Transcript of 17th Session between Charles Balis, M.D. and Ms. Anna Green, Thursday, October 24th, 1996 at 4 pm.

Ms. Green: Hello Doctor. Are you going to make me feel bad again today?
Dr. Balis: Hello Anna. It's never my intention to make you feel bad.
Ms. Green: That's not true. Last session I felt like you were interrogating me. You were trying to make me say that I was lying to you or something. Isn't that true?
Dr. Balis: I was just trying to talk to you about the difference between reality and fantasy. Both are very important. But it is also important for me to know which you are talking about. I honestly wasn't trying to make you feel bad, Anna.
Ms. Green: I see.
Dr. Balis: For example, last time we talked about you and Caren and whether she actually did make love to you. I believe you admitted that it didn't actually happen the way you described it to me.
Ms. Green: That's not true, Doctor.
Dr. Balis: You mean Caren did make love to you?
Ms. Green: No. You know what I mean.
Dr. Balis: Hmm?
Ms. Green: I never told you--admitted, the way you put it--that Caren didn't actually make love to me. You are trying to manipulate me to tell you something wasn't true. I don't know why you think you can play these kinds of games with me, Doctor. Do you think that I'm dumb or have a poor memory or something?
Dr. Balis: No Anna. I think you are extremely smart. But I am worried that your fantasy life might be interfering with your real relationships with people. I am also worried that some of your fantasies are about self-destruction.
Ms. Green: How would you know if you think that I'm a liar?
Dr. Balis: I don't think that you are trying to deceive me on purpose. I think that your stories sometimes get away from you. You lose control and reality and fantasy mix together.
Ms. Green: You told me that you liked me! And now you're saying that I'm crazy? That I don't have a good grasp on reality? Which is it Doctor?
Dr. Balis: I do like you Anna. I was hoping that by now, after all this time together, you would believe me.
Ms. Green: Well I love you Doctor. And I was hoping that after all this time together you would notice.
Dr. Balis: Anna, we talked about this before. You know the rules. We can never have a relationship. Even if I stopped our sessions right now, I would always have been your therapist and as such could never hope, dream, or even think about a relationship with you other than that of a therapist and a patient. You do understand?
Ms. Green: I'm not sure. It seems like psychiatrists wouldn't have such unrealistic expectations of humans and their behavior. What if I go away and have plastic surgery. I'd look like a completely different person and then we meet again about twenty years from now. We fall in love but you never know who I am. We get married and, after our first anniversary, I tell you that I used to be your patient. What would you do, divorce me? What if we have children together by then?
Dr. Balis: That's quite an elaborate set of circumstances. Do you think that two people could love each other and get married if one of them is lying the entire time and pretending to be something she is not?
Ms. Green: Here you go again--accusing me of lying.
Dr. Balis: No. I was working within your fantasy. Do you think that two people could really be in love if their relationship is built on a lie?
Ms. Green: I don't know. Well maybe not. But what if I don't remember you. What if the reason that I had the plastic surgery was because I was in a terrible accident. Let's say I was in a plane crash and survived but lost part of my memory. Then the relationship would not be based on a lie. And would it be fair to get a divorce because of a misunderstanding?
Dr. Balis: Well, if you lost all your memories of our sessions together and I had not recognized you as Anna Green, I suppose we would be able to stay married and keep our children.
Ms. Green: Doctor you are making fun of me.
Dr. Balis: Don't you think that this elaborate hypothetical is a little absurd?
Ms. Green: I admit--it's a little far fetched. But it could happen.
Dr. Balis: In a soap opera maybe.
Ms. Green: Well, in a soap opera I could even be dead for a couple of years and then come back and marry you. There are no laws about marrying dead people are there?
Dr. Balis: I don't know, that's not my speciality. I'm glad you're not as angry at me anymore.
Ms. Green: I'm not good at staying angry with people. I'm far better at being hurt and feeling pain for a long time.
Dr. Balis: I sincerely hope that I will never be a source of pain for you Anna. I really care a lot about you and what happens to you.
Ms. Green: Thank you Doctor. I want you to care about what happens to me. I want you to care a lot.
Dr. Balis: Is it why you tell me your fantasies?
Ms. Green: Maybe. I always wonder about how you look at the world. You see people that are screwed up or disturbed in some profound ways. I know you have been seeing Helen, the janitor woman. She is really out there and needs your help. I'm...there isn't very much wrong with me, other than having zero ability and no skill for developing relationships. But that is not very serious. Why waste your time on me? You must have better things to do.
Dr. Balis: I don't feel like I'm wasting my time during our sessions. I would love very much to help you. I think you are a beautiful, sexy, smart, and very sensitive woman. I would like to help you find confidence and feel secure in your relationships with other people. Do you think our sessions are helping you?
Ms. Green: I don't know. I think so. I was very upset with you last week, so it's hard for me to tell you today how beneficial our sessions have been.
Dr. Balis: That's fair. Maybe after you think about it.
Ms. Green: I had a fight with Caren last week because of you too.
Dr. Balis: I'm sorry to hear that. Caren is a very good friend of yours and she cares very deeply about you. I hope you worked things out.
Ms. Green: Not all the way. I think that some things are very personal and a therapist is one of them. I think it was very wrong of Caren to call you.
