Transcript of 13th Session between Charles Balis, M.D. and Ms. Sharon Lough, Friday, April 17, 1998 at 10:00 am.

Ms. Lough: Hi, Doctor Balis.
Dr. Balis: Hello, Sharon. How are you?
Ms. Lough: Okay, I guess.
Dr. Balis: You missed a few sessions. Have you been feeling okay?
Ms. Lough: Yeah, there's been a bug going around.
Dr. Balis: Hmm. How are you and Rob getting along?
Ms. Lough: I haven't seen him for a while.
Dr. Balis: You haven't? Haven't you been living together?
Ms. Lough: I'm not home much. Neither is he.
Dr. Balis: How are things at work?
Ms. Lough: I don't know. Okay, I guess.
Dr. Balis: Okay?
Ms. Lough: Yeah.
Dr. Balis: You mentioned earlier that you were unhappy with your job at SII.
Ms. Lough: Yeah, well, who isn't?
Dr. Balis: Sharon, when was the last time you reported to work?
Ms. Lough: Oh. Who tipped you off?
Dr. Balis: That doesn't matter.
Ms. Lough: Yes, it does.
Dr. Balis: Sharon, you haven't reported to work in over a week.
Ms. Lough: Has it been that long?
Dr. Balis: What happened?
Ms. Lough: I'm enjoying the life of the leisure class.
Dr. Balis: Are you sure you can afford to do this?
Ms. Lough: No. I don't care, though.
Dr. Balis: This is serious, Sharon. You could jeopardize your job.
Ms. Lough: I think I already have. Que sera sera.
Dr. Balis: Hmm. You don't seem to understand the consequence of your actions.
Ms. Lough: Are you upset because this session isn't covered? Are you afraid that I won't pay up?
Dr. Balis: Money isn't the issue here.
Ms. Lough: You better not say that--they'll take away your license to practice.
Dr. Balis: Funny. Don't worry, you're insurance isn't immediately canceled when you lose your job.
Ms. Lough: No wonder you're acting so concerned.
Dr. Balis: This is not about your insurance coverage. I'm concerned about you.
Ms. Lough: And you call yourself a doctor?
Dr. Balis: Sharon, are you under the influence?
Ms. Lough: Under the influence of what?
Dr. Balis: Don't play games with me. Have you been using drugs? Are you high right now?
Ms. Lough: What if I say yes? Are you going to throw me out of your office? You'll accept someone who can't pay, but you'll throw out someone who can just because she's stoned? That's not very compassionate, Doc. You should demonstrate your concern by giving me a hug or buying me a cookie or something.
Dr. Balis: I made it clear the last session that you were not to come here drugged again.
Ms. Lough: Well, I'm not quite as high as I was last time. I haven't been smoking weed.
Dr. Balis: What have you been smoking? Have you been using stronger substances?
Ms. Lough: No, why?
Dr. Balis: Are you being completely honest with me?
Ms. Lough: No, why?
Dr. Balis: This session isn't going to be productive for either of us if you persist in being evasive.
Ms. Lough: It was a matter of necessity.
Dr. Balis: What was a matter of necessity?
Ms. Lough: I couldn't very well smoke dope in the building. I tried using this brownie recipe I found on the web, but you don't get a lot of bang for your buck. At least I can never get that marijuana brownie to turn out right. I just don't have the knack. Some people can make good marijuana brownies, but not me. Mine always end up looking like chunks of horse shit with bits of green plant matter in them. And they don't taste so hot either. And they don't really get me high. Anyway, I can't stand facing life without getting baked, so I had to switch to something else; something more discreet.
Dr. Balis: Are you using intravenous drugs?
Ms. Lough: I only do it because with my numerous allergies it's hard for me to snort powder. I end up sneezing it all up. But I don't do that much. I'm really not using that much.
Dr. Balis: So you've been shooting up. What are you using? Methamphetamine? Cocaine? Heroin?
Ms. Lough: Yes, no, and yes.
Dr. Balis: And how do you plan to support your habit without a job?
Ms. Lough: I don't know. I have a tax refund coming.
Dr. Balis: That's hardly enough to support a growing drug habit.
Ms. Lough: Yeah, it's almost like having a child.
Dr. Balis: You do realize that your habit is going to grow?
Ms. Lough: Planning ahead isn't really part of that glamorous dope-addict lifestyle. We're improvisationalists, like jazz musicians. It's very Zen.
Dr. Balis: You can romanticize your drug addiction all you want, but you and I both know where this will lead.
Ms. Lough: Yeah, yeah.
Dr. Balis: Do you want to die, Sharon?
Ms. Lough: You're asking the wrong person. Do you know how most people fantasize about winning the lottery someday and all the things they will be able to buy with their winnings? My daydreams always revolve around dying suddenly and unexpectedly--a tragic accident. I'd be hit by an oncoming bus, or a drunk driver. Or better yet, I'd die heroically, like that woman in Arkansas who stepped in the path of a bullet to save the life of a child. That way, everyone would remember me fondly, and my life would not be such a waste.
