Charles Balis' Journal for the Week ending 01/09/98

Saturday, January 3, 1998

Sunday, January 4, 1998

Monday, January 5, 1998

4 pm. Second Session with Olivia Stillwell. Olivia looked like she'd gotten some rest and she confirmed that the Melatonin was working for her. She also said that she has been dreaming more although she can't remember their content. When I asked about the restraining order, Olivia explained to me that her stalker is someone she met on the Internet. He gleaned certain personal information from her during their chat sessions together and has been calling her at work and threatening to arrive in person. As she talked about him, she started shaking and crying. She did a little research of her own and discovered that he is a professor at the University of Denmark--as he represented himself to be. I don't believe that I was expressing any form of disbelief or treating the matter lightly, but Olivia took offense at something I did and began to storm out of my office. She told me that she wanted to be taken seriously and not be trivialized. I urged her to calm down and to talk this out, but although she calmed somewhat and apologized for yelling at me, she asked to leave early to clear her head. She wouldn't meet my eye and was so anxious to get out of there that she was unfazed by the fact that I'm going on a vacation. I wonder if I've lost her as a patient.

Tuesday, January 6, 1998

1 pm. Thirteenth Session with Kester Langford. Kester feels like he has discovered a world outside of himself as a result of his experience sitting bedside in the hospital while Me's 80 year old aunt Maymilu recovered from a stroke. He says that he's gotten a sense of purpose beyond being a mark maker. Kester sees making marks as a way of giving to others and he also thinks of them as transcending the temporal limits of his lifetime. But caregiving to older people feels more direct, I suppose. Kester says he feels like he has discovered compassion. He compares it to Chester's born again conversion to Christianity. Kester was able to stand up to Chester a bit during a telephone call, which raises a whole host of sibling issues for Kester. But Chester took it with good grace. Kester even told me that Chester had sent him some money, which Kester is using to invest in the stock market. He told me his investments, and they were all either blue chips or mutual funds. I commented that he is investing quite conservatively. I have to admit being surprised that Kester is a player in the market.

3 pm. Seventh Session with Rachel Tanner. Rachel is evidencing substantial improvement which I ascribe primarily to the fluoxetine trial. She described a visit to her brother's apartment where she was able to adjust quickly to an unfamiliar environment. She told me that she stopped the rituals--a conscious decision that they weren't going to do any good. She told me that the inner voice that used to be mercilessly critical has moderated its tone so that the voice has congratulatory elements. Rachel told me that she had a crush on her brother's roommate Evan, and she adapted quite readily to their lifestyle. She described one embarrassing moment where she was in the bathtub practicing her aquatic masturbation technique when Evan walked in--but the incident was passed over. Rachel told me that she's interested in going back to school--in fact, she's going to register for the upcoming semester. Because she's late, she'll have difficulty getting into the classes that she desires, but she seems reconciled to that--going back to school has suddenly become important to Rachel. I'm somewhat surprised, given her previous vehemence against it, but I'm certainly pleased. Rachel told me that she went to a concert and smoked marijuana with her brother and Evan. She seemed to be testing me to see if I'd disapprove. Of course I did, but I tried to put it into a medical context rather than acting in loco parentis. The truth is that it wasn't very cleanly done on my part and I'm afraid that she'll close that part of her life to me now. Rachel was interested in how much her improvement is related to the somatic treatment and how much is a result of her conscious effort. I told her that it was likely that she would have to continue the fluoxetine for some time before cutting back.

Wednesday, January 7, 1998

4 pm. Thirty-First Session with Katherine Lippard. Katherine was really quite angry when she found out that I was going on vacation. She seemed angry and frustrated that she wouldn't be able to continue her therapy during that time; it seemed that a little of the emotional content of the sushi bar incident stole over Katherine for just a bit--a disruption of her plan. She calmed down quickly, though, and became almost contrite. But she's anxious to discuss her father. She brought me a bowl of lobster bisque that Phil made. I ate it soon after our session and it was terrific--maybe the best I've had, subtly spiced and bursting with lobster flavor. Katherine has described Phil as a natural talent in whatever endeavor he chooses--perhaps I believe her now. Katherine told me that Larraine Rozzi had been admitted to a psychiatric facility. She seemed ready to take the blame for Larraine's psychiatric problems, but I was able to convince her that she was not responsible with a minimum of effort. We spent the rest of the session talking about her vague but growing dissatisfaction with her comfortable but unexciting life with Jake. Katherine seems confused between the external excitement of a motorcycle ride, and the inner excitement of discovery and renewal that sometimes comes in a great relationship. She seems to have given up on the latter. Now she's hoping that Jake will provide an adrenaline type of excitement almost as compensation for the lack of emotional commitment.. I pointed out that she could make her own excitement of that sort and Katherine got quite caught up in it. Katherine reminded me that she has never heard Jake laugh out loud. Apparently he really doesn't express himself that way, even though Katherine insists that he has a very good sense of humor. When I ventured a couple of possibilities--insecurity, emotional reserve--she rejected them all out of hand. She prefers to believe that Jake's behavior is more inexplicable than that. When I finally just asked her if she loved Jake, she hesitated and then gave me a fairly weak, "Yeah." It wasn't enormously convincing.

