when i was 17, i had a friend. she was pretty. back then, all my friends were pretty girls. i was...nonthreatening. i think that's why they felt they could tell me things they didn't tell the other girls. i couldn't use it to take their boyfriends or spread rumors or any of the other things girls do. i was just their ugly friend. and i was an ugly girl. not just because of my looks, but because i wasn't a girl, and it ostracized me from the idea of girlhood and experiencing it. so i wasn't lusted after or anyone's first choice. but i was a confidant. over and over and over.

tell me more about this friend that brought these feelings up.

it was the summer after high school graduation. i was 17 and working part time and socially free otherwise. she called me crying and asked me to meet her at her house. it was 2 in the morning. i had work at 9. i went. then she suggested that we go to steak 'n shake, this 24/7 place. so i ubered us there. and she's telling me about her boyfriend, the one i always hated anyway, and how they got into a breakup fight and im listening and the uber gets there and...well, he's there. and she knew he would be there, i think, she just didn't want to tell me.

we sat down anyway. he's with friends. she's clearly been crying. we order. i have the money because i was the only one who worked. we ditch the food halfway through and go outside and then he's there. and im on guard duty, because she's crying again, and i'll never forget the look he gave me. this look like i disgusted him, like i was nothing more than the fat girl protecting his hot girlfriend, that One Friend every girl has. but i didn't back down and i asked if she wanted to talk to him anyway. and she did. and it was 3 in the morning now, and im seventeen, and she left me on the curb to go back inside and talk to her boyfriend.

she left you on the curb alone at 3 in the morning.

yeah. she did. and i was sitting there. it was dark except for the drive thru lights. i put my chin in my hands and went on my phone and i just sat there. and 15 minutes later she told me it was okay to go home. that she was going back with him. we were adults now. it was okay to be out this late, i was living practically on my own anyway. so i ordered an uber back home. and i went home to an empty house, with no one wondering where i was. and she got back together with her shit boyfriend, this pretty girl who could have anyone she wanted. and we never talked about that night. but i remember it. i felt like a dog. a pet people call to feel better. and i came. every time the whistle hollered i perked up and i went. i felt so pathetic after i put my keys down that night. used, somehow. i haven't spoken to her in years. i don't know what she's doing now. but i promised myself i would never do anything like that again.

what's making you think of all this so many years later?

ive spent countless hours at work and after work listening to my coworker talk about this girl. the one they just can't stop seeing. and ive spent probably around 12 hours now listening to her talk about them, the person they just can't stop inviting in. these talks, over and over, and im a sounding board. we dont talk outside of that, and if we do, i initiate. i came home the other night from one of these sessions and i realized that im 26 now, a week from 27, and i was still in that uber from steak n shake. i came from a bar instead, and the subway instead of the uber, and it's a different state now, but i was still there. coming when called. being dismissed when my presence was no longer needed. and i put my keys in the same ceramic dish and even though the walls are different, i came home to the same empty apartment. and that same feeling came over me. this...despair.

despair?

i just thought...these two talks happened back to back, and in neither conversation did i leave feeling like i had a conversation. i felt like i did at 17. like the nonthreatening friend. an amorphous blob that'll hold your secrets like a safe and never cause a mess because who would be interested in them? it's a safety blanket. it's like...a pet. one you can scratch behind the ears and throw a bone for and they'll be loyal forever because what the fuck else do they have. and i hate that it's true.

you hate that what's true?

that logic. every fat girl knows it. and even though i'm not one, you'd be surprised by how many people treat fat gay men like a fat girl. especially people who know you're trans. i feel so messed up. so inconsequential. im 26 and staying out till 10 on a tuesday listening to my friend cry just to watch her go back less than 24 hours later. just to be ditched on plans you made for the same person who'll make her cry the next day. my other friend is getting married, and im not even at the wedding. im watching her fucking dog. im just...there. i feel like a tool. like my purpose is to be useful. because im not important. no one actually cares. im just...there. and when im gone people will reach for that tool again and maybe wonder when they misplaced it or feel briefly sad that they lost it, but they'll have another new one waiting, or they'll have whoever they were going to use that tool on anyway, and life will return to normal. and i'll be an inconsequential speck of a human that listened to you cry 10 years ago, and you probably won't even remember that my eyes were blue, or that sometimes when im too tired my lisp will slip out, or that im afraid of heights. because maybe you never learned those things.

