Transcript of 27th Session between Charles Balis, M.D. and Mr. Thomas Darden, Monday, June 29, 1998 at 2:00 pm.

Dr. Balis: Hello, Tom. Please come in.
Mr. Darden: Thanks.
Dr. Balis: Let's see. I believe you owe me a homework assignment.
Mr. Darden: Right here.

Thomas Darden's Pyramid of Social Interaction
Dr. Balis: Ah. Thank you.
Mr. Darden: I know you said to draw it by hand, but I figured I might as well do it in Paintshop Pro and print it out rather than have you attempt to decipher my crappy handwriting.
Dr. Balis: I appreciate that. Let's go over what you have listed here. I see Rachel's name twice on this paper. At the bottom of your pyramid, you write that you'd like to ask her to lunch. Haven't you already done this?
Mr. Darden: Yes, but I asked her via e-mail. E-mail is a cop-out, really. Everybody is brave when they only have to stare back at a computer monitor. It's too impersonal. I want to have the courage to get up, walk over to Rachel's desk, and ask her to lunch verbally. The idea of doing so makes me very uncomfortable.
Dr. Balis: Why do you think that is?
Mr. Darden: I think it's mostly because I'm afraid that my nearby co-workers will overhear me. I don't want to have them snickering or making me feel embarrassed. They're all female; it's easy for me to imagine them immediately gossiping back and forth about me after that.
Dr. Balis: You don't particularly trust the co-workers in your department, I take it.
Mr. Darden: Absolutely not. I constantly hear them sharing with each other the personal lives of other employees. Lately, they've been delighting over the sexual appetite of one of the women in the programming department. It's something about her being involved in S&M. I even hear that she had invited a few male co-workers over to her house for an S&M party.
Dr. Balis: Hmm.
Mr. Darden: The Help Desk confers with the programmers almost on a daily basis, so I talk to this woman fairly regularly. You'd never guess she was ever into something like that. She seems very pleasant over the phone. But it's hard to decipher what the truth is about people in our company anymore. And that's why I try not to broadcast the fact that I adore Rachel so much, even though I think it's pretty obvious to everyone by now. I don't want to be the next focal point of their gossip sessions.
Dr. Balis: Suppose you managed to get involved in a relationship with Rachel, how would you handle your co-workers then?
Mr. Darden: If I ever manage to get to that point, it won't matter what they say. I would care less.
Dr. Balis: So why should you care now?
Mr. Darden: Because they have the power to sabotage my chances with Rachel. They can try to talk her out of dating me.
Dr. Balis: Why would they want to do that?
Mr. Darden: I don't know. But I feel they may take it upon themselves to impose their views on Rachel and distort her perception of me.
Dr. Balis: I don't think you're giving your co-workers enough credit.
Mr. Darden: Maybe not. But that's how I feel--distrustful to the end.
Dr. Balis: Besides, if you're in a relationship, there's more to gossip about. It's to their advantage to have you go out with Rachel.
Mr. Darden: Hmm.
Dr. Balis: Do you think you can ask Rachel out?
Mr. Darden: In time, I think I will muster the courage, but I'm afraid of making her feel cornered and I don't want her to turn me down. And then she brought that guy to Gina's wedding, she may still be seeing him. I think he may work for SII--he had that familiar look. In any case, I'm really fearful of having all my hopes dashed should she say no. But I guess I'll never know her answer until I'll ask, right?
Dr. Balis: That's right.
Mr. Darden: We'll see.
Dr. Balis: Okay, let's move on. Test-driving a car is a social goal of yours? Why is that?
Mr. Darden: I just feel that an encounter with a car salesman is one of the most aggravating social experiences anyone has to endure. I'm too passive in situations that require me to control the flow of conversation or risk having some fast-talking hoodlum convince me to spend twenty-thousand dollars on a Volkswagian throwback to an era that only an aging hippie wannabe could appreciate.
Dr. Balis: So you want to work on being more assertive when dealing with salespeople?
Mr. Darden: Yes. I feel that if I can learn to handle them, it will give me more confidence overall and that will carry over into other social scenarios. It's hard to be firm with people without sounding rude. I've had Jehovah's Witnesses knock on my door, and I've ended up letting them go through their whole speech without telling them I'm not interested. What I'd really like to do is cut them off before they can get more than two words out, tell them I worship Satan, and tell them to fuck off or I'll toss chicken blood on their shoes.
Dr. Balis: I agree that it's important to be firm sometimes, but usually it must be done with discretion. You can interrupt them by politely thanking them for stopping by and telling them that you're not interested.
Mr. Darden: I know. But I feel guilty for doing that.
Dr. Balis: Making you feel guilty is often part of a salesperson's job. Keep that in mind. What else do we have on this list? Hmm, this is a bit strange. Why do you want to pick up a prostitute?
