Saturday, July 20, 1996
a letter from Bill. From the safety of hospital practice he says he
envious me in my frontier practice. He tweaks me on "caffeine narcosis."
Remembering my penchant, he thinks I'll fit right in.
Sunday, July 21, 1996
I went to the Zoo. They are making a big effort to improve the quality,
and there is an interesting mix of spectacular exhibits with roomy quarters
for the animals and the old style penitentiary type zoo. It seems that they
are working from the front to the back, so the initial impression is one
of a totally modern zoo, but with a dirty secret in the back--animals doing
hard time. The place is filled with young families. Every other group seems
to have a stroller. I thought it would be hot--it was in the apartment on
Russian Hill--but it was actually quite cold.
Monday, July 22, 1996
am. Telephone Call with Mr. Tom Bows. Sylvia apparently did not come
home Sunday night. Tom believes that the Zoloft is responsible for her changed
behavior. It's possible that he's right. He describes her as acting like
a whore, dressing differently, etc. I believe he thinks that she is having
an affair, but is prepared to forgive her and blame it on the drug and me.
I got a certain insight into Tom's personality. He is more worried about
appearances than his wife's actual fate. He tried to bully me in the beginning
of the call with threats, and then tried to coopt me into a plan to institutionalize
Sylvia. I told Tom to have Sylvia call me when she gets in. I think Sylvia
and I need to discuss again switching medications.
10 am. Session with Hal Mainor. Hal came in feeling sorry for himself. He wrote in his journal and decided that his concerns about life passing him by were shallow and that the reasons that he wanted to be a writer were just for image. But in a flash of self knowledge, Hal asked me to talk me out of it--to reassure him that he was really a writer. I reminded Hal of his past work, which he thought was good, and told him that he needed to stifle his inner critic. I suggested that Hal write without editing until he had finished a first draft and that he might try working in a different genre than that occupied by the glories of his past. Hal admitted that his parents weren't supportive and told me about learning the violin and being patronized by his parents. He also told me about not being able to satisfy his parents with an A- grade. Paradoxically, Hal feels his parents were genuinely proud of him when he published his first westerns.
1 pm. Session with Anna Green. I found myself looking forward to the session with Anna and when she arrived, I greeted her heartily. She immediately brought me back to earth by noticing my attitude and telling me that she had a really bad weekend. I should strive to be more neutral in my affect shown to my patients. Anna sounded like she really felt bad over the weekend without having any precipitating crisis. She tried to write a journal but is having trouble with it. My guess is that Anna is of a hysterical personality type, but not overly pronounced. She describes her mind as racing ahead of herself. She talked a little about Bill and how she had been warned against him. Bill apparently liked to talk to Anna about multiple partners and Anna believes in encouraging a rich fantasy life. Anna played along and they talked about bringing another woman into their bed. But Anna wasn't seriously considering it. Anna believes that Bill was trying to "test the waters." Anna also thought that she was really in love with Bill. Martin, the guy who warned Anna about Bill, apparently had a crush on Anna himself. Anna describes herself as having an "indiscretion" with Martin during an out-of-town convention that never went beyond a kiss after Martin declared his feelings for Anna. At the end of the session, Anna was worried that she might have depressed or bored me.
4 pm. Session with Joseph Mazurka. Mr. Mazurka, 33, strikes me as a full blown misogynist, but still I find myself feeling sorry for him. He describes his wife as a "manipulative bitch" who "screwed her way into a meal ticket." Apparently, he married her when she became pregnant during college. His two children, a boy and a girl, he describes as "broken rubbers." He admits to not being a very good father, and I believe it. He accuses his wife, whom he refers to as "the bitch", as turning the kids against him and putting him down in front of them. He complains that his shoulder hurts, of gastrointestinal distress, back pain, and intermittent impotence. He describes sexual relations with his wife as infrequent. He has been consorting with prostitutes and having increasing difficulties maintaining an erection. I would guess that his shoulder pain and impotence are psychosomatic responses. Mr. Mazurka wishes to blame everyone else for all of his problems. The fact that he is coming to these sessions is probably the first time he has acknowledged any responsibility for his own mental well being. Still he is resisting treatment, although he has agreed to come to future sessions.
