TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

THERAPIST: Is it a little hot in here?

CLIENT: A little bit.

(PAUSE)

THERAPIST: That makes a huge difference.

CLIENT: Yeah. (PAUSE) Hi.

THERAPIST: Sorry I'm late.

CLIENT: That's okay. I left my phone at home so I couldn't tell. But yeah. Although...

THERAPIST: (LAUGHTER) (inaudible at 00:00:39)

CLIENT: I guess. (LAUGHTER)

(CROSSTALK)

CLIENT: No. I was going to say it's very funny because I can hear you run up the first two flights of stairs and then walk up the rest. (LAUGHTER) It's like, "Oh, that's exactly what I do."

THERAPIST: (LAUGHTER)

(PAUSE) [00:01:00]

CLIENT: I sort of have a case of like... (PAUSE) I feel like I'm scared of so many thing about this relationship that it's a little surprising to me that I'm not... (LAUGHTER) afraid that you'll lose patients when I... Or if you'll be disappointed in me if I'm upset or sad. I guess I'm more afraid that (SIGH) you will lose patients if I continue to be sad and not sad about the same things. [00:02:01]

Like... Well, if I'm going to talk to you about my problems I should have a new topic once in a while. (LAUGHTER) (PAUSE) I was talking to James (ph) last night and it had just been sort of a day where everything he said was hurting my feelings and I didn't know why and he didn't know why because it wasn't stuff that would ordinarily hurt my feelings or like we were... Just like every conversation we had, I felt like I was being attacked but I couldn't tell who that was coming from. [00:02:59]

You know, probably a little bit of both. But I said, "I just feel like a giant bruise right now. Like everything hurts." (PAUSE) So I'm, yeah, scared to be here because if I show up then it's going to hurt. (PAUSE) I went to the doctors yesterday. This is my PCP I signed up to be a patient several months ago but never made an appointment with her. (LAUGHTER) I, you know, forgot her name so getting an appointment was delayed for several days when I tried to get in touch with the right person who would tell me my doctor's name. (LAUGHTER) [00:04:03]

THERAPIST: I see. Yeah.

CLIENT: But, yeah, she's very nice.

THERAPIST: Good.

CLIENT: You know, she didn't say anything truly stupid about the depression. So...

THERAPIST: Good.

CLIENT: I'll call that a keeper. (LAUGHTER) (PAUSE) Yeah. (PAUSE) And she didn't guilt trip me for completely neglecting all other aspects of my health for the past six month. (PAUSE) Yeah. I just haven't paid attention to anything. I'm supposed to get an ultrasound for my thyroid like every six months or a year. That hasn't happened.

THERAPIST: Yeah. [00:04:57]

CLIENT: Yeah. So... (PAUSE) But she's good. My doctor, well endocrinologist at least, he was a douchebag. But oh well. That's specialties, I guess. He's the only endocrinologist there. It's kind of surprising that like a college has somebody who has someone who specialized in it. So my options are limited.

(PAUSE) [00:06:00]

CLIENT: I was talking with my dad yesterday. I told him about this book that I... I read a book over the weekend, The Fault in Our Stars. It's really good. It's about teenagers with terminal cancer. (LAUGHTER) No. It's very funny and it's like a very, very good book. And he was like, "Well, you know, I'm going to be a hospital chaplain next year. So send me the title. I should read it." [00:07:15]

(PAUSE)

CLIENT: I don't know. He's pretty great in some ways. Just, you know, I am really proud of him that he's... (SIGH) You know, he's 60. He's kind of said, "I don't see any reason for me to retire." He's going into this new field where I imagine the attrition rate is pretty ridiculously high. [00:008:05]

I don't know. (PAUSE) It's a good book. I get a little bit evangelical about books is the problem. Yeah. I try to get everybody I know to read it. (LAUGHTER) So... (PAUSE) You know, it's fun being an English teacher. (LAUGHTER)

THERAPIST: (LAUGHTER)

(PAUSE) [00:09:00]

THERAPIST: You have a captive audience.

