Saturday, April 19, 1997 |
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Sunday, April 20, 1997 |
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Monday, April 21, 1997 |
2 pm. Ninth Session with George Landau. George had a breakthrough of sorts. After his experience throwing up on the sidewalk before his training class last Monday, George took things into his own hands. He explained the situation to his supervisor, who took it very well, actually. George spent a number of his early sessions vilifying Simon Taylor. I remember being surprised when Mr. Taylor called me and sounded genuinely concerned about George. The spectre of Mr. Taylor was obviously primarily a projection of George's anxieties and had little to do with the actual man. And George gave a lot of thought to his malady over the last couple of weeks. He was even able to come to the conclusion that his carpal tunnel syndrome was a sham. He never actually had a doctor diagnose it--instead, he had read about the syndrome, had a friend in a hospital who got him a wrist brace, and used it to treat pain which he actually imagined that he felt. I'm certain that the pain he felt in his wrist was quite real, even though at one level he knew that he was deluding himself. I talked to George about flooding as a technique to confront his fears and he seems ready to try it. 4 pm. First Session with Katherine Lippard. Katherine presented a businesslike appearance when she first arrived for her session. She strode purposefully into the room, sure of her authority, with none of the hesitancy entering my office that many patients exhibit. She shook my hand firmly and chose the straight-back chair. She came off as clear and frank, during the initial part of the session, and generally gave the impression of a calm, no-nonsense, hard-driving, professional. She is about 5 feet 7 inches in height, with shoulder-length, swept back hair, brown with a touch of red in it. Physically, she was a little thin perhaps but still attractive. I can imagine that some men might describe her as cute but probably not to her face. She was dressed in contemporary feminine business attire--a skirt, a conservative silk blouse, and camisole. She wears a subtle amount of make-up. Katherine was concerned about confidentiality, but she seemed perfectly ready to accept my assurances. Our conversation turned toward her complaint. An incident occurred where a man was seated in her favorite seat at a sushi bar where she is accustomed to eat lunch. After he refused to move, she took a substitute seat which she acknowledges was objectively just as good. Her concern was the disproportionate disruption to her composure that the minor deviation in her routine had on her. She admits that the event was trivial, but even while discussing it, she became flushed and pounded the arm of the chair as she recounted that he was in her seat. It was the only time during our session that she lost her professional demeanor, and she was clearly embarrassed and somewhat contrite about it. She is concerned that her loss of equilibrium over such a trivial event points to some deeper emotional or mental issue. My guess is that she suffers from some slight degree of obsessive compulsive personality disorder. Although it is too early to tell, I would associate Katherine with a degree of rigidness, perfectionism, and inflexibility characteristic of the disorder. I would question whether Katherine shows perfectionism that interferes with task completion which is part of the formal definition of the condition. But given her apparent high functioning, I would guess Katherine suffers, if at all, from only a mild form of the disorder. I suspect that there is something else lurking beneath the surface with Katherine. She doesn't strike me as the type who would have sought my services for what she must consider a trifle. I could imagine that she might desire to put me through a test prior to revealing her true confidences. I will question Katherine carefully about perfectionism, how she approaches a task, and look for signs of dysfunctional rigidity during our next session, but if nothing further develops, I am going to reassure Katherine that she has nothing overly to worry about--except perhaps a certain tendency towards perfectionism that she should be careful doesn't overwhelm the task itself--and recommend that she not continue her therapy. My guess is that she may be waiting for just that. As an accountant, she would have a sensitivity to the possible waste of time and money caused by a therapist eager to increase his caseload at her expense. Perhaps she needs to be assured in this way that I am not of that breed. |
Tuesday, April 22, 1997 |
