TRANSCRIPT OF AUDIO FILE:

BEGIN TRANSCRIPT:

CLIENT: How's it going?

THERAPIST: Good.

CLIENT: Good. It's dark in here.

THERAPIST: Yeah?

CLIENT: It feels like it. It's bright in the other room.

THERAPIST: Oh.

CLIENT: So, real quick. I don't want to take up too much time with this.

THERAPIST: Yeah, sure.

CLIENT: But I wanted to just see if we could finalize, or if I could just get some like finalized hard information from you because I need to submit this financial aid thing like today.

THERAPIST: Yeah. Totally.

CLIENT: I needed to submit it like weeks ago but I think with the info that I got I should be able to reasonably produce the info that I need.

THERAPIST: Okay.

CLIENT: So I'm just going to ask you a couple of questions. And if it's helpful, this is just a printout of the, even if just to look at it for a moment. There are just a few things I wanted to just see if I can -

And I realize that you're not the insurance company. You know what I mean? But I'll talk to them today too, but to the best of your ability. So you should be able to confirm then that it's a fifty dollar deductible annually. I asked them on the phone and I asked for a couple of times and she was like, "Yeah." [00:01:20]

And I was like, "You've got to understand. This was like a thousand dollars for me before." This seems like I'm not reading it right or something.

THERAPIST: Yeah.

CLIENT: But everything on there seems to suggest that to you?

THERAPIST: Yeah.

CLIENT: Even if like, I know you said there was some change where you're doing the insurance now and you're not going to be or something?

THERAPIST: Right.

CLIENT: Even with that stipulation?

THERAPIST: (inaudible at 00:01:40)

CLIENT: So fifty dollar annual deductible.

THERAPIST: Yeah.

CLIENT: That is. I don't know what to make of that.

THERAPIST: I think it's just because it's a student plan and they can negotiate much better deals for, you know, people in their twenties. They're healthier. They don't use the benefit as much. So they can -

CLIENT: I suppose.

THERAPIST: I mean I imagine. I'm just (inaudible 00:02:09).

CLIENT: Yeah.

THERAPIST: Yeah, no, I imagine that's exactly what it's about. Because you don't have a lot of sick people that are in a plan.

CLIENT: I guess just maybe this is my like cynical political and economic views. But it just seems like students don't have any other option. Do you know what I mean? If they made it a thousand dollars. It's not as if students would then be less likely to take it. Like they have to, by law, take this or they don't have health insurance. Do you know what I mean? And I guess that's -

THERAPIST: But see what the school can do is they can kind of shop around and, you know, they can then go to Ithaca, they can say, "Hey listen, we've got these healthy people. Give us the best deal possible." And so, you know, they want to have the business.

CLIENT: Yeah. I guess it's sort of a rarity too that folks in my situation would be doing something like this. It's probably -

THERAPIST: You guys don't get sick. You don't get -

CLIENT: Or even probably not a lot of people doing this type of thing. [00:03:18]

THERAPIST: Oh yeah, yeah, no.

CLIENT: Well, okay, cool. We'll do that.

THERAPIST: That's probably the most likely use of it, actually. So fifty bucks.

CLIENT: This is Let me just So first off, I starred the line that seems to be pertaining to what's going on here.

THERAPIST: Yeah.

CLIENT: Right.

THERAPIST: Yup.

CLIENT: So based upon that, and actually I haven't read it in a few days, but that says twenty percent?

THERAPIST: Mm hm.

CLIENT: Co-insurance afterwards? So that means it's an 80/20, as opposed to what I'm on now which is a 60/40?

THERAPIST: Yeah?

CLIENT: So -

THERAPIST: Now here's the thing is that Let me just see something here.

CLIENT: In the page beforehand there is a little clause that I read with the person on the phone. And she basically said -

THERAPIST: That doesn't make any sense. I read that too. I don't know what that meant. [00:04:22]

CLIENT: I guess basically what she was saying is that that means is, not unlike what you told me my insurance I have now did, was they said, you know, "We'll do 60/40 of a price that we determine to be appropriate, regardless of what you might bill."

THERAPIST: Yeah.

CLIENT: So what she referred to as "the usual and customary."

THERAPIST: Customary, yeah.

CLIENT: She said it would be hard for her to give me like an estimate of what that might be. She said that if you had a, what was it called? Like some kind of a number. She said a CPT code or a procedure code.

THERAPIST: Yeah.

CLIENT: Do you have one of those?

THERAPIST: Yeah. You can tell them that.

