Charles Balis' Journal for the Week ending 10/11/96

Saturday, October 5, 1996

2:30 pm. I was having a cappuccino this afternoon at El Greco, a coffeehouse on Columbus Avenue in North Beach. I like this place because it overlooks the street and has some sidewalk tables in addition to those next to big open windows, and because they serve Illy Cafe--the type of espresso that I've decided I like the best. So I'm relaxing, reading the newspaper, when a deranged man appears walking up the center line of this very busy street. About fifty, he is stripped to the waist and has a very full beard. He looks a little like Oliver Sacks actually--sort of jovial. But his actions belie the friendly impression. Holding an imaginary fusillade of weapons, he animatedly takes aim at each passing car and at assorted pedestrians and mows them all down. He switches rapidly between an imaginary hand gun and an imaginary machine gun, first shooting the driver of a passing car point blank in the head and then mowing down a group of pedestrians with his low slung machine gun. He even mimed pulling the pin of a hand grenade and lobbed it into the cafe window where I was watching. He continued up the street, good naturedly killing everyone he met, reaching the busy intersection up the block. There he continued right into the middle of the intersection, with a total disregard of the traffic lights and the passing vehicles, continuing to fulfill his homicidal fantasies. Past the intersection, he was out of my view. The thing that really astonished me during this display was that nobody reacted at all! The drivers of the cars he shot at, the pedestrians he mowed down, and my fellow patrons of the cafe gave this character hardly a glance. He did not merit their attention--just another lunatic, how dull. And I was surprised at my own reaction. Although, due to my training, I viewed the man as a curiosity, I had not the least inclination to try to help him in some way. I reacted much as the crowd did. And I will soon forget all about him and his troubles. Callous but true.

Sunday, October 6, 1996

Monday, October 7, 1996

10 am. Eleventh Session with Joseph Mazurka. Oh god! I think that Joseph raped Phylis! I'm not sure but he describes a sleazy bar, a woman named Martha who looked better without her make-up than with it, a man who didn't know her name but insisted that she leave with him (Phylis' husband Jack, who probably is now in a hospital, wouldn't have known the name 'Martha'). It has to be Phylis, doesn't it? I certainly hope not. I'm listening to Joseph describe this rape and he's trying to make it sound like he's being the perfect gentleman. Somehow I doubt that will be Phylis' take on the events of last Thursday. I can't believe that I'm treating this monster! At the end of the session, I actually begged him to keep coming for therapy. I know I'd feel less responsible for his actions if he just split and never came to another session. He keeps coming and I feel responsible for whatever he does on the outside. He might end up killing someone. If I read about it in the papers, it would be surrounded by a nice unreal gauzy haze that would lessen its emotional impact on me. But if the police dig up his wife and children from their backyard, I'm going to be emotionally crippled as a result. Am I in some way responsible for what happened to Phylis? Would Joseph have been there that night if I had had the courage to order his commitment? In the history of psychotherapy, has it ever happened that one patient raped another patient? How do I treat their conflicting needs? Should I counsel Phylis to report Joseph to the police? I've got to call her immediately. Other items that Joseph discussed included using his sniper's scope on his rifle to peer into his neighbors' windows and his denial of any criminal wrongdoing respecting his wife and children.

11:20 am. Telephone Conversation with Phylis Birch. I'm enormously worried about Phylis after my session with Joseph Mazurka. I called her at work nominally to confirm our session this afternoon but actually to try to determine whether Mazurka's Martha was Phylis' Martha. Phylis sounded quite odd and upset but was unwilling to talk while at work. She also cancelled our session today, but wanted urgently to reschedule it. Apparently she's not ducking our session, but rather must have something very urgent to have cancelled. So we made a new appointment for tomorrow at 5:30 pm. I hope she is okay although I fear the worst.

2 pm. Fourth Session with Sarah Wright. Sarah had a dream that has a lot of significance for her. She keeps replaying the dream in her head over and over. And I believe that she has given the dream an appropriate interpretation. She dreamt that she was handcuffed to a wheelchair and Jeff push the chair around, but when he wasn't there, she could slip out of the handcuffs and walk on her own. Jeff treats her like an invalid and she lets it happen, when she knows that she is a strong individual. She describes a series of complaints against Jeff, all of them objectively petty. But to her they are serious issues of lying and disrespect. My guess is that she can read the actual motivation behind Jeff's actions and thus is reacting to the motivation (the disrespect) rather than to what he actually says or does. For example, she was furious when Jeff questioned whether or not she should volunteer to buy a camping coffee pot. She's also caught him in petty lies that don't really amount to anything but which annoy her nonetheless. However, she describes Jeff as a good husband who doesn't drink, cheat, or abuse her. She is trying to stand up for herself more and Jeff is concerned about how this will impact on his life. Sarah thought once of leaving Jeff to marry Robby and construct a front behind which Robby could hide his homosexuality, but Robby refused the offer. I'm surprised that being homosexual could hurt a dental practice in San Francisco, but perhaps the fear of AIDs communicability would cause patients to seek another dentist. I also presume that Robby purchased a rather conservative dental practice. Sarah's upbringing was loving but unstructured. Jeff, who idolizes his mother, insists on emulating the conservative upbringing of his youth. Sarah is feeling stronger in her position and is starting to challenge Jeff's dominance over their lives. Sarah believes that standing up to Jeff makes her a better person--someone she respects. I told her that making such a transformation was not going to be easy to accomplish as she and Jeff have long established patterns that must be broken. But Sarah sees making these changes as the key to her survival.

