TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: I don't know, I guess I could. I mean I don't know, it's a weird thing. If you have to then, I don't know. It's yeah, it's tough. Ten bucks would definitely be tough, 5 would be tough but, I don't know.

THERAPIST: It's sort of, it's hard to define what tough actually means, right? And that's what we are asking. It's not a have to on my end, but it is something we do bring up and have a conversation about every year so, because things change for people. So I don't know if it feels like anything has changed about your circumstances now versus when we started doing the 20?

CLIENT: Not really. In some ways not gotten worse, but I mean I barely pay my mom rent anymore. Just because I'm like picking up some of her bills and the whole student loan thing isn't, I'm trying to get that fucking thing organized. It just is what it is, you know. But so yeah, I don't know. No it hasn't improved. Basically it's the same. [0:01:16]

THERAPIST: So let's keep it what it is for the time being. If something changes you'll let me know?

CLIENT: Yeah.

THERAPIST: I also know you have still the outstanding balance I don't know if you look at that every month or not or. If that's hard to look at.

CLIENT: Not that I can get to. I just right now feel like I'm a bit overwhelmed.

THERAPIST: I know things are stretched thin right now, your car. Is it hard for me to even bring that up?

CLIENT: Uh yeah, I mean I hate talking about money stuff. [0:02:02]

THERAPIST: I have continued flexibility about that balance but I'm also remiss if I don't ask you about it from time to time just to make sure it's on our radar screen.

CLIENT: Of course, of course.

THERAPIST: It sometimes takes on meaning. Money can mean something or avoiding money can mean something. Our task is to figure out what's comfortable for both of us and bring it up if there's something that starts to grow uncomfortable on my end as well as on your end.

CLIENT: Right. Sure.

THERAPIST: I feel comfortable enough with my [inaudible]. (pause) And thank you for your message. I got your follow up.

CLIENT: Oh sure. [0:03:08]

THERAPIST: Looks like I deflated you.

CLIENT: No I'm already doing really shitty so it's okay.

THERAPIST: Just adding to the pile then?

CLIENT: Yeah, yeah, but that's alright, it's not your fault. Just some normal stuff we've gotta talk about.

THERAPIST: What's going on?

CLIENT: Well I've just not been, I was sick all last week, but I felt better for like two days, and now I'm having like panic attacks, anxiety attacks and but some TMJ thing going on all of the sudden. I felt really nauseous two nights ago all of a sudden. And that kind of happened once before some months ago. Like late at night, just sitting in bed I got really nauseous and then my hands got really sweaty and cold. So I don't know. [0:04:05]

THERAPIST: And having panic attacks.

CLIENT: Well I guess not full blown panic attacks, but anxiety attacks.

THERAPIST: About not feeling well, specifically?

CLIENT: It's a vicious cycle. No, I think it's my grandmother's thing, she's just gotten so much worse. I'm not sure what it is. Something. (pause) I feel like a little stuck. Like even with the Kelly thing, like I kind of feel blah. I don't know I think I just feel tired, and I've been feeling overwhelmed a little bit. You know just everything. [0:05:02]

CLIENT: So I've been sleeping a lot. (pause)

THERAPIST: You sounded pretty awful on the phone when the [inaudible] kicked in. Under the weather.

CLIENT: Yeah and I was really sick. Yeah I was really sick. I mean I don't know if I still have a touch of something maybe that's

THERAPIST: I can, it's in your voice still.

CLIENT: Maybe, yeah. But the anxiety part is definitely. Yesterday I was gonna have a drink with a friend of mine, and you know I was driving, or I'd just gotten out of the car to stop at like a 7-11, I don't know what, suddenly I feel like tightness in my chest and blah blah blah. I'm like what the, you know? I feel like lately, it's like every little thing. It's like I feel like things are going haywire. I don't know what the fuck this TM, whatever this things is.

THERAPIST: You mean grinding at night? Is that what you're trying to say? [0:06:14]

CLIENT: I assuming I've been grinding. I don't know what I've been doing. But like right now it's not that bad, but towards the evening sometimes, this thing right here.

