Therapy, as the therapist: "Sunday night blues"

I've been trying to come up with a way to show people what I do as a therapist. The problem is that the service I offer is private. And, I am obligated by several governing bodies to maintain strict confidentiality.

So, I've had various ideas. I could talk about a famous person. Or, I could get a friend to act as a client while I video tape them. I could present real cases and change identifying information. None of these ideas felt authentic nor professional. 

But, today I had a new idea. You Tube. Why didn't I think of it earlier? So, I found a video that feels somewhat realistic. This is an example of the type of dialogue someone might say to me in a therapy session. Let's watch it together. Pretend we are in my office, and this person has come to me for a consultation to assess how I can help her. I'll write down the thoughts that go through my head and what I would say to her.

My thoughts (string of thoughts as she talks)

Who diagnosed her with borderline personality disorder? Why does she like this term?

She has a lot of insight into her thought patterns

She mentioned a boyfriend. I want to hear more about this relationship.

What issues did she have at her job? Why is it an unhealthy environment?

Currently, she is not fulfilled by her home life. 

Calls it "Sunday night blues" 

"depression" and "anxiety", "in the pit on my stomach"

she feels better on monday and tuesday

Has a hard time remembering she will be ok on the weekend/work week

very articulate

My response (what I say outloud to her):

"Well Debbie, what I hear you talking about is a combination of depression, or as you call it, "sunday night blues" that come both at the end of the work (or home) week and at the end of the weekend. And, sometimes some accompying anxiety. Did I get that right?

I'm impressed by your ability to really articulate and describe this pattern that you have noticed in your week. That ability shows me that you must already be working hard to notice how events in your life influence your moods and feelings. It sounds to me like you have a hard time really holding onto the emotional memories of the different parts of your life. Let me try to explain that some more. During the week, you have a hard time remembering, I mean really remembering that you enjoy hanging out with your boyfriend and being at home. It is as if all the previous weekends you've had together are a very distant and foggy memory. Likewise, at the close of the weekend, you have a hard time remembering the positive aspects of your weekdays. This discrepency might be part of what is causing these depression and anxiety symptoms. But, being aware of this pattern is the first step in getting better.

Of the other things that you mentioned, if we worked together, I would want to hear more about work and in what ways it is an "unhealthy" environment. I am curious why you are now not working and what other current stressors you are facing. I also would like to hear about your relationship with your boyfriend - the details about how you met and what it has been like to be in a relationship with him. I also would like to hear a bit about the family that you grew up in and how those relationships have influenced or shaped some of who you are now.

The last thing I might add is that I see you have a diagnosis of Borderline Personality Disorder. I am curious who diagnosed you with it and what that diagnosis has been like for you to have. Has it felt like a relief to belong to something? Is it stigmatizing? Has it felt like it explains part of what happens to you?

So, to summarize, the work that I would be able to offer to you Debbie is around these types of patterns that you are describing with your mood fluctuations and events in your life. I imagine there are other things that trigger you into feeling depressed or anxious. What therapy, at least therapy with me, could offer you is a chance to have awareness, insight and eventually some strategies to manage and soothe yourself through some of those triggering events."