CLIENT: Because she said that if I can get that she can give me a pretty good estimate.

THERAPIST: Oh yeah. Oh, she should have known that. 90834 is the number.

CLIENT: 90834? [00:05:22]

THERAPIST: Yeah. Oh maybe she did know that, it was a general She probably was just dealing with general. Yeah, 90834.

CLIENT: Cool. Well she didn't even have that in front of her. She couldn't even find it. She was from the insurance. So I had to read it off to her.

THERAPIST: Because I think the insurance has like thousands of different plans.

CLIENT: Yeah, probably. So, yeah, that will be like one of the only stipulations that will make it hard to -

THERAPIST: That's right. It's not clear what they consider usual and customary. It's totally dependent on the insurance company?

CLIENT: Yeah?

THERAPIST: I mean I think they have to I don't know how they come up with that number exactly. I think it has to call within certain kind of parameters. But it's not clear who sets it. It's definitely not maybe.

CLIENT: Sure.

THERAPIST: (laughs) And so -

CLIENT: It sounds like my company now is doing something along those lines though, right? Like that was that shift that they made recently, right?

THERAPIST: Yeah.

CLIENT: Okay.

THERAPIST: Yeah. Yeah. Yeah.

CLIENT: And I guess if anything is promising too, that it's 80/20, because then they would even be covering more of the amount. [00:06:33]

THERAPIST: Right. And so your copayment would go down a lot.

CLIENT: Yeah.

THERAPIST: It might be cut in half.

CLIENT: Yeah. Yeah. Assuming the same rate. You know what I mean? Assuming that they're operating on the same usual and customary?

THERAPIST: That's right. That's right.

CLIENT: Do you know what I mean? Well, which is why So basically -

THERAPIST: Yeah.

CLIENT: Yeah. And if I was doing one time a week we could assume that they would cover once a week.

THERAPIST: Oh they will cover twice a week.

CLIENT: They will cover twice a week?

THERAPIST: Yeah.

CLIENT: So -

THERAPIST: Yeah, but PPOs of the insurance will cover twice a week. They cover multiple. You know, they'll cover four.

CLIENT: So then for me try to budget this thing, I'll try to get a number from them today with this CPT code.

THERAPIST: You know what, though. It's like Yeah, yeah, that's true, that's true. But the other thing I was thinking of is Yeah, try to get that and then we could figure it out. Because the other thing I was thinking of is that we could use, if it's much less than what it is now, we could use the money from the recordings to apply it. [00:07:52]

CLIENT: And that's the other thing. Is that I realize that even right now we're already, like in a way I sort of got grandfathered into the rate that I'm at now. Do you know what I mean?

THERAPIST: Yeah.

CLIENT: So what I was wondering was if you would want me to get this information and then provide it to you and then you could let me know. Because I don't even really know how much, like per session, you are taking away from this.

THERAPIST: Mm hm.

CLIENT: Based upon what your average is. I realize you have been very accommodating. You know what I mean? And I recognize too that that was based upon this set of circumstances with my insurance now.

THERAPIST: Now.

CLIENT: So I don't know if you want me to get this information and provide it to you and then you could reassess and then you could say that under those conditions, this is what it would be like. [00:08:55]

THERAPIST: Yeah.

CLIENT: This is what your copayment would be, or something.

THERAPIST: Well, one thing that I think of, just in terms of submitting this budget is, if you would feel comfortable doing this, that you just, and I'd agree with this, that I wouldn't charge you more than you're paying me now. And if it ends up being that they -

CLIENT: Per appointment, you mean?

THERAPIST: And that it will actually likely go down. If that is something you're comfortable with.

CLIENT: I'm totally comfortable with it. Then I'll budget thirty eight. I think it's thirty eight dollars an appointment.

THERAPIST: Yeah.

CLIENT: Does that sound cool? But if not -

THERAPIST: Yeah, that's fine.

CLIENT: Okay. Cool.

THERAPIST: If that works that's okay with me.

CLIENT: Hey, that's fine with me.

THERAPIST: Okay.

CLIENT: I just recognize that you've been very accommodating. I didn't want to not take that into account.

THERAPIST: That's nice.

CLIENT: No, that's really cool. Then what I'm probably going to do then is I'm probably not even going to stay on my mother's insurance. Because if anything, even like the fifty dollar co-pay with this plan is probably going to be less per appointment. [00:10:06]

THERAPIST: Probably less.

CLIENT: You know what I mean? So it makes no sense for me to stay on my mother's insurance.

THERAPIST: If you can get off of it now.

