Friday, November 7, 1997	12 pm. First Session with Sharon Lough. Sharon is a 29 year old female of mixed racial heritage--she wrote on her form that her mother was Japanese and her father was Caucasian. She has a dark complexion and strong, handsome features. Her hair is brown in color and long and curly--she hides a bit behind her bangs. She avoided eye contact through much of the session, and spent a great deal of time nervously picking at her cuticles or her face or her hair. Her clothes were baggy, as if to hide the shape of her body, although she is physically quite attractive. Sharon has a slight stutter. When she is not picking at herself, Sharon makes a series of nervous hand gestures or she physically sits on her hands. Sharon is a current suicide risk. About a year ago, Sharon reports that she was abusing methamphetamines and became irrational, trying to provoke her boyfriend by breaking up his things. He responded with physical abuse, beating her up. They broke up, and about a month later she says that she was still angry with everyone, including her then boss who was blameless. She got into an argument with him and was fired. That triggered a suicide attempt which Sharon describes as half-hearted but which I believe was a serious effort to kill herself--the scars on her wrist run parallel to her forearm. She took a handful of pills, drank as much alcohol as she could, and cut her wrists. I think she's very lucky to be alive. Her experience at the hospital and at the inpatient mental health facility where she ended up was less than ideal, and she has a rather low opinion of psychiatrists in general, although she was quite cordial to me. But now Sharon feels the same pressures building on her that eventually led to her suicide attempt last time, and so she sought out my care. Physically, Sharon presents symptoms of stomach disorder (she thinks it may be an ulcer); migraine headaches; and back, shoulder and neck pain. Sharon is a secretary for an engineering group at SII, where she describes being hideously overworked. She also complains about her landlord and his family, who live in the apartment above her, and she complains about a co-worker whose slovenly habits and poor work ethic increase Sharon's workload. Sharon lives alone except for the company of a female ferret named Harriet. Ferret ownership is apparently illegal in California, and Sharon is a member of a group which is fighting to change the law, which Sharon described as stupid. In summary, Sharon is a suicide risk and has a history of both substance abuse and utilizing prescription drugs in an attempt to overdose. Obviously, I am going to be very leery of treating her with drugs. I'd like to spend the next session trying to get a handle on some of the emotional issues which led to her feeling of being overwhelmed. I think I'll split the time between trying to understand her current issues and trying to understand what precipitated her previous suicide attempt.
Friday, November 14, 1997	10 am. Second Session with Sharon Lough. We spent much of the session talking of Sharon's feelings about her co-workers. Sharon describes herself as fundamentally anti-social at work--she hides behind her computer and tries to avoid talking to people. But Sharon has little sympathy for either the ineptitude or personal commitments of other people. Sharon became quite passionate in her antagonism to single mothers who require special dispensation in order to be able to balance the demands of their children with those of work. Sharon expressed the opinion that single motherhood is a burden on all of society, and that kids who are not wanted are a particular tragedy. She doesn't like it that society puts single mothers on a pedestal, what with birth control, abortion, and adoption as viable alternatives now. In the midst of this denunciation, Sharon mentioned that she might feel so passionate about these issues because of her own "screwed-up" home life. Sharon disclosed that she believes that she is sterile as the result of an ovarian cyst. At the same time as she expressed her happiness at not being burdened with motherhood, she described herself as feeling "defective." And Sharon was particularly hurt by an inexperienced therapist's seemingly flip reply to her emotional tale of being physically abused by her father. Sharon has a number of issues related to motherhood and her own childhood which will need to be carefully explored. Specifically, although she is reticent to explore these issues, her father's physical abuse has resulted in a lifetime of nightmares and anger. She says that she can't stop her painful memories from flooding back at inopportune times. I need to gain Sharon's confidence in order to be able to conduct a realistic suicide assessment, which I think is critical. I am hopeful that after a couple of more sessions, she'll be more forthcoming about her foundational issues.
Thursday, November 20, 1997	2:30 pm. Telephone Conversation with Sharon Lough. Sharon called me. Her landlord is apparently trying to evict her from her apartment and is claiming that she sexually molested his son--"inappropriately touched" is the term he used. I told Sharon that she needed to speak with an attorney who specialized in criminal law. The attorney will advise her about what she needs to do about the unlawful eviction as well as how to avoid the landlord's false charges.
Friday, November 21, 1997	10 am. Third Session with Sharon Lough. Sharon is dealing with the crisis of her landlord. He's accused her of "inappropriately touching" his son, mostly as a ploy to evict her from her apartment, it seems. Sharon is beside herself. She feels that everyone will believe that she sexually molested the boy, regardless of what she says, and she thinks that the landlord will be able to take advantage of her--wrongfully evict her, keep her security deposit and last months rent--by threatening to make this false accusation. I'm no lawyer, but it sounds like extortion to me. I strongly advised Sharon to seek the help of a criminal defense attorney, and she says that she will. Sharon has a friend, Charlotte, who has taken her in and put her in touch with an attorney. Sharon also has a younger sister, Linda, who lives in San Francisco and who Sharon views as the favorite child. While Sharon sees herself as socially awkward, Linda is the one who can "play the game." But Linda is nothing but a harpy as far as Sharon is concerned. Linda is caught in the common sibling trap of one upmanship, rendering her useless for Sharon's support network. Sharon describes her own primary current emotion as anger rather than depression, although she sees this as a low point in her life. She says that she first came to see me when she thought things couldn't get any worse, and now they have. But I don't think Sharon is an immediate suicide risk. Primarily, she seems motivated by revenge fantasies. Sharon was concerned that I would seek her commitment, but I basically explained that her feelings of hatred towards her landlord seemed pretty well motivated at the moment, and that as long as they were just feelings and she didn't seem about to act violently towards him or towards herself, I wouldn't seek to physically intervene.
Friday, December 5, 1997	10 am. Fourth Session with Sharon Lough. Sharon began by confessing that she is beginning to dread her therapy sessions. But as she spoke, it became increasingly apparent that she wants to avoid any reminders of her current situation. She spoke with some empathy for a girl that she read about that denied and hid her pregnancy and killed the child when it was born. She talked about getting caught up in the denial and being able to pretend that the unpleasantness is happening to someone else. She went to a lawyer, but seems unlikely to carry out his advice. It's for a similar reason--to avoid the reality of her current situation. Sharon is depressed rather than angry. She said that she was "depressed, defeated, drained." She's been eating in binges as well, and called in sick today merely because she didn't want to face anyone. Sharon opened up quite a bit during today's session, telling me something about a promiscuous sexual past which involved experimental homosexual and alternative lifestyle activities as well as illegal drug use including methamphetamine, cocaine, and marijuana. Now she says that she feels like a neutered cat--that she has lost interest in sex, although she used to be obsessed with it. She describes her recent past like a morality tale: "Girl does drugs, has sex, goes crazy, ends in mental hospital." Sharon told me that she thought at one time that she was a lesbian, although she doesn't believe that now. While Sharon has opened up a bit about her past, we are still not near the foundational issues which have shaped her. Her promiscuous sexual history is as much a reaction to those issues as is her current persona. But her current depression coupled with her suicidal tendencies is a dangerous combination. I need to continually update my suicide risk assessment for Sharon.
Friday, December 12, 1997	10 am. Fifth Session with Sharon Lough. Sharon revealed a bit more of her previous sexual history--a history which has left her dreading the prospect of sexual activity of any kind. With a previous boyfriend, she became involved with the Society of Janus, an S&M club. While she had some positive experiences there as a submissive, mostly she recalls negative ones. Although she admits that she may not have communicated with her partners as effectively as she might have, she recounts situations where she feels that she was victimized. Apparently, she performed certain acts in public for other club members. She thinks that she got in over her head and she is now worried about Charlotte, who has joined the S&M community. It is a worry paradoxically tinged with jealousy--Charlotte seems at ease socially and has become part of the "in crowd," cavorting with the professional dominants who are the celebrities of the S&M world. Part of Sharon wishes that she could feel at ease in that world, while part of her is revolted by a vision of what she once was. Charlotte is pursuing sexual adventure at the expense of her husband, Robin, who Sharon believes is sticking with Charlotte but feels betrayed. While it is obvious to me that Sharon realizes that she has a number of problems of her own--most notably her antipathy for sex, her suicidal ideation, and her living situation--she has become obsessed with Charlotte's and Robin's difficulties as a way of escaping her own. Charlotte made a comment to Sharon about her "keeping Robin company" which Sharon thought might mean that Charlotte wants her to engage in sexual relations with Robin as a surrogate for Charlotte. The thought disgusts Sharon, not because of her attitudes towards Charlotte and Robin, but rather because the thought of the sex act itself is revolting to Sharon. She said that the thought of bodily secretions, nudity, and being touched were nauseating. Sharon clearly has an extremely low self image. She finds herself repugnant in the harshest possible terms and filters her experience of daily life through that prism. Sharon projects a certain air of competence which masks a deeply felt sense of inferiority. We have a lot of work to do together.