Mr. Darden: I think I put that on there as a joke. I haven't been laid in over two years. Jesus! Two years. I can't believe it's been that long! Lately, I've been feeling like I'll never have sex again. It's horrifying to watch my youthful appearance slowly disappear, ever decreasing my chances of attracting a woman. Every morning, it seems I find a new line in my face or there's an extra gray hair on my head. It's so unfair that I don't have any sexual frame of reference other than my relationship with Sharon. Sometimes I think about prostitution as a viable alternative to loneliness. But I think it's just one of those things you fantasize about but would never really follow through with in real life. I guess that's why I put in on the list--deep down, I'd like to go through with it and experience something not many people have.
Dr. Balis: Hmm. I like your first answer better--that you put it on the list as a joke. I'd rather you didn't seriously consider seeking the services of a prostitute.
Mr. Darden: "Seeking the services"--you make it sound so sanitary, Charles. You should be Hugh Grant's agent.
Dr. Balis: Well..let's look at what you put at the top of the pyramid: you'd like to flirt with a woman and ask for her phone number; and you'd like to show up at a party. Do you consider these activities to be the most socially challenging for you?
Mr. Darden: Aside from public speaking, I could think of nothing else that would make me more uncomfortable. In fact, I'm breaking out in a cold sweat just thinking about them.
Dr. Balis: Would this have anything to do with the negative experience you had at a couple parties you told me about? You said you felt as though you had been singled out by the crowd during those times.
Mr. Darden: Partly, yes. I am so afraid of being rejected--I imagine myself at a party, walking about nervously trying to blend into groups of people without much success. I can't picture myself joining in on a conversation. I can only imagine myself in a corner somewhere, alone, drinking a great deal of beer. I feel so trapped at parties, it's like there's no escape. While everyone else is enjoying themselves, I usually experience an overall feeling of dread.
Dr. Balis: There are medications available to help with the anxiety and depression you endure, Tom. Before you shake your head, hear me out. I've prescribed Librium for you in the past. You took it off and on, but you stopped before giving it a chance. It can be frustrating not seeing results immediately, but many of the antidepressants take at least three to five weeks before you notice any results. You have to give the medication time to build up in your system. I'd like to prescribe another drug. Over time, I think it will help you feel more in control and relaxed in situations you've described, as well as removing your feelings of hopelessness.
Mr. Darden: I don't know, Charles. You know how I feel about that--I don't want to turn into some zombie. I really believe that all these new antidepressants you guys give out are nothing more than the Nineties answer to electric shock treatments. I have little desire to end up like Jack Nicholson in "One Flew Over the Cuckoo's Nest."
Dr. Balis: You won't. Your faculties remain intact, I assure you. The drug I have in mind, fluoxetine, is designed to restore normal levels of serotonin in the brain. This will primarily help with your depression. My belief is that once the drug has time to take effect, you'll notice a difference in how you feel and hopefully won't be interpreting what you see so negatively.
Mr. Darden: Fat chance of that. What is fluoxetine, anyway? I've never heard of it.
Dr. Balis: You're probably familiar with its trade name: Prozac.
Mr. Darden: Oh, Jesus Christ!
Dr. Balis: Now, Tom...
Mr. Darden: Fucking Prozac? Are you shitting me? Doctors drugged me up with Ritalin when I was a kid, and now you want to put me on a drug that's getting a similar bad rap for being over-prescribed?
Dr. Balis: I agree that it shouldn't be prescribed as liberally as it has. But in your case, I feel such a prescription is warranted. The drug will truly help you overcome a great deal of the negativity you've been battling, Tom. Two weeks ago, you were frustrated with me because you felt as though we'd made little progress. I told you that progress was directly related to your willingness to be helped. You have to allow yourself to be open to suggestion, lest you wallow in your depression indefinitely. It is my firm belief that through our continued projects like the one today, and through medication, you'll notice a profound difference in your attitude. And once that has changed, you may see an improvement in your social life as well.
Mr. Darden: I don't know, Charles. I've been fighting the idea of being drugged for a long time.
Dr. Balis: I know you have. But you have to trust me. You've seen me long enough that you should know that I wouldn't suggest medication unless I was sure it can be of benefit to you.
Mr. Darden: All right, Charles. My sanity is in your hands. Jesus, I don't believe I'm doing this again.
Dr. Balis: Okay. You'll be fine, Tom. I'm going to write you a prescription for 20 mg capsules that you take once a day. Here you are. Now, there are some possible side effects that I'd like you to be on the lookout for. If you experience any insomnia, nightmares, headache, or dizziness, don't hesitate to let me know.
Mr. Darden: Don't worry--I won't.
Dr. Balis: We'll pick up where we left off in two weeks.
Mr. Darden: Yeah, if I haven't crashed my car in a tunnel by then, killing off a famous princess.
Dr. Balis: Which reminds me--how are you doing with the alcohol consumption?
Mr. Darden: I don't know. I guess I haven't been pounding the beers as much lately. All that beer does is make me too tired, but I still drink.
Dr. Balis: Try to keep it down to a minimum, especially now that you'll be on this medication.
Mr. Darden: Okay.
Dr. Balis: See you later, Tom.
Mr. Darden: Bye.
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