Capella University Psychotherapeutic Skills and Listening Skills Discussion

EXCERPTS FROM INITIAL COUNSELING SESSIONS
Excerpt 1
Dr. Attridge: Good morning Marisa
Marisa: Good morning!
Dr. Attridge: Share with me what brings you here today.
Marisa: Well, I am kind of feeling like I am caught between a rock in a hard place. I am having some issues, barrier issues. I do not know what you would call them with my mother who lives with my husband and I.
Dr. Attridge: Barrier issues?
Marisa: Maybe not barrier. My mother lived with me for years before we were married and I was married later in life to my husband and she has continued to live with us. She is having a lot of problems adjusting to not being the focus in my life.
Dr. Attridge: Help me understand that better.
Marisa: I am an only child and was born late in life to my parents and my mother always used to say, “You are my whole life.” When she lost her job, when she was in her late 60’s, she could not afford to live alone and so she came to live with me. And while I was single that was not a problem, but I met and married just a wonderful man a couple of years ago. She continued to live with us and she is really struggling with the fact that there is somebody else in my life who is a priority and she tries to kind of insert herself in our marriage more than I would like.
Dr. Attridge: She is struggling.
Marisa: Yes, and as a result, we are all struggling because it is really hard – when you get married in the first place it is hard – it is hard being married later in life because I was kind of used to be independent even though my mother lived with me. We are all struggling to figure out where our place is. I just feel like I am stuck in the middle of she and husband all the time.
Dr. Attridge: Stuck?
Marisa: Yes, stuck because even though my husband has been very tolerant, my mom really does try to insert herself into our relationship in ways that are pretty uncomfortable for him. He was not ever close to his mom or dad. He, even though, he tries to be tolerant, there are times that that – it bothers him and he talks to me and if he tries to push her away then she gets hurt and she comes to me and I keep telling him, “They need to talk to one another,” but I am always stuck in the middle, it feels like —

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Dr. Attridge: You are stuck?
Marisa: I am stuck and I do not like it. My husband, like I said, is really tolerant, but when I try to talk to my mom then she cries, and she kind of motivates my guilt. It is like, “I should just go out and find somewhere else to live because I do not belong here with the two of you.” So it is kind of – it always feels like it is a messy situation.
Dr. Attridge: You mentioned guilt.
Marisa: Yes. That is actually something my husband has helped me to see, she apparently motivates me by guilt. When I try and be assertive about something then she will say, “Fine! I just will not do that anymore. I will just go to my room and eat. I do not need to sit here with the two of you.” I would always fall for that until I was doing the same thing to my husband and he said, “You know–”
Dr. Attridge: This looks familiar.
Marisa: Yeah, which was really amazing to me because it was not anything that I had been aware of, but now, it has been 35 years. I do not know how many years that has worked for her and now suddenly when I say, “That is not going to work” then she does not know what to do and I do not know what to do with those reactions.
Dr. Attridge: Help me understand that better.
Marisa: Well, we have always been so close and we always have talked about a lot of things and so, it never seemed like before that it was really intrusive and I never realized how deeply ingrained she was into my life. Now that I do try and pull back — there are limits to the information that I want to share with her or places in my life where she does not want to go, it is really painful for her. I do not want to hurt her, but at the same time, I feel guilty because my decision to make a different change in my life has really impacted her and it has impacted our relationship in a lot of ways.
Dr. Attridge: Tell me more about this notion of guilt that you are feeling.
Marisa: She always says, “You are my whole life.” My mom and my dad were married 20 years before I was born and they tried the whole 20 years to have a baby. All I have ever heard is, “You are our miracle child. I live for you and everything you know.” All of a sudden, her miracle child is branching off – miracle adult, miracle middleaged adult – is branching off into an area that is — it is just hard for her because she cannot go there, and so I feel guilty because I feel like I am taking away the focus of her life.

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Dr. Attridge: Sure. That makes sense to me.
Marisa: It makes sense. Then I sit back and I try and look at it objectively and they kind of through my husband’s eyes as well, but I am just living my life like most people do. I am married and my husband is a priority and we have a relationship that is a oneto- one. It is not a two-to-one type of a thing, so even though I feel guilty, then you feel angry because it is like I should not feel bad about being happy in a marriage.
Dr. Attridge: The way you share this story with me Marisa really makes sense. Almost as if you are triangulatd in this situation.
Marisa: That is it, exactly.
Dr. Attridge: I think I have a pretty good understanding to where you are coming from. I would like to explore this further with you if we could.
Marisa: I would like that very much.
Dr. Attridge: All right, excellent! Thank you so much.
Marisa: Thank you.
Dr. Attridge: I really appreciate your sharing.
Marisa: Thanks.
Dr. Attridge: Thank you.
Excerpt 2
Dr. Attridge: Marisa, tell me more about this feeling you have of being triangulated.