Friday, December 19, 1997	10 am. Sixth Session with Sharon Lough. Sharon allowed herself to be used as a "beard"--a pretend lesbian slave to allow Charlotte to make an impression with the bigshots of the lesbian S&M community. Sharon feels that she owes Charlotte, so she allowed Charlotte to parade her around so that Charlotte could brag of having both a husband and a little slave girl. While Sharon described Charlotte as having been a super feminist in college, Charlotte seemed to have no problem in talking and acting in a way calculated to be demeaning to Sharon. It seems particularly insensitive given Sharon's distaste for the S&M community, which she must have communicated to Charlotte. Sharon says that she gave in to Charlotte's request partly out of a sense of obligation to Charlotte for providing her a place to live and partly because she is "weak and spineless." But Sharon took some actions during the event to make Charlotte realize that she wasn't enjoying herself. Sharon said that when she was a member of the S&M community, she never could trust anyone. Everyone had ulterior motives--usually involving sex. Sharon spent a day with her sister Linda and it sounds like there are no vestiges of warmth in that relationship. Sharon said that Linda is verbally abusive and her abusiveness reminds her of her father, whom Linda is closer to than Sharon. Sharon's father was Irish, and he was an abusive alcoholic. Although Sharon told me that he was physically abusive, she didn't describe any physical abuse. But she went into some detail about her father's verbal insults, which clearly sting to this day. Sharon has revenge fantasies, one of which she told me about: she imagines visiting him in the hospital when he is seriously ill and helpless, and abusing him both verbally and physically. In fact, she hasn't spoken to her father in a number of years. Sharon says that she wants to cut off her relationship with her family altogether, although she hasn't said anything about her relationship with her mother yet. I suggested, instead, that she focus on resolving a number of these issues through therapy, which Sharon joked was part of a money-making racket. I guess in a way she's right. Where would my business be without parents who abuse their kids? Sharon did open up a lot during this session, and I think the approach of allowing her past to come out slowly with only gentle probing on my part will ultimately be the most effective.
Friday, January 9, 1998	10 am. Seventh Session with Sharon Lough. I've had patients walk out on me before, but Sharon left at the end of the session in a quite inexplicable manner. I'm sure that, objectively, I did nothing that could be deemed offensive, but she was clearly filtering my responses through some previous bad experience with a therapist. Sharon was tense and irritable throughout the session. Sharon has been spending a lot of time with Robin, who has been made a virtual widower by Charlotte's S&M exploration. Sharon finds Charlotte's "in your face" sexuality annoying, particularly because Charlotte insists on telling Sharon all about it in some detail. Sharon links sex with alcohol, drugs, other compulsive behavior--Sharon told me that she used to be bulimic until her back teeth fell out--and ultimately, she links sex with her suicide attempt. Sharon tried celibacy before for two years, but she felt like she was constantly battling with lust. Now, she says that the lust is gone, and she thinks that she is the better for it. She sees herself, and Robin, as two neutered cats, getting their pleasure out of eating and watching television. Sharon told me that happiness is just self-delusion, and she can be happy if she just divorces herself from reality as much as possible and pretends to be happy, or at least content. I'm concerned about Sharon because she seems to be making a conscious effort to disassociate herself from her feelings as a form of avoidance. But given Sharon's bad experience with therapists and our session together taking a bad turn today, I'm not sure that I haven't lost her as a patient.
Thursday, January 29, 1998	10 am. Eighth Session with Sharon Lough. We covered a range of topics today, and Sharon evinced more willingness to talk with me about sensitive issues in her life, although she is still clearly guarded. She told me about a deep hatred that she holds for her father, even fantasizing about being the instrumentality of his death. She told me a little about the abuse that she suffered at his hands--physical and emotional--although she bristled at my inquiry as to whether there had been sexual abuse. The vehemence of her negative reaction made me more suspicious that there may have been a sexual component to the abuse she suffered from her father. In a sharp insight, Sharon saw that there might be a connection between her involvement in the S&M community and her feeling of being victimized by her father. I suspect that is one of the reasons that she has such a strong reaction against the S&M community and sexuality in general now. She's overcharged those normally emotional issues into volcanic upwellings of potent feelings. She's imbued her sister with some of the negative feelings that she wraps around her father--there seems to be a host of sibling issues that stem from childhood interactions and now continue into adulthood. Her father's abuse is still the subject of nightmares and "flashbacks" for her--unbidden memories which torment her suddenly without an obvious trigger. Her self-image is quite poor--she sees herself as an antisocial, miserable, "cranky bitch." She also sees her perceived status as a "loser and victim" as an unalterable part of her destiny. When I pointed out that by seeking therapy, she was showing a willingness to overcome her "destiny," she said that it was hopeless and that at 30, she was all washed up. Sharon told me a bit about a birthday dinner that she had to endure with both Charlotte and Robin at a trendy Japanese restaurant. Basically, Charlotte embarrassed Sharon through her condescending attitude towards the Asian waitress and through her table manners, although it sounds like Sharon might have reacted more to the underlying emotional subtext rather than to Charlotte's overt behavior. I wondered whether Sharon's half-Asian ancestry would become an issue during therapy--specifically if there are any cultural issues of which I should be aware. I know there is a cultural tendency towards self-deprecation which might come off as a poor self image if it came from someone from a western culture. However, Sharon's poor self image is clearly beyond any cultural norms. While I have a laundry list of issues that I believe Sharon needs to work on in therapy, I'd be interested to know what she thought were the pressing issues that she needed to address. I suspect that her antipathy towards sexuality, for example, or her low self image generally won't make the list.
Thursday, February 12, 1998	10 am. Ninth Session with Sharon Lough. I'm confused by Sharon. While my instincts tell me that she's not actually suicidal, when I review what she's told me, I have to dispassionately conclude that she is a significant suicide risk. Next session, I must conduct a formal suicide assessment to determine if hospitalization is warranted. I'm particularly concerned about taking that step because winning Sharon's trust has been difficult and she would clearly see involuntary commitment as a betrayal. Sharon has some undiagnosed gynecological complaint involving irregular bleeding, dizziness, and nausea over a two week period. It sounded to me like an ectopic pregnancy, but Sharon assured me that she hasn't had sex and so can't be pregnant. However, Sharon claims to welcome the disorder as a means of passively killing herself. She fantasizes about having ovarian cancer, and sees dying in that manner as a romantic tragedy. She even toyed with the idea that she might have AIDS. Sharon became dizzy during the session and threw up on my floor. She refused my urging to go to the emergency room and assured me that she would make an appointment to see her doctor post-haste. Sharon's pet ferret died violently last week when it was attacked by the neighbor's dog. Sharon sees her inability to protect it as further evidence of her own inadequacy. She also mentioned that she hates her job.
Tuesday, February 17, 1998	10 am. Telephone Conversation with Sharon Lough. Sharon called to cancel her appointment. She's been diagnosed with Stage III endometriosis, although she desires a second opinion. She has heavy vaginal bleeding and abdominal pain. She's scheduled for a laparoscopic procedure on Friday. I was very glad that she sought and is receiving immediate medical treatment, especially after her willingness to consider dying of a disease in a romantic light--a desirable tragedy. She asked for prescription pain killers, but she knew that I wasn't going to prescribe them. I don't even think she seriously wanted them.
Thursday, March 5, 1998	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.
