I don't know what would best serve me or if the 2 minutes of joking at the beginning when I'm uncomfortable jumping straight into a topic is really hindering any progress, but I do know if I'm hypo and have something--anything--to say, it is impossible to hold back. It's normally hard, but add in a couple nights of no sleep and change the 3*impulsivity to 4.5* and BLURRRRT.

edit: yeah I think today I'm just going to go in and try and skip the jokes. Yeah, she's used to it and that's what she expects from me and she knows I struggle a lot, but maybe if I straight out say "things are unmanageable " instead of "my life looks like my underwear after I purged yesterday...that wasn't the most beautiful sight " I'll be taken more seriously and I'll get more help than I've been getting.