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Marisa: I just kind of feel like I cannot meet anybody’s expectations right now. We are in the first year marriage with husband, we are working hard to fill this life together and at the same time my mom is like knocking at the door to get in all the time and she feels left out. So, my husband feels put upon. He feels left out, and I feel like I am not making anybody happy.
Dr. Attridge: So, it almost sounds like you are feeling that you have to please everybody. Is that accurate?
Marisa: That is accurate. I do feel like that and then I feel like I am not being able to enjoy this first year of marriage because I am always trying to make everybody else happy and I should feel like I should be able to have this time with my husband and to me it is hard anyway because I have been independent for so many years and now we are make – we are forging this relationship and it is just hard to – and I feel like I do not have the time that I need and want to devote to the marriage because I am constantly refereeing between my mom and my husband.
Dr. Attridge: You mentioned that you were independent all these years. Were you really independent?
Marisa: Yeah, I do think. Well, yes and no because there were a number of years when my mother did not live with me and so I was truly independent. Maybe never. It is a really good question.
Dr. Attridge: Much depends on how you perceive independence. How do you perceive independence?
Marisa: I guess I perceived independence as living on my own and being responsible for my own bills, with my living situation and working, and having my friends and going out when I wanted to and doing those kinds of things, but I hadnever thought about independence in terms of emotional.
Dr. Attridge: I guess that is the point I am trying to make. It sounds like you understand independence to be primarily a physical condition. In other words, physically separated from others, including mom, but independent in terms of paying your bills, paying your rent, living alone, those sort of define independence for you.
Marisa: Yeah.
Dr. Attridge: But what does independence really mean for you in terms of emotions?
Marisa: I guess I never really thought about independence in terms of emotion and if I had I guess I would have thought about it as I was free to marry who I wanted or fall in love with who I wanted or do what I wanted to or choose the friends that I wanted, but I guess I had never thought about my relationship with my mom in terms of independence before. That is really interesting.
Dr. Attridge: So, as you consider that now in this moment, what do you think?
Marisa: I think that makes a lot of sense because I guess that even though I feel like when I have gotten older and that I do not need my mom as much as I used to and that that relationship is not as central in my life that I feel guilty for that because I know that she still feels — I feel glommed onto it sometimes. I think that she is still fighting to hang on to that and so maybe I am not independent like I thought I was, because even I am trying to be independent. I am feeling really guilty about it, obviously or I would not be in here talking to you.
Dr. Attridge: If I understand this accurately, you are sharing with me that you have matured and developed a measure of independence, but perhaps your mother has not recognized that and is still perhaps fighting it.
Marisa: Yeah, I would say once you put it like that that would have to be the case. Either that or she just thought that my marriage, she would have that same kind of relationship with my husband and then she could just be in both of our businesses.
Dr. Attridge: So, you get a sense that perhaps your mom wanted to develop a similar relationship with your husband and from there, perhaps have it look almost identical to the relationship with you?
Marisa: Yeah, I kind of get that feeling sometimes. It is either that or it is kind weird because like I said he is a whole lot like my dad. Sometimes I feel like she thinks she knows him really well and she assumes a level of relationship that is not there, because he did not have that with his folks. He is not used to having that close-inyour- business kind of relationship with a parental figure and yet she has just kind of dove right in there like it should be. So, it is really taken him saying things to me, for me to understand that.
Dr. Attridge: So, it has been kind of a struggle for you to kind of acclimate to this triangulation?
Marisa: Yeah, and to feel like, because at first I was like, I did not understand his drawing back or his need for privacy or his need to not have her, that type, because that was all I have ever known and so it did not seem odd to me at first, but when I sit back and look at it through his eyes, it is a little bit like, “Yeah, this is probably excessive.” But I want him to tell her that. I do not want to be the one to have to tell her that.
Dr. Attridge: I see. Given that he has not kind of had that level of family involvement – participation in the past, what is it like for you when your mom engages him in that manner? What is it like for you?
Marisa: Tense, so tense, like for example she is a real morning person and he is not. He just wants to sit and have a cup of coffee and kind of come gently into the day and she jumps out of bed and she is just hammering right away and I could just feel the tension. I can feel him getting angry and I can her getting more desperate because she is trying to be friendly, and she knows he hates it but she can not help herself and I am in the middle just kind of wanting to sink into a bowl of cereal.
Dr. Attridge: You are in the middle?
Marisa: Yeah.

