TRANSCRIPT OF AUDIO FILE:
BEGIN TRANSCRIPT:
THERAPIST: How are you feeling?
CLIENT: Better although still kind of cruddy.
THERAPIST: I'm glad you're feeling better. That was quite a whopper.
CLIENT: Yea. I'm going to get my flu shot earlier. And (inaudible at 0:00:17). Unfortunately I had planned to go last week and then I got sick because I like to go with someone because I hate needles. And I want to hold her hand during the flu shot.
THERAPIST: Yea, right.
CLIENT: So I don't know. I used to get my ex-boyfriend to do that with me because he also works on campus in the E.R. Yea. Also, I don't know. I spent most the weekend just (inaudible at 0:00:55) Friday through Sunday just not feeling really good emotionally.
THERAPIST: Sorry just to make sure. One is so we're not meeting Wednesday. I think I had said this.
CLIENT: Yes.
THERAPIST: I just want to make sure.
CLIENT: When will you (inaudible at 0:01:12).
THERAPIST: I don't think I have anything open up yet. But I can reschedule and tomorrow I'll let you know...
CLIENT: OK.
THERAPIST: ...some of those changes. And also, I was just curious. Are you back at work soon?
CLIENT: That's the other thing that...
THERAPIST: OK. If you're going to tell me about it...
CLIENT: Yes.
THERAPIST: ...then you and I can go over it now. I just...
CLIENT: Yes. I have us not meeting on Wednesday.
THERAPIST: OK. So you just continue work. (chuckling)
CLIENT: (chuckling) So...
THERAPIST: You're feeling crappy over the weekend.
CLIENT: Yea. And also so the six weeks for the physical therapy I got to work with this guy a week and a half. And about two weeks ago, I stopped by into the therapist and be like I don't really feel done because sometimes I'll feel OK. And then she's like, "Try this exercise." [0:02:09] And I'm like, "Oh, I actually can't do that." It'll be something really easy like push your hand with one leg. And then I feel like it's incredibly difficult. And I'm moving like a quarter inch.
So what was first thing I did I called (inaudible at 0:02:29) people on. This sort of answer was the only person who would the person who decides whether or not I should take two more physical therapies with a physical therapist. Not the doctor or anyone else. So she said yes. You definitely need more physical therapy and so that I've been really anxious about. And I was nervous about talking to her and making the appointment. [0:03:00]
And also the other thing that I just like feel really worried about and I don't I just feel like someone from HR or like my manager or someone would be like, "Yea, we don't think you get to take to stay away from work more. You have to go back now." And I feel that way even more like when I'm doing something and I run into someone from work. And then I just feel like oh, God. They can I'm mobile. Obviously I should be at work...
THERAPIST: Right. I see.
CLIENT: ...which actually happened on Tuesday. I [didn't get up] (ph) and I was like oh, go to the library and do homework and then I'll go to therapy. I was thinking like oh, I feel a little feverish. [0:04:02] And then I was like OK. I'm running a fever and drenched in sweat and really dizzy. I think I'll go home. But I ran into a coworker while in the process of doing that and felt horrible. I got up. I was like oh my God. I felt just guilty and weird and he's going to report on me although what that would mean. Like, I just felt really nervous about it.
And I called the person in charge of facility services at Cambridge and she didn't call me back. So that makes me feel I'm like, oh God, what and then I got e-mail from Chet (ph) on Friday asking if I was still inclined to come back on in about two weeks. And that made me worried too. [0:05:00] I mean, this e-mail really literally was just, "Ju, are you on schedule to return in two weeks?"
THERAPIST: Right.
CLIENT: "Are you still on schedule?" But in my head I'm like oh, God. He if I say no, things will just happen.
THERAPIST: Right. He'll start looking at medical records.
CLIENT: Or the person of disabilities will say, "Well, you know Chet (ph) I'm really am suspicious about Ju (ph)." I mean, part of it is also like when I was on when I was on disability for fibroids, one of the personnel officers said that that wasn't necessary because I'm not that bad. And so she thought I shouldn't be out. And I was just like I didn't realize that that was something you did. And I'm pretty sure you shouldn't. And it really hurt. It wasn't about anything about what was wrong with me. So I'm like that's part of it too. [0:06:04]
I don't know. So basically I'm just sort of feeling like dread and nervousness about dealing with that more calling the discipline people again for me or whatever. What do I I don't know what else I have to do to continue to being out. And I'm looking at my HR policies online. It's basically talk to your local HR department which I don't really have. So I don't know. I feel very I would like someone to tell me what at or to tell me what I need to do. And do I need to fill in these ten forms? Do I need to what is the process? And I am failing at that. [0:07:01] And I'm also worried that if I try to do that, their response will be like, "OK. You need to fill these ten forms. Oh wait, you have to go back to work right now." (pause)
And the other two things being that I had my final homework assignment due on Sunday. [0:08:03] And my brother like my mom e-mailed him. My brother was like this is when Tricia (ph) and I are traveling to my parent's house. And her, oh I was like, "Oh I have to do this." And my mom e-mailed asking when. And dealing with that was just not really what I wanted to do either. I don't know. (pause) [0:09:00]
THERAPIST: (inaudible at 0:09:43) feel like your guilty like you're getting away with something for not being at work.
