Charles Balis' Journal for the Week ending 08/07/98

Saturday, August 1, 1998

Sunday, August 2, 1998

Monday, August 3, 1998

10 am. Twenty-Ninth Session with Thomas Darden. Tom arrived clearly showing the results of a bender that he went on during the weekend. He was disheveled and ragged. He had clearly slept in his clothes. When Thomas first walked into my office in March of last year, he thought his choice of which chair to sit on was a test: "Which chair marks me as a psycho?" It's ironic that now I note that Thomas picked the couch for the first time, and it worries me. His whole attitude seemed to suggest someone who'd given up. He seems to have allowed himself to succumb to his loneliness and to have forsaken his recent struggle for social achievements. He told me that he sees himself mirrored in the faces of the wasted old men who sit at the lunch counter of a faded coffeeshop. And he feels a strong connection with the suicidal character portrayed by Nicholas Cage in "Leaving Las Vegas." I'm concerned that Thomas may be leaning back towards suicidal ideation. The upshot of all this is that I don't believe that the fluoxetine trial has been successful, either because it is the wrong drug or because of problems in patient compliance. We began the fluoxetine on 6/29/98 for a six week trial. If I'm not seeing positive benefits by our next session together, I'd like to switch to another serotonin reuptake inhibitor altogether, perhaps Zoloft, rather than increasing the dosage of the fluoxetine.

11 am. Sixth Session with Jesse Trent. We spent this session getting caught up to date on the tumultuous events in Jesse's life. Just after Thanksgiving, during a visit, Maddie's parents found out about the pregnancy and Maddie's rape. They are religious people who don't believe in abortion under any circumstances. They wanted Maddie to return with them to St. Louis, and Maddie might have gone if not for the timely and effective intervention of their friend Sammy. Sammy also sat down Maddie and Jesse as a couple and made them talk to each other. In January, they got the results of the genetic testing and found that Jesse is the father. That enabled Jesse to focus on Maddie's pregnancy and the coming baby. In March, the police caught the man they believed raped Maddie after another woman in the area was raped and killed. The man apparently has attacked a number of women in the area. Jesse told me that he had been reading about rape, and that rapist fall into categories based upon their motives for committing rape. This serial rapist falls into the "sadistic" category. The man in custody was employed as the property manager of the building they were living in when Maddie was attacked. He had showed them the apartment when they were first deciding whether to live there. Jesse said that he didn't match his image of a deranged maniac--he was very clean-cut. The police want Maddie to help make a case against this man, and the pressure she felt as a result was beginning to effect her pregnancy. Maddie's doctor put her on bed rest after she began to suffer from preterm labor. The baby, Natalie Ann Trent, was born after her due date, on May 14th, 1998. She's now 3 months old and healthy. Maddie went back to work in July and Jesse is the primary caregiver during the day. The trial for the rapist is scheduled for the end of September. All in all, the relationship between Maddie and Jesse seems quite improved and currently stable, although there are the normal stresses, including a substantial adjustment, that come with becoming new parents. Although Jesse didn't mention it, I'd suspect that they are not getting much sleep, either. But Jesse and Maddie both want to see the same therapist--not as a couple, but as two individuals. I explained the conflicts, but Jesse was adamant that this is what he wants. Jesse is hoping they'll each gain some perspective on their life. We ended the session a bit early so that Jesse could get Maddie back from the neighbor who was watching her.

Tuesday, August 4, 1998

Wednesday, August 5, 1998

2 pm. Second Session with Kelly Wiseling. Kelly came alone today and she brought a palm-top computer. She used the computer to spell out the few words that she had difficulty saying: "oralism" and "schizophrenic." Other than that, and some initial instructions to me about keeping my face towards her and nodding my head instead of saying, "Hmm," we were able to communicate just fine. I noted that Kelly signs certain words almost reflexively while she speaks. We spoke about Kelly's family, her brother Mark, and her mother's desire for a normal, hearing daughter. Her mother's approach to Kelly's education was influenced by her wish that Kelly be as "normal as possible." Kelly was born with normal hearing, but suffered an ear infection when she was about three which left her with substantial impairment in both ears. Her mother insisted that Kelly's education focus on allowing her to interact with hearing people, through speech and lip-reading, rather than allowing her to focus on ASL and deaf culture, as is apparently the preferred current approach. Kelly went to elementary schools which promoted a practice called "Oralism" which stressed teaching deaf children to speak as normally as possible. Kelly recounts some early cruelty arising out of her mother's refusal to acknowledge any of Kelly's sign language. Kelly did well in school, although she felt frustration at not being able to really fit in to a hearing world. When Kelly was ready for college, her mother insisted that she attend Gallaudet because of its strong reputation for educating the deaf. Kelly feels that she was ill-prepared for Gallaudet, which is a bastion of deaf culture. She describes her signing as clumsy while her classmates' ASL was fluid, quick, and graceful. She feels handicapped both among the deaf and among the hearing. Kelly told me that, while she was growing up, her father was quiet, distant, and emotionally reserved. Kelly's brother Mark, however, seems to have been a bane of Kelly's existence since childhood. Mark is the favorite of Kelly's mother. When he was a senior in high school, he was diagnosed with schizophrenia after some violent and paranoid behavior. I'm not certain whether or not he received somatic treatment, but he became a born-again Christian a few years later. Although pushed by her mother, Kelly didn't want anything to do with Mark's church friends. Kelly describes Mark as having a short attention span. He left school and took up missionary work for a few years. Later, he got married and had a son. Then he left the church, broke up with his wife, and started abusing drugs, especially cocaine. Meanwhile, Kelly graduated with honors from Gallaudet. Mark was in and out of mental health facilities and drug rehabilitation clinics. Through it all, Kelly sees her mother as making a series of excuses for Mark. At the end of the session, Kelly told me that, although she doesn't like others to know her business, she found it easy to talk to me.

