Transcript of 15th Session between Charles Balis, M.D. and Ms. Rachel Tanner, Friday, July 24, 1998 at 3:00 pm.

Ms. Tanner: Hi.
Dr. Balis: Hello, Rachel. How are you?
Ms. Tanner: Fine.
Dr. Balis: Good. Hmm. You have a look...
Ms. Tanner: Do you mean I look like the cat that ate the canary?
Dr. Balis: Something like that. What's up?
Ms. Tanner: I have something to share.
Dr. Balis: I'm listening.
Ms. Tanner: I'm exploring my sexuality.
Dr. Balis: I see.
Ms. Tanner: With a woman.
Dr. Balis: Hmm.
Ms. Tanner: I knew that's what you would say! You always do that when you don't want to reveal what you are really thinking.
Dr. Balis: I want to give you room to talk about it.
Ms. Tanner: Okay. Where do I start? We went out for beer after class with a couple of other people. They left. We stayed and had another. She said that her daily swim would be a challenge. I said not really, especially if we went to my house. Gram was...she's in Germany. So Carla followed me home. We laid in the sun, swam, talked...
Dr. Balis: Sounds like you were comfortable with each other.
Ms. Tanner: She is easy to talk to. I have to admit that ever since she showed up at the school's pool, I've been thinking about her. That look she gave me was so intimate. It was like that time when Evan was staying at the house and I came out in the hallway in just a T-shirt. Instead of looking away, I dared to make eye contact with him--what a rush! I'm somewhat of a tease, I guess. Anyway, there I was laying face down by the pool, in the sun, wet with goose bumps, eyes closed. She started putting on some sun lotion, and then she rubbed some on me. I rolled over and things progressed from there.
Dr. Balis: Did you have any problems being that intimate?
Ms. Tanner: I'll tell you about that in a minute. She was so sensual. I keep thinking about how her hands felt on me. It was all hands and fingers. There were a lot of firsts, if you know what I mean.
Dr. Balis: So you were able to relax and enjoy her touch?
Ms. Tanner: Oh yeah.
Dr. Balis: Are you able to relax around her now?
Ms. Tanner: I haven't seen her since then, but I've talked to her on the phone. She's coming over again on Sunday. It's a really weird feeling.
Dr. Balis: How so?
Ms. Tanner: Well, it's exciting but weird. She's a woman and...well, women and women aren't your usual combination. She's older; she's my teacher. And because Gram is gone, I feel like I'm getting away with something I'm not supposed to be doing. And we were outside in front of God and everyone! But as far as the contamination thing, it hasn't really been a problem yet.
Dr. Balis: Yet? Do you expect it to be?
Ms. Tanner: Well, I felt safe. I think it was because we were at my place. The pool made it feel familiar somehow. And having the water nearby made it feel cleaner. Plus, we only used touch--there wasn't any exchange of bodily fluids. But if we were just on a couch or a bed, and if it involved something like kissing...well, I think I might have trouble with that.
Dr. Balis: Why?
Ms. Tanner: Well, uh...
Dr. Balis: Let me ask another way. Was cleaning up after the event something you just couldn't wait to do? Did you need to wash your hands right away? And was it ritualized at all?
Ms. Tanner: I washed my hands first, then I took a shower. Neither one was any different than it has been lately. There was nothing like what I did before I started therapy.
Dr. Balis: Do you think kissing might generate the urge to wash or brush?
Ms. Tanner: Probably. And floss.
Dr. Balis: You're giggling; that's a good sign. Rachel, personal hygiene is important to most people, especially when intimacy takes place. However, if you feel the need to repeat or ritualize cleaning and washing up, I want to know about it. This is one of those tests for you. It's much like becoming a student again, or swimming in the school's pool, or using a public restroom. By the way, do you know how to practice safe sex?
Ms. Tanner: With a man, yes. But this is a little different.
Dr. Balis: Exchange of fluids is the key concept. Saliva is not known to be a carrier, but vaginal secretions and the commingling of them is where you will need to think about using a barrier.
Ms. Tanner: We haven't discussed this. But since she teaches human sexuality, I figure she knows all about protection. I feel like the encounter with her was kind of like a milestone for me. It was my first successful sexual experience, you know? It felt good, really good. I was able to let go with her. But I don't know if I really want a relationship with her. It could get ugly. How do we maintain the teacher-student thing and be lovers at the same time? It kind of just happened, but maybe it shouldn't happen again.
Dr. Balis: If you are concerned about your privacy and hers, you can be very discrete. How important is Carla's class to you?
Ms. Tanner: I need it to complete my degree.
Dr. Balis: Hmm.
Ms. Tanner: I'm just having doubts. On one hand, I was able to let go and feel a great deal of pleasure. But then there are risks...
Dr. Balis: Perhaps you could just wait and see what develops. I'm sure Carla has feelings about this, too. Open communication with her will help guide you.
Ms. Tanner: What would my grandma say? And my brother? Am I a lesbian now, all of a sudden?
Dr. Balis: I'd say that your sexual orientation is in flux, but I'd avoid labeling yourself after one encounter or even a series of encounters. As far as your brother or grandmother, this relationship may make them feel uncomfortable, threatened, or prejudiced.