CLIENT: Yea. I mean...
THERAPIST: And in fact, as you said to me, you were actually well enough to work. [0:10:02] That's not the problem as I understood it. I mean, for the most part it's like it's not that you're usually in so much pain you couldn't do stuff. It's more that in order to alleviate (ph) the pain you been for longer quite a bit longer than your doctors say you should have been. You have to do intensive physical therapy. There's no way to coordinate that with work or a part time schedule.
CLIENT: Yea. I mean, the other thing is that I'm not in pain every day. So how to maybe like of several days be like oh, I feel fine. I'm walking around and do whatever. And then I'll have a day where I'm like oh, sitting down really hurts and walking hurts and everything hurts. So whenever I feel OK, (inaudible at 0:11:02). And then when I'm in no other pain, I think well, but it wasn't every day. I start to think, how bad is it really? And yea, I know that like and theoretically where that physical therapy will make it so that I won't be in pain at all or less. And therefore I have reasons why I want to do that. But...
THERAPIST: Has it helped?
CLIENT: Yes. It's definitely helped.
THERAPIST: Good.
CLIENT: And where maybe that's part of what make me like I'm just like, "Oh, but since it's helped, I should go back right now." And I actually see the physical therapist. She's really great about I don't know like talking about improvement. [0:12:03] And also pointing out how yes, it makes sense that that whatever I want to do is whatever things she's going to make me do is difficult. Because of the muscles being grr or like whatever.
And yea, I mean, also I'm started thinking of like it's not even it's really hard to schedule. Or it's not possible to schedule with work. And in some ways like working full time is exacerbating. And working full or part time and doing physical therapy, I don't like I guess I could do that. But I feel like having a physically active job. [0:12:58] Like I'm not sure either being physically active or trying to sit don't help impacting my almost like I think it's I don't know. Like I almost feel like going to work would be hindering physical therapy and getting stronger and better in a way, if that makes sense.
THERAPIST: Because you're sitting down most of the day?
CLIENT: Well, it's really hard to it's both hard to sit down for a long period of time or stand and move around for extending periods of time. They're both painful in different ways. And like once like especially with once my hip starts getting painful and inflamed, it's kind of like well, that's just it for the day. It's going to do that for several hours if not a couple days. [0:14:01]
And so like practically speaking, working half time wouldn't really make sense either. But I still feel like no but in my head I'm like well, but I could, I guess, in theory. (pause) It's just like I could. I would be kind of miserable. But theoretically, I could probably work full time and do physical therapy or work part time. But I'm pretty confident it would be pretty miserable. (pause) But that doesn't entirely seem like a reason not to. [0:15:00] (pause)
And the other thing that's really hard for me to think about physical therapy or time away from work without wanting to sort of explain why maybe I should actually be going to work. I mean, they well, it's not that bad. I mean, I guess I could sort of I keep on wanting to I don't know indicate I could still soldier through somehow if I had to which is not what I want to do. [0:16:12] But I feel bad about it.
THERAPIST: I see.
CLIENT: And so I don't really want to call in. And I call HR and be like, "So I need I want to take more time off with disability. But I mean, I could go back to work if you think that would be a bad idea," is basically like in my head what I...
THERAPIST: Right.
CLIENT: ...don't want to say. But I keep on thinking about. (pause) [0:17:00]
THERAPIST: I'm not really sure what to say.
CLIENT: Yea. (pause) [0:17:57]
THERAPIST: I mean, it seems to point towards what is so often typical which is (pause) well, let's back up a little bit. What's it like to sort of talk about this and getting it out there?
CLIENT: Well...
THERAPIST: I guess I also have a feeling now I'm totally changing direction, asking a question and then (inaudible at (0:18:53). I guess I kind of feel like you want you are of two minds about what you how you want me to respond. On one side wanting me to be supportive. Like, hey look. Don't make yourself miserable. Of course, (inaudible at 0:19:19) but you're going to be in pain and will that really help. And you need physical therapy sounds medically necessary. And the problem there is that you sort of have trouble believing in the importance of how you feel and the way that's getting played out through this.
