Transcript of 4th Session between Charles Balis, M.D. and Mr. Sam Eldrich, Thursday, June 18, 1998 at 2:00 pm.

Mr. Eldrich: Hi, Doc.
Dr. Balis: How are you doing, Sam?
Mr. Eldrich: Okay, I suppose.
Dr. Balis: Good. How was your interview?
Mr. Eldrich: Well, the interview went pretty well. I'll start working on Monday, though there is a slight problem with that.
Dr. Balis: What is it?
Mr. Eldrich: I have to get my wisdom teeth pulled about two weeks after I start. I swear, I can't remember when things are scheduled for the life of me. There was this whole thing with having to cancel our appointment last week, and now this. I think I'm getting spacier by the day.
Dr. Balis: Do you think it's a problem if you need to take a day off from your new job to get your teeth done?
Mr. Eldrich: Hmm. I guess I can reschedule my dentist appointment. But I've sort of steeled myself to have it all done that day, and I don't exactly want to put it off any longer. I can't stand the thought of even such minor surgery. I hate scalpels and needles and all that junk.
Dr. Balis: Why?
Mr. Eldrich: The sight of blood is extremely repulsive to me. Shoot, even thinking about blood makes me a bit nauseous. That's one major reason I'm not even thinking about going to medical school. While the thought of making people better appeals to me, I couldn't begin to imagine myself treating some major traumatic wound with all sorts of blood gushing from it...
Dr. Balis: I understand.
Mr. Eldrich: Yeah. That's one of the major reasons I don't think I'd ever try anything with knives. I can see it now: I take the kitchen knife, and just as I start to slide it down my forearm, I get completely grossed out and can't even finish attempting to kill myself decently. That's the sort of thing a loser like me deserves, anyway.
Dr. Balis: Sam, are you still feeling as badly as you did during our last session?
Mr. Eldrich: No, Doc. I'm just swell. Peachy keen. I have a new job. I'm a fresh high school graduate. I'm going to a great university next semester. Why in the world would I possibly feel bad about myself?
Dr. Balis: Just a bit of sarcasm?
Mr. Eldrich: No shit. Damn, but you're brilliant, Doc. Do you think I'd still be here if I wasn't feeling like an absolutely worthless waste of human flesh?
Dr. Balis: Sam...
Mr. Eldrich: Relax, Doc. Don't get your panties all in a bunch.
Dr. Balis: Sam...
Mr. Eldrich: I just mean that you're getting all worked up over nothing, over a nobody. Besides, I know that deep inside, I don't have the courage necessary to take that final step. I don't even have the ability to do a simple thing like run a knife down my arms a couple of times. What the fuck is wrong with me? I am so pathetic.
Dr. Balis: Here are the tissues, Sam.
Mr. Eldrich: Doc, why can't I even get up the nerve to at least try to kill myself?
Dr. Balis: I don't think you really want to end your life, Sam. Your religious beliefs, for one thing, tell you it's the wrong thing to do. And as a human being, you have a very strong sense of survival--a strong desire to live. I think you're here trying to work...
Mr. Eldrich: Yeah, yeah. Life goes on, life thrives, life will never give up. It's all propaganda from the biology textbooks, as far as I'm concerned. Maybe that applies to animals with no higher brain functions. But human beings can take an accurate assessment of themselves and can reasonably conclude that they're worthless in comparison to the rest of their species. Well, I don't buy that I have a reason to live.
Dr. Balis: What is it that makes you feel so worthless, Sam?
Mr. Eldrich: My inability to stop the deterioration in my grandparents' lives showed me how worthless I am in general. And this is just one example of an overall trend. It's an experiment that confirms a scientist's theory.
Dr. Balis: Do you really believe that your assessment is truly accurate?
Mr. Eldrich: Of course it is. I wouldn't be so convinced of it, if it weren't completely right.
Dr. Balis: Are you sure about that?
Mr. Eldrich: What do you mean?
Dr. Balis: Sam, I believe that you are magnifying one event in your life and overgeneralizing its importance.
Mr. Eldrich: Oh, of course I am. You see? You're just backing up exactly what I'm saying. I can't even think straight. I really don't deserve this existence.
Dr. Balis: Your depression in responsible for distorting your image of yourself. Your depression is masking and distorting your normal thought patterns.
Mr. Eldrich: Great. So now I've got some sort of mental filter that's...hmm, let's see, I have a filter that is warping my "proper" perceptions?
Dr. Balis: Yes.
Mr. Eldrich: And you see your job as "helping me" by removing that filter and thus taking part of who I am away? Now I know that what they say about shrinks is right. You only care about making people think what you want them to think and not what they truly perceive and think. You're just all mind controllers, not doctors.
Dr. Balis: I'm not trying to get you to think or act in a certain way...
Mr. Eldrich: Bullshit.
Dr. Balis: Sam, listen to me. All I'm trying to do is point out the reasons you're feeling so bad about yourself and give you some tools to combat your negative thoughts. Whether or not you ultimately choose to implement these tools is up to you. I'm not trying to control your mind. And I will only interfere if you're an immediate danger to yourself or others.