THERAPIST: Will what? Pop or hurt?

CLIENT: It doesn't pop but it hurts when I try to open my mouth wide or whatever. Yeah, like I just don't feel well. Oh, then Christmas Eve I had that thing again where when I swallow it hurt really, really bad. So I'm fucking trying, people are talking to me and I'm having a fucking panic attack cause it hurt so fucking bad. I had to excuse myself, went to the bathroom. I coughed it up. Like what the fuck is going on? And then of course I was fine once that, I don't know. I don't know what. All I can think is that I must be so stressed and so wound up tightly, I don't know. Because I read about that thing and the only thing that seems to makes sense is that you can esophageal spasms. [0:07:30] (pause)

THERAPIST: So it hurt worse, but not just like sore throat you're saying.

CLIENT: No I get these like things where like I can never tell when it's going to happen, but when I'm eating, the first few bites I take I can suddenly. The food is not going down. So it's like, it's incredible pain in my chest, incredible pain. Like unbearable. So it sometimes it'll eventually go away, but still it fucking kills, so I have to stop eating and just kind of try to act normal and you know. Try to swallow even though it hurts, other times, but lately it's not I have to excuse myself and I spit it up and all that comes out is saliva and the chewed food. Not to be gross, but. [0:08:26]

THERAPIST: So it's not like you're throwing up or something.

CLIENT: No it's as if it's stuck and I'm just getting it out.

THERAPIST: Yeah, yeah.

CLIENT: And as soon as I do that somehow I start eating and things are fine. And I never know when it's going to happen you know? (pause) I don't know. So basically I just feel like a wreck. (30 second pause)

THERAPIST: It's so different than how you were feeling on Thursday even, last week.

CLIENT: Yeah, last week I just felt like ok I'm really sick, and you know when you have a bad cold. But yeah now I just. I think it just turned into like anxiety, I don't know what it is. I can't figure it out. [0:09:36]

CLIENT: I don't know if my grandmother's thing her continue to [inaudible] triggered something? I don't know if the Kelly thing maybe makes me nervous on some level. I'm enjoying it but I'm nervous about it maybe, I have no fucking idea. Or I just feel stuck in general like I'm feeling a little something you know? I don't know. Stuck or restless. (pause)

THERAPIST: It's also the first time we haven't met for a whole week since starting this.

CLIENT: Oh.

THERAPIST: it just makes me wonder if also

CLIENT: I didn't think about it, but yeah maybe.

THERAPIST: At least in the mix of things. Even if it's just that we missed the opportunity to catch what's going on a little sooner. [0:10:35]

CLIENT: Right, yeah that's true. I didn't think about that.

THERAPIST: I wonder what it was like not to be here for a week.

CLIENT: Well because I was sick the last week was a blur anyway. I think if I haven't been sick I would have noticed it more. But I was just out of it anyway. But I'm sure on some level, yeah you know maybe. (pause) I think there was like, even if I wasn't feeling too great I seem to feel better when I left here, so yeah maybe that on some level. [0:11:20] (pause)

THERAPIST: You do sound like the thing that's descended on top of not feeling well is a tremendous amount of anxiety, this week. For probably a number of different reasons that are all coalescing, like your grandmother's health failing, and then yourself also simply coincidentally not feeling well. I feel like of all the things that could add a little trigger for you about the kind of anxieties that get kicked up around someone potentially dying. Around someone being there and not being there. [0:12:05]

CLIENT: and usually what happens it's an avalanche. Then I start thinking about not just death, but I start feeling claustrophobic like fuck I don't have money and you know my credit sucks, and how am I gonna fucking these student loans, and the house and that leak. I start feeling really like overwhelmed, and then the anxiety gets worse because then this voice is "See this is all bad. This is why you're fucking gonna drop dead. Because this is way too much stress for anybody, you know?" And that's not good for you and that's been proven that that causes illness and fucking heart attacks and. It's just becomes this bad place you know? (pause)

THERAPIST: It snowballs inside. When even things like you felt really kind of ordinary and in control about that are stressful, it's not that they are not stressful, like how to pay off loans or a mortgage.