Dr. Balis: She was just trying to help.
Ms. Green: She stepped over the line--there are some things that even a friend should not interfere in. She's done it before too.
Dr. Balis: What did she do?
Ms. Green: When I got pregnant with Bill, I told her about it. I wanted her support and sympathy I guess. But she was very weird about it.
Dr. Balis: Did she...
Ms. Green: She just got too involved in the whole process--started to tell me what I should and shouldn't do. Got very offended when I told her that I needed to do things my way. Stuff like that.
Dr. Balis: Could you give an example?
Ms. Green: I had a very bad abortion. I went to this doctor and he yelled at me for taking so long to make up my mind.
Dr. Balis: What do you mean?
Ms. Green: I got the abortion at the end of the first trimester of pregnancy.
Dr. Balis: Why did you wait so long? It's more dangerous...
Ms. Green: I know. I know. But I wasn't ready before then. It's a hard thing to do and Bill was also...well you know the story.
Dr. Balis: A little. What happened to you after the abortion?
Ms. Green: I got very sick. I kept bleeding for three months. It was bad.
Dr. Balis: Did you go back to the doctor? Did you seek medical attention?
Ms. Green: I felt really bad for what I have done really not going to like this Doctor.
Dr. Balis: That's okay.
Ms. Green: I just sort of felt like I deserved it.
Dr. Balis: You thought that you deserved to be in pain and to be sick?
Ms. Green: Like a punishment or something.
Dr. Balis: Do you know what was wrong with you?
Ms. Green: I was taking some night classes at the time so I just went to see the school nurse. Caren went with me. She insisted. The nurse took my blood to check for hormone levels or something. I was too out of it to really pay attention. The next day I got a call from the school's infirmary. They said that my hormone levels were not dropping back to normal--there was a possibility that abortion didn't go through or something.
Dr. Balis: You mean they told you you might still be pregnant after the abortion?
Ms. Green: Something like that. I had these images of a baby all torn apart inside of me, bleeding to death. It was horrible.
Dr. Balis: Did the nurse call your doctor? The one who performed the abortion? They always check. The doctor should have been contacted if there was something wrong.
Ms. Green: No. They kept taking my blood every day for the next couple of weeks--keep checking those hormone levels. My arms began to look like I was addicted to heroin or something. I had these blood pockets under my skin that would form on their own and just move around and down my wrists. I had to wear long-sleeved shirts.
Dr. Balis: That nurse didn't know what she was doing. It's outrageous what they did to you.
Ms. Green: Eventually they called the doctor and I came to see him again. I really didn't want to do it because that whole place was just gave me the creeps.
Dr. Balis: Did the doctor find out what was wrong with you?
Ms. Green: Not really. He did tell me that I didn't have a dead fetus inside of me. That was good. But he didn't know why I was bleeding so much. He ended up giving me birth control pills. He said that they would stabilize my hormones and end the bleeding. It worked.
Dr. Balis: And the entire time you felt like you were being punished?
Ms. Green: Yeah.
Dr. Balis: And how did Caren interfere with your getting help?
Ms. Green: She was just too pushy. I wanted to be left alone. As I said, I wanted to be punished. What I did was a pretty horrendous thing to do. She just kept bothering me. She had no idea how I was feeling. She went too far and I told her that.
Dr. Balis: So is Caren upset with you now?
Ms. Green: No, not really. We had it out and cried together. She thinks that we are okay now.
Dr. Balis: But you don't?
Ms. Green: I don't know. I guess we are okay. I just don't think I can trust her any more.
Dr. Balis: I think her motives were good.
Ms. Green: It doesn't matter. There are personal boundaries that even good friends have to observe. You should know that Doctor. You are full of personal boundaries.
Dr. Balis: Well we can talk more about it during our next session. Next Thursday, October 31st at 4 pm?
Ms. Green: Actually I would like to change that session to another day. It's Halloween and I would like...
Dr. Balis: No problem. I didn't realize it was a holiday.
Ms. Green: This is San Francisco. Have you been here for Halloween before?
Dr. Balis: No.
Ms. Green: You are in for a treat. Or a trick, depending on your point of view. Halloween is San Francisco's big holiday. Like Carnival in Rio.
Dr. Balis: Do you want to cancel all together or would you like to come in on Friday? I usually don't take patients that day, but I will be here anyway. How about 4 pm on Friday the 1st?
Ms. Green: That works for me. Thank you for being flexible Doctor.
Dr. Balis: No problem. Goodbye Anna.
Ms. Green: Goodbye Doctor. Enjoy Halloween!
Dr. Balis: Oh wait a minute Anna. You mentioned Helen before. Do you know what happened to her?
Ms. Green: Not really. She seemed to disappear. At first everyone just thought that she was sick or something. But after she stopped coming to work for a week we just assumed that she just took off or something. She was very strange, you know.
Dr. Balis: Did she ever just take off before?
Ms. Green: I don't know. I suppose so. Oh and the police came about two weeks ago to ask about her.
Dr. Balis: I didn't hear about that.
Ms. Green: Well you're not in the building, thank god. They just asked some questions but nobody knew anything. You think something happened to her?
Dr. Balis: I don't know. But thank you for telling me about Helen.
Ms. Green: No problem Doctor. Have a good weekend.
Dr. Balis: You too.
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