and i need to wallow about that for awhile. plus, our time is up. maybe i'll see you next week, doc.

this is very introspective. anything else?

i stop myself from getting angry, but it means i stop my other emotions too. i suppress them because it's easier to believe they hate me than feel joy with me. than care about me. because caring about me means i could get hurt. its easier to keep everyone at arms length. but then i wish for someone to really see me. i act hurt when no one can. when really it's my fault i've built this chrysalis no one can break through.

you've been giving this a lot of thought.

yes. i've had a lot of time alone.

how do you see yourself?

i try not to.

try not to what?

see myself.

you spend a lot of time alone, picking apart your interactions, your negative traits, but you have no image of yourself.

of course i do. i just don't like it.

if you could pick five words to describe yourself, five words that won't be shared outside of this room, what would they be?

i don't know.

i know this is a difficult question to answer. i'd like you to try. if you find it too distressing, we can move on.

no i... it's okay. stupid, is the first one that comes to mind. i think i am stupid. i can't hold up academically. i think i know the right words, can say things with the right inflection, make people believe i'm saying something important. but it's simlish. what do i know? i don't know anything.

can you think of anything else?

ugly. i'll never be beautiful, handsome. i wasn't born for it. i'll melt into the background. i've made peace with that. that's only two, isn't it? maybe...anxious. i'm a very anxious being. jumpy. always looking over my shoulder. loud. i've always been loud. too loud, too much noise. and the final one...that should probably be positive. i think i can be kind. it's hard, though, to remember to always be kind. it's easier to be cruel. and sometimes, if my day has been difficult, or i am too tired, i am afraid i pick cruelty too easily.

you find yourself unappealing

i told you. i try not to look.

you know, you told me before you're in a phd. that field in particular, its acceptance rate is incredibly low. under 1%.

yes. it's a difficult field. but i'm not at the best school. i'm not on full scholarship.

do you always do that?

do what?

negate your achievements?

i don't have many achievements to negate.

what i'm hearing is that you spend a lot of time alone, but you don't have a relationship with yourself. when was the last time you celebrated something you'd done? or something about yourself? did you celebrate getting into grad school?

i called my sister.

did you do anything physical?

no. it was just an acceptance. they can be happy when i graduate.

when can you be happy?

i don't know. maybe when i deserve it.

you know, you were very insightful at the beginning of this session. you're very attuned to how your behaviors affect others. but you seem to ignore how you treat yourself, and how those behaviors affect you. i think that should be our biggest goal in our work together. reaching a point where you can have a relationship with yourself.

i don't know.

how does that goal make you feel?

we're back to what-if's, doc. what if we peel it back and there's nothing on the other side? what if this is just who i am.

you're in a phd. what do you do with hypotheses?

test them.

right. well. would you be willing to test this one? that there is something to find during our work together?

i guess i told you i'd do anything to make this stop. i figured i would get drugs.

i can refer you out to a psychiatrist too, if you're interested in medication.

it'll have to be next time. our time's up.

the clock is wrong. how did you know?

i told you. i always tell you. it's always the same.

right. well, i'll see you next week.

yeah, doc. next week.

can you explain to me what you want to stop?

this ache.

where do you think the pain comes from?

projection. someone puts slides in me and spit them out on a wall. always projecting. images of things. my friends dating each other. being so far away. having other people when im alone. an angry jealousy. not...it's not deserved. they aren't at fault. they don't deserve this from me. it's not their fault that i can't pull it together.

you know, these past few sessions, i've noticed you make excuses. you don't let yourself be angry. or hurt. maybe you're mad at your friends, whether they deserve it or not. but you won't let yourself reach that point.

why would i? it's not fair to them. i think they do a lot for me. even if we haven't spoken in awhile. i know...i hope i know...i tell myself i know that they care. i have to tell myself this.

do you ever get angry?

of course i do.

when's the last time you were truly, really upset? not sad. angry.

i don't know. there's a lot of things that make me angry. i am a citizen of a country that won't stop soaking this earth in blood. that makes me angry.

let's narrow this down. i mean interpersonally angry.

i don't...i don't like to get angry. im my father's son. im my mother's son.

your parent's son?