CLIENT: Mm hmm. It's great. The fifth graders that I teach are... So I do some grammar with them. They like... They hate grammar obviously. Everybody hates grammar except for me, weirdly enough. Though I hated it as a student. I felt learning about it was stupid. It was just like tremendously boring. So I do like five minutes. They write an essay every week. I'll like take a sentence that's grammatically incorrect and write it and say, "Okay. What's wrong with this? How do we fix it?"

THERAPIST: Yeah.

CLIENT: You know. And like get them to figure out what's wrong with it by being like, "Okay, where is the subject in this sentence? Where is the verb?"

THERAPIST: Right. [00:09:57]

CLIENT: "Oh, trick question. There is no verb. That's the problem."

THERAPIST: (LAUGHTER)

CLIENT: So they started doing this thing where, you know, they kind of complained a little bit. I was like, "Yeah, I know. It really sucks." And I started doing this thing where I was like, "Grammar is so wonderful. I love grammar. I don't want to do anything else." (LAUGHTER)

THERAPIST: (LAUGHTER)

CLIENT: It's pretty hilarious. Yeah. They're pretty cute.

THERAPIST: That's very endearing.

CLIENT: Yeah. They're really nice kids. Yeah. (PAUSE) I'm in kind of a weird... I think it's over. I hope it's over. But there's been kind of a power struggle with the woman who, from the tutoring company. I told her I would have to be gone and she kind of like flipped out and then she sent me a couple of like... [00:11:11]

And then she sent me a couple of like guilt inducing text messages.

THERAPIST: Right.

CLIENT: "Do you really have to go away? The parents, they complain." I was like, "Yeah. I have to go away." (LAUGHTER) She was like, "Okay. I told the parents that you'll be in a conference relating to your field." (LAUGHTER) Like okay? I just didn't say anything.

THERAPIST: Yeah.

CLIENT: It's like... I mean, I'm not going to confirm that story if they ask me about it. But they're not going to ask me about it. I don't talk to the parents.

(PAUSE) [00:12:00]

CLIENT: But I think she's over it. (PAUSE) I've been diligently not thinking about starting work next week. There's nothing I can do to prepare. There's just nothing I can do that would be productive. I'm not going to get myself tied up in knots more than I already am.

(PAUSE) [00:13:00]

CLIENT: It is a huge relief not to be looking for a job. Yeah. That really, really helps.

THERAPIST: (inaudible t 00:13:31)

CLIENT: (LAUGHTER) Yeah. A little bit. Well, no actually because... (SIGH) (PAUSE) Sort of like getting up in the morning, the longer I stay in bed in the morning, the more I know I have to get up. So the longer you go without saying anything, the more I'm like, "Well, what's he going to say?" (LAUGHTER)

THERAPIST: I see. [00:14:03]

(PAUSE)

THERAPIST: So you can feel the tension.

CLIENT: Yeah. (PAUSE) Well and I am afraid that I will disappoint you in some way. So if you're not talking about it (inaudible at 00:14:41) The longer I talk, the more likely it is that I disappoint you.

THERAPIST: I see.

CLIENT: (SIGH)

(PAUSE) [00:15:00]

CLIENT: I... (PAUSE) You would think that I would learn over time that just because I don't articulate these things to myself doesn't mean I'm not afraid of them. It doesn't help not to like articulate them in my head. But I don't learn that. (SIGH)

THERAPIST: Meaning like the thing that you just said...

CLIENT: Yeah.

THERAPIST: ...about disappointing me? Like you don't formulate that for yourself...

CLIENT: Yeah.

THERAPIST: ...as though that would make it less true which, as it happens, it doesn't.

CLIENT: Exactly. I prefer to be vaguely uneasy without much an idea why.