CLIENT: Because initially the reason I wanted to stay on it was because I thought that there was going to be another thousand dollar deductible. And I didn't want to have to have those both in the same year.

THERAPIST: No. That's a good one you got there.

CLIENT: Wow.

THERAPIST: Yeah, and the fifty dollars you spend now will go a long way. It will save you in the long run.

CLIENT: Yeah, big time.

THERAPIST: Pretty quickly.

CLIENT: Well that's cool. Well than that will, I think that goes into effect like August 1st or something. So that will be something we can keep in conversation about.

THERAPIST: Gook. Okay. Cool.

CLIENT: No, this is really cool. This is really comforting. This was something I was really worried about. Well, not worried about but I was just concerned about trying weave through all these details.

THERAPIST: That's an excellent That sounds like an excellent plan.

CLIENT: Yeah. I really don't know what to make I'm just waiting for the catch. Do you know what I mean?

THERAPIST: I think, like I'm trying to remember, but I think the plan that I had in graduate school was similar to that. It was, you know, just very low cost for the student because they don't use medical. [00:11:22]

CLIENT: (laughs) Yeah. I guess I thought it would be a low cost if you're not using it. But then if you wanted to do something like this it would be very difficult. Do you know what I mean?

THERAPIST: Yeah.

CLIENT: But, whatever. And I guess I just assumed that like employer based insurance I was getting with my Mom would be more competitive -

THERAPIST: Yeah.

CLIENT: than student insurance.

THERAPIST: Yeah.

CLIENT: But, whatever. So that's good news.

THERAPIST: Yeah.

CLIENT: Cool. So done with that. Yeah, I know we talked last week. We were having a conversation about smoking and thinking about that and so on and so forth. And leaving at the last point, but I wanted to keep talking about that. But this morning on the subway on the way here I got a message from Marcus. [00:12:30]

THERAPIST: Mm.

CLIENT: Reese's (ph) fianc�.

THERAPIST: Fianc�, yeah.

CLIENT: And it was weird. It just like it really kind of tyrannized my thoughts all morning leading up to this.

THERAPIST: Mm.

CLIENT: So I figured I'd like to talk about that. I mean he just sent me a very brief message saying like, "Hey Geoffrey. Did you get my e-mail?"

THERAPIST: Mm.

CLIENT: And I saw it and I was just like, "Oh." You know? "No, I mean, I don't remember getting anything from you. You know, it's been a while since we talked and I didn't receive anything from you recently in e-mail." And so initially I just thought it was like, "Oh, when I get service back I'll just send him a message saying 'No, can you resend it?'" But I was thinking about it and I think I did. I got an e-mail from him a while ago when we were having like an exchange. Right around the time when this thing happened with my Dad. [00:13:48]

THERAPIST: Yeah.

CLIENT: And it was sort of like after he had e-mailed me and said, "Oh, everything's cool. Like no worries." And then we kind of just started shooting around some small talk to kind of leave it on more -

THERAPIST: Mm hm.

CLIENT: just kind of cordial note. And we were just talking about like current events. He always asks me about politics and stuff because he knows I'm interested in it. And he sent me something back and I sent him something. And I'm pretty sure, I haven't looked, but I'm pretty sure he sent me something back and I just never got back to him. And I realized that that's probably what he was talking about it.

THERAPIST: (inaudible at 00:14:32) Yeah.

CLIENT: A while ago.

THERAPIST: Two months ago or something like that?

CLIENT: Yeah. And that he did send me an e-mail and I didn't get back to him. And, yeah, it was just odd because when I first read his message I was very candid (ph) in thought, just cavalier in my thoughts. But I was like, "No, I didn't get anything from you. Can you send it again." Of course, I'll get back to you. (pause)

But, yeah, it just And then I felt really different about it when I realized that he did send me something and I didn't get back to him. [00:15:24]

THERAPIST: Hm.

CLIENT: Partially because I think a lot of the times when I talk to my Dad or something about it, I think I phrase it as like, you know, "I send Marcus messages all the time but I don't really hear back from him too much." And I don't know how to explain it but I started to think about it like (pause) I started to think about just a lot of different instances where people asking me to stay in touch with people.

Like my Mom asking me to call my grandparents a lot. My Dad telling me to, you know, give Reese (ph) and Marcus a call or stay in touch with them. And I get very indignant when people say stuff like that to me. [00:16:31]

THERAPIST: Mm.

CLIENT: I get very frustrated. Not necessarily because I am keeping in touch with them and they're being redundant, but because I feel bothered by them like putting that obligation upon me to do so.

