Transcript of 16th Session between Charles Balis, M.D. and Ms. Anna Green, Thursday, October 17th, 1996 at 4 pm.

Ms. Green: Hello Doctor. Isn't this a beautiful day? I love this time of the year in San Francisco--everything is bright and sunny and yet there is a certain autumn chill in the air.
Dr. Balis: Hello Anna. You sound in a very good mood today.
Ms. Green: I am Doctor. I bought a sandwich and went out on the waterfront to eat my lunch. It was so nice with the sun and the birds and the ships going by.
Dr. Balis: I'm glad you had a good time. I was a bit worried about you.
Ms. Green: You mean the last session? You made me feel a lot better. It was nice to hear that you actually care about me.
Dr. Balis: I do very much. I would like to talk to you about some of your fantasies today.
Ms. Green: I knew the animated dog would make you think that I was a bit out there. Is that what you want to talk to me about?
Dr. Balis: Actually I just wanted to talk about fantasies in general. What do you think a fantasy is?
Ms. Green: Well it's a dream, I guess. Although sometimes fantasies happen when you're not asleep, so maybe fantasies are just unexpected thoughts and visions that come to mind.
Dr. Balis: Do you believe that a person has no control over their fantasies?
Ms. Green: Not exactly. I think that there is an initial thought that starts the fantasy and after that a person has some degree of control. Also the amount of control we have over a fantasy depends on when it happens. If I'm asleep, I have little control over which direction the fantasy will take. But If I'm awake or only sleeping half-way, then I'm like a movie director. I can change the storyline, or I can change the way the story is told--like taking multiple takes of the same scene, or I can play the same scene over and over again if I really enjoy it. I always assumed that everybody did this, right?
Dr. Balis: Some people have more control over their fantasies and some less. I think you are right and it very much depends on whether a person is sleeping or awake. What I would like is for you to give examples of the kinds of fantasies you are having.
Ms. Green: Well I told you a few of my fantasies. The animated dog is one.
Dr. Balis: Are there others?
Ms. Green: I told you about the catacombs in Paris and the alien patrol ships.
Dr. Balis: With both of these fantasies you had a lot of control over their direction. You even mentioned trying to make the fantasy or dream happen again and again over a series of nights.
Ms. Green: Yes. I like those type of fantasies the best. I like to have control and watch them again and again if I want to.
Dr. Balis: What about fantasies or dreams that you don't have control over?
Ms. Green: I have a fair number of those as well. A lot of times though, when I wake up I know I had an interesting dream, but it seems to slip away as I get more awake. I try to remember what has happened but I cannot.
Dr. Balis: That's fairly common with dreams. People have far more dreams during the night than they ever remember having.
Ms. Green: Sounds like we are missing out on a lot of fun.
Dr. Balis: Do you sometimes try to initiate a fantasy?
Ms. Green: You mean like daydreaming?
Dr. Balis: Do you daydream?
Ms. Green: Yes I do. A lot as a matter of fact. I find that it is a good way of relaxing and switching gears, so to speak, at work.
Dr. Balis: Do your fantasies feel real to you?
Ms. Green: I'm not sure what you mean. But when I was a little girl, I remember making up stories and telling them to my parents and after a while I couldn't tell if what I was saying to them was real or just my imagination. It was almost as if when I thought about something for a long time and talked about it, it became real. I know that in some instances I would have passed a lie detector test.
Dr. Balis: Do you still have problems telling the difference between reality and fantasy sometimes?
Ms. Green: You mean am I crazy? I don't think so. I was a kid when I did that. Probably all children do it. It doesn't mean that they turn out to be crazy.
Dr. Balis: I don't think you are crazy Anna. I just wanted to find out if some of the fantasies that you have as an adult now take on the same quality of reality as those childhood stories you told to your parents.
Ms. Green: You mean if after a long exposure to a fantasy I begin to believe that it's real?
Dr. Balis: Yes.
Ms. Green: No. I'm pretty sure I can tell the difference between reality and fantasy. But why are you being so weird today, Doctor? Did I do something to make you believe that I'm delusional?
Dr. Balis: No. I just wanted to know...
Ms. Green: About my dreams? I would be happy to tell you all my dreams Doctor. You just have to promise not to throw me out. Quite a number of them are about you.
Dr. Balis: Hmm. Let's talk a little about the sexual fantasies that you have when you are awake.
Ms. Green: Doctor I thought you'd never ask. I would be delighted!
Dr. Balis: Okay. Over our sessions together, you have told me quite a number of fairly erotic stories about yourself. It's quite natural for people to exaggerate some parts of their stories to make them more interesting to their audience.
Ms. Green: Doctor are implying that I lie to you?
Dr. Balis: No. But I'm interested in whether you sometimes exaggerated your stories?
Ms. Green: Well, sometimes I omit certain details that I don't think are important to the overall story.
Dr. Balis: Hmm.
Ms. Green: I might have on occasion over described certain things.
Dr. Balis: Like what things?
Ms. Green: Doctor I feel like you are angry at me. You are making me very uncomfortable.