CLIENT: Yeah for some reason, they yeah. Yeah.

THERAPIST: Start to take on a really different feel to them. [0:13:07] (40 second pause)

CLIENT: I think it didn't help though like my grandmother's gotten so much worse, and then Christmas day night, I had to take her up to her apartment. And that's, I'm not doing that again. Like that's, I mean that broke my heart in so many ways, you know? She doesn't know where she is. She's a kid. Like I'll be honest with you this is how like frustrated I am. I [inaudible] [0:14:18] it that night. I got the idea, I was like you know what? I bet you I could call anonymously to the state, and be like there's this fucking old woman. I live in this building, blah blah blah. This old woman that's alone at night and I don't know what's going on here, but she's clearly you know. That's like where we've gotten. Like where I can't take it anymore. I can't you know. I've never seen anything like this. But it's all on my uncle and I don't want him to, I don't know what kind of trouble you know? I don't wanna, but that's. If I knew that he really wouldn't get into trouble, trouble. I think I would do that. That's as absurd as that sounds, that's where we are now. [0:15:09]

THERAPIST: This dream you've been having with your wife, she's in danger is that?

CLIENT: Yes, but I thought that's putting it like. It's just the whole thing is very, I'm worried for her, I'm worried for my mom who's in her fucking 70's. I'm kind of annoyed at my uncle. I'm also worried for my uncle. The guy's got diabetes, and he's like, they don't, they just, I don't know what's going on. And I'm starting to actually think that is he flipping cheap? Like he is paying for stuff, but wait a minute. Like what, what's going on here? You know what I mean? And then I wanna get into that because I hate shit like that. I don't know. Just the whole thing is not good at all. [0:16:10]

CLIENT: You can't, you can't keep having this woman around and then keep trying to rationalize with her and then they get annoyed because she doesn't get it. Like what? What are you fucking retards, like what?

THERAPIST: What happens specifically? What are you, what were the exchanges?

CLIENT: Well like one thing on Christmas Day what happened was, she hates going to his house now, right? That's fine whatever, we're there. She's sitting at the dinner table, she's sitting next to my cousin and his fucking retard of a girlfriend. Everyone's speaking English because my one cousin in law is Assyrian, but he doesn't know Assyrian, okay? That's a thing for her now, she gets very angry, she kept saying speak Assyrian, speak Assyrian, and my uncle lost it. It's like dude. He didn't lose it lose it, but he like went over and was like Ma look I've told you a million times he doesn't know English. Stop, you're bothering these people. It's like dude what? First of all who are these people? Like fuck, You know that annoyed me that he got annoyed that she was bothering my cousin's disgusting fat girlfriend. Like you know, that's our grandmother man, and she's fucking sick. [0:17:24]

CLIENT: I don't know, people are just. I just, he's done a lot, he's doing a lot, but he's there something though that he's just not completely stepping up, you know? You gotta just fucking. This would be solved in my opinion in a 1 week period. You find some people, you set up a schedule you come up with whatever the payment is you're done.

THERAPIST: You mean getting her into a home?

CLIENT: Either a home or a fucking person that stays with her over-night. Done, I don't care if she likes it or not. [0:18:00] (Sniffling) Think about that for a second, imagine you're mom, my mom, imagine me leaving my mom at 90 years old in a fucking apartment to do God knows what. When she doesn't know where the fuck she is.

THERAPIST: it's horrible.

CLIENT: I don't know what to do. And the thing is I don't know what else I can say. I've said it to them. I've been clear. Every time it's like oh absolutely she needs somebody, you know. I've said it, I've said to your mom too, let's just find someone, but why isn't it happening? I don't know. So it literally makes me feel sick, like I. I mean I think I'm too sensitive a little bit about these things, but (pause) [0:19:00]

THERAPIST: You talk as if she's being neglected.

