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Tuesday, September 3, 1996 |
11:30 am. Introductory Session with Phylis Birch. Phylis Birch is a 31 year old computer graphic artist from SII. Stunning in appearance, she was somewhat reticent to describe what had brought her to my office. After describing a perfect work and home life, I finally called her on it, somewhat abruptly perhaps. She is concerned that her husband Jack believes that she is having an affair. She isn't. Instead, she is spinning a web of lies to create time for herself to pursue her hobby--hanging out in dive bars, and occasionally strip clubs. She isn't sure what draws her to these establishments, but I sense that the danger inherent in dressing down to hide her obvious physical attributes and lurking through the seamier side of human nature as an impostor appeals to her. She has been married to Jack (she called him Frank once at the end of the session) for about 4 years now. They've discussed having children--he seems ready but she prefers to wait. My impression is that it is beginning to be a point of conflict between them, but hasn't developed overtly yet. Phylis (she spells it with one "l") admits to carrying out an elaborate series of lies to her husband. She put it in a funny way. She said that her story wasn't always "supported by fact." She seemed a little taken aback that I would call her "stories" lies. I got the impression she was proud of her abilities to cover up her activities, although she now complains that her life has been unduly complex as a result of trying to keep her lies straight. She can't admit to her husband that she is seeing a psychiatrist, for example, unless she could make up a plausible complaint for which she would need to seek help. She also doesn't seem particularly interested in giving up her unusual hobby. Instead, she wants help in keeping her life straight while continuing her seedy adventures. |
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Monday, September 9, 1996 |
12 pm. Second Session with Phylis Birch. Phylis had a close call with Jack. He went to surprise her at the office and she wasn't there. Instead, she was at one of her dives. She managed to smooth it over, but she wants me to help her devise some form of memory system to aid her in her continued deception. The idea of stopping her activity hanging out at dives is abhorrent to her. She is not ready to quit, seemingly willing to sacrifice a happy marriage for it, if necessary. I've encouraged her to come clean with Jack, but she is resistant. She wants to have a sound, logical reason for her visits to the dives, but she doesn't have one. I told her that rather than helping her with her deceptions, I could help her articulate her need to visit dives. She also wants her journal to consist of photographs of the outside of these dives with her comments. I've encouraged this. We started to talk about what she does in these bars. Apparently, she has a fictional persona that she adopts--Martha--that has a complex history. She sticks with this one character so that she can keep her deception straight. |
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Monday, September 16, 1996 |
12 pm. Third Session with Phylis Birch. I was met at the door to the office by Martha, Phylis' alter ego. I wouldn't have suspected that someone with the tremendous physical attributes of Phylis could make herself so totally unappealing. But Martha is a frump. She walks differently, as though life has beaten her down, and she looks up from eyes that are filled with pain. Phylis is quite a convincing actress. Phylis wanted the session to be about Martha, so Phylis played Martha during our time, although she was careful to let me know that she was just playing a role. I think she was worried that I might think she was a multiple personality. Martha's character has a 13 year old daughter who is living with an ex-husband in Minnesota and with whom Martha has been forced to have little contact. Interestingly, she populates her story with many details except the name of her ex-husband. When I questioned her on this omission, she explained that she didn't want to make a slip and substitute the name of her fictional ex-husband with that of Jack. But perhaps that is exactly what she did in our first session when she came up with the name Frank instead of Jack. Phylis all of a sudden ended our session over my objections to go hang out in some dive. I guess she wanted to take advantage of the fact that she was in make-up, but it was rather odd. |
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Thursday, September 19, 1996 |
Letter to Bill Bennett respecting Phylis. I spoke in part about Phylis in my letter to Bill Bennett. |
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Monday, September 23, 1996 |
12 pm. Fourth Session with Phylis Birch. Phylis came as herself this session, leaving Martha in her make-up kit. She is so gorgeous that I can't help but stare at her, but she doesn't invoke the same feelings in me that Anna does. Phylis is more of a pure aesthetic experience. She apologized for the irresistible compulsion which drove her early from my office last week and described some of the origins of the Martha story as coming from the life of her college roommate Jessy. Phylis sees leading a double life as making her life more interesting and daring, exploring her own dark side, and bringing her more in touch with the common man. Her deceptions are of only the most passing concern. However, she did indicate that she was interested in telling Jack, but that she might want to use the more controlled environment of my office to accomplish that. I encouraged her to come clean with Jack. |
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Monday, September 30, 1996 |
12 pm. Fifth Session with Phylis Birch. Phylis was very upset about a young woman whom she met at one of her bars. Apparently she strongly identifies with this young woman, just graduated from college with a degree in International Relations, who is reduced to a job at Noah's Bagels and spends her free time drinking in sleazy bars. Phylis apparently thought she was seeing the beginning of a life going to ruin, which affected her more strongly than seeing already wrecked human lives. Perhaps the young woman represents an alternate future for Phylis if things had turned out differently. Perhaps her agitation over this woman is a key to figure out the fascination that dive bars have for Phylis. Perhaps Phylis will be able to contrast the girl's unhappy prospects with her own life. Phylis loves her husband Jack and her work. She may place a greater value on these elements of her life if she can see what might have been had she lacked them. She is much closer to telling Jack her secret than she was during our first couple of sessions. I think now she is looking for an appropriate opening to bring him into her confidence. |
