Charles Balis' Journal for the Week ending 9/27/96

Saturday, September 21, 1996

Sunday, September 22, 1996

Monday, September 23, 1996

12 pm. Fourth Session with Phylis Birch. Phylis came as herself this session, leaving Martha in her make-up kit. She is so gorgeous that I can't help but stare at her, but she doesn't invoke the same feelings in me that Anna does. Phylis is more of a pure aesthetic experience. She apologized for the irresistible compulsion which drove her early from my office last week and described some of the origins of the Martha story as coming from the life of her college roommate Jessy. Phylis sees leading a double life as making her life more interesting and daring, exploring her own dark side, and bringing her more in touch with the common man. Her deceptions are of only the most passing concern. However, she did indicate that she was interested in telling Jack, but that she might want to use the more controlled environment of my office to accomplish that. I encouraged her to come clean with Jack.

2 pm. Second Session with Sarah Wright. I started to talk to Sarah about her heart attack and the stress in her life leading up to that event, but she deftly changed the subject to tell me a story about her ex-boyfriend Robby Treynor, who also became her employer until a month before the heart attack. The upshot is that when she was 18 and just finishing college she discovered that he was gay after she had become pregnant. Without telling Robby, she ended up marrying Robby's best friend Jeff who knew that she was pregnant with Robby's child. This was in 1981. In 1982, Melissa was born, followed by Jeff, Jr. (JJ) (approx. 1985) and Nicolas (approx. 1987). The two boys were fathered by Jeff. At one point during their marriage, Sarah tried to initiate a relationship with Robby again, but Robby informed her of his sexual preferences which Sarah eventually accepted. Robby now knows that he is Melissa's biological father, although Melissa has not been so informed. Sarah was surprisingly dispassionate as she told me this tale of lost love. She seemed to be relating a story that happened to someone else, chuckling sometimes at some of the parts that must have been particularly wrenching when they occurred. She seems to have come to terms with this part of her history.

4 pm. Tenth Session with Joseph Mazurka. What am I going to do with this guy? I threatened to have him committed and he just lost it--I'm afraid that he would get out of confinement and kill me, I really am. If I'm honest with myself, I know that I would have him committed if not for fears for my own safety. If Joseph was an elderly lady exhibiting the same symptoms, she would be at Bellevue, or whatever the San Francisco equivalent is (SF General?), so fast... I'm not sure how much good I can do for a patient that I'm terrified of, or to be honest, that I loathe as much as I do Joe. What a terrible person at a fundamental level! When I think of the mentally ill, I'm drawn to those people who are basically good but who are wrestling with psychological or neurological deficits. I'm not considering those who are genuinely evil. Joseph's illness is on top of his evil qualities, not causing his wickedness. Should he be institutionalized? My pick would be jailed. Was he just blowing off steam as he insisted or is it possible he's going to act on some of his threats? If I had him committed, he would be away from amphetamines for 3 days, just long enough for him to appear completely lucid during the commitment hearing. I would appear before the court and testify that, in my professional opinion, Joseph is a danger to himself and to others. Joseph would be completely in control and would make an effective counter. Joseph would be released and I would be in mortal danger without ever having made a difference. An institution would merely be a holding place for Joseph--he'll never get the treatment there that he so desperately needs. And even if completely cured, he would still be an evil and malevolent force in the world. I'm not sure if he is ever coming back and I have to admit I feel some relief. But could I do anything more? Do I owe a duty to society at large to do more? I don't have the answers and I hope I never have cause to revisit the questions.

Tuesday, September 24, 1996

4 pm. Eleventh Session with Sylvia Bows. Sylvia is very concerned about how she is going to tell Tom about her pregnancy. For some reason, she feels that she should not serve him with divorce papers until after she has given him the news. But now she fears that he might already know. Now that I know she is pregnant, it is obvious to me that she is showing, which I guess is normal with twins at 10 weeks. But it's hard for me to be objective. I'm not sure I would notice if I wasn't looking for it. But she describes Tom as staring at her all the time. It may be paranoia on her part, but she even feels that he is acting solicitously towards her. She is planning on telling him in a public place to restrain his display of anger and then to hide at Rene's. Sylvia is having difficulties getting used to the physical side effects of her pregnancy, especially the nausea. She is also questioning the wisdom of performing an amniocentesis. I think Sylvia is more jittery, maybe a bit more paranoid, not as relaxed and sure of herself as she was when she was taking Zoloft. In some sense, my hands are tied because of the difficulties of finding an antidepressant appropriate for a pregnant woman, but I could wish for an improvement in her reaction to the Sinequan.

