Saturday, February 28, 1998
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Sunday, March 1, 1998
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Monday, March 2, 1998
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4 pm. Eighth Session with Olivia Stillwell. This was a session in which Olivia flat out refused to discuss the issues that were important to her. Instead, we talked about gossip at work--including a reference to Katherine Lippard and Alex--jokes, her new puppy, and stories about people she'd heard about. She seemed quite edgy to me, and she told me that she's not sleeping well, perhaps 3 to 4 hours per night. She said that the melatonin isn't working for her. She adopted a Rottweiler puppy and hopes that it will provide protection for her when it grows up. Now, she jokes that she can throw her puppy at an intruder.
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Tuesday, March 3, 1998
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Wednesday, March 4, 1998
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4 pm. Thirty-Sixth Session with Katherine Lippard. Katherine is recovering well from the accident. Her dizzy spells are both less severe and less frequent and she's started driving again. Her assistant at work has picked up some of the slack. In fact, she's discovered that she was having trouble letting go of the managerial side of her old job, and taking the more reflective role appropriate for a senior executive. She plans to rectify that mistake. Katherine told me that Alex visited her at work, and she was surprised to see the open gawking of people around the office as they whispered and pointed fingers. Katherine went to Alex's house and saw his mother, who seemed a totally different person from the one who accused her of an illicit relationship with her son. Katherine isn't sure what to make of it--Katherine described the two Larraines as two different people, and Katherine thinks it possible that neither was genuine. Most of the session was devoted to Jake, though. It turns out that Jake was the buyer for Alex's paintings. He'd intended to give them to Katherine for her birthday--he missed it by a month--but then, when she talked about her interest in contributing to the arts, he decided to donate the paintings in her name to the Bay Area Youth Arts Alliance. Now Katherine has the decidedly unpleasant task of telling Alex that his paintings weren't bought by the anonymous art connoisseur that Jake invented, and Katherine has to further convince Alex that she didn't buy the paintings out of feelings of charity or pity. Alex has invested a lot in the idea that the paintings were purchased for their own sake. I think he will be quite disappointed. So Jake, who thought that he had done something praiseworthy, found himself blindsided by Katherine, who decided that since they were in the midst of an argument anyway, she should bring up all the dissatisfaction that she'd been feeling over the months and had been planning to discuss with Jake at an opportune moment. It wasn't a good discussion. Katherine accused Jake of being manipulative and not listening to her, although she admitted that Jake's idea of donating Alex's paintings, although clumsy, came from his trying to be responsive to her stated desires. This was two days ago and they haven't spoken since. Katherine seems to have contradictory feelings about Jake. As she was calling him an asshole, she clearly wasn't angry with him; she sounded more frustrated or tired. At other times, she really did sound angry. But, then again, sometimes she almost sounded mushy. She was clearly embarrassed at the way she handled the argument. Katherine hopes to have a conversation with Jake tomorrow where she rationally explains why she was upset with him. And Katherine realizes she has to tell Alex about the paintings before he finds out for himself. Katherine wasn't closed about her emotions today. She was allowing herself to feel all of the emotions as she talked--she wasn't suppressing her feelings. At the end of the session, Katherine told me more about her relationship with crows. She was in Golden Gate Park, looking at the crows there, and a man asked her, "Are they yours?" He turned out to be a professor of anthropology and he told her about the symbolism of the crow and how it is expressed in a number of cultures. They are apparently considered messengers from the spirit world, or spirit guides. Now Katherine says that she is no longer bothered by the crows. Instead, she wants to find out what they have to teach her. Katherine is not the patient who I'd expect to go this route. She's never seemed particularly superstitious and is usually extremely rational. This fixation on crows seems antithetical to her character, especially when she believes they are calling to her personally.