Friday, March 27, 1998	10 am. Eleventh Session with Sharon Lough. Sharon's been sick with bronchitis and she seemed tired during our session today. But she seems overly interested in starting up again with illegal drugs. She admitted to some marijuana use just before she got sick and I have the impression that she would not be adverse to taking her drug use to a higher level. Sharon is an escapist; she said that she's happiest when she's "fucked up." I wanted to persuasively argue to Sharon that she should avoid these drugs, but I couldn't argue about the deleterious health effects because she wouldn't have cared. She argued that Paul Prudhomme, the very heavy Cajun chef, was happier and more appealing before he took to dieting. And, while she admitted that she didn't want to repeat her mental breakdown of last year, Sharon believes that drug use is somehow part of her destiny. So I told Sharon about the dopamine studies which indicate that part of why drugs work to make their users happier while they are under their effects is that they artificially increase the dopamine levels in their brain. The problem is that once the dopamine is used up, it's gone. The user becomes incapable of experiencing pleasure--at least that's what I said. I had hoped to give Sharon a picture of using up all the pleasure that life has to offer over the course of a few weekends. Sharon sees her own life ending early, so she wasn't as concerned as I would have hoped about using up her "measure of pleasure" all at once. Truthfully, I'm not convinced that those studies apply to occasional drug users--all the studies that I've seen only addressed hardcore drug addicts--or that dopamine levels can only be depleted like a bank account which allows for withdrawals but not for deposits. It's interesting that, with the best of motivations, I was willing to possibly exaggerate the dangers of drug use to try to stop Sharon from embarking on what would clearly be a disastrous course of action for her. It gives me some insight into the reason that physicians have lost a lot of credibility on this issue with the drug-using public--an example of the "Reefer Madness" approach backfiring. While I pleaded with Sharon to allow the Prozac to have a chance, she airily waved me off.
Friday, April 3, 1998	10 am. Twelfth Session with Sharon Lough. Sharon came in for her session reeking of marijuana. She admitted that she had gotten stoned before coming in and said that she had been smoking before going to work several times a week. She's bound to get caught and fired--it would be hard not to notice that she had been smoking pot. Sharon says that it is her ambition to be a nondescript nobody at work, and that she's failed even that. Sharon has been having some side effects from Prozac--she reports nervousness and nausea--but she hasn't tried it for more than a few days. Of course I'd be willing to switch medications if Sharon was suffering from side effects, but I didn't get the impression that Sharon has given Prozac a chance at all. She seemed to be only interested in angling for illegal drugs. I thought it was in jest at first, but it seems to be a recurrent theme in our sessions together. Sharon also told me that she and Rob are now sleeping together. She's clearly doing it as a way of repaying her financial obligations to him. With her general repugnance to sex, I don't see that prostituting herself is going to result in the healthiest of outcomes. But Sharon reports that she didn't find it as repugnant as she expected--although she expressed a desire that Rob suffer from premature ejaculation, so I presume that she is less than indifferent. Sharon seemed to be fishing for a negative reaction from me. She called herself "a stoner and a slut," and then asked if I thought less of her as a result. Perhaps she's hoping that I will play a parental authority role in her life. I did come down pretty hard on her illegal drug use, so I can evaluate her response to that in order to gauge the rest. Sharon is not practicing safe sex with Rob. She's unconcerned about pregnancy because he had a vasectomy. But condoms didn't seem to work well for them. Sharon said that she'd try the Prozac again.
Wednesday, April 15, 1998	11 am. Telephone Conversation with Robin Young respecting Sharon Lough. Robin Young (always referred to in Sharon's sessions as Rob), called to tell me that Sharon was missing and that he was worried about her. He described a bit of what sounds like a hellish confrontation--something about Charlotte walking in on Sharon and Rob while they were in flagrante delicto. Charlotte did not take it well. Sharon took off while Charlotte was still there ranting, abandoning most of her possessions. Now Robin hasn't heard from her for several days. He went through her things and, besides for finding my name and number, found a hypodermic syringe. He suspects drug abuse, although he says that he wasn't aware of Sharon utilizing any drugs more serious than marijuana. I shouldn't be surprised that Sharon may be currently injecting illegal drugs intravenously. I hadn't really considered the possibility before, but it would explain some parts of her behavior. Robin asked me to tell her to call him and also asked me to tell her that she's always welcome to stay at his house, regardless of what Charlotte may say. I told Robin that I'd pass on his message to Sharon when I saw her next.
Friday, April 17, 1998	10 am. Thirteenth Session with Sharon Lough. Sharon arrived disheveled and bleary-eyed to our session. Her clothes were wrinkled and dirty, as if she had slept in them. She acted drugged and lethargic. After attempting to lie to me, somewhat weakly, Sharon admitted that she is injecting a combination of heroin and methamphetamine. In fact, she was clearly under the influence during our session. On Wednesday, I got a call from Robin Young telling me that she disappeared after a confrontation with Charlotte. She's missed a substantial amount of time at work and believes that she may have lost her job there. I spent the session urging her into a rehab program and finally got her reluctantly to agree to a voluntary admission through a combination of cajoling and threats. I got her admitted to the California Pacific Medical Center Rehabilitation Group for one of their two week programs. We went over together and she was admitted without incident.
Friday, April 24, 1998	11 am. Fourteenth Session with Sharon Lough at California Pacific Medical Center. Sharon is outwardly bitter over her "incarceration" at the drug rehab facility, but underneath her anger and dark humor, I think she understands that this is what she needed. She threatened to shower me with hideous craft projects if I kept her locked up--she gave me a really awful chartreuse and orange potholder and told me there were more where that came from. I told her that if she sees the program through successfully that I'll be able to reinstate her at SII. I'm not sure that's within my power, but I can write a letter suggesting that she suffered a psychiatric disability and that now she's fine. What with the ADA rules on disabilities, I think that would likely do the trick. Sharon said that she didn't want to return to SII, but really she has no work, no home, and no friends except for Rob. But her relationship with Rob is not healthy--Sharon is in it because of her feeling of financial obligation. If Sharon is going to successfully give up drugs and avoid another suicide attempt, she has to have something positive and stable in her life to return to. I therefore strongly urged her not to give up her job at SII. Although Sharon resisted my advice that she participate in group therapy, I think it would be beneficial for her to interact in that setting and continue seeing me once a week. When she's out of the rehab facility, I'll set her up with the rehab outpatient group therapy. She'll realize that she's not alone. I expect Sharon to be released next week.
Friday, May 1, 1998	11 am. Fifteenth Session with Sharon Lough at the California Pacific Medical Center. I spoke with Victor Brisbane of the CPMC rehab staff last Monday and approved his recommendation of clonidine for Sharon, .5 mg. B.I.D. They determined that although she manifested signs of poly drug abuse, her primary withdrawal symptoms were related to opiates. I went to see her this morning and she seemed in relatively good spirits, considering. She reports a disinclination to continue with her crafts and seems predisposed to a bit of lethargy. But except for complaining about institutional food, and worrying about how a co-worker from SII found out that she was there, Sharon seems to have adapted to the program, and I believe that she's benefited. She is anxious to be released. She told me about an interview with Peter Coyote on the radio, where he apparently described in some detail the process by which he used to inject narcotics. Sharon felt a certain nostalgia in listening to the program. She told me what I've heard from several other addicts--the ritual of buying, cooking, and injecting the drugs is itself a source of pleasure. That's always surprised me, because were I an addict, I believe I would view the injecting of the drugs as a repellent necessity rather than a tasty appetizer. Sharon is due to be released tomorrow. I urged her to get Rob, or someone else, to pick her up.
Friday, May 8, 1998	10 am. Sixteenth Session with Sharon Lough. Sharon clearly made substantial progress in her drug rehab group. She still maintains her caustic wit, but she's a lot more perceptive about her own situation. I believe that she is now grateful to be off of drugs. She does not reject out-of-hand the Rational Recovery group that she's joined. Sharon professes to having a very short tolerance for new-age psychology or religious dogma, both of which she feels are associated with Alcoholics Anonymous. Sharon is also beginning to feel certain yearnings to become sexually active again with a partner of her choice. She is having a sexual affair with Rob, but he clearly disgusts her. She's in the relationship strictly for the financial benefits it provides. She sees herself as a maid with whom Rob can have sex. Apparently, Rob is quite fat and not scrupulous about his personal hygiene. He seems to admire hippos, and Sharon makes much of the similarity between hippos and Rob. But the fact that she is sexually involved with Rob makes it difficult for her to consider other opportunities for romance.