Wednesday, September 25, 1996

Fax from an anonymous faxer. This one is really quite strange and difficult to interpret. There is a dome shaped caged lined with glass. Inside, there is what appears to be a body swaddled in cloth straining to break free. The dome is broken at the top and what appears to be a rose is breaking its way free, although the glass has cut it, and blood is dripping in a thin stream down the edge of the cage and pooling on the ground, next to shards of the broken dome top. Although the background is totally blank, the dome appears to be located in a room covered with tiny lights in the ceiling--reflected in the dome itself. Actually, it reminds me of a Casino. Could this have something to do with taking risks? Becoming free but injured in the process? Is the bound figure's only chance at achieving freedom through taking a risky, bloody escape route?

Thursday, September 26, 1996

4 pm. Thirteenth Session with Anna Green. I had hoped that Anna had forgotten about quizzing me on my dreams, but she started off asking me about them again. She's thinking a lot about me and even made several overt sexual references. Apparently, I play with my pencil while she talks about sex. I never noticed before, but she caught me twice at it during this session so I guess it's true. Patients are so sensitive to every nuance of a therapist. As I'm getting to know them, they are getting to know me, and I should remember that. Anna talked about the intimacy that has developed between us as having sexual connotations for her. The goal, through therapy, is to try to turn this transference outwards towards others, showing the patient that she can trust others and not just the therapist. But with Anna, my own feelings lie heavily upon me. Despite myself, I enjoy her sexual interest in me. As a therapist I must turn her interest away from me and direct it to other people, but as a man, I enjoy the attention. I feel like I might not be willing to let go. Anna and I need to talk frankly about this. It may be that I am not the best therapist for her, my own needs and wants seem to be interfering with my duties as her doctor. Although painful, perhaps I should refer Anna to another doctor. Anna described a dream during this session--a metaphor for closeness, trust, and death. She is a rock, immobile at the ocean's shore and the tide is coming in, slowly submerging her, pleasuring her, and bringing her peace. She told me that she thinks of me as the water in this dream. Anna also described initiating a bath with Caren in a big old fashioned tub at Anna's apartment. Anna didn't think of it as initiating further sexual contact--apparently women do this kind of thing together. I can imagine my inviting Bill over for a bath! Anyway, she went into quite specific detail trying to get me to imagine a scene of herself and Caren (she went into some detail describing Caren's attributes) cavorting naked and suggested that it would have been good if I could have observed unseen. I'm afraid her descriptions worked and I was glad for the table top's protection from her gaze. Anna insisted she's not a lesbian and said that she would be glad to prove it to me! I declined her offer. But Anna will probably be successful in one of her aspirations. I'm sure I will be dreaming about her tonight.

5:30 pm. Eighth Session with Cassandra Evans. Cassie reports that the side effects from the Prozac have diminished and I couldn't hear any evidence of the slurring speech problem that she suffered from previously. I was horrified by the insensitivity shown by the members of her acting troupe who equated Chronic Fatigue Syndrome with voluntary laziness. Cassandra was very hurt at her first attempt to "come out of the closet" as she put it. Her parents were more sympathetic but not being acquainted with the disease were of little help in trying to assist Cassie in coping with her diagnosis. They will become a better resource as they come to grips with Cassie's condition. Cassie's relationship with Brian is getting stranger and stranger. She reports that he is much more attentive to her now that she is increasingly hostile towards him. Cassie seems to be deliberately seeing how much he will take. She is irritable towards him even when he is making an effort to be nice. Cassie continues to have her dream about a mysterious stranger against whom Brian suffers in comparison. I think that the dream is having an effect on Cassie's relationship with Brian. The mysterious stranger with all the positive attributes sought in a lover (or at least missing from the current love interest) is a fairly common fantasy. I was startled when Cassie described almost smashing a vase over Brian's head because he was irritating her, but she successfully checked her violent reaction. It seems completely out of character for her, but a long exposure to pain can change one's personality rather drastically. I think that Cassie should receive some pain medication and I will speak with Dr. Halsey about some appropriate analgesics. I'm concerned about giving Cassie narcotics-based medications because of their addictive potential in a chronic pain situation. Perhaps Dr. Halsey can recommend a better pain management program, perhaps involving Naprosyn or Datril. In general, I'm concerned about Cassie's ability to cope with her newly diagnosed condition. While before her base emotion was fear and being out of control, now she is getting more aggressive, and not channeling her aggression against her condition. She seems fatalistic about her disease and hasn't yet learned how to direct her aggression against her disease rather than those that surround her.