Ms. Tanner: I know some gay couples that keep very private lives--double lives, if you will.
Dr. Balis: You'll have to think about all these issues if you pursue this relationship.
Ms. Tanner: It's getting complicated.
Dr. Balis: Are you still writing?
Ms. Tanner: Yes, but not as much. The writing group disbanded for the Summer because people were coming and going. I miss it. It sort of kept me honest--kept me writing.
Dr. Balis: This experience will provide something new to write about, won't it?
Ms. Tanner: Good idea! I should write a poem about it.
Dr. Balis: I hope you'll share it with me. The poem you read to me earlier this year revealed a lot about you and your mother. I'd be interested in hearing new material.
Ms. Tanner: The anniversary of her death is coming up next month.
Dr. Balis: How many years has it been?
Ms. Tanner: It will be three years on August fourteenth. Poor mom.
Dr. Balis: Where are her remains?
Ms. Tanner: She opted not to get cremated. I think my father was behind that decision. He wanted the world to see how beautiful she was even in death, except for her hands, which were gloved--they were always reddened from picking and rubbing.
Dr. Balis: Did she ever go to a therapist?
Ms. Tanner: My father would never have allowed that. She would have had to do it on the sly. No, she went to her mother for therapy, if you can call it that. It was more like intensive care. Gram would baby-sit; Mom would vegetate. It makes me wonder what Mom was like when she was my age, dating and working. It's really hard to imagine. I could have ended up like her, maybe.
Dr. Balis: Your grandmother probably recognized the symptoms that you and your mother shared. She directed you to me so they wouldn't be repeated, don't you think?
Ms. Tanner: Probably. Oh, I meant to thank you for sharing that OCD site. I get a lot of feedback and information about peoples' struggles and doubts. It's usually reassuring to read what others say. Sometimes, though, it works the other way. One woman said she felt like she might pick up a knife and cut her daughter's hand with it! She was afraid to boil water or use the garbage disposal for fear that she might mangle or scald her kids.
Dr. Balis: Hmm.
Ms. Tanner: I was cutting carrots for a salad and I looked over at Gram and thought, "What is stopping me from throwing this knife at her?" But I wasn't even mad at her or anything. So I think about this. It couldn't happen by accident. And it couldn't happen consciously. So it couldn't happen, right?
Dr. Balis: Right. That's the doubting disease for you. You ask yourself, "I could never kill my own child or my grandmother, or could I?" The answer is, of course, no. But you feel guilty for even thinking these thoughts.
Ms. Tanner: True.
Dr. Balis: Therapists try to get OCD sufferers to first relabel the thought--recognize it as an intrusive thought not based on reality--then remember that it is the OCD thinking and not you. The third step is the hardest. You have to retrain yourself to ignore or work around these thoughts by redirecting them and performing another behavior that is useful and positive. Last, you need to learn to view these thoughts as having very little value, as being senseless. With enough practice and intervention, you'll have control.
Ms. Tanner: Hmm. Let's say I want to kiss someone, but I'm afraid of the saliva.
Dr. Balis: Why are you afraid?
Ms. Tanner: Because of germs.
Dr. Balis: You have to look at the reality behind that fear: is there a chance of getting germs through saliva?
Ms. Tanner: Yes.
Dr. Balis: Then you have to gather information about what germs it might contain and pass on to you. Are you afraid of getting a cold, a flu, or are you afraid of dying?
Ms. Tanner: It's something like that.
Dr. Balis: Colds and flus are transmitted through saliva. One of the risks you take when getting close to someone is of getting sick. But the chances are slim that a kiss would lead to death. You can gather clues as to the general health of the person you are about to kiss and then decide whether it's worth it.
Ms. Tanner: It seems a shame to take such a clinical look at foreplay, doesn't it? So, I have to look at the reality of the situation and then ignore the unreasonable fear.
Dr. Balis: Don't ignore it, just understand that it's mental noise.
Ms. Tanner: It's my OCD, not me.
Dr. Balis: Right. Refocus the thought.
Ms. Tanner: By reminding myself of how good it's going to feel, for example?
Dr. Balis: Or by engaging in a useful, positive activity that helps you refocus.
Ms. Tanner: A prescription for pleasure.
Dr. Balis: Rachel, I understand your enthusiasm for pleasant sexual feelings.
Ms. Tanner: It's more than that.
Dr. Balis: I agree.
Ms. Tanner: There's a part of being affectionate with someone else that's not sexual--it's like it's the satisfaction of the spirit, of making a connection with someone. I'm hungry for that.
Dr. Balis: You can enjoy all the facets of interpersonal contact, both physical and spiritual.
Ms. Tanner: Yeah. I look forward to it.
Dr. Balis: Once again, you are sounding very healthy.
Ms. Tanner: Thank you, Doctor Balis.
Dr. Balis: I guess we are finished for today. This was a good session. So, I'll see you in two weeks. Let's see, that's Friday, August 7th at 3 pm, okay?
Ms. Tanner: Sounds good. Bye!
Dr. Balis: Goodbye, Rachel.
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