Charles Balis' Journal for the Week ending 8/02/96

Saturday, July 27, 1996
I had a nightmare which really unnerved me. There was a tiny bird on a branch with a very long beak. I went and picked it up. I expected the bird to fly away when I touched it, and it surprised me when it didn't. It felt soft and warm when I put my hand around it. In the bottom, it felt wet as I picked it up. But in my hand, the bird started to grow. And it got slimy, with more and more slime under the bird. It was oozing slime. I looked at the eyes of the bird, and the eyes turned this milky blue color with this pale white slime seeping in rivulets from its eyes and running in viscous streams between my fingers. I awoke.

Sunday, July 28, 1996

Monday, July 29, 1996

4 pm. Session with Joseph Mazurka. Joe reports feeling worse, like he is a zombie and not really alive. He reports his physical pain being reduced, but his extremities being numb. He says he has a feeling like he doesn't care about his limbs (paresthesia?). Mazurka related a dream about a baseball game where he is about to become sexually involved with Suzy from work when the ball is hit his way. When he touches the ball, it falls apart and drips blood. He said he wanted to consummate his experience with Suzy in the dream so that he could tell her about it. I mentioned sexual harassment and counseled him against telling Suzy about his dreams with her that have sexual content. To illustrate his bad temper, Joseph then told me about an episode in his childhood where he was in a confrontation with an older boy and suddenly found himself with his hands around his neck repeatedly smashing his head into the blacktop. They took the older child to the hospital. He said that it gained him respect in the school. Since then, Joseph keeps it bottled up and his wife and kids stay out of his way when he is in a bad mood. Apparently, Joseph was physically abused by his father who also abused his mother. When Joseph's father died (after Joseph's childhood), Joseph reports that his mother was happy. Joseph says that his mother was strict but not a mean drunk, like his father, who used to have drill sergeant rituals with his children which would end in beatings. Joseph tells about hitting his own children. He was administering a spanking to his daughter when his son came to his sister's defense with a baseball bat. Joseph ended up physically punishing both of them. Joseph reports that he might be losing control. He said that "you can only push a guy so far before he snaps." He said that he is feeling dead and then threatened, "If a guy's dead already, if he's got nothing to lose, he can get very dangerous. And there's a few of them he might take with him when he goes." When questioned, Joseph said that he was just talking through his hat. But I'm very concerned. I think Joseph is headed towards a crisis and that it could easily become violent. I prescribed Prozac and made an appointment for Thursday.

I wrote a letter to Eisenstadt at CalaCare today. Told him about the privilege statute in California. I hope this works.

Tuesday, July 30, 1996
1 pm. Session with Cassandra Evans. Ms. Evans made a point of being extremely punctual this session. She describes being treated as a flake by the other employees at SII. She ascribes this to her wish for an acting career and points out that she went to college and has a minor in business technology operations--hardly a flaky major choice. I should order up her personnel file to see what I can learn there. She is trying to prove that she has brains and not just looks. Her family apparently is pressuring her to a "respectable" career path and Brian is joining in the pressure. Apparently Cassie just feels overwhelmed by it all. She has a subserviant attitude towards her superiors at work, and she lets Brian get away with dominating her most of the time, although she clearly resents it. But she is a virgin (and very defensive about it) and won't let Brian sleep with her. She indicated that she might have, if he hadn't come on so strong. This is one area in her life when she is not going to be pushed over. Here she pushes back! I might probe here and find out why this is the point at which she pushes back. It might reveal some formative past events. At the question of whether Brian was faithful, she showed a genuine flash of anger at the idea that he might not be. I suggested that she might do a role playing exercise on demanding respect from her superiors. She was very tuned in to the role that putting on a character's "mask" can have in distancing her from the reality of her situation. She even told me that she could make me blush with her sexual ribaldry, but it would really be a character. To reveal herself, she wants to discourse through her writing. I'm willing to give it a try. She said that she'd drop something off before our next session.

4 pm. Session with Sylvia Bows. Ms. Bows and I discussed the side effects from the Zoloft which I prescribed. She said that she had carefully observed her behavior during work and came to the conclusion that she had no memory loss or changes in her ability to concentrate. She said that her cognitive functions have not been impaired. However, she did tell me that she has experienced a sharp increase in sexual activity. She told me that she had a one-night stand with an engineer in her office named David, and she engaged in a ménage à trois with Rene and a photographer named Matthew. Sylvia claims that she is rediscovering sex and that while the drug may be influencing her behavior, it is a positive benefit of the drug. While Sylvia's behavior has changed, I believe that she is not acting under a compulsion respecting her sexual activity, but rather that she is in control of her sexual activity. Rene is considering a move to San Francisco. Rene has a twelve year old son, Robert, who Sylvia describes as very sweet but too serious. Robert, during the Summer, is living with his grandfather Phillip in the vineyard in France, just like Sylvia and Rene did when they were kids. Robert is interested in succeeding his grandfather in the family business and his grandfather is thrilled. Rene is a widow, her husband Tad dying of a brain tumor when Robert was still a baby. Sylvia has only been at home one night since our last session. She says that she has been staying with Rene. She believes that Tom is partly relieved because, while he hates it when things aren't under his control, Sylvia's coldness to him has really made him uncomfortable. Tom has been having daily contact with Sylvia's mother, who believes that Sylvia is making a mistake by desiring to get pregnant. Sylvia says her mother looks at her and sees "Down's syndrome, divorce, depression, and unemployment."

