Charles Balis' Journal for the Week ending 8/08/97

Saturday, August 2, 1997

Sunday, August 3, 1997

Monday, August 4, 1997

1 pm. Ninth Session with Peter Hossfeld. Peter has been fired from his job at SII. While Peter admits that his performance has not been up to par during the period following the beginning of his epileptic seizures, he said that he had been making a special effort during the last couple of weeks to try to focus on his work. However, he believes that someone higher up in the organization had already decided to fire him, and he was particularly unhappy that they gave him a series of reasons for his termination which he believes were bullshit. They said that he wasn't meeting productivity goals and that his termination was the result of a standard cut back--they even held out the possibility that he might be rehired. Yet the project that Peter had been focusing on was the Millennium Bug which, as Peter points out, is unrelated to the normal ebbs and flows of the Company fortunes. Peter's termination has affected him far more than he ever imagined it would. He finds that he thinks about it continually and that the unpleasant thoughts and emotions caused by the termination recur unbidden even while he's meditating. The termination is especially unfortunate because Peter has been making an effort to reestablish contact with his physical life. Now that life is falling apart, making it more likely that Peter will retreat back into a spiritual world fantasy life. Complicating Peter's return to the here and now is that apparently Eliza and he had a fight. Peter said that he finally had an opportunity to see Eliza free of Serena's influence--they had a date. But Peter describes his personal reactions to the evening as completely detached--as if he was watching a robot body go through the motions with Eliza while he remained aloof. He even described the event in the third person. From what Peter told me, it sounded like Eliza was really hurt by Peter's reaction during their date--she left in tears. I wonder if this incident has something to do with why I haven't heard from Eliza in the last couple of weeks. The particular dissassociative reaction that Peter described together with certain cognitive deficits that he's noticed, could be caused either by a drug side effect or, less probably, a drug interaction. In addition to the anti-convulsants, Peter is also taking antibiotics to treat the vicious bite on his hand inflicted by Serena. I told Peter that I would check the literature and see if I found a drug interaction. Peter is clearly in need of substantial help to complete the transition back to reality. I hope that we can establish regular sessions once again.

4 pm. Third Session with Lloyd Major. Lloyd called me himself and scheduled this appointment. When he arrived, he was quite agitated over recent decisions of Apple Computer. In a nutshell, his feelings were hurt that he had been passed over in Apple's attempt to develop a brain trust among its board of directors. Lloyd took it as a personal affront. There's obviously a lot going on behind the scenes that I'm not privy to. It's my impression that Lloyd's motivations with Apple are more than monetary. It's as if Lloyd sees himself as Apple's messiah. Apple is clearly at a turning point in its history and Lloyd wants to make his mark on computer history. But Lloyd's real complaint during the session has to do with his sinus problems. Lloyd broke his nose in a childhood accident in Hungary, and it was never set properly. As a result, the physiology of his sinuses are such that they don't drain properly and Lloyd is subject to chronic sinus infections. Lloyd's resources have enabled him to educate himself on his condition to a degree that I found remarkable--he sounded like an ear, nose, and throat specialist. Lloyd first researched exactly what his problem was. He even took the step of having a 3-D fly-through view of his sinuses created from CT scans. He then went ahead and educated himself in depth on the surgical options. I'm just another step in his research effort. Lloyd's surgeon believes that Lloyd's condition is correctable by a relatively simple surgical process. However, Lloyd has been avoiding the surgery for the past five years. Lloyd's primary concern is that immediately following the surgery, he will be unable to breathe through his nose. Apparently, being unable to breath through his nose has almost phobic proportions--akin to claustrophobia. He went so far as to interview patients who had undergone a similar procedure to try to determine how well they could breathe through their nose following surgery. But Lloyd is convinced that he needs the surgery, so he wanted to explore the possibility of using tranquilizers to sedate him for a few days following the surgery. I told him that a central nervous system depressant following anesthesia was not a good idea because of its effect on respiration and I recommended against it. I tried to suggest that we treat the underlying phobia through flooding and desensitization techniques, but Lloyd was having none of that. I became convinced that there was no way that I was going to get Lloyd to undergo any form of desensitization. I had a thought that perhaps a narcotic such as oxycodon might be more effective at eliminating his concerns about not being able to breathe than a tranquilizer would be. Although oxycodon is a CNS depressant, it is frequently prescribed following a surgical procedure and I thought it would be sufficiently safe to be a viable option if Lloyd was closely monitored--he plans to have a doctor move in with him for the duration of his recovery. But Lloyd wasn't interested in my following through on any sort of plan, he was only interested in gathering information and further evaluating his options. At the end of the session, I had no clear sense as to whether or not he was going to decide to actually undergo the surgery or not.