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Monday, October 7, 1996 |
10 am. Eleventh Session with Joseph Mazurka. I think that Joseph Mazurka raped Phylis! I'm not sure but he describes a sleazy bar, a woman named Martha who looked better without her make-up than with it, a man who didn't know her name but insisted that she leave with him (Phylis' husband Jack, who probably is now in a hospital, wouldn't have known the name 'Martha'). It has to be Phylis, doesn't it? I certainly hope not. I'm listening to Joseph describe this rape and he's trying to make it sound like he's being the perfect gentleman. Somehow I doubt that will be Phylis' take on the events of last Thursday. I can't believe that I'm treating this monster! At the end of the session, I actually begged him to keep coming for therapy. I know I'd feel less responsible for his actions if he just split and never came to another session. He keeps coming and I feel responsible for whatever he does on the outside. He might end up killing someone. If I read about it in the papers, it would be surrounded by a nice unreal gauzy haze that would lessen its emotional impact on me. But if the police dig up his wife and children from their backyard, I'm going to be emotionally crippled as a result. Am I in some way responsible for what happened to Phylis? Would Joseph have been there that night if I had had the courage to order his commitment? In the history of psychotherapy, has it ever happened that one patient raped another patient? How do I treat their conflicting needs? Should I counsel Phylis to report Joseph to the police? I've got to call her immediately. Other items that Joseph discussed included using his sniper's scope on his rifle to peer into his neighbors' windows and his denial of any criminal wrongdoing respecting his wife and children. 11:20 am. Telephone Conversation with Phylis Birch. I'm enormously worried about Phylis after my session with Joseph Mazurka. I called her at work nominally to confirm our session this afternoon but actually to try to determine whether Mazurka's Martha was Phylis' Martha. Phylis sounded quite odd and upset but was unwilling to talk while at work. She also cancelled our session today, but wanted urgently to reschedule it. Apparently she's not ducking our session, but rather must have something very urgent to have cancelled. So we made a new appointment for tomorrow at 5:30 pm. I hope she is okay although I fear the worst. |
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Tuesday, October 8, 1996 |
5:30. Phylis was a no-show for our session today. I'm very worried about the mental and physical state of both her and her husband, and I'll try to get in touch with her at the office tomorrow. |
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Monday, October 14, 1996 |
8:35 am. Telephone Conversation with Phylis Birch. Phylis called sounding a little shaky. She apologized for missing her sessions on Monday and Tuesday, but said that she'd be in at her usual time today at noon. She said that she had "a little trouble" last Thursday so my speculation was correct--she was Mazurka's victim. It sounds like Phylis is trying to be strong. 12 pm. Sixth Session with Phylis Birch. I heard Phylis' story of her encounter with Joseph Mazurka and it was as I feared. When Phylis was playing Martha and was surprised by her husband, Joseph viciously beat him and then, while Phylis was in shock after watching her husband reduced to bloody unconsciousness, tried to rape her. Jack suffered substantial damage including broken ribs, broken nose, broken right leg, a missing tooth, and internal injuries. Phylis still seems a little numb. I feel that she really needs to talk further, but she is trying to be strong for Jack. Of course she feels guilty for having brought this upon Jack, and I don't think that she's had the opportunity to come to terms with her own feelings about the events of that Thursday night. Right now, most of what she is feeling is fear. She got a page from Jack about half way through our session and had to run off to minister to his needs. I didn't tell Phylis that I'm treating Joseph Mazurka and, of course, I haven't told Mazurka that I'm treating Phylis. I feel by concealing his identity I'm protecting Mazurka in some way and I can barely stand that thought. He's such an awful human that I don't think therapy is really likely to cure him. I'm glad he canceled his session today because I don't think that I would have been able to face him after having listened to the pain he has brought upon poor Phylis and her innocent husband. |
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Friday, October 18, 1996 |
10:30 am. Telephone Call from Phylis Birch. Phylis called me to reassure me about her reason for running out of last Monday's session. Apparently Jack had an infection resulting from his knocked out tooth which precipitated a spiking fever. But he is better now and Phylis says that she is holding together and will see me at her normal session on Monday. |
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Monday, October 21, 1996 |
Got a call from Phylis cancelling her session for today. Apparently she is going into some important meeting at work and she feels especially obligated to attend due to all the missed work in the last couple of weeks. I think she's finding excuses to avoid having to deal with her own pain. She promised to try to come in during this week, but we didn't set a firm date. |
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Thursday, October 24, 1996 |