CLIENT: Yeah, yeah. In those hours, yeah. Well even during the day I feel like it's still not healthy to just. She's, they can't her to coffee anymore really or anything like so what are we doing here? What is this? She just sits at my mom's house and annoys the shit outta my mom, and then my mom can't handle it. It's not, it doesn't make sense, you know? It doesn't make sense. (30 second pause)

[0:20:00]

THERAPIST: I wonder. This may sound like it's a little outta of left field, but I just start to wonder if there's also not some element of this for you that you are indentified with your grandmother.

CLIENT: Yeah, I wouldn't be surprised, sure. Oh, and my mother. I mean that's the one thing I have always gotten about my mother, I do feel like you know something just doesn't add up. She should be taking it easier now, and things shouldn't be so stressful for her, and somehow things. Like I do get, I just never liked her approach to it, because she just whines and complains. A lot of it doesn't have to be it's her own fault, but still it does annoy me that even if someone is whining or complaining I wouldn't do that. Like if I was my uncle I'd be like wait a minute, why is my sister? So yeah I do feel like a certain indignation, I'm angry about certain things. Yeah. [0:21:14]

CLIENT: And that's a tough emotion because it's a helpless, I don't know what do you, I'm not gonna get into a war with my uncle.

THERAPIST: Well that's what I think I'm wondering about your identification with her if there's some part of this that is like your, the indignation is actually about here. How you were left alone.

CLIENT: Yeah, partly. Yeah. Well but I've always said. This is just my uncle's typical behavior. He's just, there's something about him. He's a softy or I don't know? He's decisive about his fucking condo projects, but when it comes to just fucking I don't know he's just a wuss. There's something about him, he just weak on those fronts, you know? He's stepped up, whatever, whatever, but c'mon man. He could really help my mom out more. Yeah okay he's bringing his guys over to look at the roof whatever, but let's face it he could help my mom more. He knows that things are not that easy for my mom. Plus with my grandmother he could, you know. It's like I don't want to hear that stuff from my mom, but sometimes. So that bothers me. [0:22:38]

CLIENT: She'll be like you know, what is this? Like he gave us $60 so I could buy your grandmother shoes. Like what, you know, for someone that spends so much money, and obviously makes so much money, it's like something about that is just kind of just crass, ugly. It's like step up, and sorry that it's on you, but hey. If I was making that much money I wouldn't feel that burdened. You know, just fucking step up. I don't know the whole thing is just like not pretty. It's not cool. And again it's just a helpless, like I can't. He's doing just enough that I can't, what am I going to say? And also it's not my place. So it's just this balancing act of I can't act like I don't give a shit, but I can't get too involved. I can't allow myself to get. [0:23:42] (pause)

CLIENT: I told my mom though, I'm never doing that again. Don't ever ask me for me to walk her up to her apartment and leave her there. That's not gonna happen. So you guys figure it out. I don't know what you do, but I don't want that on me, I don't want that memory.

THERAPIST: What was it like? [0:24:13]

CLIENT: She was a child. She was like you're coming in the morning right honey? In the morning you'll come? Like yeah grandma were like neighbors. Oh yeah we're like neighbors? I'm like yeah we live across the street. She's like oh honey that's good, that's good. And she kind of like whimpers almost a little bit. It's dark in there, I mean it's just too heartbreaking. (pause)

CLIENT: What would happen if I called, like how bad, how much in trouble would my uncle be if someone reported that she's alone at night?

THERAPIST: Is he her legal guardian?

CLIENT: Yeah, he signed some papers at the hospital.

THERAPIST: Well he is the guardian.

CLIENT: I'm assuming. [0:25:12]

THERAPIST: I don't know exactly, I mean they're unusual circumstances. He's the legal guardian, he's more responsible? I don't know that, I can't imagine that he would get thrown in jail or anything like that. (pause)

CLIENT: I don't know. I've been thinking about it. It's crazy, but I just feel like I, I feel like I have to do it for my grandmother. How could that possibly, can you imagine at night, all those fucking hours where it's not like she's making a cup of tea and going to bed. That's a fucking nightmare.

