Since starting this program have you done anything that makes you proud? Where does this sense of achievement come from? I have realized that I am not happy with my job and I think several of my TMS symptoms stem from this. I feel helpless to change my situation. I feel that my identity is very much tied to my job. I always am told that I must be very smart and that I am successful for having the job that I have. My family is very proud of me for having the job that I have, so, I feel that it is very difficult to change things. I say this as my tms symptoms continue to persist. I am taking steps to change my job to one where I at least have more control over my hours. I do enjoy my job, but I am very tired by the end of the day. So, I feel that if I could at least work part time, then I would not be as stressed or anxious at work. Over the past few weeks, I have explored moving my job to a new location. I feel proud of that step, because I tend to get locked into a way of life and not changing things even if it is not good for me. This time, my feeling of achievement, of looking for others jobs, is coming more from me trying to take care of myself versus trying to please or impress someone else. I hope I can actually go through with it. I also need to face taking responsibility for my decision even if it doesn't turn out the way I want. In that case I have to realize that I can change again. Nothing is permanent and I need to focus on taking care of myself.