Tuesday, August 5, 1997

1 pm. Fifth Session with Kester Langford. Kester came in literally bubbling with enthusiasm. His old girlfriend Evelyn was delayed from embarking on her trip--something about the AIDs epidemic in Zaire--and, without putting too fine a point on it, Kester and Evelyn spent a couple of days in bed together. It signaled the end to what appeared to be a long dry period for Kester's sex life. Whatever sexual problems Kester had hinted at during our previous sessions seemed to have resolved themselves under Evelyn's ministrations. He told me that her full name is Evelyn Bliss, which seemed to accurately describe Kester's experience with her. So Kester wanted to keep the mood of our session one of celebration. Indeed, things do seem to be looking up in Kester's life. Kester described the apartment above the gallery in glowing terms and he moved in over the weekend. Evelyn both helped inaugurate the apartment and helped him unpack his possessions. With Evelyn, Kester seemed to connect more than just reviving an old friendship. Kester described Evelyn as a healer and they seemed to have spent much of the weekend working through various emotional issues from their past life. Kester said that they both cried a great deal and, although Kester is comfortable and claims no difficulty expressing emotions through tears, Kester said that this was different, as though the tears were coming from the bottom of his soul. Apparently Evelyn precipitated a great emotional release in Kester. Kester's lab work-up came in a couple of days ago and there was nothing remarkable. Kester is clearly healthy enough to consider a somatic therapy if that's an appropriate course of action. Both Kester and I agreed at this point that medication would not be the right answer at this point. From our last session, I got an impression that Kester was pushing for medication. I believe that he was looking for some sort of hope and the medication was to provide that hope. But Evelyn has now taken on that role for him. Without Evelyn, I think that Kester would have been insistent on medication.

4 pm. Forty-Ninth Session with Sylvia Bows. Sylvia was obviously quite distracted, and I finally found out why. During the project that she worked on with Richard at SII, Richard told her that he was suffering from testicular cancer--something which Lloyd Major had already told me but which Tom had withheld from Sylvia. Richard was surprised that Sylvia didn't know; he had disclosed it as part of his lawsuit. In any event, the knowledge of Richard's motive for the custody suit quite affected Sylvia. Although Richard is using the courts to try to take her children from her, Sylvia now feels like she owes Richard something--a paternity test, perhaps, and an opportunity for him to get to know his progeny better. She is unsure and apparently Tom is not in accord with Sylvia on this issue. I urged Sylvia to carefully consider any such plans and particularly to avoid communicating her thoughts on this matter to Richard directly. I told her that she must go through her attorney. Otherwise, I'm afraid whatever she says to Richard is going to come back to haunt her.

Wednesday, August 6, 1997

12 pm. Eleventh Session with Alex Rozzi. Suddenly Alex is seeing himself as a victim. Instead of being the sure, confident young man that he's always been before, suddenly Alex is displaying the classic signs of someone suffering from childhood sexual abuse. He says he doesn't feel safe anymore. He says that he can't seem to look people straight in the eye. He says that other people can tell just by looking at him what happened. He's lashing out more. He says he feels dirty and used-up. He says that he is of no use to anyone. He thinks that he is now "totally fucked-up." I haven't quite understood why Alex has undergone this sudden shift in his outlook. Several weeks ago, he was in love with Benny, his abuser. Then Benny broke up with him and he found that he had been used--videotaped engaging in sex with Benny. I would understand a myriad of responses to that--including many that Alex previously exhibited--rage, pain, and a feeling of being dirty and used. But now Alex has taken on the role of the victim in a way that almost makes me think that I am being conned for some reason. I don't think I am, but there is an element of the theatrical in Alex's crisis. I think that Alex is subconsciously slipping into the role that everyone is expecting of him. The tapes have been turned over to the police, and Alex has been interviewed by the authorities. Alex's mother is back on the scene, evincing concern about Alex. His father has moved back with his mother, bringing with him two daughters--Alex's younger half sisters. Alex's mother is making an effort to reunite her family. Alex might feel that while he was on the streets by himself, he could have one attitude, but now that he is rejoining the family, he needs to justify his previous actions and take on the persona of the victim--a play for sympathy rather than condemnation. In particular, Alex's father might have difficulty understanding Alex's history as an underage gay prostitute as a matter of choice, but as a child forced into it by someone else who is now incarcerated, Alex's past history might be a lot easier for him accept. And in the role of a victim, Alex doesn't have to account for his actions or explain them. Everything is explained for him. As a victim, all his actions subsequent to the molestation are forgiven.

