Transcript of 12th Session between Charles Balis, M.D. and Ms. Rachel Tanner, Friday, May 15, 1998 at 3:00 pm.

Dr. Balis: Rachel, you look well. Hello.
Ms. Tanner: I feel pretty good. I survived two midterms and one paper. Another speech is due next week. I've been busy.
Dr. Balis: Now I feel bad about the assignment I asked you to write.
Ms. Tanner: Don't. It was an interesting diversion. You're in it. So is Evan. I still have this major fantasy about him. I got his e-mail address, and now I'm sending him stuff. It's not really that personal, yet. He's into games and jokes, and there're a lot of those on the Net.
Dr. Balis: So your future includes Evan?
Ms. Tanner: This particular future does. Let me read you my poem first, though. May I?
Dr. Balis: Poem? Certainly.
Ms. Tanner: It's called "Suicide." "Can Rachel come out and play? Try it again. Can Rachel come out and play yet? Stop the tape. Try it again. Why is your mom rocking? Rewind the tape. This isn't right. Do it again. Why is your mom sitting in the car? Check the stove, Babydoll. Michael, did you lock the door? It has to be perfect. Momma has to check. Why is your Momma crying? Rewind. Be a good girl, Rachel. Checking. Checking. You can do better than that. Stop the tape. Get out of the car. Stop the car. I'm sorry, Momma. Fast forward."
Dr. Balis: That's haunting.
Ms. Tanner: By repeating certain phrases, I was trying to create a mood, a tempo.
Dr. Balis: It's very revealing, even though I already know your story. It reads well out loud. And I like how you changed your voice for the little girl. It seems that there were many voices.
Ms. Tanner: Do you think the title makes it too obvious?
Dr. Balis: I think it would be a lot tamer without it. The reader wouldn't know how tragic it was. Have you shared it with your writing group?
Ms. Tanner: Not yet. Do you think I should?
Dr. Balis: It's up to you. It might bring some questions and attention your way. Rachel, was there something that made you think about your mother?
Ms. Tanner: I think about her every day.
Dr. Balis: Do you think about her suicide every day?
Ms. Tanner: No. It just needed to be said. My first poems are probably going to be about the most important things. I've been carrying around a lot of stuff. I've found writing to be a good way to let it out.
Dr. Balis: What else are you carrying around?
Ms. Tanner: You know about my baggage: the OCD comes through in everything I write so far; my mom's suicide; trying to please when I was a little girl; my dad...
Dr. Balis: Whom did you please?
Ms. Tanner: Excuse me?
Dr. Balis: You said you were trying to please as a little girl. Whom were you trying to please?
Ms. Tanner: Everyone--my teachers, my mom, my grandma, my brother.
Dr. Balis: Your father?
Ms. Tanner: I suppose even him. He was rarely happy with what any of us did. I kind of gave up trying. Also, I learned to fear him, for obvious reasons.
Dr. Balis: Did any of the other people you mentioned appreciate you? Were your efforts ever acknowledged?
Ms. Tanner: I know my mom needed me. I was her sweetheart, her little helper. But sometimes, she didn't even seem to notice I was around. And other times, I think I was her only friend.
Dr. Balis: Did she depend on you during her illness?
Ms. Tanner: You know what? I was her mom. That's how I felt. Who needed toys? I had a giant rag doll on my hands to take care of.
Dr. Balis: Was she really that incapacitated?
Ms. Tanner: Yes, damn it. I had to hide my mother, cover for her for so many years. I didn't really get to be a kid. And Michael wasn't much help.
Dr. Balis: You sound angry, perhaps even resentful.
Ms. Tanner: I was robbed of some of my childhood. I worried about her so much. At one time she was so beautiful. Look at this.
Dr. Balis: You're right, she is beautiful. Who took this picture?
Ms. Tanner: My dad. It must have been one of her good days. He was parading her around in her yellow dress to match the yellow T-Bird.
Dr. Balis: Were you ever jealous of the attention your father gave her? What I mean is, do you feel like he should have given you more of his time?
Ms. Tanner: No! I didn't want to be around him. Anyway, it would be more accurate to say that my mom was jealous of me. She would always tell me how pretty I was and that I would make someone a good wife. I think she realized that I was more capable and responsible than she was. When she blew it, she blew it big time. So it was always a challenge to get the house and dinner taken care of before the tyrant got home.
Dr. Balis: That is a lot of responsibility for a child to handle. I think it made you more resilient. But it probably contributed to your obsessions. You wanted to get things right. You developed a methodical system that you thought would guarantee a successful outcome and give you control over your life.
Ms. Tanner: Yes, but it didn't turn out just fine.
