Transcript of 5th Session between Charles Balis, M.D. and Ms. Anna Green, Thursday, August 1, 1996 at 4 pm.

Ms. Green: Hello, Doctor. How are you?
Dr. Balis: Hello, Ms. Green. I'm well, thank you. How are you?
Ms. Green: I'm having some problems.
Dr. Balis: Would you like to talk about them?
Ms. Green: Yes, actually I would. I think they might actually be medical problems.
Dr. Balis: Oh?
Ms. Green: Yes. When I first came to see you I was all wired up, you know? Like a spring compressed to its maximum point. I was tense and nervous. My mind was wandering all the time. Well, things have changed a bit.
Dr. Balis: Can you describe the changes?
Ms. Green: I think so. I think I'm a lot less fixated on Bill now, you know? I don't spend all my time talking with him anymore. I mean, it's not like I'm not talking to him but I am talking a lot less.
Dr. Balis: That's good.
Ms. Green: Yes. I think it's good too. But now, it's as if there is this great void. When I was with Bill, we spent all our time together. We would have dinner together and watch movies in the evening. We would go out for lunch. At know. Even during the day, when we were both at work, we would still find time to spend a few minutes together here and there. It's like he was...he became my addiction. When I had any free time at all, I would go and spend it with him. Or I would want to spend it with him. Now, there is this emptiness. And I even feel it in my stomach, you know? Like I'm anxious or something all the time. It's better when I am at work. I can concentrate on what I'm doing and I can keep this empty feeling at bay for a while. But when I am at home, it's really hard. You don't know how many nights, when I couldn't sleep, I dialed your number. I just wanted to hear your voice, you know?
Dr. Balis: Why didn't you actually call me?
Ms. Green: I was too embarrassed. I didn't really have anything to say. I just wanted to be close to you somehow. You make me feel...I just feel better when you are around, you know.
Dr. Balis: It's my job.
Ms. Green: I know. But it feels more somehow. When I work late into the evening, and I do lately, I sometimes stare into your windows.
Dr. Balis: Can you see anything?
Ms. Green: I saw you talking on the phone. And once I think I saw Ms. Bows in your office. I'm surprised she is your patient. She seems so together, you know?
Dr. Balis: Hmm.
Ms. Green: I don't care really--we all have problems and she is lucky to have you, Doctor Balis.
Dr. Balis: You were telling me that you have been having troubles sleeping?
Ms. Green: Not exactly. I have problems falling asleep. I work really late so I can get very tired. Then when I get just feels like I'm too tired to sleep. I'm tired and want to sleep but can't. Do you understand?
Dr. Balis: It's a pretty common side effect. It's almost like the grief associated with losing a loved one. You have gotten used to a certain regime while you were with Bill and now you have to learn how to live alone again. I know it might be hard to believe now, but with time these sleep disorders will pass.
Ms. Green: But there is more, Doctor. When I do fall asleep, I could sleep for 24 hours or more. It's so very hard to get out of bed in the morning. I just feel so tired. My whole body hurts and I just want to be horizontal. I was late for work three times last week. I mean, it's not like anybody in my department really cares when we come in. We all have such different schedules. But for me I was late. And when I'm finally at work, I feel like I'm too tired to think even, you know?
Dr. Balis: There is a supplement available over the counter called melatonin which you might try. There's considerable evidence that it helps people fall asleep. I take it sometimes when I have difficulty falling asleep. I've found that it works great for me. You can get it in almost any drugstore. It works about half hour after oral ingestion and since it's not a narcotic or a sleeping pill, it doesn't leave you drowsy in the morning. If melatonin works for you, maybe we can stabilize your sleep cycle. If you actually get some quality sleep at night, you might feel much less tired during the day. I'd also suggest limiting you caffeine intake. Drinking too much coffee and other caffeinated products like Coca Cola can contribute to making you feel edgy and can interfere with your sleep cycle.
Ms. Green: Melatonin. I will try it tonight. It would be nice to get a good night's sleep. I think the last really good night's sleep I got was when I spent the night with Caren.
Dr. Balis: Oh?
Ms. Green: It's not what you think! This was a couple of weeks ago. I had dinner over at her place and ended up spending the night. We slept together in one bed. We didn't do anything, we just slept. And it was good to hear another person breathing and to feel the warmth. It calmed me down somehow, you know? When Bill and I were together, I used to cuddle up with him during the night. It just made me feel good all over, you know?
