Transcript of 6th Session between Charles Balis, M.D. and Ms. Kelly Wiseling, Wednesday, September 16, 1998 at 2:00 pm.

Dr. Balis: Hello, Kelly. Please come in.
Ms. Wiseling: Hi, Doctor Balis.
Dr. Balis: How are you feeling?
Ms. Wiseling: I'm much better this week, thanks.
Dr. Balis: I'm curious, what happened to the man you met last week?
Ms. Wiseling: He has a name--Doug. He left me his name and phone number and a very nice note by the bed the next day. Angie saw him as he left, but the other two girls I live with were still asleep. Angie kidded me about it because he was so young and baby-faced. She called me a cradle-robber.
Dr. Balis: I see. Did you call Doug?
Ms. Wiseling: No, I didn't. I can't use a conventional telephone, and I felt funny about using the relay service for that. Angie said she'd call him for me, but I felt funny about that, too.
Dr. Balis: Did you tell Angie about spending the night with Doug?
Ms. Wiseling: She knew about him anyway because she saw him leave, so I thought I'd come clean. I told her everything. Now, she keeps telling me that I should see him again.
Dr. Balis: Hmm.
Ms. Wiseling: Since neither of us had dates last weekend, Angie took me shopping. Guess what store we went to?
Dr. Balis: Where?
Ms. Wiseling: Good Vibrations! It was a whole store full of vibrators and dildos, and all these books about sex...
Dr. Balis: I'm familiar with that store...I mean I've heard of it.
Ms. Wiseling: Hmm. Well, I was nervous when we first walked in. I never went to a place like that before. Only in San Francisco, right? I love this city. At first, I wouldn't even go into the section where the vibrators and dildos were displayed. I stayed on the side with the books and greeting cards until Angie snuck up behind me. She was holding a big dildo. It was really big! I tried to get away from her, but she kept poking at me. And then she started chasing me around the store with it. I screamed and ran away from her. I must have screamed really loud because people were looking, but they didn't look too surprised.
Dr. Balis: Hmm.
Ms. Wiseling: I went into the vibrator section to get Angie to stop chasing me. The store even had a little room where you can try out the vibrators. Angie tried to make me go in there, but I wouldn't. That was just too strange. She did talk me into buying something, though.
Dr. Balis: What did you buy?
Ms. Wiseling: A Hitachi Magic Wand with a special G-Spot attachment. Angie said it was the Cadillac of vibrators. It was very expensive. I hadn't planned on spending so much. But I have to say it was worth every penny.
Dr. Balis: I see.
Ms. Wiseling: It's very...well, it's very intense. It was a little too much at first. But after a few tries, I got to really like it. It's almost as good as the real thing. Too bad it can't hug you or take you out to dinner.
Dr. Balis: I suppose if it could, men would be an endangered species.
Ms. Wiseling: No, we'd still need you to lift heavy things.
Dr. Balis: Of course, I had forgotten about the heavy things. Does this mean you no longer have an interest in dating?
Ms. Wiseling: Do you mean the guy from the dance club?
Dr. Balis: I meant dating in general. Do you want to see Doug again?
Ms. Wiseling: No, not really. I don't want to spoil the fantasy. The vibrator helps with the immediate physical need. I can tell I'm going to get really spoiled by this thing, though.
Dr. Balis: Hmm.
Ms. Wiseling: I've been thinking a lot about Peter, my college boyfriend...or whatever--the one who called me a nymphomaniac. I wonder if he was right about that. I wonder if I think about sex too much.
Dr. Balis: There's an old joke: "A nymphomaniac is anyone who has sex more often than you do." But to answer your question, no, I don't think you're a nymphomaniac. You seem to have a healthy interest in sex appropriate for a woman your age. In fact, I would be concerned if you expressed no interest in sex.
Ms. Wiseling: Lately, after that one-nighter, I've been thinking about sex a lot. Sometimes, I think I'm obsessed with it, like there is something wrong with me. What if I'm addicted to it?
Dr. Balis: There is some dissension in the psychiatric community over whether sexual addiction really exists. A large percentage of Americans believe they are sex addicts. But a definition of a sex addict is any man or woman whose sexual behavior is compulsive in nature and harmful to their relationships and jobs. That's not a...
Ms. Wiseling: Like Bill Clinton?
Dr. Balis: I wouldn't go so far as to diagnose him, but there are certain aspects of his behavior that resemble that of a sex addict. In addition to having affairs, sexual addiction may include the use of pornography, masturbation, sexual fantasies, and placing inordinate sexual demands on a partner. Some people use sex as a means of escape, the same way an addict uses drugs. Studies have linked a deficit in the neurochemistry of the limbic system in people thought to have a sex addiction. These patients have sex to restore the Dopamine levels in their brains.
Ms. Wiseling: I read an article about Clinton which labeled him a sex addict. That would explain a lot of things. Why else would such a smart, ambitious man ruin his life and embarrass his family by doing what he did?
Dr. Balis: Sex addicts often describe their needs as overwhelming. They feel out of control. While normal people want sex, sex addicts need it and will go to extraordinary length to get it.
Ms. Wiseling: I don't think I'm like that, at least not yet.
Dr. Balis: I don't think you are sex addict, Kelly. One brief encounter does not make you a sex addict. If you were to engage in compulsive sexual behavior--such as having numerous one-night-stands with strangers--I would be concerned. Such actions can have a devastating impact on your emotional and physical well-being.
Ms. Wiseling: Yes, I know. I was bad.