7:15 pm. Telephone Call from Sylvia Bows. I got a call from Sylvia and I have to admit that I was relieved to have heard from her. She was fine. She seemed completely in command of herself and her situation. She scoffed at the notion that she was missing or that Tom was worried about her. She said that Tom had known about her plans for the evening--meeting with her cousin and good friend Rene. (Is Tom playing some sort of elaborate game?) Apparently Rene is a confidant. Sylvia agreed to talk about her medication during our next session tomorrow, but she said that she is feeling better than she has in a long time.
Tuesday, July 23, 1996
Initial Session with Cassandra Evans. Ms. Evans, 24, is a secretary/executive
assistant who is trying to realize her lifelong desire to become a Hollywood
actress. Filled with nostalgia for the Golden Age of Hollywood, Cassie has
joined an improvisational theater group called "Winging It" in
addition to taking acting classes, etc. from a young age. Cassie was shy
and seemed unwilling to discuss her real problems in any depth. This unwillingness
was further exacerbated because she arrived 25 minutes late to the session.
Apparently she has been having a relationship since college with Brian,
who she says is jealous of her acting out love scenes with other men. Cassie
also believes that Brian is unwilling to make a commitment to her unless
she gives up her unrealistic fantasy of being an actress and becomes a "breadwinner"
by devoting herself to her current career. Cassie said one odd thing about
how Brian gets his way in everything except "romantically." She
immediately became self conscious and refused to go further. Cassie has
been keeping a journal for years and I advised her to continue with the
journal. She may or may not allow me to read it.
4 pm. Session with Sylvia Bows. Sylvia presented me with a diskette containing a collage which she called her family tree. Apparently, she put it together on paper with Rene during the night when they talked together and then transferred it to the computer at work. I promised to take a look at it tonight. We started to talk about Zoloft and I expressed my concern that recent behavior changes she's experienced could be due to the drug. Sylvia admitted that Rene thought Sylvia had become more bold, even in her mannerisms. Rene liked the differences, ascribing her previous, more restrained behavior to "corporate contamination." Sylvia said that she did not regret anything she had done so far. She thought that Zoloft might have been a catalyst to get her true self out in the open. She thinks that living with Tom has caused her to repress her more passionate side. She blames Tom for pushing her towards more lucrative but ultimately less socially relevant positions. Now, Sylvia feels a lack of purpose. Sylvia said that Zoloft allowed her to get some perspective on her life and that she didn't want to give that up. I told Sylvia that, since she was happy with the effects of the drug and since her anxiety was certainly lessened, I would allow her to stay on the Zoloft another week or so and then we will carefully evaluate the drug again. Sylvia said that she felt it important that I have a good opinion of her. I told her that I did, in fact. We then turned to her relationship to Rene. She told me some of Rene's history. Apparently Sylvia aunt (and Rene's mother) died in an auto accident when Rene was five and Sylvia was two. Although entirely blameless, Phillip felt responsible for his wife's death and never really got over it. Rene then lived with Sylvia's family in Paris during the school year and Summers were spent with Rene's father at a vineyard in the South of France. Sylvia remembers being scared of the vines at the vineyard during the funeral of her aunt. She has a memory of them being lifeless in the Spring--black and disfigured. During the Summers, Rene "adopted" Sylvia, who was without her real mother. Rene called herself Sylvia's "Summer Mother." Rene was and is protective of Sylvia. Rene would experience something first and then decide if it was right for Sylvia. This pattern continued through early drug and sexual experiences in adolescence. Sylvia remembers Rene punching a boy at school for kissing her in fifth grade. Rene seems to be quite a risk-taker. Sylvia tells a story about Rene going alone to some man's boat to buy marijuana and staying out all night. Later, Rene and Sylvia smoked that marijuana together.
8 pm. Looked at Sylvia Bows Family Collage. Rene and Sylvia spent the night talking and cutting up magazines. They rearranged the features of the pictures they cut up to create a collage representing members of their family. Profiled are Margarite, Sylvia's mother; Roland, Sylvia's father; Phillip, Rene's father; Jeorge, Sylvia's brother and Rene and Sylvia. Each of the images has some accompanying notes.