i never got the worst of it. i told you, i wasn't the worst kid. but i have my mother's tongue and my father's temper. my mother's fists and my father's swing. i don't like to get angry. i'm afraid of my genes.

your parents were physical with you, and now you don't like to get upset because you're worried about becoming physical as well.

i don't want to hurt anybody.

have you ever wanted to hurt your friends before?

what? no. of course not.

could you tell me what you think would happen if you got mad at one of your friends? if you confronted them?

i...i'm afraid they'll see how horrid i am. they'll leave me. i try not to get angry. i get annoyed, sure, but just little things. nothing that needs to be voiced.

you never have disagreements?

not really, no. academic ones maybe. good debates. not personal. i don't see the point.

because you're afraid they'll leave you.

i know i'm a doormat. you don't have to tell me. i'm pathetic.

well, to me, it sounds like you're always putting on a front. you filter all of your raw feelings and then funnel them into something you think is palatable. that sounds exhausting. it sounds very tiring to live that way.

not really. my friends don't do anything to make me mad. i have no reason to get upset with them.

have you ever confronted them head on about your feelings of loneliness?

no. it's not their fault. i don't want them to feel responsible for my stupid feelings.

so you have this filter going, you don't communicate with your friends, but then you feel sad when they don't reach out, despite not telling them how you really feel. am i hearing that right?

what am i supposed to say? 'sorry, i'm really struggling, can you tell me you love me?' i know that's reassurance seeking. it's the damn textbook entry. i do it once i'll do it a thousand times and nothing will change except everyone will be tense, waiting for me to struggle again. i have to figure out how to do this on my own.

have you–

i told you i need to figure this out on my own.

we'll work on self-soothing techniques then.

what are you smiling about?

well. i believe you just got upset with me.

right. our time's up.

would you prefer i remove the clock?

i'll still know.

i want to stop thinking of my friends this way.

how do you think of your friends?

like they don't care. i know they care. it's not very nice of me, i think. to force my feelings on someone. i think they care about me very much. i have tangible evidence. in case i forget. a key to a front door. a hand bound notebook. every card someone has ever written me. a painting. evidence of love. but...it's not enough. it's not fair. i think i am selfish. i've always been selfish.

i'm hearing that your friends care about you very much and you know this, but there's a disconnect between what you know and what you feel. (paraphrasing)

i feel... i feel. i think i feel too much. it's always too much. i always want more.

you've mentioned wanting "more" a few times now in our sessions. could you describe what "more" is?

when i was young, when i tried to get up for school, my sister would force me to cuddle. i went under the blankets and i was late for school. my dad gave me hugs. he cooked dinner for my mom. my sisters walked me home from school. i lived in a three bedroom apartment with seven people. pets everywhere. i hated that place. i would stay out as long as i could just to avoid going home. but it was always full. until it wasnt. i started living alone when i was 17. ive never stopped. and sometimes. i guess...sometimes when i wake up...i still wait for my sister to ask me to cuddle. i live 500 miles from them now.

so you grew up in a physically affirming family, even if the space couldn't accommodate your size, but you haven't had that physical closeness in a long time and it's starting to affect you negatively.

i've always been touchy feely. maybe too much. maybe i ask for too much. i come home to an empty space. i make dinner for myself. i go to bed without saying goodnight. i wish someone did the dishes. said welcome home when i came back. i had a dream once. my two friends, the ones i see most, theyre dating each other. i had a dream where we lived together. i dont know why all three of us would. i was in the kitchen, making dinner. i like to cook. i was watching the sunset. i heard them in the background, laughing and drinking. i woke up happy. but then i thought...this was my dream. and even in my dream, i am removed. i am alone. an outsider looking in. i hate myself so much i cant even conjure someone who cares for me in my dreams. how pathetic is that.

there are a lot of things you mentioned here that i think will inform our work together. before we start on that, i want to learn more about you. you mentioned your sisters and some routines from when you were young. what else was your childhood like? (potentially dismissive)

there were always people looking after me. until i got to high school. i was old enough then. my sisters moved away. my mom...she moved away for a bit. we never got along. still don't. my dad worked a lot. i was an easy kid. not much trouble. i fought a lot with my parents but i didnt party or get into anything serious. bit of a nerd i think.

