Saturday, September 12, 1998
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Sunday, September 13, 1998
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Monday, September 14, 1998
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12 pm. Thirty-First Session with Thomas Darden. Thomas quoted the old aphorism today: "When it rains, it pours." Sharon unexpectedly moved to San Francisco to join the nursing program at UCSF. She contacted Thomas and they had an evening together, which ended up with them having sex. While Thomas believes that each was only looking for a one night stand, Thomas admitted he felt a rush of old emotions towards her. I'm obviously not surprised and I'm a bit concerned he's going to renew a relationship that was quite destructive. Thomas also said Rachel invited him out to lunch. Thomas thought this was the opening he had sought, until Rachel showed up with Kelly Wiseling. Rachel was obviously trying to set up the two of them together, which dashed Thomas' hopes as far as Rachel went. But Thomas liked Kelly, although he said he can't see himself with her. I'm undecided if Thomas' hesitation is related to Kelly's deafness. He says it isn't, and he even appeared to try the handicap on for size--he declared he'd rather be deaf than blind or unable to taste, smell or feel. Thomas said he thinks Kelly is too good for him--as though she's out of his league. But perhaps he's just covering his uneasiness about dating a deaf woman. Thomas reports he hasn't had any side effects from the Zoloft, although he did say he had a bit of trouble initiating an erection the other night when he was with Sharon. However, he also said he had a considerable amount to drink that night, not to mention the long and emotional history the two of them share together.
5 pm. Telephone Call with Herbert Michel. Herbert called me from Reno, Nevada, obviously drunk. He told me he had married Lenore and said both of them were going to come and see me on Thursday.
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Tuesday, September 15, 1998
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12 pm. Fourth Session with Madeline Trent. I felt it was important to spend the session today giving Madeline some tools to handle her stress levels. I filled out a social readjustment rating scale for Madeline in blue ink and came up with 200 points. She added an additional 180 points in red ink. On that scale, 250 points would indicate someone who was severely overstressed. With both of our markings, Madeline tipped the scale at 380 points. I told Madeline about some research into body clock cycles and stress and urged her to try some basic relaxation techniques. Obviously, she has a considerable problem in trying to get back into an adequate sleep/wake rhythm when she is nursing a baby at night. I wanted her to try to give some of that responsibility to Jesse, but she was reluctant to do so--she likes to nurse Natalie. We spoke a bit about endorphins and neurotransmitters, and she seemed enthused about working on the things we discussed during the session.
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Wednesday, September 16, 1998
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2 pm. Sixth Session with Kelly Wiseling. Kelly and I had a frank discussion about her interest in sex. She needed reassurance that her substantial interest didn't make her unusual. Kelly said that she thinks frequently about sex, and she told me that she went to a Good Vibrations store with a friend and purchased a vibrator and a book on anal sex. She happened to mention the title of a book which one of my patients at Columbia had recommended to me--"Anal Pleasure and Health" written by Jack Morin. I felt particularly erudite being able to rattle off the book's author. Kelly must now have the impression that I've read every book available at the local sex aid store. While Kelly briefly experimented with anal sex with Peter, she had a poor experience. However, she's still clearly interested in the practice. I gave her some brief advice about safe sex practices, but I know that Morin's book goes into great detail on the subject. Kelly's primary difficulty with sex at the moment seems to be a fairly typical embarrassment in discussing topics which disclose she has an interest in sex. Again, I tried to reassure her that her interest was quite normal. I asked Kelly to create a list of the qualities that she's looking for in a romantic partner and a list of the goals she has for a long-term relationship. I want her to have those items firmly in mind when she cruises the dance clubs looking for a sexual encounter.
5 pm. Sixty-First Session with Alex Rozzi. Alex was very upset today. He told me he had gone to visit Benny in jail. Alex was particularly embarrassed and ashamed because he wasn't able to keep his cool and stay unemotional. Instead, he experienced a violent upwelling of contradictory feelings--a recap on all the issues we've spent so much time dealing with over the last year. There was reconciliation, confrontation, condemnation, declarations of love and hate. It was a full spectrum of emotions--the whole nine yards. At the end, Alex felt there was a certain finality, as if perhaps he'd never see Benny again. I'm not sure whether Alex's visit to Benny really represents a catharsis or not, but it certainly has triggered a host of emotions that probably needed to be exorcised one way or another. He had driven to the jail with Cami, and afterwards he was physically ill. He experienced chills, shaking, and nausea. Cami gave Alex some of her mother's pentobarbital. I saw the bottle and they were 40 mg. Nembutol capsules. Alex has been taking them for several days to sedate himself and as a self treatment for insomnia. Of course, I reacted strongly against his using someone else's prescription drugs, particularly a barbiturate as addictive as Nembutol. He said he'd give the pills back to Cami. Alex is also smoking marijuana both to ease his insomnia (and attempt to dull the vivid quality of his dreams) and for recreational purposes.. After Alex had this emotionally wrenching scene at the jail, he turned to Ted, the waiter from Waiters on Wheels who looks so much like Benny. Perhaps he views Ted as an emotionally safe Benny surrogate. Alex calls Ted "Mr. Wow" partly because of the initials of his employer, and partly because of the size of his genitalia. Alex feels a strong physical attraction for Ted, but otherwise doesn't seem to have much real feeling for him. And Luke was not mentioned. Perhaps I was too quickly dismissive of Alex's feeling that his relationship with Luke had come to an end.