The Collage Section on Sylvia has Sylvia writing a revealing autobiographical paragraph about herself. She talks about moving to San Francisco in the age of love and flower-power. Sylvia decided to become a journalist and moved to New York City to go to NYU. Sylvia says that "her parents openly grieved and secretly were relieved from the burden of knowing too much about their daughter." In New York, she joined up with Rene. As a freshman, she had an article published in the New York Times entitled "Women of Conscience," written from a jail cell after being arrested during a demonstration.
The Collage Section on Jeorge discusses him as the Don Juan of San Francisco. Aged 33 and good looking, Jeorge likes to show off his body and play the violin. But he has a talent towards the Stock Market, mentored by Tom Bows. Converted to the joys of capitalism by Tom, Jeorge is now mostly interested in price earnings ratios. Sylvia describes Jeorge as being ruthless and cold when it comes to breaking the heart of the women with which he comes in contact.
The Collage Section on Rene is written more tongue in cheek--quite literally. Rene announces the astonishing talent of tying a cherry stem in a knot with her tongue. Rene exhibits some maternal feelings towards Sylvia, taking credit for the "minimal damage sex drugs, and rock and roll did to Sylvia's brain tissues."
The Collage Section on Phillip says that Phillip is a gentle soul but clueless. His wife Angeline died when Rene was 5. Phillip ran a vineyard in France and Rene and Sylvia spent long boring summers there, dreaming of escape and then actually doing it and hitchhiking around France.
The Collage Section on Margarite says that she was born in a small town in France and apprenticed in her grandparent's tavern. She showed great talent and was apprenticed to a great chef in Paris, the renowned 3 star Tour d'Argent. Margarite left the Tour d'Argent to open a restaurant on her own, unusual in a male dominated world of high powered chefs, something Sylvia still admires. Sylvia remembers Margarite as very strict about everything but food. She obeyed her husband and ruled in the kitchen with the authority of an empress. Sylvia remembers a summer working for her mother in the kitchen of the restaurant and being humiliated by her mother's public browbeating of her for some offense. Tom Bows won over Margarite through effusive and knowledgeable compliments of her cooking. Tom and Margarite are buddies, often allied against Sylvia.
The Collage Section on Roland says that he was responsible for getting his family to San Francisco. Roland is passionate about San Francisco, knowing detailed information (often excruciating detail) on streets and the history of San Francisco. But Sylvia writes that he hardly remembers that he has two children and a wife. Apparently, the move to San Francisco was forced on the rest of the family, over their objections.
Wednesday, July 24, 1996
Got another letter
from George Eisenstadt of CalaCare. These guys are intent on getting
my patient files. I can't figure out why they would want the transcripts
of the therapy sessions, but of course there is no way that I can ever give
them that material. They aren't satisfied with what I sent them before.
Eisenstadt is trying to intimidate me into giving up the file, with a bunch
of veiled threats about canceling my HMO contract. I am going to have to
write them again. Perhaps I can find the privilege statute in California
and quote it in the letter to get them off my back.
Received a strange, anonymous fax. It's in the form of a rebus and translates to "I'm watching you." A little sinister but probably just a prank. The sender was somewhat technologically sophisticated, because they managed to eliminate the usual info at the top of the fax which tells the phone number of the sender. There are no markings at all on this fax. Technological sophistication could lead one to suspect an SII employee, but I'm not sure. The graphic elements are an eye, an old wristwatch, an antique corset and a playing card. I can imagine all sorts of connections, but they were probably the images that were at hand to support the rebus. I imagine the faxer will soon come forward.
