Transcript of 6th Session between Charles Balis, M.D. and Ms. Rachel Tanner, Tuesday, December 9, 1997 at 3:00 pm.

Ms. Tanner: Hello, Doctor Balis.
Dr. Balis: I'm glad to see you again, Rachel. I was very concerned about the way our last session ended and about your cancellation last week.
Ms. Tanner: Yeah, sorry about that. I was sick last week, and our session before that was...well, I panicked.
Dr. Balis: I know our conversation about school upset you, but I think we should pursue it.
Ms. Tanner: I think I'm ready to talk about it now. God, it's all I've been thinking about for three weeks. Plus, I'm going to have to cancel our next session, so I'd better get it all off my chest today.
Dr. Balis: Are you going somewhere?
Ms. Tanner: I'm taking the bus to visit my brother, Michael, for a few days. Gram will drive up to visit too, just a little later that week. Michael's going to take me to a concert.
Dr. Balis: Sounds like you're looking forward to it.
Ms. Tanner: I haven't seen his new place. Plus, his roommate sounds really cool.
Dr. Balis: When is the last time you visited him?
Ms. Tanner: At the beginning of the summer. It's always a little weird being away from home, but I guess I'll survive. He's going to be working a lot, so I'll be on my own at his place. But it's by the water, and he says it's close to a lot of shops and coffee places. He has this great cat, too.
Dr. Balis: I just got a cat myself, but I can't say she's great yet. Taking care of a kitten is a little more than I bargained for.
Ms. Tanner: Is she at home while you're here?
Dr. Balis: Yes. Obviously I can't bring her to the office.
Ms. Tanner: Why not?
Dr. Balis: Rachel, I know I started it, but we should probably talk about you rather than my kitten. You said you were ready?
Ms. Tanner: Yes, but talking about cats is more fun.
Dr. Balis: I want to know what made you flee from my office, no pun intended.
Ms. Tanner: Very funny. Seriously, I have a few bad memories of school...well, not really high school--although even then, I knew I was different and didn't make that many friends. At the J.C. I kind of came out of my shell. I took a drama class, English IA, anthropology...fifteen units all together. I really got into school, and I have to admit I was pretty good at it. My mom was having a tough time, though. She seemed really happy in a relieved sort of way when my dad left. But by the time I graduated, she started getting really weird. She had more time to herself since Michael and I were busier and not at home as much.
Dr. Balis: What do you mean she started getting weird?
Ms. Tanner: She didn't want us to go anywhere, but she didn't want to drive us either. She wouldn't let us get driver's permits. I didn't really care, but Michael freaked. He would yell at her, then storm out of the house--kind of like Dad used to do. Michael was having a hard time, too. That's when I remember Mom doing the checking. Before we went anywhere, she'd have to check the stove to make sure it was off, the dog to make sure his leash wasn't tangled, the phone to make sure it wasn't off the hook, the lights, the door. God, she drove us crazy! Oops, I guess I shouldn't say that, huh?
Dr. Balis: It's just a figure of speech. So her OCD symptoms increased once you and your brother spent less and less time at home?
Ms. Tanner: Yes, now that I think about it. We were her projects. I felt like I had to come home just so she could serve me the dinner she took two days to plan and prepare. It was like her ego was on the table at every meal. She was definitely the Good Housekeeping mother. And I wanted to be a Good Girl. We were quite a pair, I guess.
Dr. Balis: Hmm. Do you recall any of your own rituals at that time?
Ms. Tanner: Yes. I had to have order. Everything on my dresser had to be in a certain place. I had to have my desk set up just so, or I couldn't get started on my homework. I called it my work dance--it was the dance I had to do before I could accomplish anything. I remember sometimes, I didn't get my homework done because I couldn't get things set up the right way. One night, I stayed up all night to get a paper done.
Dr. Balis: Rachel, why do you resist the idea of going back to school?
Ms. Tanner: Remember when you were asking me questions before you prescribed the medication? You asked if I could be pregnant? Well, I have know, once. It was someone I met at school. He was in one of my classes, and we just started talking one day. He was kind of a loner, a little off, sort of disheveled. Our conversations got longer and more interesting. And then one day, we met in the library to work on a project.
Dr. Balis: Go on.
Ms. Tanner: This guy was like a fallen angel--that's how I thought of him. He seemed misplaced, like he was too sensitive for this world. He was a writer. Anyway, we didn't really get much work done on the project, we just talked about stuff. A week after that session in the library, the project was done and the quarter ended. I was spending a lot of time thinking about him. I had built up a trust in him, and I guess that made it easier to plan for the big event.
Dr. Balis: The big event?
Ms. Tanner: Losing my virginity.
Dr. Balis: Oh. You planned it?
Ms. Tanner: Yes. I wanted things to be just right. Well, they weren't just right. It was awful. I sort of changed my mind in the middle of it all, but I guess I wasn't convincing--he turned into some kind of animal.
Dr. Balis: Did he rape you?
Ms. Tanner: I don't know, maybe.
Dr. Balis: Is this the first time you've spoken about it to anyone?
Ms. Tanner: Yes.
Dr. Balis: How are you feeling right now?
Ms. Tanner: Kind of sick to my stomach. Angry again. Stupid for letting him do that to me. Now I know how my mother must have felt.