5 pm. Twenty-Ninth Session with Alex Rozzi. Alex showed up with a goatee, but it was just a harbinger of the other changes that have occurred in his life. The most startling is a reconciliation of sorts with his mother and Mark. His mother ended up in the mental health facility at California Pacific Medical Center sometime before Christmas. She was suffering from recurrent panic attacks, exacerbated somewhat by the conflict she was engaged in at work with Katherine Lippard, and by her current pregnancy. But Alex, whose attitude towards his mother has become noticeably more sympathetic, said that she had apologized to him, and she laid out some of the difficult circumstances surrounding her parenting of Alex--not as an excuse, really, but more as an explanation. Alex also said that he connected with Mark as the two of them discussed his mother's problems. He seems perhaps overly optimistic as to his future with his parents, but I didn't feel it right to urge caution. He is naturally cautious. He met with Luke's sister, who knows Luke is gay. But Luke is hiding his homosexuality from his father, which perhaps explains Luke's reticence to introduce Alex to his family. Alex has an uneasy feeling about a girl who appears in several photographs with Luke in his house, especially since every time he brings her up, both Luke and his sister dodge his questions. Alex told me about a vivid dream that he had of Benny standing over his bed, crying and begging forgiveness from Alex. When Alex awoke, he found the bedroom window open, which he was sure was closed. The dream made a large impact on Alex, although I'm not certain exactly how Alex felt about it.

Thursday, January 8, 1998

4 pm. Sixty-Seventh Session with Anna Green. Anna confirmed that Kathy is indeed pregnant. All three of them went to Kathy's OBGYN appointment and saw an ultrasound of the fetus. Anna wanted nothing more than the fetus to die, and Martin acted pale and shaky--enough to make the obstetrician concerned. Martin told Anna that he is still in love with her and doesn't want to lose her, and he apparently hinted to Kathy that she might consider an abortion, but Kathy is having none of it. Anna is furious with Kathy for getting pregnant and she's angry about the power that the pregnancy gives her in their current struggle. Beyond that, Anna is clearly delusional. Anna has concocted a fantasy about marrying Martin and then wresting custody of the child away from Kathy. Anna first said that Martin was going to go along with this plan and then she admitted that she was thinking for the two of them right now. I didn't even challenge Anna's delusion at this point. Things will play themselves out and end up in some painful mishmash. Anna hates this child and would make a wretched mother, given her current attitude. I had just an idle thought during the session, and I realize it's completely unthinkable ethically, but I might be doing Anna a service by expressing an interest in a romantic relationship with her. We would have an affair and she would dump Martin--I believe she would--and allow Kathy and Martin to fade away. Then I could redirect her affections towards a more appropriate mate. I could be a transitional love object. Reading that over, it sounds like the rationalization of some quack up before the medical license board arguing why his license shouldn't be suspended--"it was sex therapy." Obviously, I have no intention of acting on that unethical thought.

Friday, January 9, 1998

9 am. I received a fax from the Anonymous Faxer. This one was like a holiday card. It shows a baby with wings, like a Cupid, carrying what may be a Christmas pudding on a plate with a gift card which reads: "Balis--warm and soothing center covered with nuts!" I don't think the image reveals much about the Anonymous Faxer's progress towards reconciling his gender identity, but perhaps it does indicate something about his sense of the therapeutic process. I'm not sure he likes being one of the nuts.

10 am. Seventh Session with Sharon Lough. I've had patients walk out on me before, but Sharon left at the end of the session in a quite inexplicable manner. I'm sure that, objectively, I did nothing that could be deemed offensive, but she was clearly filtering my responses through some previous bad experience with a therapist. Sharon was tense and irritable throughout the session. Sharon has been spending a lot of time with Robin, who has been made a virtual widower by Charlotte's S&M exploration. Sharon finds Charlotte's "in your face" sexuality annoying, particularly because Charlotte insists on telling Sharon all about it in some detail. Sharon links sex with alcohol, drugs, other compulsive behavior--Sharon told me that she used to be bulimic until her back teeth fell out--and ultimately, she links sex with her suicide attempt. Sharon tried celibacy before for two years, but she felt like she was constantly battling with lust. Now, she says that the lust is gone, and she thinks that she is the better for it. She sees herself, and Robin, as two neutered cats, getting their pleasure out of eating and watching television. Sharon told me that happiness is just self-delusion, and she can be happy if she just divorces herself from reality as much as possible and pretends to be happy, or at least content. I'm concerned about Sharon because she seems to be making a conscious effort to disassociate herself from her feelings as a form of avoidance. But given Sharon's bad experience with therapists and our session together taking a bad turn today, I'm not sure that I haven't lost her as a patient.

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