Saturday, February 21, 1998
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Sunday, February 22, 1998
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Monday, February 23, 1998
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4 pm. Seventh Session with Olivia Stillwell. Olivia is living in fear that her attackers will somehow discover who she is and retaliate against her. As I suggested, she told her father what happened, and she describes him almost having an apoplectic fit. He immediately got on the phone with his attorney and is pursuing an all out attack on the two brothers who assaulted Stephanie and his daughter. He is considering a civil suit, he is protesting to the State Department, and he is calling the papers--specifically, the Washington Post. Olivia wanted some action against these two and her father is providing it, although now Olivia isn't happy. I believe she's primarily distressed because the action is coming from her father, undercutting her feeling of independence. At one point in the session, Olivia threw an empty Kleenex box across the room; she was instantly remorseful. Olivia says that she is stressed, uptight, upset, scared, and angry. I tried to calm her fears. Although vicious, the attack was essentially a random one.
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Tuesday, February 24, 1998
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10 am. Fourteenth Session with Kester Langford. Kester is still suffering from the same disconnectedness of thought that he has demonstrated since the beginning of our sessions together. But he is introspective and seems to be coming up with positive and happy insights into himself, which is propelling him in a socially positive direction. Kester is still enthused about his revelation of the value of assisting the elderly, and he is taking on added tasks in that regard. He's also become comfortable referring to his work as art, rather than simply marks. His self-esteem is clearly up, and I feel that no particular therapeutic benefit would come by my challenging any of his new insights. His relationship with Me is suffering, apparently. Kester thinks that Me is somewhat put off by the new person that he's become, but I suspect that it has more to do with Kester's self-absorption and his inability to relate to others and achieve intimacy. Kester reports that he is feeling less exhausted lately, and that he is getting more relaxed sleep. He has a new sense of energy, probably because he's less anxious. He plans to quit his job at the gallery and take on his work with the elderly full time. He also reports that he has a new sense of his work. Before, he hid behind his mark making as a way of disconnecting himself from life, even as he gave lip service to celebrating it. Now, he sees his art as an adjunct to his relationship to people, which I see as a positive sign.
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Wednesday, February 25, 1998
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4 pm. Thirty-Fifth Session with Katherine Lippard. Katherine was involved in a serious traffic accident in Texas while there on business. She was hit broadside by a pickup truck filled with firewood which ran a red light. She lost consciousness for a few minutes, apparently, and was unable to accurately identify who she was or where she lived when she regained consciousness. She clearly suffered from a concussion. Emergency medical personnel isolated her neck and transported her to a neurological unit at the hospital where it sounds like she was given a fairly thorough exam. She is still suffering from dizziness, is walking with a slight limp and with the assistance of a cane, has a serious contusion on her left hip and a sore shoulder, and has psychological injuries associated with the trauma she suffered, including night disturbances. During the session, I was surprised when a large crow landed on the windowsill. But Katherine's reaction to it was astonishing. She almost jumped out of the chair and screamed. The crow seemed to be looking straight at Katherine. She got out of her chair and clapped her hands at it, yelling. The crow flew serenely away while Katherine muttered, "Damn bird" at its retreating back. She explained that there had been an unusual number of crows at the scene of the accident. She clearly formed an association between the accident and crows. Now she is sensitized to crows and sees them everywhere. When she sees them, they evoke some of the horror of the accident itself. I tried to explain that it isn't that there are more crows in the world or that they are following her but rather that she is a lot more aware of their presence and pays attention to them when she sees them. She made me repeat the explanation twice; she said that she couldn't keep what I was saying in her head, which worried me. Katherine has never had trouble understanding even difficult concepts. When she asked me to repeat, she sounded like a young girl. And when she cried during this session, it was not the sad, sobbing cry that I've heard before. Rather it was a quiet, stunned sounding, "more than the mind can handle" kind of cry. She still hasn't confronted Jake, and she intends to join him for a ski trip, which worries me. I need to talk to Katherine about high altitude, neurological injuries, and dimished reflexes. I also won't be surprised if Katherine starts suffering from severe headaches. We went past our normal time, but Alex was late and Katherine was doing so well remembering the accident and relating the feelings that she felt, that I didn't want to interrupt her.
5 pm. Thirty-Fourth Session with Alex Rozzi. Alex is having difficulties in school although he tells me that he isn't currently a truant and has been keeping up with his schoolwork. He particularly dislikes P.E., especially getting naked around other men. When I mentioned that people who have endured childhood sexual abuse often have similar feelings, Alex reacted strongly. He really doesn't like to be identified as a victim, and doesn't want to be defined by reference to his past. Alex was concerned about Katherine. He talked to her and she told him that she had been in a car accident in Texas. Alex said that she sounded strange--sort of shaky, perhaps. I told Alex that Katherine would be fine. Alex also told me that his mother is exhibiting the same lack of maternal feelings towards Aaron that she demonstrated with Alex. She's ignoring the baby since she came home from the hospital and Alex said that Mark has to force her to feed him. Racyl told Alex that his mother wanted her to talk Alex into leaving. Alex is reminded of how his mother ignored him when he told her about what Joe was doing to him. As he told me the story, he kept on losing track of where he was, as if he has been suppressing these memories for so long that his brain just automatically derails any consideration of what happened. Alex described his mother as a party girl, and what he told her about Joe was ignored because it was sobering. Alex can't remember her precise reaction when he told her that he was being sexually assaulted, but he said that after he told her was when things became particularly bad between them. Alex has been having dreams about Roly since his suicide. He even described a waking hallucination where Roly said that Alex was becoming complacent. Alex also saw someone who looked like Roly standing on a street corner. Although Alex thought these incidents were strange, he was unrattled by them, actually. He seemed almost matter of fact, although he said that he was concerned that he might be hallucinating. But Alex also got a telephone message from Benny on Ralph's answering machine. That had a much stronger effect on Alex. Benny said that he had received Alex's letter and told Alex that he was sorry. Then, on the tape, Benny cried. It was the crying that most affected Alex. And then Sael, the paramedic that Alex had been briefly interested in last year, just showed up to visit. His grandfather died and he was in San Francisco for the funeral. Alex said that he was visited by three men from his past this week.