Thursday, July 25, 1996
pm. Session with Anna Green. Anna said that she has been having conversations
with her good friend Caren about our conversations. Caren believes Anna
"has feelings" for me. Anna says that she likes me, but that Caren
is crazy, although Anna admits that she is having long imaginary conversations
with me, like she has been having with Bill since their breakup. Anna is
obviously experiencing some transference. Anna talked about her sixth grade
experiences. She was a "good girl" and an A student. She says
that she was unpopular because she was good at math. She describes herself
as an awkward, shy geek. Her father is and was a university mathematics
professor who played math games with Anna, and both parents sound fairly
supportive. Anna describes writing her papers in tiny tiny letters, somewhat
obsessively. Anna also sounds like she felt like a victim throughout her
school years. She describes being traumatized by some boys who destroyed
a homework assignment. She also tells of agreeing to switch seats with another
girl even though it meant that she lost her cherished seat next to a boy
she really liked and had to move to a seat next to a boy she despised. Anna
again was concerned about whether she was boring me. She said that in her
conversations with me, she feels that she can tell me very private, embarrassing
things. I asked whether she felt that it was true in my presence or only
in her imaginary conversations. She said that if she told me about Caren,
it would be a test. In questioning her further, Anna described a dinner
engagement she had with Caren last night. Apparently, Caren turned the conversation
to experimenting with new sexual experiences, and said that she wanted to
make love to a woman. Anna agreed that it would be an interesting thing
to try. Anna was shocked when she realized that Caren meant for the two
of them to have sex together that evening. Even though she felt that Caren
was not sexually attractive, Anna felt that it would hurt Caren's feelings
too much to refuse. So Anna allowed Caren to perform cunnilingus on her.
Anna simulated orgasm quickly to end the experience. Anna said that she
is embarrassed that Caren's oral ministrations felt good, even though she
said that she was "freaked" by her first homosexual experience.
Anna said that she had often simulated orgasm in her sexual encounters with
Bill. Actually, in this session, Anna spoke very little about Bill and since
her distress seems markedly less, I reduced the frequency of the sessions
to once a week.
I got the Personnel Records I requested from SII relating to Hal Mainor, Joseph Mazurka, Anna Green, and Sylvia Bows.
Hal Mainor's Personnel File shows just what you'd expect. He got a badly needed job as a technical writer, scored well on his technical writing test and got the job. He works hard to repress any sense of style or personality from his work, which seems to be what the job demands. His supervisor describes Hal as having an "ironic" sense of humor. All that I was sent was the hiring section.
Joseph Mazurka's Personnel File indicates that he was hired because he was good at socializing with clients. He is described as a "strong closer." He was a lateral hire from Zephyr Electronics, who wouldn't give him a job recommendation. He is also mentioned as being coarse. He was told to be less aggressive. Then there is one complaint from a Ms. Stephanie Roberts who said that Joseph Mazurka verbally harrassed her by telling obscene jokes in front of her and making obscene comments about her. Mazurka didn't deny the allegation exactly, but the problem resolved itself this time when Ms. Roberts quit and moved, apparently without intitiating legal action. A reprimand was put in Mazurka's file.
Anna Green's Personnel File shows that she was hired right out of college. While her programming skills were referred to as adequate, she was apparently really hired on the basis of her social skills. There is an approving reference to her baking cookies for the programming staff, and plenty of references to problems that SII is having with its programming contingent. Anna is described by her boss as a "great girl" and upbeat, positive, and well liked by everyone. Actually, the file struck me as patronizing, without much reference to her actual programming talents. Anna apparently tripped on the stairs outside the building and sprained her ankle in March, 1995. There is an "incident report" about Anna "necking" at night in the company lounge with Bill Torbett.
Sylvia Bows' Personnel File, Hiring Section shows that she was hired directly by the CEO of SII and was considered a find. Sylvia is definitely a high powered executive. Personnel was bypassed entirely in this lateral hire from CommSoft. It seems that SII was in desparate need of a person to fill the head of Customer Service. Will Sylvia's new found sexual freedom jeopardize her position with SII?
Friday, July 26, 1996
Took a look at the doodles
that Anna Green brought in yesterday. They are a collection of very
controlled little thumbnail sketches of representative objects--a bride,
a bow, an eye and shoes, irises, a cute puppy dog character and maybe some
coins. Near the eye are a pair of either needles or chopsticks. All of the
images are crowded near the top of a piece of binder paper. Somehow they
give the impression of someone who is very tightly wound inside.
Got a message from the service. Hal Mainor cancelled his appointment for Monday, July 29 without explanation. I assume that he'll be here on Monday, August 5, so I wrote him into the appointment book for that day.
Wrote a letter to Bill. I asked him about Sylvia and the Zoloft problem and gave him a general description of my patients.