10 am. Wrote an E-mail Response to Peter Hossfeld. I acceded to Peter's request and am trying to give him counsel via e-mail. It is an interesting experiment, made more interesting by the prospect of convincing the HMO that they should pay me for this. But no matter...I'm worried about Peter and the depths to which he is being dragged by Serena. I'm unable to give him the support that he wants, but perhaps I can assist him in keeping him grounded a bit in reality. 12 pm. Eighth Session with Eliza Raven. We skipped around from subject to subject during this session, but I didn't feel that we were getting to the core of Eliza's difficulties. I have noticed a change since prescribing the Zoloft, particularly in the reduction of crying episodes that plagued Eliza during our first sessions--although last week's shirt was a total loss. This session was mostly about her relationship with her family, including her prospective husband, Luke who groveled his way back into her good graces. She was sporting a rather large diamond ring during this session which she waved proudly at me, calling it "Luke's apology." She seemed fairly happy about being back together with him though. She's gained more self-confidence lately. She was able to stand up both to a collection agency, and to her mother, all in one week. She finally convinced her mother that she didn't like pink by saying that her mom was Spring and she was Winter, or some such. And, more importantly, she told her mother that she was unwilling to allow her to usurp her father's position in her heart as the dominant nurturer during her adolescence--her mother, if you will. While not apologizing for leaving, her mother acknowledged that her father had raised her, and wept over what a good job he had done. Eliza found herself taking on the mothering role with her own mother, which she described as strange but not painful. Eliza also talked about her father and his therapist. The therapist, who doesn't garner a lot of Eliza's respect, told her father to rid himself of all tangible reminders of Eliza's mother. Apparently, her father is still torn by grief for the loss he feels from the breakup with Eliza's mother, many years before. Eliza proudly described how her father stood up to Ben, her mother's new husband, as her father delivered the remnants of his marriage to the front door of his ex-wife's new house. His therapist apparently recommended that he cut all images of his ex-wife out of family photographs. I agree with Eliza that such an action would have been extreme. Her father was unable to comply. Eliza told me about her band, which sounds like quite a collection of characters. She described a gay couple like a Thurber cartoon, with one of the partners acting like the little man in those cartoons, while a man named Anders plays the role of the huge female. Anders is a drag queen who is part of the group. Most surprisingly, I think she referred to the same Malcolm that Christina Herald is seeing currently. I don't think that there's any connection between Eliza and Christina, although it is possible that they are somehow connected through Christina's father at SII. But she described a very tall, dark, gloomy, dangerous character with the nickname Malcolm the Malcontent. How many can there be? Apparently, Eliza's Malcolm is responsible for impregnating Eliza's best friend Camille, although Malcolm is unaware of that turn of events. Camille, whom Eliza described as both extremely wild and promiscuous, has invited Malcolm to the concert on Friday to tell him of her pregnancy and to try to win him back. It promises to be a tumultuous evening, regardless of the quality of the music. 4 pm. Thirty-Sixth Session with Sylvia Bows. Sylvia is dealing with the turmoil in her life caused by her infamy. She is having anxiety dreams and associated waking feelings where she is out of control. She came up with an interesting image--that of trying to collect fleas on a plate. She grabs one, but the others hop away. Besides for the obvious anxiety, the dreams strike me as being about losing control, and Sylvia hates losing control. As to being in the public eye, Richard even went on a local radio program to talk about his lawsuit. He apparently knows that his legal action is doomed, but he claims that he is maintaining it to try to save his children from a loveless marriage. But really, Richard's conduct reinforces my suspicions that his actual goal is to break Sylvia and Tom up. I pointed out that her problems with Richard and her newfound celebrity were self-resolving over time. But then we started to talk about her relationship with Tom, which is one problem that won't resolve itself without a lot of work on both their parts. Sylvia told me that her previous feelings for Tom were so consuming that she lost herself to them. It was the great love. But when Tom had his secret vasectomy, the betrayal that Sylvia felt was so damaging to that love, that Sylvia said she almost felt destroyed. She said that she only managed to survive by squirreling away a piece of herself, building walls around that piece, and carefully nurturing it back to health. Sylvia won't allow that piece to belong to anyone else again, and she feels that since she is keeping that piece to herself, she will never truly be able to love Tom again with the same abandon. Over the last several sessions, I've noticed Sylvia's hesitancy in actually stating that she still loves Tom. Clearly, this is why. I pointed out to Sylvia that love can evolve and that even if she keeps that kernel of herself as hers alone, she can still deeply love him. She said that she felt that Tom would only accept her if she gave herself utterly to him, and yet I felt that it was more her sense that her love was now inadequate that was holding her back. I almost imagine that it as if Sylvia feels that she is betraying the old love, somehow, to love Tom on these new terms. It's almost as if the love Sylvia feels for Tom has to be all or nothing. |
