Tuesday, July 15, 1997
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1 pm. Eighth Session with Peter Hossfeld. Peter gave me a call yesterday and asked for an appointment. He came in wearing a bandage around his right hand. He told me that he had invited Eliza to visit him at his apartment when Serena wasn't there--very much the way that Eliza told it to me. Eliza came there at his invitation and discovered Serena's penchant for growing poisonous plants and keeping them in jars in the kitchen. Eliza apparently found foxglove, henbane, and jimson weed growing in Serena's pleasant little garden. And she also identified the poisons in the kitchen that Serena has probably been making into tea for Peter's consumption. Eliza destroyed much of Serena's garden and dumped her "teas" into the garbage. When Serena came home, well after Eliza had left, she was none too pleased at what she found. Eliza had left some sort of a sign in the garden, made out of sticks and rocks, that caused Serena some considerable consternation. Serena hit herself in her supposedly pregnant belly and said, among other things, "She did it all!" Peter tried to soothe her, but she grabbed his right hand and bit into it hard, breaking the skin. When I saw his hand, it was clearly infected and probably septic. I judged that Peter's hand was in need of treatment without delay. I was able to get hold of Doug Halsey, and he squeezed Peter in for an immediate appointment. After biting his hand, Serena disappeared. Peter hasn't heard from her in about a week--she hasn't even returned to retrieve her belongings. Peter also disclosed several other interesting items: he's taking Dilantin that was prescribed by his neurologist, but Peter believes that he is suffering some cognitive side effects--he said that he feels "fuzzy" including having a fuzzy taste in his throat and being fuzzy minded. He seemed to demonstrate some slight inability to differentiate between dream and waking states. And he's apparently raised the concerns of his supervisors at work, although apparently they are cutting him some slack because of his epilepsy and hope that he'll rebound soon.
4 pm. Forty-Seventh Session with Sylvia Bows. It has been exactly a year since I began practicing in San Francisco. And Sylvia was one of the patients I saw on that first day--Sylvia, Anna, and Hal. Sylvia arrived late for this session, citing the press of work and the demands of family. She pled that she seems to have so little time. I used the opportunity to suggest to Sylvia that we cut back on our sessions together. All of the issues that Sylvia came to me about initially have been resolved. While we are doing good work in helping Sylvia sort out the issues in her life, I think we could probably cut the sessions back to once or twice a month without substantial detriment. Sylvia reacted as if I was trying to abandon her--I was hoping she'd think of it more like graduating. But I'm allowing her to make the ultimate decision of how frequently to schedule our sessions together. If she feels that it is not essential, I would hate her to feel like she has to keep coming frequently out of some displaced loyalty to me. Sylvia told me that the pressing demands of her day frequently leave her too tired to engage in sexual relations with her husband. While she claims that she is still interested, she frequently refuses Tom's sexual advances. She has projected onto Tom a whole train of thought--essentially, that he must be thinking that she wasn't too tired when she was sleeping with four guys a week just a few short months ago. I told her that she shouldn't assume that her imaginings about what Tom is thinking actually represents his thoughts and concerns. Furthermore, I reiterated my belief that she and Tom and the boys, together with a couple of babysitters, should take a relaxing long weekend somewhere--Doctor's orders.
5 pm. Twelfth Session with Cassandra Evans. Cassandra called this morning and asked me to squeeze her in for a session today. She and David had an argument over money--David was angry that Cassandra was spending some money that she really couldn't afford to take a friend to lunch to celebrate her friend's promotion. I've never met David, but it sounded a lot like the argument was over something very different than what was expressed. Cassandra said that David seemed to be spoiling for a fight. Cassandra reacts poorly to arguments. She said that she's afraid that she'll appear stupid, she's afraid of the argument escalating, and she's afraid of feeling even more pathetic. She feels like she's being punished for not being a good person. I tried to teach Cassandra some fairly straightforward communication skills--refusing to be drawn into an argument, but instead framing a conversation as an explanation of how she is feeling without interruption. But I know that all that is much easier said than done. Cassandra also is feeling helpless in negotiating the normal details of ordinary life and it makes her feel like a sick pet. She finds it difficult to accept other people's help. I asked Cassandra about her day, and I got the distinct impression that she is waiting to get better before giving herself permission to live at all. So I told her to find something that interested her--a hobby perhaps or a field--and try to spend some time working towards that goal. I told her not to spend her life waiting to get better--to engage her life in whatever degree she was capable in now.
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Charles Balis' Personal Diary & Log