5 pm. Fifty-Seventh Session with Alex Rozzi. Alex made some truffles and brought some for me. These are the truffles which, last Thanksgiving, his Aunt Sofie said were "to die for" just before she actually did die. The chocolates were really marvelous--completely professional in appearance and wonderful in taste. I know that chocolate is difficult to work with--I've heard about tempering chocolate for certain effects and having the chocolate seize when a little liquid is present or it is overheated. To produce truffles of this quality requires quite a bit of knowledge. I was impressed. Alex told me about the Stevie Nicks concert that he went to, and a physical altercation he had with a religious zealot who was protesting there. I would have been much happier if Alex could have just let it go, but when the protester called Stevie Nicks a witch and a whore, it was more than Alex could take. He says that he pushed the man down to the ground and then slipped away back into the crowd before security could spot him. Alex had another interview with the police about the man who was murdered. The police apparently want Alex to testify against Benny again. Benny has been weighing heavily in Alex's thoughts recently. The interview with the police certainly brought it to the fore. Not all of Alex's memories are negative. In fact, Alex runs the risk of idealizing the predatory relationship that Benny had with him. Alex says that Benny made him feel like the most important person on earth. Alex also saw the man who looks like Benny again--this time, he was at the Dore Alley event dressed in a leather codpiece. That triggered an erotic dream in which Alex engaged in almost anonymous sex with this man. Alex thought it was significant that, during the dream, he didn't think of this man as Benny even though he looked like him. Ralph also believes that his strip bar is being investigated--apparently, there is a surge in requests for admission by underage boys. Ralph thinks he is being set-up by decoys. And Regina has decided to attempt to sue Ralph for maintaining a dangerous premises. Apparently, while she was pounding and screaming at the door trying to get admittance, she injured herself somehow. Alex told me that there were broken flower pots around; perhaps she broke them out of spite or perhaps they were broken because she tripped and fell. Anyway, a lawsuit isn't something that Ralph needs right now. But Alex seems to be fulfilling Ralph's healthcare needs now. I think that's very positive. If Ralph dies, Alex will be able to look back at the care he provided with a great deal of pride.

Thursday, August 6, 1998

4 pm. Eighty-Ninth Session with Anna Green. Anna didn't show up last week because of a business trip to New York that she thought she'd told me about. A week ago Sunday, she went to the Dore Alley event with a couple of detectives dressed in leather pants with open bottoms. Anna was supposed to be seen with these guys playing the part of their slave, so that later they would be accepted as a legitimate part of the S&M community. She only went to the event for about an hour. She described the Dore Alley event as a somewhat tame social venue, except for the dress and the props of the participants. Anna also had a conversation with her father which was heavily edited for his consumption. But the upshot is that her father views her as a hero for befriending Kathy in her hour of need and then for assisting the police in their investigation. Her father's view of Anna's actions are in sharp contrast to the opinion of Anna held by Kathy's grandmother. It's interesting that the same basic facts lead to two totally divergent views. Her father hooked her up with a friend who's a lawyer. The three of them spoke in a conversation that, since her father was present, probably wasn't covered by attorney-client privilege. But Anna told the lawyer less than she told her father--and she's told the police everything already, anyway. The lawyer recommended that she not allow herself to be pressured by the police, and if anything made her uncomfortable, to request an attorney. Anna was touched by her father's concern and she likes that he has cast her in the role of a hero.

Friday, August 7, 1998

10 am. Twenty-Eighth Session with Sharon Lough. Sharon started the session with a long harangue against Hispanics. I'd attribute it to out and out racism, if I hadn't heard Sharon do the same thing over and over again on a variety of different subjects. Sharon does this type of vicious oratory every time she gets annoyed at anything. I don't even see the ranting as a reliable indicator of how she really feels. It sounded particularly vicious, though, being applied to an ethnic group. Perhaps it is my sense of political correctness that makes an expression of overt racism sound so shocking. But, although I'm used to hearing the most extreme variants of human emotion without distress, it made me distinctly uncomfortable just to listen to it. Although I had assumed that she had some homosexual experience, Sharon confirmed that she is bisexual. Sharon also spent a good part of the session giving me a run-down on the sensual inadequacy of most of the barrier methods recommended for safe sex practices. Sharon's prodigious sexual experience with multiple partners of both sexes, together with her keen critical eye and unwillingness to capitulate to societal conventions, make Sharon a pretty good reviewer of the various barrier systems. Her conclusions were that these devices were all aesthetically inadequate and that they weren't actually being utilized by those who touted them. However, Sharon doesn't have a lot of alternatives to suggest--merely criticisms. Sharon did get back her AIDs test--it was negative. But she hasn't yet heard from the police lab to find out if the substance that she was growing in jars was on their schedule of illegal narcotics or not.

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