Wednesday, April 23, 1997 |
I received another fax from the Anonymous Faxer. This one depicts a man being sucked into a computer screen. The man isn't particularly resisting--he has almost a calm expression as he meets his wiry fate. The Anonymous Faxer never responded to the e-mail that I sent him after his get well fax on April 9th. Maybe he is trying to say that he got sucked into his work and hasn't had any time. Or maybe it's a metaphor for being singularly focused on one area of his life to the exclusion of all others. The man is naked, as he disappears into the monitor. Perhaps the Faxer is trying to express that he has concentrated on just one aspect of his sexuality without exploring other options. It seems a bit of a stretch, actually. He works at a computer company, he hasn't written in a long time--he's trying to say that he's been consumed by his work. Let's leave it at that. |
Thursday, April 24, 1997 |
Decker Jenkins called the service and cancelled today's appointment. I hope I didn't scare him away with my insistence on medication. But without it, Decker is clearly headed towards institutionalization. I received an e-mail from Peter Hossfeld. Peter now has a story to go along with all the evil things he did in his past lifetimes. Serena has channeled an entity which told Peter that he loved a woman who spurned him and that he then falsely denounced her as a witch. As she was burned at the stake, she put a curse on him that his sould would be tortured throughout infinity. The "work" that Serena and Peter are trying to accomplish is to contact the spirit of the woman that was burned, get her forgiveness, and also the forgiveness of her god--a female entity named Ishtar. Although I sensed a little waivering at the end of his e-mail message, indicating that I might someday succeed in getting him back to a neurologist, mostly he was steadfast in his praise for Serena's work. I have to consider carefully my response to Peter. 12 pm. Seventh Session with Christina Herald. Christina came in today, quite relaxed and was voluble. She said she was hungry and brought in a huge plastic bag filled with Chinese take-out, which she proceeded to eat with gusto. I noticed that she used her chopsticks with a great deal of expertise, not spilling a drop on her white blouse. She still seemed tired, but didn't have the dark circles she used to. I also noted a reddish mark on her shoulder, near the neckline of her shirt. Not a hickey, it looked more like a bite, presumably inflicted by Malcolm. Does the guy think he's Dracula, or what? Christina's Grandma Strauss arrived in town and moved in during her visit. When Malcolm walked in without knocking one evening while Christina was out, Grandma Strauss brandished a kitchen cleaver and drove him from the apartment. Christina confirmed that Malcolm is indeed the same Malcolm that Eliza Raven told me was the ex-boyfriend of the promiscuous band member, Camille. Indeed, Malcolm is going together with Christina and Jonny to the concert tomorrow. Given Camille's pregnancy, and the fact that it has been ascribed to Malcolm, who is still unaware, there could be some fireworks in addition to the music. The obsidian ring that Christina wears on her thumb is Malcolm's, and with the ring, he seems to feel that he has legal claim to Christina. Malcolm has some sort of criminal past in New York, and is probably a fugitive. Christina had no details, and couldn't even rule out the possibility that Malcolm had committed a murder. But Christina justifies her continued relationship with him as a walk on the wild side, prior to settling down to a life of domestication, Christina style. Christina slipped in her anti-caffeine resolve--"dove into a lake of cappuccino," as she puts it. In any case, Christina left me a notebook that has a week's worth of journal entries in it. 4 pm. Thirty-Ninth Session with Anna Green. Anna came in with a neck brace and a large contusion on her forehead, and I nearly had a fit! I was expecting her to be a bit sore after her run-in with the whip-master, but I wasn't prepared for her to be crippled by the experience. But she told me that the neck brace and the contusion were her fault--ultimately I learned that she had been in a car accident--so I calmed myself down and listened to her story. She arrived a bit late for her session with Gray, who used it as a pretext to abase her, forcing her to strip naked and then leading her upstairs to his attic "dungeon." There, he tied her standing to a pole, tied her legs spread-eagle to rings in the floor, and proceeded to whip her. Anna said that it hurt a great deal more than she was expecting it to, but she also found a part of it pleasurable. She seemed to particularly like being helpless and completely at this man's mercy, which isn't completely unexpected given her previous history. She also said that she was completely caught off guard by the intensity of the emotions that she experienced. After whipping her, Gray demanded that she