Doodles of Cassandra Evans. Cassandra gave me a little pink sheet with some doodles on them and said that they related somehow to her romantic mysterious stranger dream. Although they are less revealing than they might be, the thing that strikes me immediately is that they are all crowded into the upper left hand corner of the paper. They are little doodles, cramped, tight, and disconnected one from another. There is a small face with big, closed eyes and a straight line for a mouth. There is a little group of wildflowers, lots of stems and not a lot of flowers. There is something that looks like a broken toy jack-in-the-box and one shape that looks like a cross between a teddy bear and the state of Louisiana. A little box with a shadow and a tiny arrow pointing at it completes the quintet of drawings. The drawings all give the impression of being broken somehow, perhaps slightly damaged. Perhaps Cassie really does view herself as "damaged merchandise" as she said during our last session. I can't see any connection between these drawings and her attempts at sketching the face of her mysterious dream lover.

Friday, September 27, 1996

2:15 pm. Telephone Call from Jeorge Wolff regarding Sylvia Bows. I got a call from Sylvia's brother Jeorge who filled me in on some facts that Sylvia neglected to mention. Apparently, Sylvia has a problem with her cervix, resulting from a cancer which was operated upon, leaving it weakened and unable to support a pregnancy. When Sylvia told me that Tom and she were trying to conceive, she implied that Tom was outwardly helping her. Not so. Tom understood the danger to Sylvia of getting pregnant against her Doctor's advice, and was not even outwardly supportive of her effort to get pregnant. Sylvia surreptitiously stopped birth control and attempted at-home artificial insemination, even knowing the dangers. I'm afraid this puts quite a different light on Tom and Sylvia. I knew Sylvia was manipulative, but I didn't believe that she was deceptive. Jeorge also mentioned that Sylvia was having trouble with word-finding and that she appeared jittery--he mentioned her hands were shaking. I'm not sure whether this was a reaction to Jeorge or whether it was in response to the medication, but I think I should investigate some new medication that will be acceptable to her obstetrician just in case. I have to say that while Jeorge was somewhat threatening and belligerent, I believed him.

I received a postcard, obviously from Helen Gregory. The card was slipped under my door. Apparently, she found the card in an antique store and either sent the card to someone else who then dropped it off at my office in person, or dropped it off herself. The card is an old picture of what appears to be a Roman aqueduct--a bridge over a river. It is strikingly similar to the doodle of Helen's vision that Ruby dropped off after Helen disappeared. In fact, it even has the same kind of shrubs and a little beach by the bank of the river. The card really has the same feel as the doodle, even though the drawing shows the bridge as one tier and the photo shows it as two. The postcard itself has a postmark from 1958 and has some writing on it which is still visible, even though violently scratched out. The only word penned by Helen is my name. The card appears to be of a location in France--Nimes, perhaps? It is hard to read beneath the pen's masking. The text of the original message written in 1958 says something about the card being from France even though the postmark shows that it was originally mailed in Britain. I presume that Helen is trying to bolster the evidence for her vision by showing me that there exists a real place that looks like the drawing she made. It's even possible that she had the postcard first, made the drawing based on the card, and then reversed the order that she presented them to me. Perhaps she is giving me a clue as to her whereabouts. I am terribly worried about Helen and wish that she would contact me in person, although I'm glad to know that she was at least all right at the time she sent this card to me.

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