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Hi, this is Dr. Anderson on Friday, May 10th reporting in on patient AP. I am just sharing a few notes from a session that was missed due to the tape recorder running out of space. So this session is number 77 from Wednesday May 8th, it's the first session of the week. I do have the recordings for the following two days but, as I said, the tape recorder cut off right at the beginning of the session so there's nothing recorded for this missing session and I thought I would present a quick summary just to fill in the gaps.

This felt like a very important session, important to include in summary form in the ongoing process, because the patient came in in a state that felt like the confusion around relational dilemmas with his girlfriend, who he refers to as Kelly in prior sessions and prior weeks, with the confusion of that relationship all of a sudden starting to feel clearer. The analyst, I have had a sense over the past three, four weeks of a building sense of confusion about what was what, and we've been articulating together that it's just hard to tell whether him wanting to back away from this primary romantic relationship is defensive. In other words, is he feeling claustrophobic, or is he feeling afraid that he's going to get hurt, afraid of hurting her or afraid he's going to get hurt, or is it a primary healthy developmental growth process in him to be backing away. In other words, is it something like him really starting to feel like he's getting to know himself in a deeper way than ever before, and as he gets to know what he wants and needs in life, rather than what he feels his mother wants and needs from him or even a girlfriend could want and need from him. Is he starting to get some clarity around his own desires that maybe she's not it.

So we've been going back and forth just trying to bear the uncertainty and the confusion about this for some time in the past number of weeks, and this session really did feel like the patient arrived in a-like all of a sudden as though the fog had cleared. The content of the session is largely the patient talking about feeling that he's really coming to terms with that something is going to have to change in the relationship. And in contrast to prior sessions, this did not feel defensive to me, the analyst.

I didn't speak a lot in the session; the vast majority of the first at least two-thirds of the session is the patient speaking openly and fairly clearly, and with a fair amount of affect, about coming to a sense that what he's going to want in his life in the future includes a high likelihood of wanting to get married and wanting to have children, and that it has been dawning on him that she really does not want that, and that she's in a place in her life that he can totally empathize with, having already been married for ten years, had a very difficult divorce, and having a 12-year-old child at home that she really just doesn't want-doesn't even want to get married. And what felt so moving and important about this session is that he wasn't describing seeing this difference as an insult to either one of them or as either one of them doing something wrong, as though there's a right and wrong. He really had a sense of intersubjectivity, perspective taking, that allowed him to feel like his needs and his desire to keep open really opened the possibility of marriage and kids as valid, as well as her desire to not go there as valid, but that because this is a fundamental difference between the two of them, that it might mean that they were not going to be compatible in a long-term relationship.

So he talked some about what he wanted to say to her about this, and went back and forth about whether to call or text or e-mail, but always kind of walking through picturing having an honest conversation, and putting more of his heart out on the line, and really trying to share with her that he cares about her tremendously, that he loves her even, and that the timing just isn't right. And the analyst weaves in at the very end of the session the theme about how the patient is starting to face for the first time experiences of separation and loss that come on a loving platform, rather than a very, very, very chaotic, crazy, rejecting, volatile kind of platform that they've been on before. The patient acknowledges, wow, this is actually the first time I've ever had a "normal breakup in my life."

We talk about the psychodynamic theme of when he's in a prison without choices it's quite easy to just do what you need to do because you're told what to do and you go do it, there's no free will, there's no choice. And as freeing as it feels to be out of the prison, what he's now beginning to grapple with for the first time in his life is that when he has a sense of freedom, in freedom we have choices, and therefore we have to make choices. And as we make choices we let go of certain options and live with the feelings of loss, and even potentially regret and sadness and longing, for the paths not taken, that that's a part of actually being in a free place, rather than a sort of compulsively restrained place in his life. And that he really could take in genuinely what it was like to struggle with letting go of someone you love but with whom you don't think a long-term relationship will work, and it felt like a quite healthy coalescing of these things. From confusion comes clarity. So through the fog the streak of sunlight and clarity which we call a selected fact for the day from a [unclear 7:23] perspective, out of the confusion emerges something that he feels very clear about and that felt quite non-defensive to me in the moment.

So that was pretty much the end of the session, him getting a sense of this as a movement in his life, a movement in his psyche, and feeling fairly good and proud, and yet in pain and sad about what it meant to go actually start bringing this kind of conversation into the relationship with her and potentially bringing it to a close. That was the essence of the session.

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