Dr. Balis: Kelly, I'm glad you approached me with this topic. I sense it was somewhat difficult for you to bring up. Exploring one's sexuality and need for intimacy are common concerns. But many individuals find themselves engaging in frenetic sexual activity when what they are really seeking is love and companionship. I'm concerned that in your quest to fulfill your emotional needs, you might find yourself falling into that trap.
Ms. Wiseling: I see what you're saying. I didn't want to tell you at first, but then I thought, "Who else could I talk about it?" Nice girls aren't supposed to talk about things like that, right? Before the session today, I told myself I would tell you about it and see what you thought.
Dr. Balis: How do you feel now that we've discussed this?
Ms. Wiseling: Hmm, I'm feeling brave, so I better tell you the other thing before I lose my nerve.
Dr. Balis: What other thing?
Ms. Wiseling: I bought something else from Good Vibrations--a book.
Dr. Balis: What book did you get?
Ms. Wiseling: It's called "Anal Pleasure and Health." I got it separately from the vibrator, when Angie was talking to someone. The woman who rang me up told me that people called it: "Ain't No Pleasure In Health." I was so nervous, I didn't get the joke until later. Do you think it's weird of me to buy that, a gay men's book?
Dr. Balis: As I remember, it's not exclusively for gay men, though many of them may find it a useful resource. So no, I don't think it's weird.
Ms. Wiseling: I was really embarrassed even paying for it. It was worse than buying the vibrator.
Dr. Balis: Jack Morin's book is a good source of information. It's always beneficial to educate yourself about a subject that interests you. It's preferable that you learn this subject from a well-researched book written by an experienced sex therapist. Popular fiction, film, and pornography often portray sexual acts in an unrealistic and exaggerated manner.
Ms. Wiseling: I was curious about it, about anal sex. All the things I've read about it made me wonder what it would be like. I tried it with Peter, and it grossed him out. He got back at me by telling all his friends that I liked it. I didn't enjoy it at all--it hurt a lot. It wasn't exciting like it's described in books. When Peter told his friends, they all thought it was disgusting, too. Pretty soon, everyone knew. People kept making jokes about it.
Dr. Balis: Peter was threatened by your sexual curiosity. Some men are intimidated by women who have a greater interest in sex than they do. I'm sure you realize that you're not the only person--and certainly not the only woman--to express an interest in anal sex. Have you read any of the research by Kinsey or Masters and Johnson? I think new editions of their books are available. I don't remember the exact numbers, but about half of the heterosexual population has tried anal intercourse at least once. From a biological standpoint, the anus has a large concentration of nerve endings and is very sensitive to stimulation. Because it is close to the genitals and contracts during orgasm, for some people, it is an erogenous area. From a psychological standpoint, anal sex is a social taboo activity that some people find exciting due to its forbidden nature.
Ms. Wiseling: I feel better now that you've said that. It's not the type of thing women are supposed to think about.
Dr. Balis: You're free to think about anything you like, Kelly. Acting out some of your fantasies is a different matter. But I want to caution you, anal sex is a high risk activity, particularly for the receiving partner. You should be selective with whom you chose to engage in this activity and be sure to use condoms and lots of lubricant.
Ms. Wiseling: Yes, I know about that. That makes it seem wrong, though--if it spreads HIV and AIDS, I shouldn't be doing it.
Dr. Balis: I don't recommend that you practice it casually. But if you take proper precautions and have a long-term partner, most forms of sex are relatively safe.
Ms. Wiseling: Now if I can only find a long-term partner.
Dr. Balis: That's an issue we can explore next week. We're almost out of time.
Ms. Wiseling: Already?
Dr. Balis: Kelly, I realize you were a bit uncomfortable discussing your sexual proclivities at first. How do you feel now that we've discussed them?
Ms. Wiseling: You're right, I was a little uncomfortable at first, but I'm better now. I didn't want you to think I was a slut--not that you would think that. I felt like you were the only one I could talk to about it who wouldn't laugh at me.
Dr. Balis: I'm glad you feel you can talk freely with me, Kelly.
Ms. Wiseling: You're okay, Doctor Balis.
Dr. Balis: Thanks, Kelly. I have a little homework assignment for you for next week.
Ms. Wiseling: What? Homework? I take it back, you're not okay. I've never heard of a therapist assigning homework. I've heard of nutty California psychiatrists giving their patients drugs and having sex with them, but homework? That takes the cake!
Dr. Balis: It's a short assignment. I want you to write a list of qualities that you would look for in a friend and a partner. I would also like a list of things you want from a long-term relationship.
Ms. Wiseling: Do you mean besides sex and someone to take out the garbage?
Dr. Balis: Sex and companionship are the main reasons people have relationships, but there are other compelling reasons. Are there goals you want to achieve or places you want to travel? Do you want a family? Those are some of the things that a partner can share with you. Give it some thought, Kelly.
Ms. Wiseling: You are going to build up my hopes only to set me up for a big letdown. What are the chances of me finding someone ideal like that?
Dr. Balis: I understand your concerns, Kelly. Dating can be a harrowing experience. Making a list of the qualities you are looking for can help you keep your wits about you. Sometimes, people who are hungry for love or who have not dated in a long time lose sight of what's really important to them.
Ms. Wiseling: You're saying you don't want me to settle for the first thing that comes along.
Dr. Balis: That's one way of putting it, yes.
Ms. Wiseling: Okay, I'll write out a list for you.
Dr. Balis: Good. Take care, Kelly. I'll see you next week.
Ms. Wiseling: Bye, Doctor Balis.
Dr. Balis: Goodbye, Kelly.
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