Dr. Balis: Was your mother raped?
Ms. Tanner: Apparently so.
Dr. Balis: What do you mean?
Ms. Tanner: My dad went after her a lot, I guess. He's the reason she used to cry so much.
Dr. Balis: Hmm.
Ms. Tanner: He made her cry! What do you think was happening? She never wanted to be with another man again after he left. She was beautiful. He ruined her!
Dr. Balis: You have a lot of anger towards your father. How old were you when he left?
Ms. Tanner: Almost twelve.
Dr. Balis: And do you remember your parents' disputes?
Ms. Tanner: Well, my grandma refreshed my memory. Remember I told you about that day when she and I talked a couple months ago? She told me a lot of stuff.
Dr. Balis: What do you remember about your father?
Ms. Tanner: He kind of ignored us. He was always showing my mom off. He would give her money to buy dresses and then treated her like she was his date and us like we were in the way. He would slam doors and drive away mad. I remember that because one time, he caught her dress in the car door and tried to drive off. It ripped as he tore out of the driveway. She cried that time; all three of us did.
Dr. Balis: I see. Let's get back to this young man at school for now, if you don't mind.
Ms. Tanner: It was a mistake. In a way, I just wanted to get it over with. He seemed nice enough. Maybe all men are like that. My grandmother would certainly have me believe that.
Dr. Balis: You said you were angry at him for letting him do that to you. You said it might have been rape. When a man takes you without your permission, it is rape. But you also said that you changed your mind in the middle. How did you let him know you changed your mind?
Ms. Tanner: I yelled at him and pushed him away. I struggled and slapped him, but I got worn out and scared. He wasn't a big person--I should have been able to fight him off.
Dr. Balis: Many rape victims describe feeling paralyzed and helpless to defend themselves from their assailant...
Ms. Tanner: I feel so stupid. It was my idea to get together with him. Then things went bad, very bad.
Dr. Balis: How long ago was this?
Ms. Tanner: It happened just before my mother died, so it was about two years ago.
Dr. Balis: Do you think that you are avoiding school because of this incident?
Ms. Tanner: I don't want to be any place where I can run into him again.
Dr. Balis: I can understand. What do you think the chances are of that happening?
Ms. Tanner: I don't know. Slim?
Dr. Balis: Probably. He might not even be enrolled in school anymore--that was two years ago.
Ms. Tanner: He might not even live in the state any more. Maybe even if I did see him he wouldn't recognize me. I know all this, Doctor Balis.
Dr. Balis: I'm glad. Rachel, your OCD has kept you from activities that other twenty-one year olds are enjoying. Rape and associated psychological trauma has made it even more difficult. But you really are making great progress in our therapy sessions. And I would like to encourage you to try some new things. Staying with your brother is good. You will be away from the security and normalcy of your home for a few days. I'm very eager to hear how things go for you. I'm also anxious to find out how the medication is working.
Ms. Tanner: So far, so good. It still takes me a while to get to sleep, but I feel like I'm more rested when I wake up. On the other hand, I feel like I'm wired most of the time. And I'm losing weight.
Dr. Balis: I noticed the weight loss. Increased agitation is a side effect that some people on this medication report. I'm glad that it doesn't interfere with your sleep. And sometimes, you can redirect the nervousness.
Ms. Tanner: What do you mean?
Dr. Balis: You're already doing it--you write in your journal, you play the piano, you swim. Let's continue with 20 mg. for another few weeks. All right?
Ms. Tanner: Okay. You know what else? I don't really seem to want to do the counting and the rituals as much. I'll probably always fidget with my nails, but I just brush my hair in the morning now or after I wash it, and that's all. And I've been taking a lot of baths instead of showers, so there's no rituals, at least with washing.
Dr. Balis: Why does that make you giggle?
Ms. Tanner: I don't know if I should tell you.
Dr. Balis: It's up to you.
Ms. Tanner: Well, I have had a hard, climaxing. You said the drug could have that effect. So I found a way that I can use the bath water as it's coming out of the fixture know.
Dr. Balis: Good. Feeling sexual is a sign of good health.
Ms. Tanner: Then I must be pretty healthy! And, Doctor? I think telling you about the..about the rape...well, I think it made me feel better. It's like some weight has been lifted. Do you know what I mean?
Dr. Balis: I do. I'm glad it helped.
Ms. Tanner: But I'm still pissed. And I'm still angry with my dad. Michael and I talk about this every once in a while. And I don't know how to get relief over that one.
Dr. Balis: It's getting rather late. Let's plan on taking that subject up after you get back from your vacation. When are you coming back?
Ms. Tanner: We won't be back until Christmas Eve.
Dr. Balis: Hmm. If we keep your sessions on Tuesdays, we won't meet again until January 6th. How does that sound?
Ms. Tanner: That sounds okay with me, actually.
Dr. Balis: This was a good session, Rachel. You really opened up.
Ms. Tanner: I feel better after getting things off my chest and off my brain.
Dr. Balis: It shows.
Ms. Tanner: Well, Happy Holidays. Good luck with your new kitten.
Dr. Balis: Thank you. I won't be in the office for a week between Christmas and New Year's, but feel free to call if you need to--my answering service knows how to track me down.
Ms. Tanner: See you next year!
Dr. Balis: Good night, Rachel.
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