THERAPIST: Mm.

CLIENT: Because I don't want to. I don't for some reason. I don't even really know why in the moment it's not something I want to do, but it's not something I want to do. And I just thought about it. I don't know, I guess I just had this long kind of like line of thought. And I was like, "God," like Reese (ph) must think that, you know Reese (ph) and Marcus, must almost like lump me into a category like with my Dad or something. [00:17:32]

THERAPIST: Mm.

CLIENT: Like when they were trying to get in touch with him and he wasn't getting back to them. You know, I was just imagining in my head them being, "Oh man." You know, "Joe and Geoffrey, they just have no interest in keeping in touch with us," or something. You know what I mean? I guess I started to like I started to worry that I was mimicking behavior that I'm very critical of my Dad for having.

THERAPIST: Mm.

CLIENT: Not returning calls to my Mom. Not keeping in touch with her when she tries to keep in touch, when she tries to reach out to him. You know what I mean?

THERAPIST: Yeah.

CLIENT: And in a way sort of like almost being shocked at seeing this parallel that I haven't really thought about before. You know, a lot of the times I When I think about the fact that I don't keep in touch with people, I think about it as like this thing that's being done to me or something almost. [00:18:48]

THERAPIST: Mm.

CLIENT: Yeah. I feel very lost sometimes for like an explanation as to why I feel like I shouldn't have to. But I feel very, I guess, confident in a way that I don't examine saying that I'm not going to do it. That it's unfair. It's just very self-evident to me, or something. But I never articulate it to my parents, to my Dad or to my Mom, I think because I tell myself it's going to hurt their feelings or something. Do you know what I mean?

THERAPIST: Yeah.

CLIENT: But, yeah, I know. I guess I just started thinking about it this morning. I was like, "God. I wonder if I am doing anything really different than what my Dad does when he doesn't, you know, keep in touch with people that care about him." [00:19:53]

THERAPIST: Mm.

CLIENT: And I see people get very hurt by that. Do you know what I mean?

THERAPIST: Mm hm.

CLIENT: I guess I sort of stepped out of like just purely thinking about it as like a "me the victim of this." And then thinking like, "God, maybe that's not a good thing."

THERAPIST: Mm.

CLIENT: Do you know what I mean?

THERAPIST: Not a good thing?

CLIENT: Sort of. Yeah. You know I kind of felt, because when I realized that I probably did get a message from Marcus, I didn't go back and resend him a new message and be like, "Oh, Marcus, you're right. I think I realized that you did." I will continue to say that I just forgot about it or something or I didn't see it.

THERAPIST: Oh. Okay. Okay. What, because that (inaudible 00:20:45)? (pause)

CLIENT: I don't know. It's just, I don't know. I just wondered if I guess I just started to second guess that impulse that I have. You know what I mean? I started to just like step outside of myself and look at it from a different perspective.

THERAPIST: Mm hm.

CLIENT: And thought, "God, maybe this is just a really shitty thing that I do."

THERAPIST: Hm.

CLIENT: You know? Maybe this hurts people.

THERAPIST: Hm.

CLIENT: The way that see hurting other people or something. Do you know what I mean?

THERAPIST: Like he might of felt kind of -

CLIENT: Yeah.

THERAPIST: blown off in some way.

CLIENT: Yeah. And maybe he would be justified in saying that that's a really shitty thing that I do. [00:21:46]

THERAPIST: Hm.

CLIENT: That that's a Yeah. I don't know. And I guess it just called into question in my mind like, what is it that? Why do I get so indignant? It's like this happened the other night with my Mom when my grandmother just had a pretty big surgery.

THERAPIST: Mm.

CLIENT: On her back. And my grandparents they are getting very old. So they're just starting to have a lot of things. Their bodies are just getting old so they're having a lot of these health problems which are just like thematic (ph) of old age. They've been going in and out of the hospital left and right.

And my Mom has been very involved with them because it's her parents, as I probably would be. But I've really been very distant from the whole thing. And my Grandma came home from the hospital the other day. And my Mom, you know, she does what she does a lot of the time, and she said, "Will you call your grandparents?" [00:22:52]

You know, she'll say, "Will you do that for me? Can I count on you to call your grandparents every single week?" Which I don't do and which she's asked me to do in the past. Which I've said I would do and then I didn't do. You know, I got really bothered by it on Friday night because she was just like, "Your grandparents, they'd love to hear from you. They always want to know what you're up to. They're always asking about you. It would make them so happy to hear from you."

