Transcript of 10th Session between Charles Balis, M.D. and Ms. Cassandra Evans, Friday, May 2, 1997 at 11:00 am.

Dr. Balis: Good morning, Cassie. It's been an awfully long time. Let's see, I last saw you in November. Well, how are you today?
Ms. Evans: Okay, it has been a long time. Well, actually, I'm miserable.
Dr. Balis: I'm sorry to hear that. What's going on?
Ms. Evans: David thought it would be good to get out last night, so we went to a book shop nearby. At first, it was quite nice. We were sitting together quietly. We both love to people watch. I decided to see if there were any new books on the treatment of CFIDS. There was a wacky diet-regimen publication. I mean, none of it made any sense whatsoever--drink a mixture of carrot and banana juices, with a tablespoon of linseed oil. The author's theory was that carrots provide beta carotene which replaces vitamins "sucked-out" by the viruses. Bananas help regulate bowel movements--the elimination of wastes and garbage from the body makes you healthier. And linseed oil...well, the author didn't seem to have a real good reason for using it. You're supposed to stick the concoction in the blender and serve with parsley sprigs. Yuck! At what point do you decide the possible treatment isn't worth all the suffering if there are no guarantees of recovery? How many weird things do I need to try? Oh, the book said not to expect results for six months. Hello?! I don't think so!
Dr. Balis: You're right. It doesn't sound promising.
Ms. Evans: Meantime, David wants me to proofread all of his writing. I don't mind helping when I can--I'm more than happy to do so. But sometimes, I just can't. Do you remember those weird dreams I was having when I used to come in?
Dr. Balis: Yes. You still have them?
Ms. Evans: I get these dreams every once in a while and I'm sure they're trying to tell me something. But I can't figure out what the heck it all means!
Dr. Balis: I'd really rather talk about you and your present situation. It's been an awfully long time since I saw you last.
Ms. Evans: I know. But I feel these dreams are really important. They might be a key to what's going on.
Dr. Balis: Okay, why don't you tell me a little about your latest dream and perhaps we can find some insights together.
Ms. Evans: Let me think...well, last night I had an odd one. I dreamt that I was in a long white hall. I told David about the dream, and he thought it might have been a hospital of some sort. But it didn't have that feeling to me. In the dream, I turned into a doorway; it seemed to be where I was living. There was a man inside preparing a meal, and we greeted each other. Two rats appeared out of nowhere. One was white and the other was black. The man and I were trying to figure out which one was the evil rat. I picked up the black one and stared into its eyes. Next, I did the same with the white rat. The latter gave me the creeps, and I threw it against the wall with all my might. It was obviously injured, but not dead, and it appeared to be growing in size. So I ran over, threw an apron over the rat, and began stomping on it violently, and then stabbing it. The entire time the rat was mocking me. Any ideas as to what this means?
Dr. Balis: What do you think it means?
Ms. Evans: I'm not sure, really. I suppose the violence I was unleashing had to do with my frustrations. The thing that I can't figure out is the significance of the black and white rats. They seemed to be so essential to the story line, something very important. But I don't know why. I mean, it wasn't even like they were in the dream that long. But even while dreaming, I recall knowing that they were important somehow.
Dr. Balis: I see. How do you feel about rats in general? What do they represent to you?
Ms. Evans: Well, they're ugly, disease-infested creatures, and generally mean-natured, I think. Scavengers. Their noses twitch in the weirdest way, like they want to get into everything and...well, like nosey-bodies.
Dr. Balis: Hmm. So you have an association between inquiring--prying and rat imagery.
Ms. Evans: That's right. Like someone is invading my privacy. Or maybe I'm still trying to come to terms with my illness. Maybe I'm being forced to do more than I'm prepared to right now. What do you think, Doctor?
Dr. Balis: These all sound like interesting possibilities.