THERAPIST: Boy she sounds scared too.

CLIENT: Of course, of course. And I don't think she really sleeps. [0:26:02] (pause)

THERAPIST: And there's no one sitting there keeping her company. Calming her down. You know I know you've talked to your uncle, but what. The intermediary path between kind of reporting it anonymously and what you've talked about before I wonder about a more serious conversation directly with your uncle. What would that be like to say I want to let you know I'm concerned enough about her safety both psychologically and physically that if we don't do something now I feel like I need to call someone and make sure that happens.

CLIENT: (Laughing) Oh that's funny. No are you kidding me? No way. No first of all he'd be flabbergasted and pissed. Second of all, then I'm putting my mom in a weird position. I mean it's her brother, I can't. See this is what I'm saying. My mom's the type where as much as angry as she gets, if I say anything, then she gets angry at me. She'll say I was just opening up to you. I don't want you to have a fight with your uncle. Like just let me handle it. He's my brother, you know what I mean? So that's the one thing about this family, they have these little snippy things, but then they get together and somehow it's fine. I don't know. [0:27:32]

CLIENT: So no, no. I could never ever do that.

THERAPIST: Or else what would happen?

CLIENT: And also I think he would really feel hurt. I think he would be, but I think he does, he feels a lot of guilt. But he just doesn't know what he's doing. Either he's still in some denial or I don't know what's going on.

THERAPIST: And so what then if that feels too intense towards him, what about going for coffee and saying we need to talk about this I'm so worried.

CLIENT: I have.

THERAPIST: You have?

CLIENT: Of course.

THERAPIST: We've gotta do something tomorrow, how can I help it happen by tomorrow? What will he say? [0:28:10]

CLIENT: He'll be like yeah, let's make calls whatever. The problem is, if I make calls they step in, like well she doesn't like this person or well this person is not Assyrian, or this person, you know? They find ways, my mom not so much, because she is just like we gotta do something. But my uncle, he'll listen to my grandmother kind of. Because of course she doesn't want anybody overnight. Of course she doesn't, that's part of this whole thing. None of them want.

THERAPIST: Some ordinary.

CLIENT: Even if she was a perfect English speaking American she wouldn't want someone, so. That's our where we can't I can't go beyond that with him. I don't know what else to say.

THERAPIST: So he's having a hard time accepting that she's moving to a more childlike place.

CLIENT: I guess.

THERAPIST: And he being the adult.

CLIENT: I don't know how because he spends enough time. He steps up in terms of he sees her often, so I don't know how he's, I don't know what's. And see then I start getting upset because well, so it's because my mom is around. He can relax a little bit because he knows my mom is around, but does nothing to do with the evening. Or I don't know, I don't know what's going on through his mind. I know that his wife would totally back him to put her in a good nursing home. She's not the best, but she's a fucking doctor. She's like this is, this woman needs 24 hour care, it's very simple. But she can't make it happen. [0:29:41]

CLIENT: I've told him, I've said look eventually she's gonna open that door and just walk out. Especially if she thinks we're neighbors or whatever the fuck, you know? I don't know what to do. I have called places, I've called some services, blah blah blah. Perfectly all seem like good places, but. (pause)

THERAPIST: You do really feel stuck.

CLIENT: Yup. I think the only thing I can do is there's this one Assyrian lady who is ready to do it. Get her a grandma price, not that I could pay her but. Just say yes start. And then I could tell my uncle look, She's Assyrian, she can stay overnight. This is unacceptable. I mean we just have to do it. [0:30:54]

CLIENT: Because I mean she's fallen. They took her to the doctor yesterday, her back keeps hurting, and she doesn't eat. She's constantly annoyed or upset or like. Christmas Eve we're at my cousin's house she just wants to go home. She got very frazzled, she's like what the hell are we doing here? So it's not, you know. Like I basically think we're in the last 6 months of this, I think. You know what I mean? I think when it gets like this it gets, it starts really declining. So why not at least make her comfortable, you know? [0:31:38]

THERAPIST: Do you think your uncle knows that?

