Transcript of 11th Session between Charles Balis, M.D. and Mr. George Landau, Monday, May 19, 1997 at 2:00 pm.

Mr. Landau: Hello, Doctor. How are you today?
Dr. Balis: I'm fine, George. Yourself?
Mr. Landau: I'm still not sleeping as well as I might. But it's been a good week with the children. There was a parents' evening at Elizabeth's school. Melissa and I went up to hear about...
Dr. Balis: George.
Mr. Landau: What?
Dr. Balis: We have to start the flooding treatment today. It will take most of our time.
Mr. Landau: You don't want to hear about the parents' evening?
Dr. Balis: I'd be happy to later. But I really must insist that we press on with this. I know you're not looking forward to it, but you can't put it off indefinitely.
Mr. Landau: I suppose you're right. Do you want me to lie down or something?
Dr. Balis: The chair you are in will be fine--anywhere you can concentrate on what we are doing.
Mr. Landau: I remember I thought you were going to demand I lie down during our first session. It's really a very nice couch. My...
Dr. Balis: George.
Mr. Landau: I know. I know. Okay, how do we start?
Dr. Balis: Close your eyes.
Mr. Landau: Don't you want me to take off my shoes first, to get comfortable?
Dr. Balis: Just close your eyes, George.
Mr. Landau: Right.
Dr. Balis: Okay. How do you get to work from home?
Mr. Landau: I walk.
Dr. Balis: You took a cab to your training course recently. Imagine yourself back inside it. Where are you sitting?
Mr. Landau: The back seat. I can see the upholstery. It's old leather and it's ripped.
Dr. Balis: Concentrate on the car itself. Can you hear the engine?
Mr. Landau: Yes.
Dr. Balis: You're inside its metal frame. Think about the mechanics of the drive system, hidden from view in the body.
Mr. Landau: It's all a bit abstract. I don't know much about how cars work.
Dr. Balis: How do you feel about being contained in the car?
Mr. Landau: Okay. The driver seems to know what he is doing.
Dr. Balis: Keep your eyes closed. The cab stops and you get out. You pay the driver and step inside a skyscraper.
Mr. Landau: Yes.
Dr. Balis: Your training course is on the sixteenth floor. You step into the elevator. You are alone. How do you feel?
Mr. Landau: A little uneasy.
Dr. Balis: Why?
Mr. Landau: The lift is such a complicated device. It has a small control panel. We shouldn't trust it. It closes the doors by itself and sometimes it doesn't go where you tell it.
Dr. Balis: You press the button for floor number sixteen. The doors close.
Mr. Landau: Now I feel very nervous. I stand in a corner of the lift. I don't really want to watch the control panel but I know I should.
Dr. Balis: Why do you say you should?
Mr. Landau: To find out what's going on. Although...I don't know that the panel is telling the truth.
Dr. Balis: The elevator moves off. You feel yourself get heavy for a moment as it accelerates. The control panel counts the levels fast from 1 to 16.
Mr. Landau: I'm just waiting for it to be over.
Dr. Balis: What do you feel?
Mr. Landau: Out of control. There's nothing I can do. I just have to hope it takes me up and lets me walk out. It could drop me down the shaft or into the furnace. All I can do is cower in the corner and wait.
Dr. Balis: You feel lighter for a moment and the elevator arrives. The doors open.
Mr. Landau: I scuttle out quickly. I half expect the doors to slam shut on me as I pass through.
Dr. Balis: You have just shivered. Why?
Mr. Landau: It's the relief. It can't get me now that I'm outside it.
Dr. Balis: What do you feel standing there in the corridor?
Mr. Landau: I feel as if there is a cliff edge behind me. I want to get away from it so I won't fall over by mistake.
Dr. Balis: Can you feel the elevator still there?
Mr. Landau: Yes.
Dr. Balis: Is it looking at you?
Mr. Landau: Not looking exactly. But it's watching me somehow. I want to walk away from it.
Dr. Balis: You begin to walk down the corridor. A sign directs you to room 1620 for the training course. From the numbers on the doors beside you, you guess room 1620 is just round the next corner. How do you feel?
Mr. Landau: Dreadful. I want to find the stairs and get out.
Dr. Balis: Concentrate on what you are feeling. You walk towards the corner.
Mr. Landau: My head feels faint. I seem to be unsteady on my feet. My stomach is bubbling.
Dr. Balis: You are going to turn the corner.
Mr. Landau: I don't want to.
Dr. Balis: You turn the corner and see room 1620 up ahead. The door is open. You hear the faint hum of computers. There are people moving around inside.
Mr. Landau: I don't want to go in.
Dr. Balis: Slowly you walk up the corridor until you stand in the doorway. A bunch of young people are drinking coffee and chatting in the center of the room. Around the perimeter is a ring of computers, all their screens facing inwards. A woman looks up at you...George, you've opened your eyes.
Mr. Landau: Stop, Doctor. I'm not happy about doing this. I don't feel comfortable with it.
Dr. Balis: You're not supposed to feel comfortable with it. The point is to expose you to the feared situation in your imagination.
Mr. Landau: You're pushing me faster than I want to go. I need to take my own time about going forward.
Dr. Balis: You don't like working at my speed?
Mr. Landau: No.
Dr. Balis: Too much like the ghost train?
Mr. Landau: Sorry?
Dr. Balis: You can't control the speed of the ghost train. It takes you forward at whatever speed it wants.
Mr. Landau: I want out of here.
Dr. Balis: Hold on, George. Relax now. We've made a good start today. I don't expect you to be able to go the full way immediately.
Mr. Landau: I don't know if I like this kind of therapy at all.
Dr. Balis: I thought I had made it clear that you wouldn't.
Mr. Landau: Can't we take it at my own pace?
Dr. Balis: There is a different imaginative technique we could try. It involves you creating the scene with only a little guidance from me. But I want to keep trying with flooding for a few sessions. Believe me, it does yield results. I have seen it work many times.
Mr. Landau: What happens when it doesn't work? Is the patient reduced to a drooling madman?
Dr. Balis: I will watch out for that happening, George, and stop just in time.
Mr. Landau: Yours is a strange job, Doctor.
Dr. Balis: Only sometimes.
Mr. Landau: I need some air. Or maybe a stiff drink.
Dr. Balis: I trust I will see you in two weeks.
Mr. Landau: Yes...I'll be here. I won't be looking forward to it though.
Dr. Balis: Do you want to tell me about Elizabeth's parents' evening now?
Mr. Landau: No thanks.
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