Dr. Balis: People need people. It's in our nature. You are going through a rough period in you life. It's natural to want to reach out to others for help. And now that we are talking about it, how is your relationship with Caren?
Ms. Green: What do you mean, Doctor?
Dr. Balis: During our last session, you expressed concerns that your relationship with Caren might be in some jeopardy after your sexual encounter with her.
Ms. Green: Oh that. It's perfectly okay.
Dr. Balis: Did you talk with Caren about it?
Ms. Green: No, not really.
Dr. Balis: Do you think you should tell Caren about how you felt?
Ms. Green: No. What happened happened and...well...never mind.
Dr. Balis: Is there something you want to tell me?
Ms. Green: I don't know. I have a feeling if I tell you, you would be angry at me.
Dr. Balis: Anna, I am here to help you, not to get pass judgment on your actions. I think it's important to talk about your relationship with Caren. Caren is an important person in your life, part of your support structure that you need more than ever after your breakup with Bill. Now is there something you'd like to talk to me about?
Ms. Green: I guess so. Remember when I told you about Caren and me? Well, she told her boyfriend about it.
Dr. Balis: Did that upset you?
Ms. Green: No. I told you that I believe in a rich fantasy life. And if telling Greg about us made Caren happy, then I have no objections. I wouldn't want everyone to know. But I would have told Bill about it and I'm not surprised that Caren told Greg. But Greg, well...I really feel bad telling you this, Doctor. But Greg...he liked it. I mean he liked it a lot. He said that he would have liked to have been there. You understand? He wanted me and Caren to do it with him.
Dr. Balis: I understand. Did they ask you?
Ms. Green: Caren came over to my apartment last Saturday. She brought me some bagels and we had coffee together. She asked me how I liked Wednesday. I said that it was fun. I mean, what else was I going to say?
Dr. Balis: Hmm.
Ms. Green: I had to. I went through all that lying already and I couldn't stop then. So she asked how would I feel if we do it again and have Greg watch. I said that I wouldn't feel good about that. But she told me that Greg has been asking her to do this for a long time now and that she would rather do it with me, a person she loved, than with some stranger who might have disease or something or would try to take away Greg from her. And after a while it made more and more sense to me. Plus she kept on saying that if I liked it anyway, it wouldn't be all that different. And that she would consider it her duty that I have a good time, if you know what I mean.
Dr. Balis: Did you tell her the truth?
Ms. Green: No. Greg came and brought dinner that evening and they both stayed the night.
Dr. Balis: What happened?
Ms. Green: We drank some wine and then smoked some pot. Please don't think that I'm a drug addict. I just do it occasionally and I never touched anything but pot including cigarettes. In fact I hate the smell of cigarette smoke.
Dr. Balis: I don't think you are a drug addict, Ms. Green.
Ms. Green: Well, pot always makes me feel a know. And both of them just kept on talking about it. Telling me what they wanted to do and how I shouldn't worry about anything and that I will really enjoy it. And somehow Caren was just wearing her jeans and not even a bra. And she was kissing Greg. And then they both came over to me and started to kiss me. And Greg was slowly unbuttoning my shirt. And then we were all naked. And then they were kissing me and touching me and I was feeling sort of dizzy. But then Greg started to make love to Caren and I just got really uncomfortable. I felt like an outsider. Very awkward and not knowing what to do with myself. Finally, I just left and got into the shower. With the running water, I couldn't hear them and I wanted to get really clean for some reason. It was as if I wanted to wash away all the kisses and all the caresses they gave me. When I came out, they were asleep on my couch. I put a blanket on them and went to bed. Luckily, pot also makes me very sleepy so I slept until morning. On Sunday, Greg invited me to breakfast with them. But I still felt like I was...I don't know...unnecessary somehow...not really wanted. So I stayed home. So do you hate me?
Dr. Balis: No. But I think we have some work to do. You should be able to say no to sexual situations that aren't what you want. Do you agree?
Ms. Green: Yes, I agree.
Dr. Balis: We're out of time now. So in the next couple of days I would like you to try melatonin and see if it helps you sleep. And I really would like you to call during the week. Especially if you think you are about to do something you don't want to do. Okay?
Ms. Green: Yes, Doctor.
Dr. Balis: I will see you the same time next week? That will be August 8th at 4 pm.
Ms. Green: Yes, Doctor. Goodbye.
Dr. Balis: Goodbye, Ms. Green.
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