you said last session you attempted to take your own life when you were 13. if you're comfortable, can you share what your life was like around that time?

it was normal. i mean, we were poor. i loved my dogs. my parents...i can say as an adult that they werent very good parents. but they were trying their best. i hope they were, anyway. they were young and broke and without any familial support. i was struggling academically. i was struggling. i remember... i wanted to leave. i wanted quiet. i wanted to rest. no one knew what to do with me afterwards. we just kind of ignored it, and it went away.

you didn't have any mental health treatment?

no.

you know, and correct me if i'm wrong, but you seem to minimize your negative feelings. you say life was normal as a teenager, but you attempted to take your own life. that doesn't sound very normal to me. it sounds like you were in a lot of pain. (confrontational confrontational)

i felt too much. i always feel too much.

too much?

i always want more. i feel too much. i am selfish.

what's the right amount?

what?

you've mentioned that you feel too much several times now. that you always want more. what's the right amount for you? (stop pushing)

i...i don't know.

is it too much to simply exist? it sounds like, to me, that you've been taking care of yourself for a long time. it sounds like you feel lonely. does that sound correct?

i...i guess. but i dont know how to stop. i hate myself so much that i cant even dream about someone being excited to see me. i dont know how to stop.

that sounds like a good goal for our work together. bolstering your self-image and esteem and helping stop negative self-feedback loops. is that something you'd like to work on.

i think i'm scared.

is there anything in particular that's making your frightened?

i've always thought of myself this way. i dont remember a time when...when i even tolerated myself. what if its impossible?

i can't speak possibilities into existence. but what i can do is try and help you achieve the goals we set up together. if that's something you're interested in working towards, then i'm interested in helping you. (what if this is wrong. what if this is all wrong. what if i said everything all wrong. oh my god. what if i hurt them.)

....

okay. i...i guess i can try.

then i think we have a good set of goals to start with.

our time's up.

you kept track again?

i told you.

right.

im sorry.

what?

everyone walks through that door for a reason. what's yours?

i want to have a clean gravestone. at least for a little while. someone who cares to clean the mildew. lay down flowers.

have you already decided you're going to die?

i think i am unimportant.

what makes you think that?

no one has called me in three days.

do people really call anymore? that sounds lonely.

i think i am unimportant.

what does that mean for you? feeling unimportant.

i am not anyone's best friend. i perform well in school but i'm not the best in my class. i have no standout talents. i am a stepping stone. a support beam. never the house its leading to. or the roof it is holding up.

it sounds like you view yourself very harshly. what are you studying in school?

i'm in a phd. to help people.

that sounds very important. you called yourself a support beam. wouldn't the house fall if not for the work of its supports? (error)

i dont care if the house falls. i think i am cruel.

let's go back for a moment. what would it look like to be important?

i helped prep for a friend's surprise party. i was there. so many people were there. i have her key. it was fun. its been months since then. i havent been outside in awhile. i dont think anyone would throw me a surprise party. if i didnt plan my birthday everyone would forget. i dont think im important enough to remember.

not important enough to remember?

yes.

we've been speaking a lot about importance, but i am sensing a lot of hurt here. correct me if i'm wrong, but it sounds like you're hurt your friends don't care for you on the same level you do for them. (correct)

i tried to kill myself. when i was 13. i think i was selfish. i wanted to leave. i'm still there. i'm still 13. the same depressed i was then. except now im 26.

do you feel like you will harm yourself?

no. i walk a lot. solitary. i think i wouldnt mind if a truck hit me on the street. an accident. i think i wouldnt mind if i got shot. a driveby, a holdup. i think i wouldnt mind if i fell and broke my neck. but im careful when i walk. i look both ways on the street. i dont go in dangerous places. i wouldnt mind if i died right now. i wouldnt do it myself. but i wouldnt mind.

you say you're the same as you were at 13. but you're telling me now that you've gone from suicidal to avoiding danger. that sounds like progress.

...

i've noticed you keep deflecting questions when it comes to your feelings around your friends. everything we talk about here today is important, but i am curious as to why you keep changing the topic. (confrontational without rapport)

i think i feel guilty. i always feel guilty. my friends are good to me. but i... i want. i feel guilty for wanting more.

you feel guilty for wanting more.

our time's up.

you kept track of our time?

i feel guilty for wanting more.

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