Dishonesty Dialogues VI

Pt: (Looks down, then back up) I don't know what's the matter with me. (Long pause) I guess I'm sorta... I don't know. Depressed. I guess.
Ther: But you're not sure?
Pt: Yeah, I'm... I guess... I'm depressed all right.
Ther: Did you know that when you came in, or did you just then figure that out?
Pt: I guess I knew it when I came in. Sorta, anyway.
Ther: But you said you didn't know. I'm puzzled.
Pt: Well, I guess I kinda knew, but.... (long pause). My wife and I had this big argument last night, and...
Ther: (Interrupting) Is this about your depression?
Pt: Yeah! See...
Ther: (Interrupting) We can come back to your argument in a few minutes. I'm feeling unfinished about what we started with.
Pt: (Puzzled) What?
Ther: When you said you didn't know what was the matter with you, but then later you said you did know. I said I was puzzled by that.
Pt: I don't know what you mean. (half smile, looks down and back up)
[Therapist thinks 'I now have to make a choice, to stay with the earlier confusion or to move on to this second instance, because he certainly does know what I mean. The pattern is that he professes to be confused when he really for some reason doesn't want to specifically address the issue. However, the second instance is just another version of the same issue, so...']Ther: Why do you say you 'don't know what I mean' when in fact you do know what I mean? Seems to be almost habitual.
Pt: Gives me time to think, I guess. Yeah, I guess that's it.
[Therapist thinks "He never says things straight out, but always with the 'I guess' or 'sorta'. I wonder if that's part of the same mechanism."]Ther: Does it seem to you that you're under some time pressure to answer me quickly? (Before patient can reply, therapist continues:) Take all the time you want.
Pt: (looks very uncomfortable) Yeah, I guess I...
Ther: (Interrupts again) No, take all the time you want.
Pt: What? Oh. I'm... I guess I... I don't know why I do that.
Ther: I don't agree with you. You do that so consistently, in such an organized way, that I'm convinced there is a specific purpose behind your behavior, even if it's not easy to put into words.
Pt: I guess I've always done that.
[Therapist thinks, "At least a step in the right direction"]