CLIENT: See I don't know. I don't know. That part I don't even know if my mom knows that. She knows it bad that something has to be done. But she has this whole thing about, Oh she'll bury us all, she's so strong, you know, because she's angry you know. I was like dude, she's not that strong. She's not that strong. Yes she's strong, she is strong, but now she's 90 and she's had two heart attacks and now she doesn't eat. She barely, she really doesn't know where she is. She has her hygiene is shit. She won't bathe. You know, I mean it is what it is.

THERAPIST: So sad. [0:32:26] (pause)

CLIENT: Then a part of me is like you know what? Maybe I'm also using this as a crutch, do you know what I mean? The part of me that likes to wallow in anxiety, and do you know what I mean? That's latching on to this thing, instead of just being like look. Like I have plenty of friends who are Assyrian friends. Nice guys, good people, they care about their family. But stuff like this? I know how they are. They'll be like I don't know, my mom's an idiot. They're somehow able to distance themselves, and just kind of not take it lightly, but be like fuck this. [0:33:18} Where as I got full indignation and how dare my mom, if something happens to my mom. Which is the way I was with my dad. And that's, that's not, I don't want to be that way. It's like what? I'm not, we're not fighting social justices causes here. It's like they're grown fucking adults, like no one's forcing my mom to do anything. (pause)

CLIENT: But you know what I mean? Like I feel like if there's a part of me that's, it's easy to wrap yourself in that blanket, and then avoid being productive, kind of (pause)

THERAPIST: It's a very familiar place for you. And especially at night I think I was thinking that too when you've been in this particular emotional space around your grandmother before, and then moved out of it, into a very different perspective on your mother being an adult and making her own choices. And you uncle being an adult making his own choices, and that you don't have to actually be responsible for both of them. Where you let some of it go. It's not that you still didn't feel terribly sad. Grief, but there something that feels like getting drawn back into. [0:34:51]

CLIENT: Well I think it's very simple. It's like other people aren't around these people all the time. You know that's the difference. They fly in for Christmas. They see them, they get these emotions, and oh they fly away. So one thing I was [inaudible], I was like you know what? Christmas day I shouldn't have gone to my uncles'. We all hung out Christmas Eve. That's enough, I got my dose. I should have been just like you know what, I'm just pooped.

CLIENT: So a little bit is also like I think I hate to say it but I gotta start physically keeping a distance. Because they are adults No one is forcing my mom to do anything. No one's, my uncle doesn't call my mom and bitch her out or something. He's just going along with this because she's going, you know what I mean? Like it's just developed that way. So I don't blame the guy. [0:35:45]

CLIENT: He's probably thinking that's nice, at least there's my sister. You know it's not like he's being an asshole, saying fuck my sister let her. He's thinking oh that's nice, at least there's my sister, and they're there together. But no one, he even tells her, don't go there. Like don't go everyday. He gets it, he sees her enough. So yeah. I think that's when I see them enough, then I can't, it starts affecting me. I'm too, cause I do care. My grandparents are really special to me, like I can't just be like oh whatever. So it's almost like it does have to a little bit be out of sight out of mind a little bit, I guess. [0:36:30]

THERAPIST: And it sounds like it stretches into like something more than just care. Like that there's something you get wrapped up in.

CLIENT: Yeah, no these emotions come up. I just feel angry about my dad and my mom.

THERAPIST: It's old stuff that gets pulled into it.

CLIENT: There's old stuff about like my mom kind of being taken for granted, but then me being taken for granted. Yeah there's a bunch of stuff. And that's the kind of stuff a lot of people carry around, that you gotta somehow let go. That's not. (pause) [0:37:02]

THERAPIST: Tomorrow? At 11:30?

CLIENT: Tomorrow at 11:30? Okay. Awesome. Thanks Tricia. See ya tomorrow.

THERAPIST: Yeah.

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