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Dr. Attridge: What is that like?
Marisa: It is just nerves. It is just kind of that creepy sense of anticipation going, “Here we go.” You know, “I am going to hear it from him because she will not quit talking. I am going to hear it from her because she feels like he is shutting her out.” I keep saying, “You talk to one another.” But —
Dr. Attridge: It sounds like it generates a lot of anxiety for you.
Marisa: Yeah, it really does, and resentment.
Dr. Attridge: Resentment, how do you manage these emotions, anxiety, resentment, guilt, how do you manage?
Marisa: I eat.
Dr. Attridge: You eat?
Marisa: Chocolate is my friend. I eat or I get angry. Or it is kind of like I keep trying to say, “You need to talk to one another. You do not need to talk to me. Do not put me in the middle of this relationship.” But they still do not talk to one another. They both still do talk to me and so here I am.
Dr. Attridge: I see. Marisa, thank you. This has really helped me understand your story much better and I think from here we can really work toward finding some approaches to help you cope.
Marisa: That would be great.
Dr. Attridge: Excellent. Thank you.
Excerpt 2
Male Speaker: Marisa, hi. I would like to explore this notion of boundaries with you further. You mentioned that boundaries is kind of an area of difficulty in your family right now. So help me understand that better.
Female Speaker: What I am finding is that for years, my mom had — we have always had an open-relationship. We have talked about everything and now that I am married I do not talk to her about everything, but she has trouble realizing that she should not be included in all aspects of my life like she always has been. Well, at least partially.
Male Speaker: Sure. So growing up, you and your mother were always very open in your communication and now since your marriage, you are sharing more with your husband and less with mom. Is that accurate?
Female Speaker: Yes, I would say that is really accurate and I think she expected my husband to be as open and as sharing with her as well and he is just not that kind of guy and so I think that that has been a problem, as well, because it is like she keeps knocking on the door and he is not really interested in answering.
Male Speaker: All right, so you contend or believe that your mother’s expectation was that your husband would be as forthcoming and open in the communication with her as you have been historically.
Female Speaker: Exactly, exactly and I think that she does not really — to me I think it is affording him the consideration of giving him space and she does not do that and it frustrates him and then she is frustrated when he does not respond like she wants and then I am frustrated because they both come to me.
Male Speaker: Sure, that makes sense. The frustration that each one is experiencing in the communication, given you are the one that is triangulated, the responsibility falls on you. What is that like for you?
Female Speaker: Frustrating because I just feel like we are all grown-ups and that they should be able to talk to one another and I feel resentment towards both of them because I do not think I should be put in that situation, even though I understand who I am. I just think that it is not fair.
Male Speaker: It is not fair. It is not your responsibility to engage them in adult relationship communication. So, how do you foster that?
Female Speaker: Probably not as effectively as I could because otherwise, I would not be frustrated here talking to you. I tend to just get really irritated and it is just like, “Why can you two not talk one another?” and it just does not seem to happen and I just keep getting more frustrated.
Male Speaker: Yes, I can see the exasperation and frustration on your face and in your voice. It makes sense that you would be. What do you think can you do to foster better communication within that family?
Female Speaker: I guess I could just sit them both down together and talk to them and say, “Obviously things are not working the way they are and I do not want to be caught in the middle of the two of you any longer. You need to work this out.” You know, I just do not want to go down to that. I just do not want to do that.
Male Speaker: So you could possibly just have a family meeting with everybody involved but you are hesitant. What is your reluctance about?
Female Speaker: My husband is going to hate it and my mother is going to cry and I am going to be stuck in the middle of that one more time. I know these people.
Male Speaker: You are sensing that there might be some really uncomfortable emotions that come from that?