The other side I get kind of the impression there's a part of you that it would be much more comfortable or is it going to be very familiar when you are the one trying to figure it out. [0:20:01] Or like Ju (ph), it has been awhile since you've been at work. And you probably you really probably could sit there. I mean, can't I mean, there's got to be some way you can work out something part time. And I know you hate work and everything. But I really think in other words like sort of I think you want me to take one half of (chuckling) to the other. I guess I get the impression of that so that this wouldn't just be playing out in your head, in a way, which is very difficult.
CLIENT: Yea. I don't know if I want you to pick one side or to come up with like the magic middle path.
THERAPIST: Oh, OK.
CLIENT: Like (pause) I guess what it is, is sort of sitting like sitting around like battling that back and forth in my head is exhausting and stressful. [0:21:03] It makes me really anxious. And then I was thinking will this like and this is like well, I feel like pretty clearly that's not helpful to just sort of sit there going yes, but no, but yes, but no, but yes, but no. So I want another option but I want sort of the magical well, but no if you just do this thing then you will sort of be crazy sacrificing yourself to go to work but not too much or something.
THERAPIST: I see. Oh well, there's kind of there's this provision where if you're returning from leave then you can sign up for this thing where for the next two months, you can leave if your issue comes up again.
CLIENT: Yea.
THERAPIST: Or you can have your physical therapist write something that somehow allows you to come back part time. [0:22:02] And that that should be dictated by your medical appointment and your level of pain and discomfort.
CLIENT: Yes.
THERAPIST: And that way you don't have to keep sort of worrying about which way to go or what to do. Something like that.
CLIENT: Yea.
THERAPIST: Feeling anxious, pretty anxious and guilty, I think.
CLIENT: Yea. And I mean, the other thing so I mean, part of it is also like I just feel kind of guilty about having the option to have fully paid short term disability because most people don't. And I'm just like, "Yay, that's great." But I feel really guilty about it. But hey, benefit stuff. [0:23:02] Financially I'm much better off to stay on short term disability than going back to work part time which is also something I find really weird and disconcerting.
I mean, my other thing is I get why it would be silly to say work 15 hours a week if my job is actually 35. Or to half to be like, "Oh, I'll be at work until suddenly I have to leave [notice by] (ph)." But part of me is kind of like, "Well, but if you could work 10 hours a week, why aren't you?" Even though it would basically like I'm like well, (inaudible at 0:23:46) get in, sit down, check your e-mail, do one thing, leave. And like who needs that? [0:24:00]
But and so I have also thinking like, "OK, well is there something I could do myself during that would make me feel like I wasn't I don't know rolling around and saying I hate work. I'm lazy. But like when I think of doing anything that's enjoyable. I'm like oh, but that's somehow also being lazy or I don't know.
THERAPIST: Yes. You're quite intensely judgmental of yourself in all of this it seems. I mean, there's no path that doesn't involve you feeling a lot of distress of one sort or another here, I guess. [0:25:04]
CLIENT: Yea. I mean, I'm way more judgmental of myself also than I am of anyone else because that's what I do. But...
THERAPIST: Yes. And it's (pause) yea, and your judgment is pretty implacable, I think, of yourself. You only reason with it or mitigate it or easily or find a whole lot of relief (inaudible at 0:26:03).
CLIENT: Yea. It's yea. I mean, I think I am very I don't know judgmental and unforgiving of myself. And there's not...
THERAPIST: Right. Well, you're going to really make yourself sacrifice something here. Either you're going to continue to disability and I guess feel pretty lazy and bad. Because it sounds like you often been feeling?
CLIENT: Yea. I think the other thing which is turned out as it was last time. Being in short term disability in winter is not really ideal mood wise.
THERAPIST: Sure.
CLIENT: Because I'm already feeling really low energy and blah.
THERAPIST: Right. [0:27:03]
CLIENT: So...
THERAPIST: Like there is, in a way, some benefits of just getting out the door in the morning and getting to work. Like having other things to focus on compared to being home without much structure.
CLIENT: Yea. I mean, well, like one of the things I was like hyper. I wouldn't do very much work in the winter. But I get really focused on like OK, you have to get yourself out of the house by this time. Otherwise I'm like because otherwise I'm relatively I would really like to lie in bed here and not move because I'm really tired and I don't feel good and 40 other things.