Friday, May 15, 1998	10 am. Seventeenth Session with Sharon Lough. Sharon came in on crutches with her right foot in a cast. She told me that Charlotte had accidentally backed the car over her foot, breaking several bones. Sharon is taking Tylenol with Codeine. I was concerned that the emergency room physician might have given her a preparation with hydrocodone without knowing about Sharon's past drug problems, but I think the codeine in low dosage is not likely to trigger a relapse. Sharon showed a surprising animosity towards the disabled. She particularly seemed upset about the parking privileges afforded those with disabled placards. When I probed, she dismissed it as jealousy. She said that she sees herself on the cusp, but not quite sick enough to benefit from government disability payments or get special parking privileges. I told her that she probably qualifies for a temporary disabled placard because of her foot. That seemed to cheer her a bit. Sharon clearly felt antipathy towards the woman in her office that visited her when she was in rehab. Sharon calls her "Godzilla"--an unkind reference to her obesity. Godzilla seems relentlessly cheerful, despite apparently suffering from Chronic Fatigue Syndrome. Sharon views the condition, together with its vague symptoms, as nothing more than malingering. I assured her that wasn't the case. Sharon is interested in discontinuing her attendance at the rehab group's meetings, paradoxically because she is attracted to Tony, one of the men who goes there. When I asked her if she normally went out of her way to avoid people that she's attracted to, she said that she does. Sharon wants to avoid social interaction for rather unspecified reasons. But she said that's why she feels envy for those on disability. She'd like to stay in her home drawing a meagre income and not face the world at all.
Friday, May 22, 1998	10 am. Eighteenth Session with Sharon Lough. Sharon was in a foul mood today. She told me that Rob had arranged to get a divorce from Charlotte amazingly quickly--Sharon said that he went to a quickie divorce place and apparently Charlotte agreed to the proposed property settlement. I remember that Sharon told me once that Rob would never divorce Charlotte. Now, he's apparently found the courage, probably buoyed by his relationship with Sharon, to sever that relationship. However Sharon doesn't see it that way. Rob has allowed Charlotte a little leeway in getting her belongings out of the house over a period of a week, and Charlotte has said that she doesn't want to see Sharon there while she's packing. Sharon is livid. She is being inconvenienced in having to move out for the week, especially outrageous in her opinion because of her foot which was crushed by Charlotte's car. Mostly, Sharon faults Rob for being spineless because he considered Charlotte's needs over her own. Sharon said that Charlotte has informed those neighbors who were her friends that Sharon betrayed her and schemed to break up her marriage. Now those neighbors give Sharon dirty looks. Sharon doesn't like to be cast as the evil "other woman," especially when she's in her relationship with Rob only for the financial benefits, which she finds meager anyway. Sharon believes that it was always Charlotte's intent that Sharon have sex with her husband so that she wouldn't have to. I pointed out to Sharon that it was her idea to make good on the sex for barter arrangement. Sharon angrily said that it didn't matter whose idea it was--she knew that Charlotte wouldn't care. Respecting Rob, Sharon acted like a jealous, hurt lover even as she vilified him and told me how much he disgusted her. Sharon fantasized about how bad he'd feel if she left him. Sharon also said that she needed "a good fuck" and she indicated that she was considering entering into a sexual relationship with Tony, the guy she met at rehab. It just struck me--the Tony that Sharon is talking about couldn't be Alex Rozzi's Tony, could he? Alex said that Tony was going to Rational Recovery meetings, too. It must be just a coincidence--there must be dozens of guys named Tony going to Rational Recovery meetings in the city right now. And besides, Alex's Tony is gay. But I think Sharon said something about once about suspecting her Tony was gay, also. Well, Sharon is looking to Tony to perhaps fulfill her sexual needs and, incidentally, get herself a place to live while Charlotte removes her belongings.
Wednesday, May 27, 1998	5 pm. Forty-Seventh Session with Alex Rozzi respecting Sharon Lough. Alex talked about Tony and Rational Recovery and confirmed that Alex's Tony and Sharon Lough's Tony are, in fact, the same. Alex even met Sharon, although he wasn't an enthusiastic fan. It sounds like Alex believes that Sharon has a dark side and he even speculated that she might be a psychopath. Alex, though, did say she sort of intrigued him and he thought she was complicated, although shy. But Alex did see that Sharon was sexually interested in Tony, although he said that Tony was oblivious to Sharon's obvious interest. Alex said that Tony has been known to be bisexual on occasion. Alex thinks that Sharon might be living at Tony's place now. Alex also told me that Tony is smoking marijuana "like a fiend" although he has given up crystal-meth.
Friday, May 29, 1998	10 am. Nineteenth Session with Sharon Lough. Now that Sharon's not on drugs, her tone has changed. Before, she had wit, but it was muddy, dulled by drugs. Now, it's sharp. She's really quite funny, in a bitter, caustic kind of way. She's also clearly very smart and quick. It's unfortunate that her energies are all misdirected and so turned against her own interests. As Alex made clear on Wednesday, her Tony is Alex's Tony. Sharon also spoke briefly about Alex--she clearly didn't like him because she had plans for Tony and she saw him as competition. Sharon sees herself as fighting against an actively hostile world. She sees enemies everywhere--at work, at home, in her parents and family. Last week she got an e-mail message from an old high school friend and instead of interpreting it as a friendly hello, she saw it as an attempt to gather information against her that others could use to put her down. I think that it's important to try to address Sharon's antagonistic view of the world. It currently makes her almost dysfunctional.
Friday, June 5, 1998	10 am. Twentieth Session with Sharon Lough. Sharon told me that she read a piece of literature that profoundly affected her--inspiring her with idealism and a new sense of purpose. I was pleasantly surprised until I found that she was referring to a Dilbert book. While Dilbert may echo deeply felt truths about the modern office, I doubt that it can be the trigger which turns a cynic into a life-affirming optimist. Sharon also said that she's having sexual fantasies featuring Scott Adams. Given Sharon's previous antipathy towards sex, I guess I should view that as a positive development. But really, I think Sharon was jerking my chain. Sharon also spoke briefly about a vague desire to get involved with politics--she would love Dan Lundgren to lose his bid for governor. Sharon fantasizes that he'll get caught in an outrageous sexual scandal. But I don't really see Sharon as a political activist. We spoke about Charlotte and I got a slightly different picture of her than previously. She apparently went on a spending spree with her portion of the property settlement and bought $7,000 worth of furniture. She's storing her old furniture at Rob's house. She also was deeply influenced by Martha Stewart and her house is crowded with the half-finished remnants of home improvement projects. I'd always had an impression of Charlotte as being somehow responsible and capable. Now, Sharon describes her as a ditz. Sharon also went to see the movie Godzilla with the woman in the office whom Sharon has also dubbed with the same moniker. Her real name is Mae. Sharon generalized that women are horrible to each other, even to their friends. She sees a basic pattern of women starting off well and then descending into snarling harpies after a few months. She used her friendship with Charlotte as an example. Sharon believes that men are easier because all they are interested in is sex. But women want to "fuck with your head." Sharon told me that she isn't having sex with Tony. She believes that Tony was only using her to make Alex jealous. She said that she's been in that situation before both with homosexual men and lesbian women. At the end of the session, Sharon accused me of being an expert in the "head fucking game" and asked me for pointers so that she could move from her current "up front and straightforward" approach to something a little more sly. When Sharon finally got personal, she admitted to having a host of revenge fantasies and described herself as seething all day, continually angry.
Friday, June 12, 1998	10 am. Twenty-First Session with Sharon Lough. Sharon arrived in a wheelchair. Both legs were in casts, and her left arm was in a sling. Her neck had a series of bruises, clearly from an attempted strangulation. Sharon ran into an old boyfriend, Josh, at a Starbucks. They had a bad history--Sharon felt manipulated and used by him, although she acknowledged the emotional power he used to hold over her. Apparently, she had unresolved anger quite close to the surface. He greeted her and then made an innocuous remark, asking about what happened to her leg, and she responded by throwing a cup of scalding hot coffee in his face. He didn't take it well. He pushed her backwards on to the floor, got on top of her, and tried to throttle her. Finally, she was able to repulse his attack by using pepper spray. He was hauled away and Sharon was taken to a hospital emergency room. She has a fractured left wrist and a sprained left ankle--her previously uninjured one--along with a mild concussion. She's now in a wheelchair. Neither of them have pressed charges against the other yet. Sharon is seeking disability leave from SII. When she didn't come to work, she was tracked down by "Godzilla." It is something of a mystery as to how she obtained Sharon's address--Rob's home address isn't in Sharon's personnel records at SII. I imagine Godzilla got it from the hospital or from Rob during one of her previous visits. In any case, Godzilla wanted Sharon to participate in the SF AIDS Walk in her wheelchair. Sharon doesn't like big organized charities and forcefully expressed her opinions on this subject to Godzilla. Sharon isn't interested in a friendship with Godzilla and doesn't see that she has anything much to lose if she offends her. My guess is that Sharon, still angry and in pain from her encounter with Josh, wanted to shock Godzilla into leaving her alone. So she started ranting about how she doesn't care about addicts, fags, and prostitutes with AIDS; how they have it coming to them; and how they can all "eat their children" for all she cares. Sharon went on about how the big charitable organizations are all corrupt. Godzilla left visibly offended and Sharon seems to have enjoyed herself doing it. I think we have some work to do on Sharon's people skills.