5 pm. Thirty-Fifth Session with Alex Rozzi. Benny's trial is scheduled for March 12th and Alex is still resistant to testifying against him. He defiantly says that he can't be compelled to testify by legal process. Benny called again and spoke with Ralph, who apparently got into a shouting match with him. At one point, Alex said that one of the reasons that he didn't want to testify is that he's afraid that Benny will find a way to hurt or kill him if he does. Roly's ghost haunts Alex's dreams--he's convinced he's real. In his dream, the ghost has a broken object that he wants Alex to fix. I suggested that perhaps the dream and Benny's trial are linked. Alex said that he needs to think some more about whether or not to testify. I told him that I would support whatever he decided to do. On another subject, Alex is alternately thrilled and suspicious of an apparent change of heart that his mother has exhibited. She invited Katherine to the house and apologized to her, and she reversed herself and allowed Rosemarie to move into Sophie's house. Alex got an in-law apartment there as an art studio. Alex feels that his mother has been too mercurial in the past for him to view this as a fundamental change, although I think he's willing to enjoy it while it lasts. When Alex spoke to Katherine about what a good mother she'd make, he noticed a whole range of emotions flit across her face. I've never talked to Katherine much about her feelings on becoming a parent. Alex is still mystified about who bought his paintings, but it bugs him. He really wants to know. He hasn't cashed the check from the gallery yet--he's holding it as a symbol of good luck.
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Thursday, March 5, 1998
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10 am. Tenth Session with Sharon Lough. I conducted a suicide assessment of Sharon, and although she's deeply depressed, I don't believe that she's currently suicidal. She has some suicidal ideation and perhaps some fantasies of death, but she hasn't concocted a plan and seems to have no present intention. However, I've decided, despite her past history of abusing prescription medications, it's time to prescribe an antidepressant to Sharon. I'm going to prescribe only a week's worth of tablets at a time to try to avoid an impulsive suicide attempt through overdose. I'm also going to choose an antidepressant out of the newer drugs which are unlikely to be fatal in overdose, i.e. bupropion, fluoxetine, or paroxetine. Bupropion is a monoamine oxidase inhibitor, which has the potential for interaction with foods and amphetamines, so I'll stick with a serotonin reuptake inhibitor. I've had good results with Prozac, so I'll try 20 milligrams of fluoxetine, once each day, for a 6 to 8 week trial. Note that I should check to make sure Sharon's not taking a blood thinner like warfarin sodium. Sharon is very intelligent and will probably read up on the drug, but I should make sure she understands the possible side effects. I'd also like to know if she was prescribed any medication as part of her treatment for endrometriosis. Beyond the obvious signs of depression, masked by a certain black humor, and her low self esteem, Sharon told me that Charlotte has taken to having sex with strangers in her husband's bed during the day. Sharon assumes that she wants to get caught. Sharon has also suffered a demotion to the position of clerk at work--she expressed some envy of those people who suffer from serious mental illnesses sufficient to receive disability payments from the government. I don't think it would be beyond Sharon to lie to her physician in order to obtain prescripton narcotics. For example, she expressed quite an interest in pain meds at the beginning of our session. Sharon did have the laparoscopic examination, but she didn't really have any findings yet.
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Friday, March 6, 1998
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9 am. I received another fax from the Anonymous Faxer. This time a man's face is clearly visible. I looked back through my file of faxes that I've gotten in the last year and a half. I believe that this is a portrait of the Anonymous Faxer--the best I've yet received. Some of the other images hint at the same facial features: elongated face, thin mouth, long hair, straight nose. Overall, the Anonymous Faxer is depicted as a fairly attractive man. I compared many of the images and the female faces also bear some resemblance to the face, and they may well be representations of himself after a gender transformation. This image depicts a naked man holding a strategically placed box of chocolates in a large, velvet, heart-shaped box. His genitals are covered by the box; could they be the present? Surrounding the image are an abundance of roses. His hand may be resting on his stomach or may be reaching somewhat lower. The body is male and clearly less tortured than previously, although there are some deformities in body musculature. It's still a man uncomfortable with his body, but not to the degree that he was before. Perhaps he's found love and some acceptance of who he is. In January, I received an image of coffee cups and opera tickets. Perhaps this is the continuation along a path of romance. It's clearly a romantic image. I'm almost tempted to go to SII and walk the halls, now that I know what the Anonymous Faxer looks like. But I think, in a fundamental sense, that would be a breach of the trust and confidence that the Anonymous Faxer has placed in me--even if he's limited to this form of communication.
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Charles Balis' Personal Diary & Log