And then when I'm at work in the winter, I often (inaudible at 0:27:50) I'm like all right. Today you just have to do one thing because that's all you're going to like just do a thing. [0:28:01] I don't feel so like I feel I was already guilty being at work and not working or whatever. But doing that same thing at home I don't know. Like I feel super yea, super judgmental on myself about it. (pause)
THERAPIST: Yea, I do. I think you kind of want me to sort of get in between you and it. [0:29:00] You know, which if I were to say something like sort of supportive about your staying home on the leave, I think it might help to mitigate it temporarily or something. And there was like I guess if there was a magically middle path or just some reassurance would be a way of like getting in between you and this sort of pretty harshly judgmental, can't be reasoned with side of yourself.
CLIENT: Yea. I also think that my major tendency is to would be to argue with a supportive comment. Like supportive of which is also (inaudible at 0:30:05).
THERAPIST: How's so?
CLIENT: I mean, what I end up thinking is well, but is it really medically necessary? I mean, come on people go to work with all kinds of problems and blah, blah, blah. I mean, definitely a big part of it is also I hate work. So somehow that makes me feel even worse about like well, what if I'm not really like I'm just sort of exaggerating my (inaudible at 0:31:00). Yea, when I talk to people about the disability, it's really hard to not either come up with a ton of excuses like justifications. Like no, it's totally OK because this, that and the other thing which no one is really asking.
THERAPIST: Right.
CLIENT: Or to just sort of be like and I'm not like I don't know. I just feel like it's really hard for me to just say yea, I'm doing short term disability and doing physical therapy.
THERAPIST: Right. I mean, let alone, I suddenly had heard you say like, "Oh, I'm so psyched to get back out of there for a little while." Because you hate a lot of hate it a lot of the time.
CLIENT: Yea. No, I'm thinking about the pleasantness of not dealing with all of that which is great. [0:32:03] I don't know. I guess it makes me feel like either I'm a fraud or like it's really inappropriate to be excited to be away from work when you're also having a medical problem.
THERAPIST: Right. But if you're not sort of bed ridden or suffering, then clearly you are a fraud. (pause) Except you're not, though.
CLIENT: Right. [0:33:01] (pause for one minute)
THERAPIST: That's interesting. (pause) There's a...
CLIENT: Oh, crap. (pause)
THERAPIST: I think there's a kind of I mean, this is already very clear to you. But to me it sort of brings into really how much this kind of harshness with yourself and that sort of real kind of negating quality to it. Where like it's so hard to sort of push back, or are you back or (inaudible at 0:35:03) have the kind of point of view even ones you know to be true and legitimate when you get judged kind of yourself like this.
I think it's just so much unfortunately a part of your life. In other words, it's (inaudible at 0:35:23) relief because you're not at work or in the situation that anybody else who's sort of playing that side of it. But I think so often it has been often somebody at work or at other times, (inaudible at 0:35:39) or in a ways your mom who kind of sort of stood in for that kind of more harsh and judgmental and kind of negating side. And I want to be very clear. I'm not trying to let any of them off the hook. I mean, in a way it sounded to me like for just as one example at work you have been treated really bad. [0:36:03] Like I'm not saying...
CLIENT: Right.
THERAPIST: ...you're just making that up. I'm just saying there is some way that you that fits right in with this kind of harshness that we can see directing at yourself even when it's just you in a way. Is that clear? Like I'm a...
CLIENT: Yes. (pause) Yea, I do agree. It's I mean, it's also scary and frustrating to me to be so harshly criticizing myself.
THERAPIST: Sure. [0:37:00] (pause)
CLIENT: I also think one of the things that makes it hard for me to not do that is like one of the reasons why I'm worried about taking time away from work is how they really kind of awful I'm taking time off work. So I'm like well, I mean, on the one hand there is a track record and the other hand maybe I should shut up a bit about it. Or having more information now like knowing what I know now, I can take more time off. Or
THERAPIST: We have to stop for now. [0:37:58] So we're on for tomorrow.
CLIENT: Yes. Sorry. I just remembered I had something else tomorrow. Oh, no. I cancelled tomorrow.
THERAPIST: Oh, you did?
CLIENT: Yea.
THERAPIST: Oh, OK.
CLIENT: Because...
THERAPIST: Oh, yea.
CLIENT: ...I'm getting injections.
THERAPIST: That's right. I'm sorry. It's probably in my calendar. I just didn't remember.
CLIENT: And then that one thing then maybe if it'll be rescheduled Thursday or Monday.
THERAPIST: Yea.
CLIENT: OK.
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