Dr. Balis: But do you want to die the way most junkies die? There's nothing heroic or romantic about that.
Ms. Lough: Well...
Dr. Balis: I think it would be best for you to get immediate care. Your insurance does provide treatment for substance abuse. I'd strongly recommend that you take advantage of it while you still can.
Ms. Lough: Do you mean I should commit myself to another loony bin?
Dr. Balis: This won't be a psychiatric ward. You would be admitted into a substance abuse treatment center, a place specifically designed to treat alcoholics and drug addicts.
Ms. Lough: You mean a prison, right?
Dr. Balis: You won't be able to come and go as you please, but the facilities are very nice, very well maintained, and visitors are allowed. This would be a chance to give yourself a rest, Sharon, and to deal with the issues that led you to drug use.
Ms. Lough: A nice prison--a touchy-feely, soft and mushy, new age-type institution, where the cells are padded with organic cotton and the inmates weave their own restraints in arts-and-crafts class.
Dr. Balis: Give it a try, Sharon. Try it for a week.
Ms. Lough: Will they make me take mud baths and sit in smelly sawdust?
Dr. Balis: I'm not sure what you're referring to exactly, but no.
Ms. Lough: Do I have to hug the other inmates?
Dr. Balis: Not if you don't want to.
Ms. Lough: Sounds like a real picnic. Is there cable?
Dr. Balis: I could give them a call and check.
Ms. Lough: Why can't I just continue seeing you? You're so dedicated, and you don't care at all about money--a doctor completely devoted to the well-being of his patients.
Dr. Balis: Frankly, I don't think you're making any progress. In fact, you've regressed into the very behavior that led you to a mental breakdown a year ago. If you continue to use drugs and arrive here under the influence of drugs, I will have to seriously consider whether I'm the right therapist for you.
Ms. Lough: You're dumping me. I can't believe it. That's the ultimate rejection--my shrink dumped me. It's not like I've been unfaithful. I haven't seen any other shrinks. Sometimes, I listen to Doctor Laura Schlesinger on the radio. But she's not really a shrink, so that doesn't count, does it?
Dr. Balis: I'm not dumping you. I'm just letting you know that there are limits. In my role as a therapist, I have the right to make certain demands on my patients. I've asked you to refrain from drug use before your sessions. This is not unreasonable. If you can't do even that...
Ms. Lough: I thought you were the one thing I could count on. The one constant in my life. I've always looked forward to coming here.
Dr. Balis: I'm glad to hear that, Sharon. I'd like to continue seeing you. But unless you're willing to undergo treatment for your addiction, I...
Ms. Lough: So you're going to have me committed. This is the one thing I was afraid of, you know? This is one of the reasons why I didn't want to see a shrink again.
Dr. Balis: I don't want to commit you, Sharon. I'd like you to check in to a substance abuse treatment center voluntarily. And that's quite different from being sent to a mental hospital involuntarily.
Ms. Lough: Well, even if I did agree to do it, it won't do any good. When I was in the psycho ward, after I got over the initial shock of being imprisoned, I only went along with what those fucking shrinks and doctors wanted me to do so I could get out. I parroted all the right platitudes, made those stupid fucking arts and crafts projects, and participated in insipid discussions with drooling spastics on the importance of keeping the communal area cleaned. It was all an act, I didn't mean any of it. If I go to this place, this druggie ward, it will be the same thing. You'll see.
Dr. Balis: I'd still like you to give it a try. If you complete the treatment and are willing to stay off drugs, I might be able to reinstate you at SII. There's a chance you could get your job back and resume a normal, productive life.
Ms. Lough: And if I choose not to?
Dr. Balis: I'm concerned that you'll be pulled into the same downward spiral that led to your previous hospitalization. Are you really prepared to go through that again? You've told me in detail how that experience was extremely painful and expensive for you--not only financially, but emotionally. I'd gather that it's not an experience you'd care to repeat.
Ms. Lough: Jeez. I don't know. I just don't know.
Dr. Balis: If you choose to pursue the treatment, I can have you admitted right away.
Ms. Lough: Okay. I'll do it.
Dr. Balis: That's great. I'll arrange it right now and we can go together. Let me just make a few calls. And, Sharon, I think you might give Rob a call. He must be quite concerned about you.
Ms. Lough: Rob? Oh. So that's how you knew. What did he tell you?
Dr. Balis: I think you should call him and let him know you're all right.
Ms. Lough: Okay.
Dr. Balis: All right, Sharon. Let me just arrange this now.
Ms. Lough: Okay, Doctor. But I don't have any of my stuff.
Dr. Balis: Don't worry about that; they provide what you need. I think it's important that you get started right away.
Ms. Lough: All right, Doctor.
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