THERAPIST: I see. [00:15:55]

CLIENT: I feel like that will help. (LAUGHTER) (PAUSE) So the thing that is strange about this relationship is that the risk of acting the way I would ordinarily and, which is to say, you know, just not talking about it and trying to control the conversation and, you know, guarding what I say very carefully, like those risks are, if anything, greater than the risk of not guarding what I say or trying to do things differently or trying to (inaudible at 00:17:49) So I feel like I'm pretty much screwed. (LAUGHTER) [00:17:59]

THERAPIST: I see. So it's not going to go well.

CLIENT: (LAUGHTER) No.

THERAPIST: I see. (PAUSE) Yeah. I mean, you seem like today to be (inaudible at 00:18:41) sort of intentment of vulnerability and expectation of being hurt which (inaudible at 00:19:05) not being something that you acknowledge. [00:19:11]

And... I don't know. I guess I'm wondering if you're trying a bit of a different strategy...

CLIENT: Yes.

THERAPIST: ...to pay close attention to it which is (inaudible at 00:19:35) or something like that.

CLIENT: Yeah. And also I feel like there's a lot of pressure on me to be able to figure things out, to be able to figure out what I'm doing and do something different. So...

THERAPIST: As in I am putting pressure on you to do that? Or that's what it feels like. [00:20:03]

CLIENT: That's what it feels like.

THERAPIST: Yeah.

(PAUSE)

CLIENT: It's one of those things where I'm very, very aware that actually, no, that pressure is coming from me. But it still feels like it's coming from you. So it's hard to say.

THERAPIST: Sure. Yeah.

CLIENT: I guess I feel like yesterday I (PAUSE) I was really upset with myself. (PAUSE) I think...

(PAUSE) [00:21:00]

CLIENT: I felt like I wasn't thinking clearly. I felt like I couldn't say what I wanted to say and I didn't really know what I wanted to say. So I guess I'm trying to take the initiative and I really hate the expression "grab the bull by the horns" but that's the only one I can think of. (LAUGHTER)

THERAPIST: (LAUGHTER)

(PAUSE) [00:22:00]

THERAPIST: I get this relationship feels kind of abusive to you.

CLIENT: Here you go. (LAUGHTER) Sorry. How?

THERAPIST: Well it feels like I put tremendous pressure on you to do things and figure stuff out. [00:23:07]

But if you say something, I'm going to get you for that. And if I don't say something, it's only because I'm waiting to get you worse later. I guess it seems to me that you feel like I'm putting you in a kind of impossible position where I'm going to whack you kind of no matter what you do or not matter how hard you work or no matter how hard you try to fit in with my (inaudible at 00:23:55)

(PAUSE) [00:24:00]

CLIENT: The thing I remember most... Or one thing I remember very clearly about my relationship with Bryan (ph) was that I always thought, "This time I can fix it." You know? I can... (SIGH) I can have exactly the right expression or say exactly the right thing and, you know, this time he won't react quite so bad.

(PAUSE) [00:25:00]

CLIENT: Yeah. I think you're right.

(PAUSE) [00:26:00]

CLIENT: I guess I knew that. I feels... (SIGH) Like I'm just sure that if I get hurt it's my fault because I couldn't fix it. (PAUSE) I'm so sure.

(PAUSE)

THERAPIST: (inaudible at 00:26:51)

(PAUSE) [00:27:00]

THERAPIST: The way you sort of kind of operate is a sort of denial of your, you know, kind of inability to control what the other person does and the horror, really, of how it feels like (inaudible at 00:27:51)

CLIENT: Yeah. I didn't really think about that. [00:28:01]

THERAPIST: Uh huh.

(PAUSE) [00:29:00]

CLIENT: (inaudible at 00:29:45) (CRYING)

(PAUSE) [00:30:00]

CLIENT: I don't really know what to say. I still feel like it matters whether I say exactly the right thing.