Mr. Eldrich: That's just wonderful, Doc. So as long as I don't have the courage to act, you're fine with me being a spineless bastard. But if I ever get up the nerve to really go through with suicide and have the audacity to tell you, you'll throw me in the nut house and pump me full of drugs that would take away my courage.
Dr. Balis: Sam...
Mr. Eldrich: No, no, Doc. I see how it is now. You're giving me that Zoloft crap to subtly change the way I think so that I'll be eager to accept your mind controlling suggestions. But if that doesn't work, you'll toss me where they can give me industrial-strength drugs guaranteed to make me a walking, talking, ever-smiling, ever-bubbly, mindless idiot.
Dr. Balis: No, Sam. That's not the point of therapy, and you know it.
Mr. Eldrich: Then I think you'd better tell me exactly what is the fucking point of all of this. So far nothing has changed for me. I've been on your drug for...what is it? Two weeks now? And I don't feel jack shit happening. In fact, I'm more convinced than ever that I'm really meant to die. You said it was supposed to help me feel at least somewhat better. But under your care, I only feel worse. What sort of quack doctor are you, anyway?
Dr. Balis: You need to remember that the drug you're taking needs time to take effect. We need to build up sufficient doses of serotonin in your brain to make you feel better.
Mr. Eldrich: Of course. Serotonin--the happy neurotransmitter. So that's how you do it. You make me get all nice and happy artificially in order to make me think that I'm doing better and to make me feel like everything's okay.
Dr. Balis: The intent is to give your brain normal levels of serotonin and to restore it's normal function. It's similar to insulin injections for diabetics.
Mr. Eldrich: Uh, marvelous. So I'm born fucked in the head. I'm naturally low on brain chemicals. Shouldn't that be a clue to you, then, that I was born defective?
Dr. Balis: Would you call a diabetic person defective?
Mr. Eldrich: No. But I'm not diabetic.
Dr. Balis: By your standards, a person born with diabetes is born defective and deserves to die.
Mr. Eldrich: Well, their problem is physical. It's not a natural facet of their personality, like what I've got. What they take doesn't screw their mind; it just corrects a physical flaw.
Dr. Balis: In a similar way, Sam, Zoloft isn't acting on your mind. Your problem is physical in just the same way that a diabetic's problem is. Zoloft is simply restoring the natural balance of chemicals in your brain. Insulin keeps a diabetic from going into a coma so that patients can go on and live their lives as they wish. Zoloft performs a similar function.
Mr. Eldrich: What do you mean?
Dr. Balis: A person with diabetes can chose to eat fatty foods and to lead a sedentary life even if it's bad for them. But they get to live that life because of insulin. In the same way, after we get your neurochemical levels back to normal, you'll be free to choose to live your life the way you want to.
Mr. Eldrich: So after the drug kicks in, I don't have to listen to a damn thing you say? And I won't be compelled to listen to you by the drug's action?
Dr. Balis: Not at all, Sam. Zoloft will just level the playing field for you. When it takes effect, you'll be free to do what you wish to do and not what your depression is forcing you to do.
Mr. Eldrich: But what if I still want to kill myself? What'll you do then? You said you would throw me in the loony bin...
Dr. Balis: If you are a risk to yourself or to others, I would have to commit you involuntarily. But in the hospital, the doctors' goal would be the same--to get you better, to get your neurochemistry back to normal.
Mr. Eldrich: But what if even after they're back to normal and everything, I still want to die and want to take my life?
Dr. Balis: If you still want to die, then you're not back to normal. You'll be undergoing rehabilitation until you are no longer a danger to yourself.
Mr. Eldrich: That's like prison. We keep murderers, or attempted murderers, in jail until they are no longer a danger to the society. But how is my suicide socially destructive? I'm just a worthless shit. What the hell does it matter if I lived or died?
Dr. Balis: Sam, imagine the pain that you would cause your parents and your family by killing yourself. That's one way your desire to die and suicide would be socially destructive.
Mr. Eldrich: Damn. I guess I understand. So I have to give this Zoloft thing a bit more time before I do anything?
Dr. Balis: Yes.
Mr. Eldrich: Okay. I guess I wait this out.
Dr. Balis: You can also take steps to make it easier for yourself. It may be a cliché, but thinking positively and trying to see past the negative mental filter you've developed will help you greatly.
Mr. Eldrich: All right. I'll try.
Dr. Balis: Okay, Sam. Will you be all right until next week?
Mr. Eldrich: Yeah, I will. I'll be able to distract myself with work starting Monday, so I won't think about all the depressing stuff as much, anyway.
Dr. Balis: That's good. I'll see you next week at this same time.
Mr. Eldrich: Yeah.
Dr. Balis: Goodbye, Sam.
Mr. Eldrich: Bye, Doc.
Arrow, Straight, Left, Earlier Arrow, Straight, Right, Later

Button to Dr. Balis' Notes Doctor Balis' Notes on this Session

Button to Samuel Eldrich's Transcripts Transcripts of Samuel Eldrich's Communications
Button to Samuel Eldrich's Patient File Samuel Eldrich's Patient File

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