either of them get anything done. (laughs)

THERAPIST: We should stop for now.

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