Wednesday, June 17, 1998	5 pm. Fiftieth Session with Alex Rozzi respecting Sharon Lough. Alex also spoke about Sharon Lough taking Tony away from him. Alex said that he was tired of leaving messages for Tony that were never returned. So he went over to Tony's house one day and discovered, through a haze of marijuana smoke, Tony and Sharon having sex with each other. Alex said that he understood how Luke felt when he happened upon a similar scene between Alex and Camille, although I pointed out that Tony wasn't Alex's boyfriend. Alex is taking it personally and he even voiced a scheme to substitute himself for Sharon in Tony's affections. Alex calls Sharon: "Little Miss move in and take over." He also described her as "odd", although he wasn't more specific. We spoke about Alex's prostitution days. Alex raised those times to show his willingness to use sex as a weapon against Sharon.
Friday, June 19, 1998	10 am. Twenty-Second Session with Sharon Lough. Sharon was in a wheelchair for this session. She told me that she's stopped going to work and has filed for disability insurance. Since she has no savings, if she doesn't qualify for disability, she's in trouble. We spent most of the session talking about Charlotte and a new age religious cult, PSI, which she's joined. When faced with the final divorce papers, Charlotte is procrastinating. Instead, she cajoled Rob and Sharon to join her at a concert put on by PSI, using dinner afterwards as a lure. Sharon described the concert and it did sound dreadful, full of sanctimony and pop psychology wrapped in a cultish religious context. Afterwards, Sharon found herself at a dinner with all the members of the PSI group. She took Tylenol with Codeine recreationally, and then proceeded to drink substantial quantities of alcohol. She remembers bits of the evening that are quite embarrassing--I suspect that the parts she's forgotten are even worse. But Sharon feels that she acted so rudely that it's unlikely Charlotte will invite her to another new age event. Sharon has a prescription for Vicodin which she says she hasn't filled yet. She also admitted to smoking marijuana with Tony, socially, although she skirted my questions about whether or not they've begun a sexual relationship. I'm concerned that Sharon will utilize the free time she now has to engage in self-destructive behavior. I've cautioned her against abusing her pain medication and drinking to excess. For her next session, I've asked Sharon to compile a wish list of things to do that aren't precluded by her disability.
Wednesday, June 24, 1998	5 pm. Fifty-First Session with Alex Rozzi respecting Sharon Lough. Currently, Alex is accutely aware of issues of abandonment in his life. There's Ralph, there's Darla, and there's Tony--whose time with Sharon is cutting in on Alex's time with Tony. Alex says that he is concerned that Tony may be using drugs again under Sharon's influence. I believe that Alex is more likely threatened by Sharon. Now, Alex is threatening to tell Sharon that Tony is suffering from HIV in an effort to split them apart. Frankly, I don't know how I feel about Alex disclosing Tony's HIV status to Sharon. I'd be relieved if Sharon knew about Tony's HIV status. On the other hand, it will clearly put a strain on Alex's friendship with Tony.
Friday, June 26, 1998	10 am. Twenty-Third Session with Sharon Lough. Sharon is still in a wheelchair. She was successful in getting her disability insurance payments. As I feared, she is now taking advantage of her free time and lack of responsibilities to consume drugs. She justifies her drug use as partly medicinal, but she is sinking back into previous behaviors that led her to almost end her life. I'm very concerned, but everytime I voice my concern, she airly waves me off. I think it is important that Sharon find something constructive to do with her free time. Sharon told me that she has looked into taking some language classes at City College, but she registered too late. I didn't sense a profound zeal for learning, but at least she had taken some initiative in registering at all. She brought in a picture of a pet rabbit that Rob gave her as a gift. She expressed a certain fondness for the animal, even as she cursed its existence in Sharon's inimitable style. Even though she lives with Rob, and that relationship is apparently stabilizing, she is spending more and more time with Tony. She said that they don't engage in sexual intercourse, although there is plenty of sexual activity short of that. I believe Tony has HIV from things that Alex has told me previously. But Tony hasn't shared that information with Sharon. When I brought up that point with Sharon, she told me that they aren't exchanging bodily fluids, other than saliva. I'm worried that sexual activity while under the influence of drugs is likely to be unprotected. Sharon's sexual interest has returned. When she first started therapy, she felt asexual and told me that she felt sex was revolting. Now, although still somewhat detached about sex, she has an obvious resurgence in sexual interest. It's a healthy thing, and I told her so. But Sharon earlier described her previous sexual interest as promiscuous. Apparently, she swings between feast and famine. Although it's always difficult to tell precisely when Sharon is joking, she apparently took my interest in her sex life as an expression of my own sexual interest in her. She offered to have sex with me--not motivated by any actual interest, but rather because of a certain chartiable impulse. I declined. We settled into a nice discussion of Sharon's sexual interest in various animals. She likes horses and dogs, but thinks that cats wouldn't make a good sexual partner. I think Sharon has been watching far too much daytime TV, and she agreed.
Wednesday, July 1, 1998	5 pm. Fifty-Second Session with Alex Rozzi respecting Sharon Lough. Alex also told me that he got food poisoning while he was with Tony and Sharon. He used the opportunity to tip Sharon off to Tony's HIV status. Alex was shocked when Sharon didn't visibly react to the news. He was thrown off balance by the coolness which she showed. Alex figures that she somehow already knew, although I don't believe that's true.
Friday, July 3, 1998	10 am. Twenty-Fourth Session with Sharon Lough. Sharon is slowly recovering from her physical injuries. She's out of her cast, although she's sometimes still using a wheelchair. She told me her side of the conversation she had with Alex Rozzi. Sharon didn't register what Alex was implying by his comment about Tony's fragile health. Only later did she feel that he might have been trying to tell her that Tony was HIV-positive. Even though she was sexually intimate with Tony, Sharon sees Tony's silence on his HIV status as stoic rather than a breach of trust. I urged Sharon to ask Tony about his HIV status and she agreed. Sharon told me that Godzilla, her co-worker, knocked on her door and invited her to some new age Native American event in Marin County. Godzilla had a tall Native American man who was considerably younger in tow. Sharon recognized his looks and mannerisms as that of a drug abuser and felt that, despite Godzilla's introduction of him as her boyfriend, he had no interest in the older woman. The three of them drove together to some wooded venue in Marin and the man slipped away. Sharon followed, hoping to get high with him. She found him smoking something and he shared it with Sharon. It turned out to be crack cocaine. Sharon said that she only had a little and didn't like its effects. However, she did describe what sounded like a drug-induced reaction to the drumming and chanting and said that, overall, she had a good time at the event--very odd for Sharon. I was somewhat floored when she said that she wanted to go back, until Sharon told me that she was looking for further ammunition to support her general derision of all things religious. I am continually surprised by Sharon's creativity even if it is currently directed towards caustic but witty sarcasm. If she could direct it into a socially productive channel, she might be able to divert herself from her fascination with illicit substances. Her reaction to my suggestion on this point, however, was characteristically dismissive and creatively obscene.
Wednesday, July 8, 1998	5 pm. Fifty-Third Session with Alex Rozzi respecting Sharon Lough. When I saw Alex, it was obvious that he'd been in a fight. He told me that Tony was angry that he'd tipped Sharon off to Tony's HIV status. Tony and Alex got into a fistfight which ended with them both bloodied, battered, and laughing together. Bloody fights with someone who is HIV-positive is not a great idea, but I didn't bring it up with Alex during the session. He already seemed upset and quite tense. Tony is developing a real enmity towards Sharon, but he is determined to follow Cami's advice that he pretend to like her for Tony's sake. He does seem resigned to her presence now.[...] Alex is fighting hard to have everything remain static in his life, but circumstances are forcing the context of all his relationships to keep continually changing.