4 pm. Fourteenth Session with Katherine Lippard. Jake still hasn't given Katherine the reciprocal assurance of his love that she desires. But Katherine is eager for their relationship to work. She's using Jake's family history of many divorces and the tone of tragedy in his poetry to rationalize his reluctance to express his feelings for her. Somewhat surreptitiously, Katherine read Jake's poetry while he slept. She said that his poems on romance were considerably darker than she expected; the poems were about "darkness and tragedy and how love always comes due in blood." I tried to reassure Katherine that people often use art to express a particular aspect of their personality and that the emotions which the art communicates are often greatly exaggerated versions of the thoughts and feelings actually held by the artist. Katherine also feels that Jake's attitude towards her has changed now--she describes him as "cockier" than before. It's certainly true that Jake seems to have the upper hand in the politics of their relationship. Katherine managed to explain his new assurance as perhaps just representing that inevitable settling-in stage after the rigors of courtship are over. But Katherine is obviously feelingly quite hurt that Jake has been unable to clearly express how he feels about her. Katherine realizes that she may be rationalizing her relationship with Jake, but when I suggested as much, she slipped into her professional persona and abruptly changed the subject. I decided to just let it go rather than press the issue. Katherine wanted to talk a bit more about her father. She told me that, after he left, she only spoke to him twice by phone and he sent her a few postcards from Alaska. That amount of contact was so minimal as to do little to assuage Katherine's feeling of utter abandonment--and Katherine was a girl who was desperate to be with her father. We followed the thread of abandonment in our conversation. Katherine said that she felt that all the men that she loved ran off to pursue their dreams--dreams which didn't include her. She cited her father--who went to Alaska to become a bush pilot, Andrew--who went into the Coast Guard, and Phil--who decided to move to California to pursue his art. As we discussed it further, Katherine admitted that she followed Phil to California because she was tired of losing the men in her life. But the admission was painful for her to make. She felt that it was a pathetic display of weakness, because she's worried that she's inherently unable to live her life independent of a male figure. For the rest of the session, we tried to differentiate between wanting someone in your life and needing them there. At the end, Katherine expressed some disappointment in the slow progress of therapy. I reminded her that in our earlier sessions, I had told her that the therapeutic process was one of fits and starts and that she shouldn't be either overly buoyed by the successes or overly disappointed by the failures. I think it would be extremely helpful if we start the next session by doing an inventory of the progress that we've made so far in Katherine's therapy. She's is an accountant by training, after all, and she should be reminded of the bottom line every once in a while.

Thursday, August 7, 1997

4 pm. Fifty-First Session with Anna Green. In previous sessions, Anna complained that Martin's friendship with Kathy seemed to exclude her. Although she said that she wanted them to be friends with each other, it was always her desire to be in the center of the friendship. Apparently, things are now arranged much more to her liking. When she was sick last week, Martin transported Anna back to his large apartment where Martin and Kathy took turns nursing and waiting on her. All three spent the weekend living there, with Martin and Kathy sharing a fold-away bed. Anna was happily ensconced as the object of both of their affections. She enjoyed a happy little fantasy of Martin and Kathy going to sleep in the same bed with each other, with each of them turned on--but over Anna. And while Anna recognizes that Kathy is sexually attracted to her, Anna considers it merely an innocent flirtation when she parades around naked in front of her or otherwise attempts to stimulate Kathy's sexual interest in her. I pointed out to Anna that she was handling fire, and that she was setting up a situation where both Martin and Kathy could easily come to the conclusion that what Anna desires is a three-way sexual relationship. Anna insists that it could never happen. She believes that Martin feels too tenuous in his position to jeopardize his relationship with her by suggesting a ménage à trois and that since Anna herself is not gay, she will easily be able to fend off any of Kathy's advances. Given what I know about Anna's pliant nature when it comes to fulfilling others' sexual desires, I believe that it may be possible that Anna, in the heat of circumstances, may be induced to enter into a three-way sexual relationship which would ultimately not be of her choosing. She'll just fall into it. I probed to discover just how far the situation had progressed in that direction. Indeed, what Anna told me about that weekend could easily lead Anna and Kathy to believe that Anna was interested in sleeping with both of them.

Friday, August 8, 1997

10 am. I received a fax from the Anonymous Faxer today. This one is quite easy to interpret. It shows a man weeping and holding the melting body of a woman in his arms. I think given what I already know about the Anonymous Faxer, there can be but one likely interpretation: he sees his dreams of becoming a woman somehow slipping through his fingers. The image is a sad one, because the weeping man, although he holds the dissolving woman tenderly, is clearly powerless to stop the woman from completely melting away. And so go his dream.