Dr. Balis: When the system let you down, your obsessions and compulsions doubled in force and necessity. When the rituals didn't work any more, you became desperate and added more and more complex steps. You began to lose track of the right way, because each time you got more and more desperate.
Ms. Tanner: That's when Gram called you.
Dr. Balis: At that point, the consequences and stakes got much higher. You conjectured that harm would come to those you loved. When harm did come--even though logic told you that your mother made her own choices--you blamed yourself.
Ms. Tanner: There's no guarantee that the system will work.
Dr. Balis: It was a house of cards, Rachel. The foundation was weakened. It wasn't you; it was the circumstances around you. You were a child. And now, you are just emerging from a world of pain and starting to live life for the first time.
Ms. Tanner: God, I'm so lucky that my grandmother is able to support me and that she made me see you. I want to see you, now. I certainly didn't the first couple of times.
Dr. Balis: It didn't take you long to accept therapy. You have been more willing than most.
Ms. Tanner: I'm a bit fried. Can we talk about something else?
Dr. Balis: Sure. How's school? Are you still doing yoga?
Ms. Tanner: Yoga is the best. Have you ever tried it?
Dr. Balis: No.
Ms. Tanner: First we go through a variety of poses to stretch, then sun salutations to warm up. Then we focus on shoulder-opening or back bends or something. Then we do Savasana, which is the reward at the end.
Dr. Balis: Reward?
Ms. Tanner: Yes. Remember the relaxation you did with me in an early session? You were trying to get me to rest my hands. I could barely sit still. The way you worked the imagery from one part of the body over to the other was the same thing we do in Savasana. We try to relax everything. It feels like a reward for all the hard work during the previous hour or so.
Dr. Balis: You do yoga for more than an hour?
Ms. Tanner: Yeah. Now it's my turn to give you an assignment. Try it, Doctor. It costs about fifteen bucks a session--a lot cheaper than your rates!
Dr. Balis: Hmm. I'm curious to see what you wrote about the Rachel of the future.
Ms. Tanner: She's not very different. Her circumstances have changed, but not much else. Take a look. It's short.
Dr. Balis: How about if you read it to me?
Ms. Tanner: Okay. "Today my therapist--the thick-haired, oddly handsome Doctor Balis--asked me to predict where my life was going. He gave me an assignment (the nerve!) asking what I thought my future would be, only three hundred and sixty five days away. It's hard to say, but I'm going to try to project. I'm twenty-three. I'm about to finish up the classes required for my A.A. degree. I'm living in Sausalito, working and reading poetry at a small coffee shop. It's the same place where Evan plays guitar on Saturday nights. I do readings at a couple of the bookstores in the city once a month. I don't live with Evan, yet, but we spend every weekend together. I continue with my yoga practice and swimming, doing both at least three times a week. I belong to an OCD support group that meets weekly. I'm still taking Prozac, but I am not seeing Doctor Balis. I e-mail him regularly, more for me than for him. He is kind for writing back, but he never initiates the correspondence. My grandma moved back to Germany because her sister's M.S. required her care. I seem to be doing so well, and my brother and I are quite close, so she felt she could depart. She gave us each a big chunk of money, encouraged us to visit, hugged me once, and said, "Goodbye, my Liebchen," as if it were the last time. The remnants of my disorder are counting steps, brushing my hair religiously, fidgeting with my hands. My obsession with numbers continues--maybe it's a math thing. My obsessions with my hair and nails continue--maybe it's vanity. The point is I control my OCD, not the other way around. Medication and therapy have helped--Doctor Balis was right. I'm very afraid of discontinuing Prozac. I'm afraid of going back. I barely recall the pain, but the memories of events are fresh, and I don't want to repeat them."
Dr. Balis: It seems very realistic. How would you feel without your grandmother?
Ms. Tanner: She's pretty easy to live with. She lets me do whatever I want, drives me around, pays for everything. But I know that it will come to an end someday. She's sixty-five, pretty healthy, but her sister does have M.S., so the scenario might not be that far off.
Dr. Balis: I wanted you to go through this exercise so that a few positive images would emerge. Goals, if you will. I want you to keep in mind the most tangible. Evan may not be a significant part of your life, but I'm sure that finishing school, writing, getting a job will be. The point is that you are seeing yourself successful and making it. And I especially like the part about you controlling your OCD, not the reverse. That was significant. I'd like to keep a copy of this, for future reference, if you don't mind.
Ms. Tanner: Okay.
Dr. Balis: Are you ready to end this session? It's about time.
Ms. Tanner: It's fine with me. Thank you, Doctor.
Dr. Balis: I'll see you in two weeks, Rachel.
Ms. Tanner: Okay, see you then.
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