Friday, July 10, 1998	10 am. Twenty-Fifth Session with Sharon Lough. Sharon asked Tony about his HIV status and he confirmed that he is HIV-positive. Afterwards, Sharon engaged in a sexual encounter which was largely unprotected. Sharon gave me a long, detailed, highly graphic description of her sexual encounter with Tony in which she played the dominant. Although she had some previous experience as a dominatrix, this was the first time in which she was doing it at least partly to please herself. And, given the relish with which she related the details of the encounter, she apparently enjoyed it. I nagged her about her lack of attention to safe sex, although I have to admit that I'm not completely sure of a proper protocol which would have afforded substantial protection to Sharon given the nature of their conduct. But Sharon isn't interested in safe sex; she's declared herself to be a risk taker while, at the same time, claiming to take precautions. Sharon really wanted me to know all the intimate details of the encounter, although I tried to stop her on several occasions during her lurid account. I'm not quite sure why it was important to her that I hear the details of her sex life. But when I asked a question, she teased me for probing for more information, implying that I was doing so merely for my own entertainment. Sharon has taken an HIV test and is waiting during the next couple of weeks to hear the results.
Tuesday, July 14, 1998	12 pm. Conversation with Robin Young respecting Sharon Lough. Rob came in unexpectedly to talk with me. Rob was quite different from what I had expected from Sharon's descriptions. I was expecting a hippo of a man--instead, while he had a paunch, he was nowhere near as obese and unappealing as Sharon made him out to be. He appears to be an aging child of the 60s like one of the many 50 year olds who hang out on Haight Street as a reminder of the flower generation. Rob told me that Sharon had been growing some sort of hallucinogenic fungus on pieces of rye bread stored in jars at his house. While he was working late, she ingested some of this homegrown substance, had a bad experience, and ended up calling 911 for emergency services. The police took her to the emergency room and then searched her residence and found 20 jars of this stuff. Now, Sharon's facing felony drug charges which include a presumption, given the large amount she was growing, that she was cultivating these drugs for sale. Rob is standing by her; he has retained a criminal defense attorney and is prepared to post bail. There's a possibility that the material that Sharon was growing is not listed in the narcotic schedules used to create the laws. If so, she may be able to avoid prosecution simply because cultivating that particular species of fungus wasn't illegal. But those schedules are quite broadly written. I presume they cover all known variants of psychedelic fungus. The police have sent the material to a lab to try to determine exactly what it is.
Wednesday, July 15, 1998	5 pm. Fifty-Fourth Session with Alex Rozzi respecting Sharon Lough. Alex told me that he was painting in his studio when Tony burst in, exploding with the news that Sharon had been arrested. Tony was clearly about to tell Alex much more when he suddenly decided against it and clammed up, much to Alex's annoyance. Tony started to smoke a marijuana cigarette and Alex joined in. When Tony was about to go, he grabbed Alex and suddenly began to kiss and fondle him in a very direct sexual manner. Alex resisted and finally succeeded in pushing Tony away. Alex was less upset than I would have expected--he seemed to feel that it was turnabout for his previous plan to seduce Tony as a way of getting Sharon out of the picture.
Friday, July 24, 1998	10 am. Twenty-Sixth Session with Sharon Lough. Sharon came into this session in a wheelchair--surprising because previously she'd been on crutches. Her hair was matted and dirty and her clothes had clearly been worn several days in succession. She looked much sloppier than she has previously. Sharon spent much of the session evading my questions about her use and production of hallucinogenics. She also elaborately avoided talking about any of the real consequences of drug crimes--i.e. criminal prosecution and incarceration. Instead, she went on and on in an emotional tirade against Pauline Kael, the film reviewer. Apparently she read some book of reviews with which she rather violently disagreed. She's afraid that Kael's way of dissecting films has infected her somehow, rendering her unable to appreciate them in their totality. I think that Sharon, in a coded way, was trying to tell me that she doesn't want to dissect her own actions regarding drugs--that it would somehow rob her of the experience as a whole. I think, ultimately, the truth is that Sharon isn't able to explain why she did the things she did. Sharon's caustic views on the "war on drugs" was more predictable, given her present circumstances. But Sharon caught me off guard when she started to talk with some approval about scatology, a fetish whose adherents use feces to enhance sexual activity. Sharon vividly described fecal fetishists and a pornographic film that she heard about which documents the practice. Apparently, Sharon downloaded a chat program and, in her first experimentation with the new software, visited a chat room devoted to scatology. Subsequently, she visited some web sites devoted to scatology's practitioners. But her interest seems to be an academic one, as if she's some sexual anthropologist examining a remote backwater of sexual deviance. I understand taking an anthropological view of much of what is seen on the web. I remember once wandering into a web site which was designed to teach people how to engage in sex with their cars--a practice with which I was previously unfamiliar. Different models apparently have different requirements, and there was a lot of discussion about types of lubricants which wouldn't harm the car's paint job. I think part of the charm of the Web are the strange web sites put up by people who want to form a community around their particular passions. But I don't think Sharon's discussion of scatology served any particular emotional purpose other than allowing her to skate past my questions about drugs which she clearly didn't want to answer. Oh, and Sharon said that she grew the fungus on rye berries, not rye bread as Rob told me. Rob's version was more picturesque: I imagined a hallucinogenic penicillin mold with a distinctly New York flavor. "Do you want your hallucinogens with caraway seeds or without?"
Wednesday, July 29, 1998	5 pm. Fifty-Sixth Session with Alex Rozzi respecting Sharon Lough. Alex accidentally caught Sharon and Tony on their way to a party where they were both cross-dressed. Alex first didn't recognize Tony, whom he said looked like a tall, beautiful, blonde whore. Alex has a very strong negative reaction to cross-dressing which he described as akin to the horror some people feel towards clowns. I suggested that we change the subject. Alex believes that Tony has a malleable personality and is letting Sharon manipulate and change him. Alex compares Tony's relationship with Sharon to the soul destroying relationship that Tony had as Tim's drugged sex slave.
Friday, July 31, 1998	10 am. Twenty-Seventh Session with Sharon Lough. Sharon spent the session describing, in graphic detail, her return to the S&M community. Both cross-dressed, Tony and she went to a dungeon party where Sharon sexually humiliated Tony in a scene. Tony was extremely grateful and Sharon says that, since then, he has been especially affectionate. I'm not certain why, but Sharon feels the need to tell me the graphic details of her sexual reawakening through S&M--I can feel that she really wants me to sit and listen. So, while I'm not certain of the therapeutic value, I'm an audience to her sexual rebirth as a dominatrix. Perhaps there's an exhibitionist streak in Sharon which public floggings and genital manipulation hasn't quite satisfied. We sparred about safe sex precautions, and Sharon seems to be taking it a bit more seriously, although not as much as I would like. She hasn't yet received the results of her recent HIV test, although she plans to get them this upcoming week. Sharon told me that the "Sick Fuck"--Alex Rozzi--came in and saw Tony and Sharon preparing for the party. Party preparations for Tony included removing all his body hair, applying lipstick, dressing in clothes normally reserved for street-walking prostitutes, and wearing a blonde wig. Sharon said that Alex was livid--he looked like he was going to physically assault them both. Tony told Sharon that Alex already has a boyfriend and possibly a girlfriend. Sharon sees his jealousy as a sign of greed--that Alex wants Tony as well.
Friday, August 7, 1998	10 am. Twenty-Eighth Session with Sharon Lough. Sharon started the session with a long harangue against Hispanics. I'd attribute it to out and out racism, if I hadn't heard Sharon do the same thing over and over again on a variety of different subjects. Sharon does this type of vicious oratory every time she gets annoyed at anything. I don't even see the ranting as a reliable indicator of how she really feels. It sounded particularly vicious, though, being applied to an ethnic group. Perhaps it is my sense of political correctness that makes an expression of overt racism sound so shocking. But, although I'm used to hearing the most extreme variants of human emotion without distress, it made me distinctly uncomfortable just to listen to it. Although I had assumed that she had some homosexual experience, Sharon confirmed that she is bisexual. Sharon also spent a good part of the session giving me a run-down on the sensual inadequacy of most of the barrier methods recommended for safe sex practices. Sharon's prodigious sexual experience with multiple partners of both sexes, together with her keen critical eye and unwillingness to capitulate to societal conventions, make Sharon a pretty good reviewer of the various barrier systems. Her conclusions were that these devices were all aesthetically inadequate and that they weren't actually being utilized by those who touted them. However, Sharon doesn't have a lot of alternatives to suggest--merely criticisms. Sharon did get back her AIDs test--it was negative. But she hasn't yet heard from the police lab to find out if the substance that she was growing in jars was on their schedule of illegal narcotics or not.