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Female Speaker: Yes.
Male Speaker: And you do not want to engage in that?
Female Speaker: It is like beating a dead horse that is how it feels sometimes because it is just kind of like well you know these two people, they are oil and water even though they love one another. They are oil and water and they have this behavior sort of ingrained and I am going to try this meeting and I will still be the one talking and trying to make everything right and they will still be doing their same thing.
Male Speaker: Thanks Marissa, you have really offered me a lot more insight into the presenting issues here and I deeply appreciate your courage. Thanks.
Female Speaker: Thank you.
Excerpt 2
Male Speaker: Marisa, you have shared some really important things with me in our earlier sessions. And our next step in this process is try to identify and pinpoint the presenting issues.
The way I like to approach this is to kind of check with you and find out how you perceive the presenting issues and what is most important for you in terms of the work that we do in the future. So I am curious, what do you perceive as the most pressing issue for our work in the future together?
Female Speaker: I think that I need to find a way to deal with being the person in the middle. I need to be more at peace with that. I would like to find a way for everybody to communicate so I am not in the middle. But if not, then I need to be able to cope with that situation.
Male Speaker: Sure. If I understand this accurately, have a better way of coping with the triangulation?
Female Speaker: Yes.
Male Speaker: Okay.
Female Speaker: Yes.
Male Speaker: Excellent! What else do you perceive as sort of the presenting issues here?
Female Speaker: I think I am really going to have to — I mean it is a given that it is a new marriage. I need to continue to work on my relationship with my husband but I also think that it is time for me to redefine my relationship with my mom.
Male Speaker: Okay. So you want to work on the marital relationship. And if I understand, it is about redefining that relationship. Is that accurate?
Female Speaker: With my mom redefining but I think with my husband we are building. We are going to the next level of relationship I guess from engagement to marriage, and just, I think probably just the normal things that you do when you are first married. But I think that we just had that added dynamic of my mom, and so I think I always want to focus on my relationship with my husband so why would I not do it here?
Male Speaker: Absolutely. Anything else come to mind in terms of what you perceive?
Female Speaker: Stress management.
Male Speaker: Stress management, okay. Anything else you would like to work on in our efforts together?
Female Speaker: I think that is good for a start.
Male Speaker: Absolutely, absolutely. I identified some of these very same things. However, I also identified some other areas and I just want to bounce those off of you to see if they fit for you and if these are areas you would like to work on. And if they are not, that is totally fine.
One area that you constantly mentioned was this notion of anxiety so I was thinking that perhaps some measure of anxiety management might be helpful. Would that be something you would like to work on?
Female Speaker: Yes. I think along with the whole stress management unit, it is probably a good idea.
Male Speaker: Okay, very good. You also mentioned several times these ideal boundaries in your family and I think this kind of falls in with your idea about redefining your relationship with your mom, the triangulation, and working on the marital relationship. So perhaps, that notion of boundaries can be incorporated into that as well.
Female Speaker: Yes. That is a good idea.
Male Speaker: You also talked about your way of coping is with food.

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Female Speaker: Yes.
Male Speaker: Do you perceive that as an area that we need to work on or is that something that you do not feel is problematic?
Female Speaker: Oh no, I am pretty sure it is problematic just based on the scale but I kind of feel like that is not where I really want to put my focus right away.
Male Speaker: Okay. And that is totally fine. If that should become an aspect as we are doing our work in the future that you do want to focus on, you can always come back to that.
Female Speaker: That makes sense because I am kind of hopeful that if we can take care of some of these other stuff that I will not be reaching for the M&M’s as often.
Male Speaker: Understood. I also kind of captured a theme about this idea of family roles and the imbalance that sort of occurs in your family right now. And again, I think this circles back around your idea about redefining these relationships with your mom and defining the marriage and the triangulation so that is sort of incorporated into this idea about family roles and kind of correcting that imbalance. Would you agree?
Female Speaker: I agree, I do. Yes.
Male Speaker: And also lastly, I guess this notion of this family of origin, you being an only child and the impact that has on you in the here and now, I am not a bout trying to excavate the past in order for you to understand but I do think it does have some bearing on the here and now based on the relationships that you are experiencing with your mom and with your husband.
So, would you be open to exploring perhaps some earlier childhood recollections as they relate to here and now relationships?
Female Speaker: Yes. There are some places that I just do not go very often but maybe it is time to do that.
Male Speaker: Perhaps, and it may not even be necessary to go there. We will look at these as necessary as it relates to what is going on currently.
Female Speaker: That sounds good.
Male Speaker: Okay? Excellent. Well, these are really good starting points. Now as goals for our future work, I can take these larger areas and develop some interventions. And when I do prepare that for you, the interventions I think you can kind of consider those the steps that we will agree upon that you will do to achieve those goals. Does that make sense?
Female Speaker: Oh, good! Yes. I am glad you said that because I was thinking about like an intervention where everybody comes in and sits down.
Male Speaker: That is a good point of clarification. If we want to look at this in terms of goals and objectives versus goals and interventions, that is fin e too. But, it is important to just recognize that the goals that we are looking at here today are sort of the more global presenting problems or issues. I do not like to consider them problems as much as I consider them issues.
Female Speaker: That sounds fine.
Male Speaker: And as we develop steps for you to accomplish your goals, we can call those interventions.
Female Speaker: That sounds good. Thanks.
Male Speaker: Fair enough?
Female Speaker: Yeah. I am glad you clarified that. That makes me feel much better.
Male Speaker: Excellent, Marisa. Again, I think we have much to work with here. And in the future, our work will focus on these agreed upon areas of consideration.
Female Speaker: Okay.
Male Speaker: Fair enough?
Female Speaker: Great.
Male Speaker: Excellent! Thank you so much.
Female Speaker: Thank you.

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