commit oral copulation on him and Anna willingly complied. I'm not certain whether they had intercourse. But Anna left very sore and feeling guilty for having cheated on Martin. She thinks of herself as the kind of person who would never cheat on a lover, and here she found herself a willing participant to an act of infidelity. That made her very angry with Martin. When she called and told Martin what had happened, he expressed no great displeasure. Apparently, he was not adverse to the idea that she might sleep with other men. If Martin had gotten angry--yelled and screamed and said that he was going to break up with her--she probably would have stayed with him. But his calm acceptance was exactly the wrong tack to take. It made Anna angrier and she took it as a sign that he really didn't care very much about her. So she told him that they were through. Of course, that's just an initial reaction and things could easily change in a week. Anna's other injuries came about through the car accident. Because of the discomfort that she felt sitting down, or having her back pressed against the car seat, she was trying to navigate through San Francisco's streets while perched, half standing, on the edge of the seat. She wasn't very successful. She hit a lamp pole with the car and the windshield with her forehead. When she was thrown back in her seat, she also injured her neck. Anna was kind enough to strip to the waist in my office and display her injuries to me. Of course, she wasn't wearing a bra. The straps would have hurt too much. I guess I should have been thankful that she didn't remove her pants as well. She had clearly undergone a whipping--about 7 or 8 marks crisscrossed her back, but it did look as though the whip had been expertly applied. While there were bruises, none appeared to have broken the skin and all were applied to the upper back so as not to damage her internal organs. My guess is that the marks will completely disappear in a week or so. I'm not so sure that the emotional scars will heal so quickly. Frankly, my greatest fear after worrying about Anna's physical safety, is that she will find herself unduly attracted to this form of sexual interaction. I believe that for Anna, a lifestyle as a masochist would be a mistake. Christina's Journal Entries for April 17 to April 23, 1997. Christina's journal entries reveals that she writes much as she talks--very fluidly and with a conversational style, she jumps from item to item, almost as if she was writing a letter to a friend. She reveals that she is a bit frightened of Malcolm, and realizes that she should terminate the relationship, even while she is feeling stimulated by the rush of danger. She also had tea with her mentor, Professor Carmichael, who is now home from the hospital. She credits his heart attack with making her realize how important he has been to her education. The tea went well. Grandma Strauss arrived like a German whirlwind in Christina's life, madly cleaning everywhere and, in the process, misplacing a number of Christina's papers. But Christina ultimately describes her as easy to live with. And Christina describes breaking her caffeine fast and finding herself having a temper tantrum and a panic attack. Apparently, too, I've become her conscience. She keeps saying, "Doc is going to be disappointed in me." |
Friday, April 25, 1997 |
4 pm. Seventh Session with Thomas Darden. Tom came in and surprised me by calling me "Doctor" for the first time. I think it is a positive sign--a recognition that he is seeking my assistance, that I am in a position to help. Tom's deep-seated unhappiness is more severe than I thought. He masks it with a sort of sardonic wit, which can serve to deflect an appreciation of just how great his underlying pain truly is. Tom is exhibiting a generalized sense of failure, manifested as a complete unhappiness with his current circumstances. He hates his job, his social life, his loss of Sharon--all of it. He has even raised it to a spiritual level: he feels that he doesn't deserve to live, that he's a "waste of human flesh." He has taken the environmentalist argument of the first world's consumption of the majority of the earth's resources personally--since he's not enjoying his privileged life, he shouldn't be entitled to it. He even obliquely references suicide as a possibility, although I didn't think a suicide assessment was warranted at this time. Thomas is also exhibiting more obvious signs of agoraphobia, although of a slight degree. While he yearns for the safety of his apartment, he hates the loneliness that he feels there. He described what a perfect life would be for him, and it sounds like he craves a life of indolence and no responsibilities. He used an episode from Star Trek, which I had seen, as a metaphor for his having made the wrong decisions at fateful moments in his life, ending in what he believes is failure. Tom admitted that he feels more comfortable among his co-workers than a group of strangers. Since I knew that Eliza's concert tonight was heavily promoted at SII, I suggested that Tom go try to make some social contacts there, and gave him one of the tickets she had given me. |
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