Transcript of 48th Session between Charles Balis, M.D. and Ms. Katherine Lippard, Monday, November 23, 1998 at 12:00 pm.

Dr. Balis: Come in, Katherine. It's good to see you again.
Ms. Lippard: Thanks. It's good to see you, too. How have you been?
Dr. Balis: Fine, fine. More to the point, how have you been?
Ms. Lippard: On the whole, I've been pretty well. I moved into a new house.
Dr. Balis: I heard, over in Seacliff--a very nice area.
Ms. Lippard: Yes, I like it a lot. I'm thinking of having a housewarming in a few weeks. Do you think you can come?
Dr. Balis: That might be a bit awkward. I assume you'll have people from SII, and I treat a lot of SII employees. Some of them might be uncomfortable if they ran into me there.
Ms. Lippard: Hmm, you're right. Maybe you'd like to come over alone some time, to enjoy a sunset on the deck before it gets too cold? Do you like cognac?
Dr. Balis: Katherine, I still don't think...
Ms. Lippard: We could have Phil over, too. I know he'd like to meet you.
Dr. Balis: So what brings you here today, Katherine?
Ms. Lippard: Okay, I understand, the decision's been made. On to business. I'm a little concerned about Alex. You know he's been staying with me?
Dr. Balis: Yes, I knew that. You understand that, even though you and Alex are friends, I'm very limited in what I can discuss about him with you without betraying any confidences.
Ms. Lippard: Yes, I know. But this is mostly about me and what I can do in this situation.
Dr. Balis: Okay. If we keep the discussion centered on you...does Alex know you're here?
Ms. Lippard: Yes, I asked if this would make him uncomfortable. He seemed okay with it.
Dr. Balis: Good.
Ms. Lippard: Okay. Well, where can I start? You know he's been staying with me. It's not a real problem, there's plenty of space, he has a room of his own. But...well, it's starting to cramp my style. I like my solitude. I like to be able to come and go as I please, play my music, have someone over if I want to. But there's very little solitude with Alex. When I'm there, he's kind of...well, clingy. Sometimes it feels like having a dependent child.
Dr. Balis: I see.
Ms. Lippard: I understand that he's been through a trauma, and it must be uncomfortable for him to be alone. He's jumpy, and emotional, and sometimes almost regressive. He needs comfort, and support, and validation, and stability. I know I represent the epitome of stability to Alex. And I know he sometimes feels like I'm the only one who understands and cares for him. And I do care. I am sympathetic, and I want to support him. But I don't really understand...I've been through the Rape Crisis Center training for counselors, but I haven't been able to bring myself to actually fill the role. I just don't think I can do the job. I've never been the victim of any kind of abuse. I don't think I have a frame of reference from which to approach him.
Dr. Balis: I see. I don't think you need to approach him as a rape victim counselor. It's not your role. Those issues Alex and I will deal with here. You're his friend, and it's that friendship that Alex wants and needs. Just be a good friend to him. Be non-judgmental, supportive, and caring. He needs an anchor, and you seem to be in the perfect position to provide him with that.
Ms. Lippard: Yeah, okay. I see that, and that's pretty much what I'm doing. But two things are happening. First, I don't feel like just being there for him is effective. I am providing a safe haven, both physically and emotionally, but I don't understand what's happening with him, what's going on in his head. Do you think you can help me with that? Why is he so skittish and unstable emotionally? And...well, why is he downright childish at times? Is this a normal reaction to a rape?
Dr. Balis: Well, we're getting dangerously close to material I must keep confidential, but I can tell you some common human reactions to rape and other violent attacks. Some of what you've described are classic post traumatic stress symptoms. Victims often exhibit hyper-vigilance: jumping at small sounds, checking doors and windows they know to be locked, being unusually aware of their surroundings. The emotional overload of the attack may put a person on a hair trigger, less able to regulate emotional responses. Plus, the grief associated with the attack--until it is properly processed--may linger just below the surface, ready to come out at a moment's notice, often surprising even the victim with its suddenness and intensity. Many post traumatic stress patients are prone to sudden crying jags which they feel powerless to explain.
Ms. Lippard: Hmm. What about the childlike behavior?
Dr. Balis: Some victims unconsciously regress to what seemed to be a safer, simpler time in their lives, when the world wasn't such a scary place.
Ms. Lippard: So he could become dependent on me as a mother figure, a protector?
Dr. Balis: It's a possibility, but it doesn't sound like Alex.
Ms. Lippard: No, he has a stubborn, independent streak that won't allow that. I don't think Alex was ever really a child.
Dr. Balis: Hmm.
Ms. Lippard: I guess you shouldn't express an opinion on that. There is something else that I kind of feel guilty about.
Dr. Balis: What is that?