You know? And then she finished it off with this little line like, "And I know sometimes it's hard to get in touch with you." And she was like, "Yeah, and I know sometimes it's hard to get in touch with you." You know? And I was like, "No, I don't know, Mom." And at the time I really took issue with the fact. Like it's not hard to get in touch with me because they don't call me. [00:24:00]

THERAPIST: Oh they don't.

CLIENT: Maybe we don't talk a lot, but it's not because I'm hard to get in touch with.

THERAPIST: Okay.

CLIENT: Do you know what I mean?

THERAPIST: Okay.

CLIENT: But I remember that's what I took away from it and that's what I was I was like I felt very slighted by that comment.

THERAPIST: Uh huh.

CLIENT: And it was something I could say, "That's not true. You're wrong," or something. But I think it's probably just like irrelevant. You know? The point is I don't call my grandparents ever. And it drives me crazy when my mother tells me to do so.

THERAPIST: Yeah, yeah.

CLIENT: It's like it really, really makes me want to like throw my phone on the ground and break it. Like literally sometimes I feel like I'm about to do that.

THERAPIST: Yeah. Can you say so? What do you notice? What do you see? (pause) [00:25:01]

CLIENT: I don't know. I suppose on some level that it's a I suspect on some level there is a frustration with the fact that maybe my Mom is picking up on something that, maybe it's bringing to the fore some layer of guilt that I feel about the fact that I don't call my grandparents more. So maybe that's frustrating because I can't do anything with that. Do you know what I mean? I can't challenge that.

THERAPIST: Mm hm.

CLIENT: But it's like, yeah, sure. Objectively, I should call my grandparents more. You know? I should eat more vegetables and I should, you know, get eight hours of sleep every night. Like, yeah, sure, on some level we could say that. Do you know what I mean? I should floss my teeth more. Do you know what I mean? But yeah, of course, on some level, it's not objectionable it's just obvious. Do you know what I mean? [00:26:12]

But there's just something about like that moment. (pause) I just feel like something is so like backwards in that moment. Like I don't like calling my grandparents because it's not, I never feel good. You know?

THERAPIST: Mm.

CLIENT: I never feel It doesn't make me It's something that's very unpleasant for me to do. I feel like I'm (pause) The idea of calling my grandparents every single week would mean like placing front and center in my lists of concerns my attachment with my family. Like that's something (laughs) I want to get away from. Do you know what I mean? Like those are like shackles I want to like [00:27:29]

THERAPIST: Yeah.

CLIENT: break off.

THERAPIST: Mm.

CLIENT: As opposed to getting tighter or something. Do you know what I mean?

THERAPIST: What do you notice when you talk? What's it like talking with your grandparents?

CLIENT: I mean all I ever feel like I'm doing is sucking a little less at being like a grandson.

THERAPIST: Mm. Okay.

CLIENT: Like my two cousins in New Hampshire grew up with my grandparents. You know?

THERAPIST: Huh.

CLIENT: So they were like, you know on all levels, they were like the model family. They're, you know, the Beaver Cleaver kind of.

THERAPIST: Hm.

CLIENT: I use that phrase just as like, you know, they're picture perfect. Do you know what I mean?

THERAPIST: Hm.

CLIENT: Always had a very close relationship with my grandparents because they grew up in such close proximity with them. Call them a lot even though they don't live near them anymore. And on some level it's just frustrating because I feel like all I'm ever doing is being a little less far away from that standard. [00:28:48]

THERAPIST: Mm hm.

CLIENT: Which just makes me feel bad. You know, it just seems like it's just a different gradation of kind of like feeling like shit afterwards. Do you know what I mean?

THERAPIST: Because you're not as close to them? You're not as -

CLIENT: Yeah. Yeah. I don't know. Because I just feel like I'm doing this thing that. (pause) I don't know, it's almost like my Mom's asking me to just (pause) I don't know. That's just like family shit. That's what families do or something. I don't feel like I have that. Do you know what I mean?

THERAPIST: Mm.

CLIENT: It's like if I'm going to do stuff like that, shouldn't I like get all the enjoyment that comes out of it too? Because that's not what I feel like. Do you know what I mean? I feel like this is just like not pleasant for me. [00:29:54]

THERAPIST: Yeah. Is it, I just imagine, does it feel kind of like phony in some way.

CLIENT: It does. It feels phony. It definitely feels phony. It definitely feels construed. It definitely feels playing a role. You know?

THERAPIST: Yeah.