Wednesday, July 31, 1996
I got another anonymous fax today. This one is stranger than the first. While the first was a fairly standard rebus, this one is graphically more sophisticated and depicts a moth or butterfly flying over what looks like the Hiroshima Dome, a bombed out building hulk. The building peers through a silhouette of a man's head. I don't know what it means, but the person who sent it obviously spent a great deal of effort in trying to come up with this image. Again, no identifying marks. I'm not sure whether the faxes are threatening or not.

11:30 am. Telephone call from Joseph Mazurka. Received a phone call from Joseph Mazurka. He canceled our appointment for tomorrow at 2 pm because he is going out of town. He reports that he is taking the Prozac, but that it isn't doing much of anything that he can tell. Made an appointment for 4 pm, Monday, August 5.

I got a letter from Cassandra Evans. I returned to the office late tonight and found a letter had been slipped under the door. The letter is filled with pain. Cassandra felt more comfortable writing the letter than discussing this with me in person. As a young teenager, Cassandra was stricken with some "undiagnosed chronic illness" which was treated with broad spectrum antibiotics. It resulted in a terrible yeast infection, which apparently went untreated for some time because of her embarrassment. Finally she went to a gynecologist and, although uncomfortable, the gynecologist was able to cure the yeast infection. Her gynecologist says that her yeast infection is gone, but that she needs to discuss this with her partner prior to having relations. (I think she misunderstood. Yeast infections are very common among women and are easily brought on by poor hygiene and/or antibiotics. Perhaps her gynecologist said that was prone to yeast infections and that the yeast infection was potentially communicable if active and she took it to mean that the yeast infection was always active. Perhaps I can get her some literature on yeast infections to put this fear to rest.) Her "undiagnosed chronic illness" left her unable to finish high school normally--she had to finish using home instruction. She feels such pain from her experience being ill at that time that she wants desperately to put it behind her, going so far as to not tell anyone of her past troubles. Rallying somewhat, she was able to go to college, although she had to have help from her family to hide her persistent exhaustion. Brian does not know of her medical history. Now she is feeling sick again. She describes it as a terrible flu that won't go away--(Epstein Barr? Lyme? Mono?). Cassandra is also concerned that she might have AIDS and is afraid to test because she feels that she could lose her job if she tested positive. Assuming that Cassandra never had a blood transfusion, and given that she is a virgin and, I suspect, not an IV drug user, Cassandra fits none of the profiles of HIV positive adults. If she is tested, a negative result would reduce her concerns somewhat. Cassandra also says that Brian knows none of this. Now she is afraid that if she tells him, he will leave her. I should refer Cassandra to a good internist and get a proper workup.

Thursday, August 1, 1996
I received the Hiring Section of Cassandra Evans Personnel File. It confirms what Ms. Evans told me about her educational background. She left her LA position to be close to her parents who moved to the Bay Area. She works for Sylvia Bows in customer service. Sylvia writes a glowing evaluation of Cassandra at the end of her probationary period.

2 pm. Initial Session with Helen Gregory. Ms. Helen Gregory presented herself for her appointment in great distress, frantic with worry that someone was trying to get her. She practically barricaded the door and then launched into an amazing monologue which left me breathless, hardly able to interject the simplest question. Ms. Gregory speaks in a baroque, old fashioned vocabulary. She also is extremely scattered, jumping from one topic to another with dizzying speed. Ms. Gregory didn't fill out my patient sign in form, so I really know very little about her. Apparently she works at SII, but I have no idea in what capacity. I can't imagine that she can perform her duties without substantial concern about her mental competence from those around her. Order her personnel file from SII. She is strongly delusional and paranoid, possibly schizophrenic. Ms. Gregory is an older woman who I'd guess is 60 years old. She reports having a 21 year old son, Matthew. Ms. Gregory reports temporal disorientation. Apparently she is having substantial lapses of memory, splicing out days at a time. She also reports playing the same moment of time over and over again. I wanted to prescribe 20 mg. of haloperidol daily as an anti-psychotic, but without a proper medical history I thought it unadvisable. I'm not sure Ms. Gregory is in crisis, and I'm convinced that there is virtually no chance that she would actually take the medication anyway. My impression is she has been living this way for some time. She wouldn't come earlier than one week from today. Ms. Gregory's appointment was made by someone who called the service. I'm not sure whether she made the appointment herself or was directed to come by someone else.

4 pm. Session with Anna Green. Anna came in talking about the possibility that she may be having medical problems. While saying that she was pleased that she was fixated a lot less on Bill, she described an anxious stomach, and difficulty falling asleep. She says that Bill became her addiction. I believe Anna is experiencing a grief reaction to her separation from Bill. She also seems to have placed me in a center spot through transference. I will fill the void until she can find another person whom she can trust in that role. Anna said that she can look in my windows and has actually recognized Ms. Bows inside my office. For the sleep disturbances, I suggested that she try melatonin and limit her caffeine intake. Anna then described how Caren and her boyfriend tried to pressure her into a threesome. Apparently, they all got naked and Anna left only after Caren and her boyfriend Greg began intercourse. Anna said that she smoked marijuana prior to this encounter. Anna agreed that we needed to work on her inability to say no to unwelcome sexual encounters. I believe that substance abuse is contributing to her weakness in this regard.

Friday, August 2, 1996

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