Friday, August 14, 1998	10 am. Twenty-Ninth Session with Sharon Lough. Sharon was in an almost violent altercation at my office door. Apparently, some man ran a stop sign and Sharon took offense. She saw him park and then she scraped her key along the side of his car, scratching the paint. He followed her up to my office, with both of them cursing at each other all the way. When Sharon spat full-on into his face, I intervened. I dragged Sharon inside the office and told the man to leave or I'd call the police. It is an obvious understatement to say that Sharon is having a great deal of trouble dealing with her hostility. I gave her a taped exercise in guided relaxation in an attempt to teach her some skills that she can use to avoid the types of violent confrontations that she's recently found herself. Sharon made a number of strong sexual hints towards me which I pointedly ignored or tried to defuse. However, I have to be careful. I don't think that classical transference or any particular sexual interest in me really explains it--perhaps Sharon's previous modus operandi was to reward with sexual favors those who were of service.
Wednesday, August 19, 1998	5 pm. Fifty-Ninth Session with Alex Rozzi respecting Sharon Lough. Alex also told me that Tony and Sharon have broken up. Sharon just stopped coming or calling. Tony is apparently quite broken up by the split. Alex says that Tony stopped eating or responding--Alex had to break into his house to find Tony in a fetal position, mostly unresponsive, and clearly showing the signs of having spent the day weeping.
Friday, August 21, 1998	10 am. Thirtieth Session with Sharon Lough. Sharon has been asked to testify in a divorce action involving her former landlords. Last November, they wanted to vacate Sharon's unit and falsely accused Sharon of sexually abusing their five year old son. Instead of standing up to the charges, Sharon fled. She was too upset by the allegations, and too concerned about the way her past would make her look in court, to fight the false charges. Now, the mother is trying to limit the visitation rights of the father by making similar sexual abuse charges. Sharon, presumably, is being deposed for the purpose of revealing the mother's predilection for making false sexual abuse allegations. Sharon, however, is predictably upset. She believes that this will raise all the issues of her past which she had hoped to avoid by fleeing the first time. She also doesn't much like the prospect of assisting the father in securing his visitation rights--she thought he was verbally abusive. Sharon's legal problems over her hallucinogenic mold continue. She told me that she is supposed to have a preliminary hearing next month, although she still doesn't know the results of the lab test on whether the particular species of mold she was growing was, in fact, an illegal drug. Sharon is using the relaxation tapes I gave her during our last session. I was afraid that she would dismiss them as new age pablum, but she seems to have given her cynicism a rest and taken them seriously. She reports that she found them effective.
Friday, September 11, 1998	10 am. Thirty-First Session with Sharon Lough. Sharon spoke to a lawyer named Fielding Walker who sounds like he gave her some pretty good advice. He walked her through the deposition process, and it was a lot milder than what Sharon had been expecting. At trial, however, Sharon believes that it could be worse if her credibility comes into question. Sharon summed up her previous history as "a slut, an S&M devotee, a heroin addict, a psilocybin-cultivator, and a mental patient." She told me that she found herself empathizing with a convicted child molester who had been exposed as such to his neighbors and had consequently hung himself. She said that she understood how trapped he must have felt. She also spoke about how she used to enjoy innocently watching kids at the playground--now she feels as if she really is a pedophile if she expresses any interest in children at all. She said that she now feels an aversion to kids and she has decided that she's no longer interested in becoming a mother herself. I assume that when Sharon no longer feels it necessary to defend herself against a charge of being a child molester, all of this will pass. Sharon also told me that her reawakened sexual interest has now withered--which sounds like the predominant reason that she broke off her relationship with Tony. She speaks of him now with nothing but contempt, and was completely unsympathetic to my attempts to get her to give Tony an explanation for her conduct. When I pointed out that it wasn't right for her to take out her anger on Tony, she told me something interesting--she said that she can't control it. And I think that's right. She's angry all the time at something. Rob is having problems with his hands, and Sharon is not filled with sympathy towards him. She remembers his lack of concern for her broken foot and now feels somehow that the tables are turned. Rob hired Charlotte, of all people, to paint the bathroom of the house. Charlotte tried a faux marble technique that she saw in a Martha Stewart magazine. After Charlotte was done, Sharon defaced the wall with pornographic line drawings and scrawled messages of her own. While I disapproved of the canvas she chose, I suggested to Sharon that she might consider drawing on paper as an outlet for her unresolved anger.
Friday, September 18, 1998	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.
Friday, September 25, 1998	10 am. Thirty-Third Session with Sharon Lough. Sharon actively tormented the one girl in class who she seemed to be developing a rapport with the previous week. She's the one that Sharon calls "Li'l Dyke." It turns out that the woman is a talented violinist, and Sharon, who acknowledged to me her talent, viciously criticized her playing and her androgynous looks. Sharon's theory is that she'll make much more of an impact--and a closer friend--if she's assaultive in her verbal conduct rather than flattering. Sharon's legendary tolerance also came into play with her ESL students. Our discussion on that topic led to a discussion of Sharon's childhood as an immigrant from Japan--a subject that I haven't heard much about. Sharon told me that her father wasn't home much, and that her mother came from rural Japan--she was not a particularly well-educated woman although she tried hard to learn English once she came to the U.S. Sharon arrived here when quite young and she learned English by watching Sesame Street. Sharon feels completely assimilated and believes that her mother is not. But Sharon doesn't feel a lot of sympathy for the students in her ESL class, regardless of any superficial similarity in their circumstances. She sees them as the products of a bilingual educational system that failed them and believes that they are failures because of an emphasis on cultural isolationism that allows people to live in ethnic neighborhoods and never assimilate or even learn English.
Friday, October 2, 1998	10 am. Thirty-Fourth Session with Sharon Lough. Sharon has been exploring the potential of a lesbian relationship with the young woman classmate who she purposely tormented. Lila is her name, not "L'il Dyke." Sharon was happy when Lila asked her out for a drink--she thought her stratagem of abuse was paying off. Lila took Sharon to an old lesbian bar called Wild Side West. Instead of staying with Sharon, Lila purposely ignored her, sat at the bar, and successfully engaged in picking up an attractive woman who was also there. Sharon took it to be Lila's revenge for being previously ill-treated by Sharon. I hadn't realized that Sharon had a sexual interest in Lila until this session, but she clearly did. When I noted this fact, Sharon almost tried to deny it by deriding Lila's body type. But she was clearly crestfallen when Lila picked up this other woman, and later, she did admit that she had an overt sexual interest in Lila and then quickly and definitively changed the subject. Beyond sex, Lila represented a kind of conquest for Sharon. Sharon said that she likes the idea of having a girlfriend rather than having a sexual relationship--she thinks it confers status because lesbians are "cool." I think Sharon is looking for a social success and sex is the only way that she really has to know that she's scored a triumph. I hope that Sharon doesn't pursue this relationship, as it seems to be built on a dishonest foundation of intense emotional manipulation on both sides.
Friday, October 9, 1998	10 am. Thirty-Fifth Session with Sharon Lough. Sharon had sex with Lila this week. She went into almost pornographic detail about the sex itself, even though the upshot was that she felt used. She said that she's "always the one on my knees doing the wet work." At Lila's parents home, Sharon performed cunnilingus on Lila and then was airily dismissed. She took a bus to an all night diner and wallowed in self pity. I'm not sure what Sharon is expecting out of a relationship with Lila. I think that Sharon is well aware of Lila's immaturity, but it seems to surprise her over and over again. Sharon gave me a short story that she wrote. It is observational fiction more than narrative, written in the first person. But although it's nominally a love story, it doesn't seem particularly connected with any of the real life relationships that Sharon is experiencing. I assume that the Chris character most closely resembles Rob. If so, perhaps in real life she underplays some real affection that she has for him, although the story is mostly about overcoming a partner's deficits. There's a couple dressed all in white whom the characters see at the copy center that forms the main locale of the story. Although they are dismissed as probable religious fanatics in the story, they hold a certain high ground in the story--they are the focus of the narrator's attention. I'm really not sure what significance they have for Sharon as a writer.