CLIENT: But it's doing family stuff. It brings to mind family.

THERAPIST: Yes.

CLIENT: It brings to mind my Mom. It brings to mind loving my family members. It brings to mind doing family stuff. It brings to mind my parents.

THERAPIST: Yeah.

CLIENT: It's just this whole web of -

THERAPIST: Yeah.

CLIENT: stuff that I just don't want to be my life. Do you know what I mean?

THERAPIST: Uh huh.

CLIENT: I was thinking about it this morning. Like my Mom asked me to write her a Mother's Day card for Mother's Day. I didn't do it. And on some level I feel some similar discomfort with sitting down to write my mother a Mother's Day card as I do with like calling my grandparents. This like (pause) It just seems to require just thinking and opening up my mind to this category of stuff that's just not enjoyable. [00:31:35]

THERAPIST: Yeah.

CLIENT: Do you know what I mean?

THERAPIST: Yeah. No. It seems to me like it awakens a lot of, I mean to put it just generally, mixed feelings about family.

CLIENT: Yeah. And I know that part of the reason I hate going up to New Hampshire is because it's just Like we go up there and we sit down at a table and we eat. Because when we go up there everyone wants to celebrate it. So it's my Grandma, my Grandpa at a table, and my Aunt Kim and my Uncle John at a table, and then me and my Mom. And it just seems to just magnify my Mom being, you know, not that My Mom seems so happy up there but she seems also so out of place. [00:32:40]

THERAPIST: Oh really.

CLIENT: Yeah. I mean she seems like, yeah, in this circle of people who everything is so privileged upon family. It's like my Mom doesn't have that or something.

THERAPIST: Oh.

CLIENT: Do you know what I mean? It's just this kind of stuff comes to mind.

THERAPIST: Is that right?

CLIENT: Yeah. Yeah.

THERAPIST: So you sense that she feels like an outsider? Like she doesn't belong? How would you put it?

CLIENT: I don't know. She just looks really divorced.

THERAPIST: Hm.

CLIENT: You know?

THERAPIST: Mm.

CLIENT: She looks really I can remember like it used to be that my Dad would be up there with her. Do you know what I mean? Yeah.

THERAPIST: Ah.

CLIENT: I guess I just feel like she looks more divorced up there than she does anywhere else. You know? So I just hate being up there. She looks really happy too in a way that she doesn't look when she's at home. [00:33:50]

THERAPIST: Huh.

CLIENT: Because she seems to have all these family connections and enjoyment that I feel like I don't do. Do you know what I mean?

THERAPIST: Meaning?

CLIENT: I don't know. I don't write her Mother's Day cards.

THERAPIST: Oh, I see. I see. Yeah.

CLIENT: There seems to be plenty of that up there for her. Do you know what I mean?

THERAPIST: Mm.

CLIENT: But I don't know. Whenever I'm up there I just feel like I'm just lacking or something. Do you know what I mean?

THERAPIST: Lacking? Yeah. What are you -

CLIENT: I feel like I don't care about my family.

THERAPIST: Mm hm.

CLIENT: You know, I sort of feel like a bad kid. I realize I don't know what to talk to my grandparents about because I haven't talked to them in a long time.

THERAPIST: Mm.

CLIENT: I want to just ask them like, "Oh, you know, what's been going on lately?" But the fact that I wouldn't know is just so glaringly a departure from everybody else who is like so involved and connected. So I don't even want to ask to find out because Do you know what I mean? [00:35:04]

THERAPIST: Oh, yeah.

CLIENT: I don't know. It's just like -

THERAPIST: Yeah. The bad kid. The one that's not in the family as much as everybody else.

CLIENT: Yeah. Yeah. I don't know. It just feels like vain. It feels like it's I don't know.

THERAPIST: Vain? Yeah.

CLIENT: Like I feel like for me and my Mom the most that we're going to able to do is like get a weekend of that. You know? Like me calling my grandparents every single week isn't going to, I feel like it's not going to do what she wants it to do or something.

THERAPIST: Yes. Yes. Yes.

CLIENT: It's always going to be shitty.

THERAPIST: Mm.

CLIENT: No matter how often we try to go up there. Do you know what I mean? Or, I don't know. [00:36:12]

THERAPIST: Well, yeah. I mean, almost like one element of it I guess is that, yeah, you don't feel part, you know, you don't feel in the same mold as these others, as your cousins and these families that are up there. But also that, I wondered is there some sense that, you know, you guys are the divorced family. You guys are the one. So you go up there with this sense of like, "It's not the same. It's different."