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Thursday, February 26, 1998
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4 pm. Seventy-First Session with Anna Green. Although Kathy went to take the test to determine if her fetus has Down's syndrome last Monday, Anna doesn't know the results yet. And it's not for lack of trying. Kathy won't come up with a straight answer and the clinic won't divulge the information to anyone except the patient. Anna got a call from Kathy's Aunt Helen and, assuming that she knew all about the pregnancy, Anna told her that she didn't yet know whether the baby has Down's syndrome. But Helen knew nothing about Kathy's pregnancy and found out only as Anna was telling her about a possible birth defect. Helen insisted on driving out from Sacramento. Kathy did not seem to welcome Helen's presence, and with Martin still in hiding, Anna found herself having to cope with Helen. But Anna has learned quite a bit of interesting information about Kathy's past from Helen, much of it completely at odds with the stories which Kathy has told. Kathy is about ten years older than she represented herself to be, and she was never sexually molested by her father, or indeed any male relation. Her mother did not die of breast cancer, as Kathy previously maintained. Her parents were both killed in a car accident along with her uncle when she was about five years old, and she was raised by her Aunt Helen. The landlady that wouldn't fix her leaky roof--giving rise to the necessity of her "rescue" by Martin and Anna--turns out to be her great aunt, a woman with whom she lived for almost twenty years. Although Helen couldn't recall the exact diagnosis, she told Anna that Kathy had been diagnosed previously as suffering from some sort of personality disorder. I've never met Kathy, but I suspect a cluster B personality disorder. When Helen asked if Martin was going to marry Kathy, Anna said that she didn't know. Helen could see that Martin's clothes were in Anna's room, and Anna feels that she figured out, more or less, something about the relationships between the three of them. Helen asked Anna if she was in love with Martin, and Anna froze, but then responded that she wasn't. Her response is probably truer than she thinks. Anna feels that the situation is spinning out of her control--a realization that I'm surprised has taken her this long to reach. Anna said something odd about Kathy. All this time, Anna has maintained that Kathy would never consider an abortion, and that Kathy felt the baby was what gave her bargaining power in her relationship with Martin. But Anna thinks that Kathy believes that Helen could just take the baby away from her and raise it herself. Anna now thinks that it's conceivable that Kathy could get an abortion. And I got the sense that Anna would not welcome that turn of events, even though it was clearly what she wanted just a week ago. Maybe Anna is realizing that the baby is her ticket out of this relationship.
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Friday, February 27, 1998
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10 am. Second Session with Claire Steven. Claire arrived late and was agitated early in our session. I took her through a guided relaxation exercise which helped her focus. I found it ironic that a patient who was complaining of a lack of interest in sex would be as provocatively attired as Claire was. She must create quite a stir at the office--not only is she physically very attractive, but she was wearing a very short miniskirt and a halter top that exposed her midsection. It's casual Friday, so I assume that conservative business attire is not required at SII. I suspect that Claire's evocative attire is linked to her low self-esteem--an attempt to feel desired by those around her. Claire's agitation was clearly greater than reasonably explained by the personnel interview that she attributed it to. She started her job in human resources just a short while ago, but already it is not satisfying to her. She complained that she has to dash the hopes of a number of young applicants, and that those who she decides to hire will probably end up in positions of authority over her. I believe that Claire's negative self-image underlies her sexual problem--which is clearly a symptom of something more fundamental. We talked about Claire's childhood. When Claire was 7, Claire's 19 year old brother was shot to death by a policeman during a traffic stop. Apparently, he was involved in criminal activity with a friend who was in the passenger seat when the car was pulled over. The friend fired a gun at the policeman, who responded by shooting both of them to death. Claire's parents, especially her mother, reacted by becoming extremely overprotective, to the point that Claire felt imprisoned by their worries for her safety. She described her father as somewhat detached--only concerned about her grades and then, usually, in a negative context. I got the impression of parents who punished rather than rewarded. She told me that her parents treated her brother preferentially and didn't care about his grades, which she described as low. But he must have been a senior in high school when she was about five or six, so she couldn't have a good sense of what her parents' real attitude was. However, it's important to realize that's how Claire perceives it. Her parents failure to trust Claire is clearly be an important factor in her low self-esteem now. I told Claire that I wanted to see her every week and that we could try to address some of these issues in therapy.
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Charles Balis' Personal Diary & Log