Tuesday, October 8, 1996

4 pm. Thirteenth Session with Sylvia Bows. Sylvia is twelve weeks pregnant. She brought me baby pictures and one of them is a boy. Sylvia told about the scene in Malleson's office when she was in the stirrups and in walked Tom. Quite a scene! Tom is clearly a master of the game--he can keep his cool and take advantage of situations that present themselves. He clearly led Malleson to believe that the twins are his. Was this really to protect Sylvia's honor or did he just not want to portray himself as a cuckold or does he have some other design? Sylvia is also finding herself at the center of a storm of gossip at SII. The potential fathers are falling all over themselves trying to figure out who is responsible and it seems to have become a topic of general interest. Hal is clearly beside himself and his evident agitation is making Sylvia so uncomfortable that she is talking about terminating him. Richard assumes that he is the father as well, but he has a strange world view where phones are tapped and Sylvia is being followed by detectives. Sylvia is taking advantage of Richard's delusions to avoid speaking with him. Chicken. My impression is that Sylvia is just not dealing with the situation at work, including her employers, the putative fathers, and the gossips. Despite her elevated position in the organizational chart, Sylvia worries for her own job while she is on maternity leave, and hers is likely to be particularly long due to her probable necessity to be on bed rest. Sylvia intends to speak to Tom and her parents sometime this week and also to serve Tom with divorce papers. But she has been talking about the divorce papers for awhile, so it's possible she'll find a way of avoiding it again this week. Sylvia gave me a couple of ultrasound images of her twins.

5:30. Phylis was a no-show for our session today. I'm very worried about the mental and physical state of both her and her husband, and I'll try to get in touch with her at the office tomorrow.

Wednesday, October 9, 1996

I received another fax from the anonymous faxer today. This one depicts a large skeleton hand reaching out from an antique baby carriage. I don't quite see how this connects with the previous images, but the image reeks of symbolism and is evocative of a series of clichés. Perhaps the creator meant to suggest cradle to grave imagery. I note that the baby carriage is of a type probably not used since about 1920. Perhaps this is an older person who would have been a baby in the '20s and is now thinking about death. But that was certainly not my impression from the earlier faxes. Perhaps a relative died in childbirth or a sibling died in infancy. I had hoped that this fax would confirm the suspicions I had developed last week, but this fax doesn't seem to fit that mold at all. It's almost as if it is designed to throw me off the track.

Thursday, October 10, 1996

11:30 am. Telephone Conversation with Michelle Markson relating to Cassandra Evans. Cassie's friend Michelle called me to tell me that Cassie was going to miss her session. Michelle is visiting from out of town and they are in Michelle's hotel room at the Clift. Cassie had too much excitment the night before and is paying for it this morning. She is having trouble getting out of bed. She asked Michelle to call in sick for her at work in addition to calling me. Michelle also said that she was in pain. Unfortunately there isn't much I can do for her physically. In CFS patients, there is no substitute for rest.

4 pm. Fifteenth Session with Anna Green. Anna looked terrible this session, as if she had spent a lot of time crying during the weekend. She said that she was feeling as if she had no energy, but it sounded like depression. Unfortunately, I was apparently the cause. Although I had thought our decision at the end of the last session to continue therapy despite our mutual sexual attraction had set her mind at ease, apparently Anna continued to be deeply upset by what she perceived as my rejection of her. As she put it, if she's rejected by her own therapist, who else is left? She's feeling insecure, rejected, and unloved. She has reevaluated her past relationships with men and now she has decided that they represent a continuing string of rejections up to and including me. Of course, although she doesn't know it, I could be counted as a conquest, if it weren't for our doctor/patient relationship. While my general policy would be to not reveal to a patient my own inappropriate sexual feelings, I had to reveal a little bit of how I felt about her. I had to make her understand that I was not rejecting her out of my heart but instead was insisting that our relationship remain pure due to professional ethics. She cheered noticeably and I think she actually understood. We talked about transference and how important it was for her to direct her feelings toward me more generally to others in her life and to make new, secure attachments. I hope she has decided to abandon her attempts at seduction because they were making my dreams troubling. Well, to be honest, I'm not sure that I really do want her to abandon her efforts--there's something nice about a desirable, intelligent, and beautiful woman attempting to seduce you through vivid descriptions of erotic activity. At any rate, during the rest of the session Anna described a party at SII involving pornographic videos and marijuana smoking in a conference room there after hours. Anna is admitted to this strange, all male sexual ribaldry that goes on in the programming department of SII. The men were describing, in their gender specific manner, their sexual preferences, fantasies, and desires. When it was Anna's turn, she opened up with a revelatory dream that she had, and she shocked them. It was not what they were expecting and they clearly didn't know how to react at the depth of Anna's sexuality revealed by the dream. So they ridiculed her as weird and perverted. Anna felt mocked by the group of males. As she was already depressed, Anna might have amplified their remarks, but in any case she left upset. The dream which brought on their derision involved Anna having a sexual relationship with an animator who donned a costume to become his famous animated character--a goofy, compassionate, and intelligent dog. I thought the choice of the dog as the animated animal is telling--a dog suggests absolute loyalty, devotion, and lifelong commitment.

Friday, October 11, 1996

I received an addition to Joseph's personnel file dated September 5, 1996. A couple of interoffice memos have made their way into his record--one from his supervisor who was upset when Joseph came into his office ranting about his plans for improvements and the other the response from higher management. I remember Joseph talking about having a conversation with his boss about some of his suggested improvements during his session at the time and I wondered then whether there were going to be any repercussions. Higher management is going to overlook this incident, although the memos did end up in Mazurka's personnel file.

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