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Thursday, September 17, 1998
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10 am. Third Session with Herbert Michel. I just finished a very disturbing session with Herbert and Lenore, now his wife. Herbert was apparently high on methamphetamine. He was verbally abusive to Lenore in my presence and she described some fairly serious examples of physical abuse as well. Herbert gambled away some money which really belonged to a drug dealer--about two thousand dollars worth. From what I hear about drug dealers, he's unlikely to take it well. Lenore was very upset as she saw Herbert gambling away money she knew wasn't his. Herbert took it as a sign she was only interested in nagging him and destroying his enjoyment of the moment. Unfortunately, Herbert is in rather deep. It is interesting to me how much similarity there is between Herbert and his methamphetamine addiction combined with misogynism and Joseph Mazurka--my now deceased ex-patient who had similar problems. I'm hopeful Herbert will follow a different path than Joe did. At one point, as I tried to calm Herbert down, he became convinced I was siding with Lenore (I probably was) and stormed from the office. Lenore was quite calm and logical throughout the session--she's obviously used to the abuse. She clearly adopts a particular protective persona with Herbert because after he left the room, she became a lot more her own person--more forceful and sure of herself. Herbert told me previously she had a father who abused her. She's gone from one abusive man to another. Perhaps she developed the milquetoast protective coloring when she was dealing with her father and now adopts it with Herbert. It's as if she's neutral, somehow. She doesn't break down while he's abusing her, but she doesn't stand up to him either. Perhaps she's found that taking either extreme tends to escalate the violence. In fact, she sat frozen with her arms folded in front of her during most of the time when Herbert was in the room. She is now several weeks pregnant. Herbert wants her to get an abortion, although it's not at all clear that's what she wants. She is attractive in a clean-cut, well-scrubbed way. She is slightly overweight with long brown hair parted in the middle. She has large blue eyes, a round face, and a vacant, naive look while she's with Herbert. There was a lot more determination after Herbert had left. She clearly cares for him--she was trying to justify his behavior towards her and she was also trying to protect him. However, she declined to tell Herbert she loved him when he was attempting to force her to. She told me Herbert takes methamphetamine and then madly writes, creating fantasy characters who seem to overcome his own sense of self. She also told me he plays some fantasy role-playing game in which he is a vampire. She said he has bit her neck and drawn blood and once, she awoke to find him digging into the skin of her neck with a razor blade. Obviously, I was very concerned. Given his propensity for violence, his current penchant for methamphetamine, and his obvious anger and abusive display in my office, I felt Lenore was in imminent physical danger. I therefore gave her the number of Casa Las Madras and urged her to contact them immediately and move out of the house. I also urged her to talk to a therapist other than myself. She said that she wanted to see me. I cited ethical concerns with treating both her and her new husband. But she said that she wouldn't see anyone who hadn't already met Herbert--she was afraid another therapist would have Herbert arrested. I made the ethically disturbing choice to see Lenore again without Herbert's knowledge, using as a pretext the notion that she can give me insight into Herbert which will be useful in my treatment of him. However, it feels a bit like hair splitting to me. I really agreed because I was afraid that otherwise she won't take any steps to leave and she'll be injured by Herbert. As it is, I figure the odds are somewhat less than 50/50 that Lenore will actually leave Herbert and show up for her appointment next week.
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Friday, September 18, 1998
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10 am. Thirty-Second Session with Sharon Lough. Rob signed Sharon up to be a teacher for an English as a second language class and a student of a class which publishes the literary magazine for City College. Sharon railed against the class and the teaching, but then she described in detail the dynamics of the class and it sounded to me like she experienced a qualified social success. The teacher decided that Sharon should be the editor because of her critical sensibilities. What surprised me was that Sharon was able to socially interact with a classroom of strangers, albeit in her usual caustic manner. It seemed to also surprise Sharon, actually. She ascribed it to not caring at all about what anyone thought of her--in fact, she said that she was hoping to be expelled. But I don't think that Sharon stays up nights worrying about how she is perceived by others. I'm glad that she is beginning to be diverted by outside pursuits, and this class might be just the thing.
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Charles Balis' Personal Diary & Log