Saturday, February 13, 1999 |
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Sunday, February 14, 1999 |
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Monday, February 15, 1999 |
10 am. Conversation with Lenore Marconi. I was at the hospital and I decided to go and visit Lenore. She's staying at CPMC's inpatient psychiatric facility. If I were following strict ethical rules, I probably would have avoided seeing her because of her adversarial relationship to Herbert. But the truth is that my sympathies are with her and not with Herbert. I can do more good with her than with him, although I clearly can't treat her as a patient--and she's Dr. Whitestone's patient now. Our conversation was strange. She told me about the events which led to her to sever Herbert's penis. She said that after a few weeks living in a women's shelter, she went back to the place where she and Herbert had lived to get a few of her possessions. She went at a time when she thought that he wouldn't be there, and he wasn't when she arrived. However, while she was there, he came in and discovered her there. He raped her, causing her substantial physical injury--she thought she would lose the baby. After forcing her to engage in intercourse, he began to orally sodomize her. That's when she said that she realized how much she hated him--and it's when she bit down hard, severing his penis. She told me that retelling the story made her feel like she was reliving it--and yet, she told the story in a strangely detached way, as if it had happened to somebody else. Lenore is concerned about what is going to become of her and her baby--she's currently seven months pregnant. She believes that she's already lost her job and doesn't know whether she'll be jailed after she leaves the hospital. She is clear that she doesn't want to return to Herbert. She was examined by a police doctor who took a rape kit on her and documented clear evidence of sexual assault. I think that should stand her in good stead if Herbert insists on pressing criminal charges against Lenore. She's also been diagnosed with genital warts and is afraid that they'll affect her baby. I urged her to focus on the present, to get better, and then to seek the services of an attorney through legal aid. Lenore doesn't seem to be connecting well to Dr. Whitestone, so I also promised her that I would help her find a therapist that she would be able to talk to. 12 pm. Thirty-Sixth Session with Thomas Darden. This session didn't go well. Tom came in extremely happy. He told me that he had proposed marriage to Sharon and she accepted. He wanted my congratulations but what I had to give was more cautionary. He wasn't interested in hearing that and became extremely hostile towards me and towards the work we've been doing together. He's come to the conclusion that I'm the problem, and he indicated that our sessions together were at an end. I suspect they really may be. Tom is likely to go through with his marriage to Sharon--it will probably increase his short term happiness--and my reservations about his relationship with her will be antithetical to his continuing commitment to her. Perhaps I'll see him again if the relationship doesn't work out, but even then, I probably won't. He'll assume that I'd gloat. Unfortunately, Tom fell into his relationship with Sharon when he was much younger, and his inability to interact socially has forced him to view her as his only option. Tom had been obsessed with the physicality of his relationship with her, to the point of stalking her after they broke up. But he told me that they shared little else other than their sexual appetites. While I have reservations about whether his relationship with Sharon is healthy, I am glad that Tom will not be living alone. I was concerned about Tom as a suicide risk and he was certainly prone to wallowing in his solitude, becoming increasingly self-destructive especially with alcohol. Sharon is likely to ameliorate those effects considerably. I'll have to remember to send the couple a wedding present. |
Tuesday, February 16, 1999 |
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Wednesday, February 17, 1999 |
5 pm. Seventy-Fourth Session with Alex Rozzi. Alex thinks that Luke is cheating on him. Alex said Luke runs hot and cold--sometimes calling him incessantly and, other times, allowing days to go by between calls. Alex was tired of waiting for Luke, so he went over to Luke's apartment. There, the door was answered by a man he didn't know wearing only a towel. The man told him, with a great deal of hauteur, that Luke was still in the shower. Alex hurled an epithet and then rushed away. He resorted to his tendency for obsessive wandering late into the night. Later, Luke called with an explanation, claiming that it was an innocent misunderstanding, but Alex wasn't having any of it. However, when I also raised the possibility that Luke could have been telling the truth, Alex seemed less sure of himself--he admitted the possibility that Luke could have been telling the truth, although he said that his gut told him differently. As Alex's temper cools, he will probably talk things out with Luke again. I'm interested that Alex was so upset by the idea that Luke had been unfaithful. I thought that Alex has been avoiding any sexual contact with Luke since his return to San Francisco. But Alex still obviously believes that Luke is beholden to him. Alex has been working hard at a gallery that sells modern sculpture in San Francisco. Apparently, he drives around picking up pieces and helps to set them up. He likes the job. He left the Bay Area with Ralph to go to a house that Ralph maintains in Bonnie Doon. Actually, I'm not sure where that is. But Ralph has a house that periodically floods, and it did so again this last weekend. They were without power, but Alex was able to make a meal on the gas stove. During the meal, Ralph began to talk about how he wanted to settle his estate, but Alex wants to avoid the subject. I told Alex that I thought Ralph was right in trying to bring it up. Alex told me that he has noticed some compulsive behaviors in himself--counting the downstrokes of a bicycle as he pedals it, for example, or going for his long nocturnal rambles about the city. I asked him to stay aware of these behaviors. If they grow more disturbing to Alex, we can begin some exercises to combat OCD, although Alex's obsessions have taken a very mild form and do not seem to impinge on his ability to function. There are many items in his life outside of his control--the trial, Luke, Ralph's health--so I suspect that these behaviors represent an attempt by Alex to try to assert control over the facets of his life which are susceptible to it. 7:30 pm. Telephone Conversation with Anna Green. Anna called me late to tell me that she isn't coming to our session tomorrow. She has been asked to stay late at work. But she also told me that she burned her hands--apparently she absentmindedly tried to pick up a hot roasting pan straight from the oven without using gloves. It sounds like she has second degree burns over at least part of both hands. I told her to go to the emergency room but she declined, so I gave her some first aid tips. She said that Trevor is with her and that he'll take care of her, if need be. I note that Anna seems to have overcome her scruples against the fact that he's a married man. |
Thursday, February 18, 1999 |
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Friday, February 19, 1999 |
10 am. Forty-First Session with Sharon Lough. Rob has been hospitalized due to severe stomach pain and Charlotte has taken over the administration of his life. Sharon can't get access to Rob due to hospital rules restricting visitors to immediate family members, and Charlotte has thrown her out of Rob's house--Charlotte even had the locks changed. Sharon has been unwilling to seek anybody's assistance--she's too proud and too stubborn. She doesn't want to beg Charlotte to readmit her to Rob's house or to seek help from her sister. She's also unwilling to get assistance at work. She's even unwilling to seek help from the public social services set up to help the needy. Now, she's effectively homeless, at least until her next paycheck. She's almost out of money and has been living in her car next to Golden Gate Park. She still has her cold, she's not able to keep warm enough, and she's lost weight. When she started talking about suicide, I even offered to place her in a psychiatric facility, but she refused for fear of losing her job. She clearly isn't suffering from the requisite degree of mental illness to allow me to involuntarily commit her. I don't believe that she's suicidal. So I just scheduled an appointment for next week. I hope that she'll be able to keep it together under increasingly difficult conditions. |
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