(PAUSE)

THERAPIST: That's not the only thing that you feel. You also feel upset about the (inaudible at 00:30:45)

CLIENT: Well, yeah. (LAUGHTER) Yeah. (PAUSE) Yeah. I realize that.

(PAUSE) [00:31:00]

CLIENT: And, yeah, I wish you hadn't brought it up. (PAUSE) This is exactly what I mean. (LAUGHTER) (CRYING)

(PAUSE) [00:32:00]

(PAUSE) [00:33:00]

THERAPIST: I think in this instance (PAUSE) I'm not actually really the problem. [00:34:01]

CLIENT: (LAUGHTER) Yeah. I know. But can you tell me why? (LAUGHTER)

THERAPIST: Sure. (PAUSE) The problem is, and what I think our interaction is confronting you with, is (PAUSE) kind of sort of the fantasy about being able to control what happens in a relationship and pretending that (inaudible at 00:34:51) and then the, and, really, the sort of problem (PAUSE) underlying that is... (PAUSE) I'm trying to figure out the best way I can to put it. Like...

(PAUSE) [00:36:00]

THERAPIST: It has something to do with, I think, grief about that never having been true as much as you wanted it to be and thought it was. That's not as (inaudible at 00:36:31)

(PAUSE) [00:37:00]

CLIENT: Yeah. [00:37:55]

(PAUSE)

THERAPIST: Like I guess another way I could put it is it kind of legitimizes like a whole lot of horror and grief that you've experienced at the hands of other people that has felt to you illegitimate because you should have been able to manage things so as not to be treated that way. (inaudible at 00:38:49) In other words, like, just to give you a recent example, which you did feel upset about but (inaudible at 00:39:07) [00:39:09]

When your dad was here not too long ago, you made plans to meet up and he went out and got coffee and you were really worried about him and you didn't hear from him for like hours and you were worried he collapsed and you called and he was like, "What? Huh?"

CLIENT: Oh. Yeah. I guess I remember about that.

THERAPIST: Is that...

CLIENT: I had forgotten about that.

THERAPIST: Yeah. But you do? Okay.

CLIENT: Yeah.

(PAUSE)

THERAPIST: You know, in that case (inaudible at 00:39:41) I don't think you felt like, "It was all my fault. I should have known that, you know... I should have had James go with him or I should have sent him with three different pagers or I should have, you know, put a tail on him when he left or something like that." [00:40:01]

CLIENT: Yeah.

THERAPIST: You know, instead it was just (inaudible at 00:40:11) have the information in front of him to know what that would have done to you. Or when you were a kid, they'd be like, they'd sort of explode on you randomly. You kind of disavowed the grief or the view that you're being treated really badly, and how horrifying that is, by thinking that, you know, if I had just been a little neater or (inaudible at 00:41:01) you could have avoided being treated that way (inaudible at 00:41:09) [00:41:11]

CLIENT: Yeah. (PAUSE) Yeah. (PAUSE) Yeah. I can't keep the people I care about from hurting me and I think, "Well, maybe I shouldn't care about them." I can't do that either.

THERAPIST: Right.

CLIENT: I care so much about people. And...

(PAUSE) [00:42:00]

THERAPIST: I guess part of what I'm saying (inaudible at 00:42:39) I think some of what is so hurtful to you about like what I'm saying (inaudible at 00:42:53)

(PAUSE) [00:43:00]

THERAPIST: (inaudible at 00:43:21) Like the part about you wanting to hold on to and looking at things. That's never really worked very well. But that sort of opens up another can of worms to acknowledge. I don't imagine it will always feel like that [00:43:51]

CLIENT: I've tried pretty hard to tell myself that I couldn't have fixed anything. I couldn't have made it not happen that way. I think that. I can see that in other people. But it just doesn't...

THERAPIST: Right.

CLIENT: It doesn't register.

THERAPIST: Sure. (PAUSE) Well, look how much it hurts. (inaudible at 00:44:39) We'll stop for now.

END TRANSCRIPT