Dr. Balis: That's not my intention at all Anna. I'm sorry if I'm making you feel bad. I'm just trying to understand you. I was thinking about you this week and upon going over my notes I realized that it might be an interesting exercise to talk about fantasies. You seem to have a very rich fantasy life and I think it's important that we explore it during our sessions. Don't you?
Ms. Green: I guess Doctor.
Dr. Balis: So I though we would talk about some of the stories you told me and...
Ms. Green: Check how much of my stories are real and how much of them are just my fantasies?
Dr. Balis: Are some of your stories fantasies Anna?
Ms. Green: I...I...maybe partially.
Dr. Balis: Well why don't we pick one. How about the story about you and Caren going skinny dipping in Lake Anza?
Ms. Green: We had a really good time.
Dr. Balis: That's good. Did you actually go in the water?
Ms. Green: I did.
Dr. Balis: Did Caren?
Ms. Green: Well, she sort of stayed on the beach as a look out.
Dr. Balis: So she didn't get in the water.
Ms. Green: No, actually she didn't.
Dr. Balis: So Caren didn't swim out to the float with you and the young man you were with?
Ms. Green: No she was on the look out for rangers. We were very scared of getting caught.
Dr. Balis: That's fair enough. Did you and the young man you were with engage in any sexual activities?
Ms. Green: We kissed.
Dr. Balis: Anything else?
Ms. Green: I touched him.
Dr. Balis: You touched his genital area?
Ms. Green: I came close.
Dr. Balis: Okay. Why do you think you expanded on your story when you told it to me?
Ms. Green: I thought it was more interesting that way. And I thought about doing all the things I told you about. I just didn't actually do them at the time.
Dr. Balis: Do you feel like that by telling me the story with sexually explicit elaborations you made it more interesting for me?
Ms. Green: I hope it was more interesting that way. It is more interesting to me. And that is how it could have happened.
Dr. Balis: But it didn't?
Ms. Green: No. But I thought about it a lot and that is how it should have happened.
Dr. Balis: Why should it have happened that way?
Ms. Green: Because if it was someone else--other than me I mean--they would have made love out under the stars and it would have been very romantic.
Dr. Balis: So you don't think that swimming naked with a man out at night into the middle of a lake and kissing and touching him is romantic enough?
Ms. Green: Sounds pretty good when you say it. But I think it's better my way.
Dr. Balis: It might be a better story, but you have represented it as completely true to me. I have no way of telling apart which parts of your stories are real and which are fantasies.
Ms. Green: Does it really matter though? It is all about how I feel and how I view my world. What difference does it really make?
Dr. Balis: Some of the stories you related to me are about you getting hurt or abused. I would like to know if the abuse is real or part of your fantasy life. Don't you think it is important for a therapist to know whether his patient's suffering has external origins or whether it is partly self inflicted?
Ms. Green: I see your point. But if I'm describing an event that caused me pain, I'm describing it in way that is most comfortable for me.
Dr. Balis: You once talked about an unwanted sexual encounter with Caren. That wasn't really true, was it?
Ms. Green: Did you speak with Caren? Is this what this is all about? Did Caren tell you something about me? I'll kill her!
Dr. Balis: This is not about Caren. I just wanted to know if you really had sex with her or if what you described to me was a fantasy.
Ms. Green: She called and told you that I'd been lying to you, didn't she? What a bitch!
Dr. Balis: I'm not talking about Caren. I want to know about you Anna. You described to me a situation which you went along with Caren's desire to have sex with you merely to avoid hurting her feelings. Did you actually allow Caren to make love to you?
Ms. Green: It doesn't matter!
Dr. Balis: Anna I need to know what is the truth. If you are having destructive fantasies about your sex life we need to talk about in our sessions. Fantasies of submitting to unwanted sexual advances are quite different from actually being powerless to stop unwanted sexual advances in real life, don't you think?
Ms. Green: I could have said no. I chose not to.
Dr. Balis: But you said that you hated it and couldn't wait for it to be over with. You even spoke about faking an orgasm to expedite the conclusion to this act.
Ms. Green: I think it was a reasonable thing to do.
Dr. Balis: I'm not talking about that. I want to know if it in fact happened the way you described it to me.
Ms. Green: I'm not sure. I guess most of it.
Dr. Balis: Most of it was real or most of it was fantasy?
Ms. Green: I don't know Doctor. Stop it!
Dr. Balis: You never had sex with Caren, did you?
Ms. Green: Stop it Doctor!
Dr. Balis: Okay, let's stop for today. But I will be coming back to this subject during our next session.
Ms. Green: I don't know about that.
Dr. Balis: Well we can try, okay?
Ms. Green: I'll think about it. Next week at the same time?
Dr. Balis: Yes. Thursday the 24th at 4 pm. And please Anna, my goal is not to make you upset. I just want to understand you and help you to understand yourself better. I think you'll have healthier relationships in the future if we can do that. Okay?
Ms. Green: Okay.
Dr. Balis: Goodbye Anna. Call me if you need to.
Ms. Green: Goodbye Doctor.
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