Ms. Evans: David, although he's a dear, is constantly asking me to try new things, explore all avenues. As far as coming to terms with the illness, I don't see it happening in the near future. Actually, that isn't true. There are days when I'm resolved to whatever God has given me--just make the best of it. Other days, it all feels useless. And then there is the whole Human Resources and Social Security Administration fiasco. I started applying to see if I could get some benefits if and when I can't work. The people there ask so many questions. I know it's their job and all, but it still feels awkward. Then, Elise in human resources wants me to get copies of all the insurance and doctors' reports on my case--"Why can't you just work like everyone else?" kind of thing. Aggravating!
Dr. Balis: So you feel like you're being pestered by people around you?
Ms. Evans: Yes, they're all rats!
Dr. Balis: Okay. What about the color difference of the rats. Do you have any negative or positive associations with these colors? What does the color black represent to you?
Ms. Evans: I'm not sure I understand the question. I mean, the color black is in clothes, jewelry, furniture, wall coverings. In what context do you mean?
Dr. Balis: Let's try this. Close your eyes. Picture the color black in any form. Concentrate. How does it make you feel?
Ms. Evans: Warm. Intrigued. It's mysterious, but not in a scary way. Knowledgeable. It feels safe and inviting, yet still filled with so many things and ideas.
Dr. Balis: Interesting. You seem to have very positive associations with this color. Now picture white. How does that make you feel?
Ms. Evans: Cold. Frightened. In pain. Like being in a hospital. Maybe that's it?
Dr. Balis: Perhaps, let's explore some more. Close your eyes again. Now just talk to me.
Ms. Evans: This scares me. Like something is missing. I can almost hear a small child crying in the background, searching for hope and answers.
Dr. Balis: Do you feel like a small child?
Ms. Evans: Maybe. Hmm...that does make sense, I suppose. I've been trying to live more of a "normal" life lately. Sometimes, I tend to ignore the fact that I'm ill. I don't want to be ill.
Dr. Balis: Of course not. I understand. And I'm sure it will always be a struggle for you. That's normal, considering your situation.
Ms. Evans: But the white rat.
Dr. Balis: What about it?
Ms. Evans: It was mocking me. Like it was better than I am. That makes me so angry. I'm not a very violent person, I don't think. But I just wanted to kill that thing--that rat. I feel badly about it. I mean, it's a living being. Doesn't it have the right to pursue its own happiness? But if its happiness causes me distress, then how do I deal with it?
Dr. Balis: You may associate people who question your illness with this white rat. It's natural that you would feel angry at them for doubting your physical condition. You might even feel jealous of them for being so healthy themselves--so healthy that they are incapable of understanding how you feel. If you have this dream again, try following it through further. Keep some paper handy, and if something strikes you as important, jot it down. Whatever comes to you--a feeling, an answer. And then we can discuss it next time, okay?
Ms. Evans: Okay.
Dr. Balis: How are you doing? Are you getting tired?
Ms. Evans: Truthfully, I am kind of wiped out. I'd really just like to lie down, rest my mind some.
Dr. Balis: I can see you're getting pale. Perhaps it would be better to stop here.
Ms. Evans: Yes, I think so.
Dr. Balis: How are you getting home?
Ms. Evans: David is coming by, but he probably won't be here for another ten or fifteen minutes or so.
Dr. Balis: I see. Why don't you lie down and I'll dim the lights. You can rest until David arrives.
Ms. Evans: Oh, that would be a lifesaver. Thank you, Dr. Balis. You're a very sensitive and kind man.
Dr. Balis: Thank you, Cassie.
Ms. Evans: No, no, I mean it. You're just very empathetic. You know life is not easy and can be harder for some people than others. You know that we all need a little help from time to time.
Dr. Balis: Now rest, Cassie. Do you want to schedule our next session now or would you rather call me to set it up?
Ms. Evans: I have to arrange my transportation. Do you mind if I call once I have discussed it with David? I can find out which days work for him and...
Dr. Balis: No problem, Cassie. Call me when you know when you can make.
Ms. Evans: Thank you, Doctor.
Dr. Balis: Now try to get some rest, Cassie.
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