Saturday, September 27, 1997 |
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Sunday, September 28, 1997 |
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Monday, September 29, 1997 |
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Tuesday, September 30, 1997 |
12:30 pm. Telephone Call with Sylvia Bows. Sylvia called me and told me that Richard died last night. She cancelled her appointment, and clearly didn't want to talk about it further. 1 pm. Ninth Session with Kester Langford. Kester came in late today. He told me that he's feeling very ill--bad abdominal pain and diarrhea. He said that he'd feeling that way for a while. He sought medical help--he went to see his doctor who then ordered a battery of tests for Kester--blood work, an ultrasound, and a sigmoidoscopy. They discovered a tumor the size of a golf ball in his liver, but apparently Kester's physical symptoms and discomfort is not due to that. The tumor is a hemangioma and is unlikely to be cancerous. But it scared Kester. He is worried about his mortality and all the things that he might have done differently in his life. He said that he always envisioned himself having a family, and now it might be too late. He also was interested in reconciling with his brother, which surprised me. Kester still needs to get more tests done before his internist can diagnose the cause of his stomach pain. But the next available opening to do the blood pool scan is in November. I told Kester that I would help him to arrange to take the test earlier--maybe I can talk with the radiologist over at Kaiser and explain how the delay is effecting Kester's mental health. Part of Kester's stomach problems might be due to stress, and waiting for over a month for a diagnosis wouldn't be good for him. Kester was too uncomfortable sitting in the chair, and we had to end our session early. |
Wednesday, October 1, 1997 |
4 pm. Twentieth Session with Katherine Lippard. Katherine is carefully planning her interview with her mother. She makes it sound like she is planning strategy straight out of a board room. She plans to maneuver the conversation into the areas that she's interested in. She knows what she is willing to reveal and how much of her emotions to show, and what to keep in reserve. She's very results oriented. She doesn't want her mother to know that she is being interrogated from a script, even though that's exactly what's happening. Her interview questions are as follows: "Thanks for the college money. Why did you keep it secret? I sure felt bad when Daddy left, but I bet you felt worse. How did you feel, and did it have anything to do with me? While we're on the subject, did you ever feel jealous of my relationship with Daddy? Because sometimes I did, of yours. Did he tell you any more about why he left? Do you know why he stopped calling? Have you heard from him since then? Do you know if he's alive or dead?" While she was rehearsing her questions with me, she reacted emotionally to the thought of her father's possible death. But she waved away my tissues and insisted that she had to desensitize herself to these issues so that the interview doesn't turn into a session where her mother comforts her. She wants to be able to show her mother that she can handle the truth. Katherine has a little trick that she does to repress her feelings. It's almost as if she can flick an internal switch and stop her emotions. Then she quickly changes the subject. When I called her on it, she acted indignant that I would indicate that she didn't experience her feelings and then, when I pushed on, she became defensive and said that she'd let herself feel again after she had the answers that she wanted from her mother. And then she changed the subject, as predicted. So we ended the session talking about her consideration of posing as a nude model for Jake's photography, and a bit about her sister-in-law, married to Joey, who is trapped in an "image is everything" mind set. 5 pm. Eighteenth Session with Alex Rozzi. Alex disclosed a fantasy about running away to join the circus, which really is an expression of his desire for independence. He won't be eighteen until January 1999, and he is frustrated by the age requirements which won't allow him to take his GED exam. Alex has worked as a male prostitute, but he desires the ability to earn his living legally. Ironically, society's rules designed to protect children, force Alex into illegal and dangerous activities in order to survive. I urged Alex to take advantage of his current stable living situation to complete high school, but Alex brushed off my advice. The conversation turned to Tony, who has had a remarkable change of circumstances. After the failed intercession, Tony was badly beaten and required hospitalization. Tim, his tormentor, is dead of a drug overdose, and Tony turns out to be the main beneficiary under his will--and is now the new owner of a successful leather store on Polk Street. Tony is currently in the highly regarded drug rehabilitation facility in St. Helena. I can't think of another situation where one has moved from being so low to so high in the space of a week--from abject, abused sex slave to business owner in rehabilitation. I hope that Tony turns out to be a success story after all. Benny's trial looms large in Alex's life. He is being threatened and told not to testify by anonymous written messages sent from someone not currently in prison. That sparked a reminiscence by Alex of his father being similarly threatened when he was going to testify as to a murder he witnessed. Alex believes that marked the beginning of his father's objectional behavior towards Alex--mostly directed against any notion of Alex's homosexual preferences. I decided to question Alex on his homosexuality--obviously, he'd made it clear enough, but I've never heard him identify himself as gay. He couldn't believe that I didn't know--and of course I did know--but he admitted that he was and asked me if I had a problem with it. I naturally turned the question around, and asked him if he had a problem with it. And he certainly did. He stammered and turned red. It was if he had been caught in a lie, or something. Alex doesn't identify himself as part of the homosexual community, was what I gathered. He thinks of himself as an atypical homosexual, but he was clearly unwilling to talk further about this subject. Perhaps it is his father's homophobia which has made him so skittish on this subject, or perhaps something else is going on. We'll have to explore this in greater depth in a future session. |