Ms. Lippard: He's starting to cramp my style. I love him and all, and I want to be there for him. And I think I'm doing an okay job at that. I'm not uncomfortable with him. We have some good times together. And frankly, sometimes, it's nice to have someone else in the house. But at the same time, I want my solitude back. I feel selfish about it, but sometimes, I wish he would find another place to stay.
Dr. Balis: That's not unduly selfish. You're used to living alone, and suddenly having an indefinite house guest, not to mention a teenager with heavy emotional needs, can be very trying.
Ms. Lippard: You know, Alex is so worldly; it's easy to forget he's a teenager.
Dr. Balis: Have you discussed this with him?
Ms. Lippard: Not really. I don't want him to feel like a burden on top of all the baggage he already has.
Dr. Balis: That's laudable, but you have to take care of yourself, too. You shouldn't neglect your own emotional needs; that could put undue strain on yourself and on your friendship with Alex.
Ms. Lippard: If I grow to resent Alex that won't do either of us any good, will it?
Dr. Balis: It could easily make a tense situation worse. Are you looking for my permission to tell Alex your feelings about having to take care of him?
Ms. Lippard: God, Charles. This is frustrating. I want to do all the right things, I want to help. Alex didn't deserve any of this, all he's really guilty of is some poor judgment. And trying to keep kids out of trouble is sort of a mission for me; that's what the Rec Alliance is all about, that's why I started the Foundation. But there, I just coordinate social workers and skilled volunteers. This is personal, and it's hard.
Dr. Balis: It is hard. Social workers have a high burnout rate. That's why it's so hard to find a good, experienced intervention professional. By the time they get highly skilled, the cumulative stress begins to take its toll. You need to be careful not to let this happen to you. Set some limits, draw boundaries. Make keeping yourself healthy and comfortable a high priority.
Ms. Lippard: Yeah. Well, I am concerned about myself. That's why I'm here.
Dr. Balis: I'm glad you came. You can strike a balance between your needs and those of your loved ones.
Ms. Lippard: I worked very hard to get where I am today emotionally. I like the person I've become. I'm well rounded, stable, and content. I wouldn't want to lose any of that.
Dr. Balis: Hmm.
Ms. Lippard: So I need to back off from Alex in order to protect myself.
Dr. Balis: Hmm. If you really feel this way, you have to be careful how you go about that. If Alex senses that you're putting up barriers, he may take that as a rejection.
Ms. Lippard: Well, then I guess we need to discuss some limits.
Dr. Balis: Okay.
Ms. Lippard: How do I approach that?
Dr. Balis: What do you think?
Ms. Lippard: How about, "Alex, you're cramping my style. Get the hell out."
Dr. Balis: I'm glad you still have some sense of humor.
Ms. Lippard: Too strong? Okay, maybe, "Have you thought about how long you're going to stay here?"
Dr. Balis: That's better. That opens up a dialogue.
Ms. Lippard: Yeah. But I'd like to have some ideas about where he could go. If that asshole Benny gets out of the hospital, then Ralph's place wouldn't be safe for Alex. Maybe Elgin or Josh could help with that.
Dr. Balis: You have to be careful and not reveal to others any of the confidences that Alex has entrusted to you. Maybe your social worker contacts could help?
Ms. Lippard: Maybe so.
Dr. Balis: So is there anything else you wanted to talk about?
Ms. Lippard: Let me see. Well, we covered Alex's symptoms, the pressure I'm feeling, and my guilt over wanting my space back--I haven't even spent a night alone in my new house. You helped get me back on track for taking care of myself--thank you. That was all the major stuff. My job is still the same. Lloyd is still an eccentric genius. My staff is happy and stable. The books are balancing. We've increased the dividend--you should have bought stock when you had the chance. More money's going into R&D. But this is all very mundane, it's not really relevant. Oh, I have a date this week.
Dr. Balis: Good for you. Who is he?
Ms. Lippard: He's a benefactor for the Rec Alliance. I started to work on him for a donation to the Foundation, and we hit it off. He's old money, never had to work a day in his life. He just dabbles in the market a few hours a week to keep the wealth flowing in. But he managed to be a real nice, down to earth guy anyway. He was raised in New York, got a business degree from Harvard. He decided he didn't like that, so he moved here to get a master's in Philosophy from Berkeley. Now he's a philanthropist.
Dr. Balis: Quite a varied background.
Ms. Lippard: Well, we'll see if he's different in a purely social situation.
Dr. Balis: So this is your first date?
Ms. Lippard: Yes. I'm going to meet him for dinner.
Dr. Balis: Good luck with that. And I'm glad you're still meeting people...
Ms. Lippard: Expanding my horizons!
Dr. Balis: Indeed. Well, our hour is up. It was good to see you doing so well, Katherine. If you need more help with Alex, I'm always here. You can come in and talk things through any time. I'm here for you.
Ms. Lippard: Thank you, Doctor Balis. I may call again.
Dr. Balis: Feel free. Goodbye, Katherine.
Ms. Lippard: Bye.
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