Wednesday, October 14, 1998	5 pm. Sixty-Fifth Session with Alex Rozzi respecting Sharon Lough. Alex told me that Tony has become a full-time drag queen. Apparently, ever since Sharon Lough left him, Tony has donned women's clothing and has become a part of the drag queen social circuit. Alex told me that he would injure Sharon if he saw her again because of what she did to Tony, but I don't think he is likely to act upon it. As I recall, Alex always seemed a little intimidated by Sharon.
Friday, October 16, 1998	10 am. Thirty-Sixth Session with Sharon Lough. Lila's mother, unaware of Sharon's previous relationship with her daughter, hired Sharon as a tutor for Lila's upcoming TOEFL test. Sharon spent half an hour trying to tutor Lila in the normal way, and was frustrated by Lila's unwillingness to cooperate. Then Sharon took advantage of their previous sexual experience and started to intermix masturbation with rote learning. After a bit of that, Sharon became the dominatrix and began to beat Lila with her hand and then a wooden spoon. Lila never consented to any of this. Finally, Sharon left Lila bound naked to the bed, although Sharon believed that she would be able to free herself if she tried. I couldn't believe that Sharon would act so inappropriately, and I told her so. Sharon airily waved away my concerns. She thinks that Lila won't tell her mother what occurred primarily because Sharon wouldn't have told her own mother. I was actually quite angry at Sharon and told her that her actions were probably criminal. I'm not sure whether or not Lila is of age, but I found Sharon's conduct abominable.
Friday, November 6, 1998	10 am. Thirty-Seventh Session with Sharon Lough. Sharon came in mumbling and incomprehensible. Then she opened her mouth to reveal her newly-pierced tongue, swollen and purple and perhaps twice its normal size. Before I could stop her, Sharon pulled down her pants and showed me that she had also had her left outer labia pierced as well--it looks just as swollen and painful. Sharon couldn't talk, but she had brought with her a battered laptop to type out her responses. So we conducted this session, side by side, so that I could view her responses on the screen. Incidentally, Sharon is an excellent typist although she made many mistakes--it was kind of like participating in an on-line chat session, except that she was here in the office. In any case, I thought it revealing that Sharon would fall into the piercing fad--it seems sort of unlikely given her armor of cynicism. But Sharon professes to love performing oral sex and she believes that this stud in her tongue is going to somehow improve her performance. Ironically, Rob apparently doesn't like receiving oral sex, which Sharon believes is un-American, given our president. Sharon hurled some invective towards Charlotte, who's apparently gained weight. Curiously, she criticized Godzilla for losing weight and told me that she looked better before, together with other sometimes fat celebrities like Oprah Winfrey and Paul Prudhomme. Rob's hand is apparently almost completely disabled now and he's getting some medical advice on treatment. Sharon apparently is taking over a caregiver role, at least tangentially. We spent a good part of the session talking about the conjunction of feces and underwear in various configurations.
Friday, November 20, 1998	10 am. Thirty-Eighth Session with Sharon Lough. In terms of getting anything therapeutic accomplished, this was a completely worthless session. Sharon wanted to talk about dead skin, toe jam, and pus. I tried to steer the conversation back to her issues, but she insisted on focusing primarily on the products of her lymph system. Sometimes I think that Sharon is only trying to get a rise out of me and, when she's in that mode, there's little I can seemingly do to get her back to reality. Sharon spent the Summer and Fall sleeping late, smoking marijuana, and watching television. Now, not surprisingly, she's not anxious to return to work--in fact she appears to be dreading it. But at least she seems to finally be on the mend physically. Her white cast was replaced by a black temporary cast and she was on crutches rather than in the wheelchair.
Friday, December 4, 1998	10 am. Thirty-Ninth Session with Sharon Lough. Sharon came in with her hair mangled and dyed. I'm afraid I wasn't very diplomatic in my expressions of shock and horror. Her hair used to be long and dark brown. Now, it's short and platinum blonde hair--at least most of it. It has streaks of varying shades running through it. She tried to cut it herself, and now her hair sticks out in tufts all over her head at odd angles. I'm afraid we spent a good part of the session on Sharon's hair. Sharon is showing a reluctance to return to work. Instead, she's staying home and playing the grumbling nursemaid to Rob, who's not going to work because of an ulcer. Sharon told me that Rob purposefully destroyed his own stomach with a diet of aspirin and water to avoid the Vietnam war draft. I never heard of that before--the war is still being fought in Rob's stomach. Rob got some pain medication which Sharon covets, although she told me that she wouldn't take any. Rob has been trying to encourage Sharon to return to work, and she's feeling the pressure. I'm not sure what her reluctance really is, but she's clearly not looking forward to it and wants to delay her return as long as possible. Her work as an editor for the school literary magazine seems to be petering out--no one has turned in work that satisfies her and the one woman who wanted to help was rejected by Sharon because of the way she looked--specifically the fact that her tight pants outlined her vulva. Sharon herself made the observation that she shouldn't be rejecting people because of their appearance given her hair in its current condition. Sharon averred that therapy is a scam because she hasn't noted improvement but said that she keeps coming back because I represent a constant in her life. I'm afraid that her antipathy to work at SII goes beyond mere dislike of the job. I'd like to explore why she is avoiding returning to work, but she will be immediately defensive if she feels that she must justify her continued absence to me.
Friday, December 11, 1998	10 am. Fortieth Session with Sharon Lough. Sometimes I feel so ineffectual with Sharon, I wonder if I'm giving her anything of value. Her cast came off and she's experiencing that sense of weakness caused by atrophied muscles. She also fixed her hair somewhat--it's now very short, but all one color. Rob has some undiagnosed stomach ailment--the diagnosis of peptic ulcers was reversed. Because of the pain he's in, he's been given a prescription for Percodan, which Sharon clearly covets. I urged her not to think in those terms and Sharon explained that she's making do by abusing over-the-counter NyQuil. When Rob needed to go to the emergency room, he called Charlotte, his ex-wife, instead of calling a cab. Sharon took it very personally. She pointed out herself how her relationship with Rob has changed: before, she was in it solely for mercenary motives; now, she feels something for him, although she steadfastly denies that it's love. Sharon tried to veer the subject away from relationship issues--she chose a broad monologue about the sense of accomplishment she gets from producing a load of snot when she blows her nose. I steered the conversation back on track and Sharon admitted that she feels used by Rob. Sharon expressed dissatisfaction with all her previous relationships. I suggested that perhaps she may want to think about taking positive steps to improve her communication with a partner. Sharon said that she feels unable to tell the lies that she believes are necessary to make a relationship work--she even gave me a few examples. Her examples were all lies to help a partner over their insecurities. When I suggested a workshop, Sharon said that she'd rather shoot herself. She veered away from the subject again, this time professing a sexual interest in me. Of course, I tried to deflect her interest, but Sharon pretended to believe that I was rebuffing her because of her physical appearance and her personality. She threw me off base by going into another monologue on the difficulties of suppressing a gag reflex during fellatio when the penis passes the epiglottis. I ended the session by telling Sharon about my vacation plans, which she also pretended to see as further proofs of my rejection of her.
Friday, February 19, 1999	10 am. Forty-First Session with Sharon Lough. Rob has been hospitalized due to severe stomach pain and Charlotte has taken over the administration of his life. Sharon can't get access to Rob due to hospital rules restricting visitors to immediate family members, and Charlotte has thrown her out of Rob's house--Charlotte even had the locks changed. Sharon has been unwilling to seek anybody's assistance--she's too proud and too stubborn. She doesn't want to beg Charlotte to readmit her to Rob's house or to seek help from her sister. She's also unwilling to get assistance at work. She's even unwilling to seek help from the public social services set up to help the needy. Now, she's effectively homeless, at least until her next paycheck. She's almost out of money and has been living in her car next to Golden Gate Park. She still has her cold, she's not able to keep warm enough, and she's lost weight. When she started talking about suicide, I even offered to place her in a psychiatric facility, but she refused for fear of losing her job. She clearly isn't suffering from the requisite degree of mental illness to allow me to involuntarily commit her. I don't believe that she's suicidal. So I just scheduled an appointment for next week. I hope that she'll be able to keep it together under increasingly difficult conditions.

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Sharon Lough's Patient File
Charles Balis' Notes by Patient



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