3 pm. Initial Session with Alan Kurtz. I wasn't sure why I felt such a sudden antipathy towards my new patient, but I have to be aware of it and guard vigorously against allowing it to cloud my professional judgment. Alan is a 28 year old male, about six feet tall, of medium build, with dark hair and brown eyes. He is employed as an engineer with SII, charged with trying to make their software as user-friendly as possible. But they couldn't have picked someone with less empathy if they tried. He has such a palpable disdain for the end user that he approaches the job completely from a technical standpoint, with no sympathy for the problems of someone wrestling with a piece of software for the first time. Alan is seeking his MBA and he intends to work at SII during his graduate studies. SII has a good program to encourage its employees to seek higher education opportunities, which Alan intends to take advantage of during his schooling and then immediately leave the company upon graduation. In his own life, he has focused on his rationality to the strong detriment of his emotional side. Alan's nominal complaint is that he is having difficulty sustaining a romantic relationship for longer than about three months. Alan attributes the short duration of his relationships to a "maniac magnet" which he says causes him to attract mentally-unstable women whom he described as "women who can't cope." And yet, when Alan described his actions which precipitated the break-up, it was clear that she left him because he displayed a remarkable lack of sensitivity towards her needs and desires. Alan invited a previous ex-girlfriend to move in with the two of them, without consulting her ("It's my house!") and then, when she was expressing anxiety about switching jobs and housing, he told her that he didn't want to hear any more of her whining. He told me that the reason that he's seeking therapy is that he is tired of making an investment of time into these women without a payoff--he wants to be able to recognize cues which would indicate that a girl was insane. I had a feeling that he regarded the session with me as analogous to hiring a plumber. But in that case, one would be acknowledging that something needed to be fixed, and Alan will have none of that. I suggested that we might look for patterns in his past relationships to see what we could learn that way, but he told me that he didn't need anything fixed in his life--he's certain that he's fine. It's the women who are crazy. Alan is very status conscious and sought to impress me with his wealth--he clearly believes that the measure of a man is by the thickness of his wallet. He described his friends who are in the arts as "flakes" because they have no money. While it's clearly too early to be thinking about a diagnosis, and while I haven't seen many of the criteria that would allow me to solidly make one, I wouldn't be surprised if Mr. Kurtz suffered from a quite rare Narcissistic Personality Disorder. Specifically, I observed a grandiose sense of his self-importance, and a strong lack of empathy making him unwilling to recognize or identify with the feelings and needs of others. Furthermore, he showed an arrogance often associated with the disorder. Interestingly, once I've put my finger on a possible disorder for Mr. Kurtz, much of my antipathy has vanished. It's as if I've collected an insect which disgusts me, until I've pinned it onto my collection board, and then can study it at my leisure. Not a particularly flattering image of myself, I'm afraid, but there it is.

4 pm. Sixteenth Session with Thomas Darden. Thomas' sardonic sense of humor overwhelmed me several times during the session, and I found myself laughing at his turn of phrase even while he was expressing something that was important to him. He even called me on it once, and I had to apologize. We spoke about his kitten which he's adopted for many of the wrong reasons. Apparently, Thomas isn't particularly fond of the kitten and it has taken over Thomas' life to a substantial degree. Although I'm far from an expert, I found myself giving Thomas advice about how to train it. Thomas is a high-risk driver. He's having troubles with his insurance company who wants to raise his rates substantially. But Thomas views his car as an oasis of privacy and uses it to avoid social interaction with other people. Thomas and I argued a bit about whether drive-thru windows in banks and fast food restaurants were a matter of convenience or were instead to cater to a desire for isolation. But Thomas' most substantial issue is that he has won an expense paid trip to the Bahamas for his job performance. This is a social event with a number of the executives of SII. Whereas most would envy the opportunity to join what Thomas characterized as an all-expense-paid "drinkfest", Thomas is very worried about having to interact socially with the people on the trip. He's so terrified of attention, that when he knew that he was going to win the award, he made excuses to avoid the ceremony. Thomas described classic panic symptoms when confronted with being singled-out of a crowd: heart palpitations, profuse sweating, and a feeling of needing to flee--like a cornered animal. Again, Thomas turned to alcohol in an attempt to self-medicate and quickly downed a six-pack of beer, which he doesn't consider a particularly substantial amount of alcohol. The trip is scheduled for sometime in October, which gives us some time to try to work on Thomas' social phobia in anticipation of the trip. I think it would be appropriate to try to do some desensitization exercises to prepare Thomas for the Bahamas.

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