CLIENT: Yeah. Yeah. And it's great that we're up there. And it's great that we get to enjoy ourselves with that part of our family. You know, but I guess it's just sort of claustrophobic sometimes to be up there and have everything just be about family, family, family, family. And I guess I just sometimes (laughs) just feels like (pause) I don't know. I kind of feel like family kind of sucks too. [00:37:28]

THERAPIST: Mm.

CLIENT: That doesn't really seem to have any place for feeling. Like even to just feel that up there seems to just be like a sin.

THERAPIST: Mm. CLIENT: Do you know what I mean? (pause) I'm never going to feel like fulfilled no matter how close I am to my family up in New Hampshire. Do you know what I mean.

THERAPIST: Mm.

CLIENT: Because I just feel like there's a I feel like since I moved out of my house what I've been trying to do is create a sense of happiness and fulfillment that is not, you know, the focus (ph) of which is not in my family. Do you know what I mean? Because that's not going to be it. You know, with Laney, with my own home, with my own circle of friends. You know? And that seems really important to me. And that seems more important to me than calling my grandparents sometimes. [00:38:28]

THERAPIST: Mm hm.

CLIENT: You know?

THERAPIST: Mm. (pause)

CLIENT: So in a way, I don't want to keep in touch with these people. I really don't. It's not because I hate them. You know? Part of it is because I do, I really do care about them in some ways.

THERAPIST: Mm.

CLIENT: But (pause) I don't know. When my Mom says, "Will you just call your grandparents every week for me?" I guess on some level I just feel like I want to be saying to her Like I feel like I don't feel like I'm in a place where I should be doing things for you family-wise. You know? Like I feel like people should be doing things for me. [00:39:45]

THERAPIST: Hm.

CLIENT: I feel like you Do you know what I mean?

THERAPIST: Yeah.

CLIENT: Like where do I fit into that? Do you know what I mean? Like, "I don't want to do that for you."

THERAPIST: [Where do I fit in?] (ph)

CLIENT: I feel like everything I've done for my family, everything I do, you know, is for you.

THERAPIST: Mm.

CLIENT: You know?

THERAPIST: Yeah.

CLIENT: I feel like I'm killing myself thinking about you so much. Do you know what I mean? And it's like (pause) Yeah. I don't know.

THERAPIST: Yeah, there is some suggestion, I think, when you talk about it, like it's got this quality to me that I've always heard of it, of like, "I've already done this much. This was our deal. You're asking me to kind of go over and beyond what we kind of agreed upon," almost. Like, "You're breaking the contract." [00:40:58]

CLIENT: I don't even know like agreed upon. I guess it's almost just like -

THERAPIST: Huh.

CLIENT: I've already tried so hard and done so much.

THERAPIST: Okay. Yeah.

CLIENT: Like I really have. I really feel like I have done so much. You know?

THERAPIST: Mm.

CLIENT: And, yeah, have just like taken so many things out of concern for you.

THERAPIST: Yeah.

CLIENT: And it just seems unnoticed or something -

THERAPIST: Mm hm.

CLIENT: when me not calling my grandparents seems just like a selfish, just not thinking about your family. You know? As benign (ph) as not writing a "thank you" note or something. You know?

THERAPIST: Huh. Huh.

CLIENT: I don't know, it's like, yeah.

THERAPIST: Oh, do you feel like your efforts go unnoticed?

CLIENT: Well -

THERAPIST: With regard to your Mom? [00:42:07]

CLIENT: Well that's the paradox of it, right? Because when I've spoken to you about it, which I really suspect is that part of the effort was for it to be unnoticed, right? Like that was the whole keeping it cool thing. You know? (pause)

THERAPIST: But while it was invisible, maybe there's some way in which you, there's some way of you being aware of the Well, not saying you wanted it to be visible but just because you didn't want it to be known didn't mean you also didn't want it to be known.

CLIENT: (laughs) That makes sense.

THERAPIST: I think you'd like to just be acknowledged or something.

CLIENT: Yeah. That's right. That's what I mean. Yeah. But it's funny because there's something substantively different with respect to how much it bothers me when my mother tells me to call them as opposed to my naturally calling them. When I get to actually calling them it's okay, it's fine. You know? [00:43:22]

THERAPIST: But certainly being asked -

CLIENT: That's the thing. That's it. And that's when it almost makes me not want to do it.

THERAPIST: Mm hm.

CLIENT: You know? And I think on some level that that's even why going up there, it feels like swallowing my pride or something.