Thursday, October 2, 1997 |
10 am. Telephone Call with Decker Jenkins. I was surprised by the phone call I got from Decker. The last time I saw him was during our fifth session together on June 26th of this year. He was very irrational then--I even suspected an interaction between his cold medicine and the risperidone that I gave him to control the symptoms of his schizophrenia. I remember that I was very bothered then by some of his comments about the murder of his mother. He gave me an impression that while he had been cleared of her murder, Decker might still had more to do with that event than anybody knew. Now, he tells me that he was in Chicago and has found his long lost father. Decker said that seeing his father made him understand that he needs help and that he wants my help. I was glad that he was interested in starting up our sessions together, but I wanted to probe just how serious Decker was about therapy. It seems that he is, and we have set up an appointment for next Tuesday at 11 am. An interesting note, not once during this conversation did Decker mention Simian--the imaginary and very distractive voice inside his head. But Decker seemed very edgy and scared, much like he was before the ameliorative effects of the drug therapies began. My guess is that he has stopped taking his medication, which must mean that Simian will have returned in full force. 5 pm. Nineteenth Session with Christina Herald. Christina showed up with a large paper plate of cookies today. She baked them herself--oatmeal with crushed hazelnuts and toffee pieces. Despite their looks, they were very good actually. I guess Chris is trying to take care of me--last week, she kept urging me to get a cat, and this time cookies. I didn't know I was such a sorry case. Chris was in a good mood today--upbeat and in her usual tempo. It didn't take her long to get over her broken engagement with Malcom. She had a pretty nasty cough. But when I asked if she'd seen a doctor yet, Chris just brushed me off--it was bronchitis, she thought, but now she's better. Moreover, she admitted to smoking cigarettes through her whole illness. I was going to preach the virtues of quitting smoking, but it was clear that Chris was not receptive to that lecture at the moment. As always, she'll quit when she's good and ready. She said that a student had spied a tattoo on Chris's back and she was worried that it would get back to the principal. I said that many people her age have tattoos and are now in professional positions. She got quite defensive with me when I referred to her as "people her age." Apparently, Chris suffers from some insecurity on that score. She's short and young and worries about whether she's being taken seriously. I tried to reassure her that I certainly respected her and thought of her as an adult. But the truth is that when I think of Chris, it is not the serious intellectual that I remember. It is something of the impish personality that stays with me. Perhaps that quality in her personality is what Chris finds incompatiable with her desire for recognition as an adult. Chris told me that her cat had an accident a few days ago, and she even thought that he might die. But while ministering to Lancelot, the vet managed to proposition Chris. She was thinking of accepting until she noticed that he was wearing a wedding ring--he was appareently married but was still asking her for a date. She was almost insulted, as if his interest somehow showed that she had been reduced to a low rung on the dating ladder. Chris also said that her grandmother has decided that her personality is like that of a long deceased great-aunt Helen, who died at the age of 25 well before Chris was born. But Grandmother Strauss has decided that Chris should inherit great-aunt Helen's possessions, so Chris will be receiving a trunk in a few days. She's looking forward to that with interest. |
Friday, October 3, 1997 |
5 pm. Eleventh Session with Peter Hossfeld. Peter is experiencing a recurring psychotic episode coinciding with the phases of the moon. He believes that he has become possessed by an evil and malevolent entity which wishes to take over his form and commit violent acts. The closest I can come to describing his psychosis is that Peter believes that he is a werewolf, without any of the lupine transformation normally associated with that legend. But as the moon goes to full, Peter feels himself losing control in his continual battle against the monster within. He is beset by auditory hallucinations as an evil voice tells him to commit acts of mayhem against children he passes on the street, or to sexually assault Eliza. To this point, Peter has not actually committed any of these acts, but he feels himself weakening. I diagnose Peter as suffering from a Brief Psychotic Disorder, but with a "culturally relevant" stressor of the phases of the moon. It is culturally relevant only within Peter's peculiar mind-set, particularly his belief in the particular form of Serena's curse. After talking with Peter, I became convinced that he required hospitalization, and he agreed to a voluntary commitment. So I asked him to wait in my reception area while I made the arrangements. I called the Mental Health In-Patient facility at the California Pacific Medical Center and arranged for his admission, but when I went out to get Peter, he had vanished. I've tried calling his home several times since, but with no results. I can't call the police, because I can't honestly say that I believe Peter is an imminent threat to himself or others, although that thought has certainly crossed my mind and I am clearly concerned. I tried to contact Eliza to let her know that I thought it was a good idea that she stay away from Peter for the time being, but I was unable to reach her either. I'll keep trying at both numbers. |
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