THERAPIST: Mm.

CLIENT: Do you know what I mean? (pause)

THERAPIST: It sounds like you feel very, very put upon and pushed, or something like that.

CLIENT: Well, yeah. It's like, "You don't have " My parents, whether it's my Dad talking to me about keeping in touch with Reese (ph) or my Mom telling me to keep in touch with my grandparents. It's like, "You're not in a place where you can speak as like an authority about how to be like the perfect family member. You're not in a position to give advice." You know? [00:44:31]

THERAPIST: [That's what it seems like.] (ph)

CLIENT: And I'm not interested in harping upon that point. I don't want to throw that in your face. But just be aware and don't act that way and make me (laughs) have to say that to you. You know? Don't make me have to say it to you. (laughs)

THERAPIST: Don't throw it in my face.

CLIENT: Yeah. You know? But it's like, yeah, I just don't feel like you two are in a place to tell me anything. You know? About not thinking about other people's feelings or something. I mean, Jesus, I feel like that's like all I ever do. You know?

THERAPIST: Mm.

CLIENT: Like, "That's all I ever do with you two." You know? It's probably like the basic sort of gag principal with everything do with my parents, is trying not to make them upset. You know? [00:45:36]

THERAPIST: Yeah, yeah. And among the things in the, I think among the things in your Mom's kind of, "Hey, call your grandparents," is in some way it feels like everything you already do is not acknowledged in some way. Like that's the implicit kind of -

CLIENT: Mm hm.

THERAPIST: One (ph) implicit kind of meaning of that to you that feels like really frustrating and infuriating.

CLIENT: Because it makes me want to just throw that back at her. You know? "I'm sorry my Mom that my weekend isn't going up and hanging out with my family and just making me think about my family. And, you know, I'm sorry that my family is just like not a source of pleasure for me." You know? It wasn't my doing. Do you know what I mean? [00:46:38]

THERAPIST: Mm. Mm.

CLIENT: "But you're right, that makes me a bad person." Do you know what I mean?

THERAPIST: Mm. Mm.

CLIENT: I'm not going to I would never throw never throw that back at her. Do you know what I mean? It's just I wouldn't do it. (pause) But this morning I stepped outside of that a little bit. and I thought about it like from Marcus's point of view. And I was like, "Geez. Maybe " (pause) Maybe Marcus would be right to think less of me. [00:47:43]

THERAPIST: Hm.

CLIENT: You know? Despite all that. Maybe (pause) Maybe this is something going on between me and my parents. You know? And not everybody else. Not me and my grandparents maybe. Not me and Reese (ph), I mean Marcus. Do you know what I mean? Does that make sense to you?

THERAPIST: Yes. Yeah. Yeah. It doesn't change You know, your awareness of the impact it has on them, as you say, like that kind of hits you, you know this morning, it doesn't change the feelings that you have about the meaning that it has when your Dad does or doesn't do something. Or getting in touch with I guess you're also saying there's this other side to it that's outside of that that's equally true, or something. (laughs) [00:48:54]

CLIENT: Mm hm.

THERAPIST: Yeah. No. That's really, as you pointed out, just like you were saying, as you put it with, "I don't mind, actually, the call itself to my grandparents isn't what's important." It's the feelings that kind of get evoked about having to call. Your Mom saying, "You should call."

CLIENT: Mm hm.

THERAPIST: Or it's not so much e-mailing back Marcus itself maybe, as much as it is this expectation that you should be or something like that.

CLIENT: Mm hm. Yeah.

THERAPIST: And then there's this perspective that Marcus has that's outside of all this that he doesn't see.

CLIENT: Yeah.

THERAPIST: He sees this other like -

CLIENT: Yeah.

THERAPIST: Like my future brother-in-law isn't too wild about getting in touch with me and doesn't want to [call me] (ph).

CLIENT: And the reason I don't want to call my grandparents or talk to Marcus is because I feel like then my parents win or something. [00:50:05]

THERAPIST: Ah. Interesting.

CLIENT: But it's like maybe that's not Maybe I should be trying to like think about it more a little bit. You know?

THERAPIST: Well, (inaudible).

CLIENT: I know.

THERAPIST: Yeah.

CLIENT: That's good. That's good. Thanks for the talk about the healthcare. That's really helpful.

THERAPIST: Yeah, yeah, yeah.

CLIENT: And I'll see you on Thursday.

THERAPIST: I'll see you on Thursday, yeah.

CLIENT: Take care.

THERAPIST: Bye.

END TRANSCRIPT