3:15 pm. Seventh Session with Phylis Birch. Phylis showed up unexpectedly and wanted to see me. We spent 45 minutes together and I hope it helped. Phylis is really a mess. She's very upset, scattered, hostile, and victimized. She has not had sexual relations with Jack since the incident with Mazurka and says that she sees Mazurka's face everywhere. She might have actually seen him at SII but passed it off as a delusion. She is having elaborate revenge fantasies against Mazurka, but sometimes she feels as if he didn't do anything wrong. She is suffering from an enormous amount of guilt for leaving Jack unconscious and bleeding on the sidewalk and going off with Mazurka, not giving herself any slack for the shock that she must have been in. She is suffering from insomnia and frequent crying spells. Phylis is now talking about Martha as almost a separate entity. She says that she hears Martha talking to her, whispering. And where before Phylis was careful to let me know that she knew that Martha was just a character she played, this time Phylis made no such effort. She also said that when she allows herself to become Martha, she looks at Jack quite coolly, but when she is Phylis, she loves Jack very much. Phylis can still clearly separate herself from the Martha character that she assumes from time to time, but this new dichotomy of self is troubling. Perhaps Phylis is trying to deal with the rape and Jack's beating by pushing it onto Martha. Martha was the one who went to the dives and Martha was the one who got raped. Martha is also the one responsible for Jack's injuries and everything else that happened. Phylis is still committed to going to dives, but now feels especially guilty for it--she perceives it as evil but feels that she must follow an irresistible compulsion. She is repressing a lot of hostility towards Jack, actually, seeing that his boy scout demeanor is forcing her to have to sneak around to explore her dark side. She almost blames him for everything that happened when she isn't crucifying herself. She had a revealing dream in which she is alternately the victim and the attacker. There is a cloaked Jack the Ripper like killer (interesting that she chose Jack as the name of the attacker) who attacks her the victim. In a dream transition, she becomes the attacker and attacks Mazurka but panics when she can't kill him. Mazurka then attacks her husband Jack and kills him. She then switches back into the role of the attacker, looking down at her dead husband with the knife in her hand. She's having sleeping problems so I prescribed 20 tablets of .25 mg Halcion, one pill before bedtime. I'm also concerned about AIDs or other sexually transmitted disease. Joseph frequently consorts with prostitutes and he doesn't strike me as a safe sex kind of guy. I urged Phylis to get thoroughly checked out, prior to resuming a sexual relationship with Jack. |
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Monday, October 28, 1996 |
12 pm. Eighth Session with Phylis Birch. Phylis has been sleeping better since the sleeping pills. She looked much better during this session. She was less apologetic about being upset with Jack. She covered up by stating how horrible she was as a person for blaming him, but blaming him she was and she was much more direct about it. She even talked, at one point, about leaving Jack as a possibility, although she quickly backtracked from that during the session. She spoke about the need for a physical sexual release, but not with Jack--she feels there is no sexual tension between them--apparently that evaporated all at once on the day of the rape. Jack felt Phylis' lack of interest, even when she was initiating a sexual encounter, and he backed off. Phylis has been thinking about the young woman who was stuck in a rut that she spoke of earlier. She also disclosed that she used to have an imaginary conservative persona named Thomas who disappeared about the time that she met Jack, her real life conservative persona. Martha, who appeared around the same time as Jack, seems to be the counterbalance to Jack's personality. Phylis thinks of Martha as a risk taker and rule breaker--everything that Jack is not. Creating secondary personas for herself is Phylis' particular coping mechanism. |
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Monday, November 11, 1996 |
12 pm. Ninth Session with Phylis Birch. Phylis is becoming obsessed with sexually transmitted diseases. She is doing research on STDs and reliving her experience with Mazurka. She remembers him as a sleazy character and so she is having a battery of medical tests performed for her own peace of mind. She again thought she saw him at SII, but passed it off as a delusion. She said that if she had really believed it was him, that she would have physically confronted him in some manner. We spent much of the session talking about STDs, their symptoms or lack thereof, methods of detection, the prognosis for those who catch these diseases, methods of eliminating vaginal warts, the history of syphlis, and the terrible effects that chlamydia has on the Australian koala bear population. Phylis described her previous sexual activity as "wild" and went to have an AIDs test performed, realizing that it was too early to detect any potential AIDs transmission from Mazurka. Near the end of the session, Phylis produced three photographs that she said she took recently, although she didn't specify if it was before or after the rape. My guess is before--she has just been too busy after, I suspect. They are all in black and white. The first was a stark photo of a non-distinct figure in what I took for rain. Phylis corrected me and told me that it was motion blur. I'm not sure what the second is. I think it is a double exposure of a flag on a rooftop with a leafless tree nearby superimposed against the side of a house. The top third of the image is much darker than the rest, as though some of the light was blocked on the enlarger during printing. The third image shows what might be a narrow hallway with a dog lying asleep (dead?) on the floor, surrounded by nude paintings in different styles. A sign that is barely visible says "No Visitors Permitted." The images are bleak and cryptic. And like so much of modern art, they are clearly not meant to be communicative. |
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Monday, November 18, 1996 |
10 am. Thirteenth Session with Joseph Mazurka. Mazurka mentioned seeing Phylis in the halls of SII. A confrontation is inevitable and I should do my best to prepare Phylis, although I can't think of a way of doing that without letting her know that Joseph is also my patient. Phylis didn't show up for her session today. She just blew it off. I can't say that I was surprised actually, even after she made a specific point of telling me how she wasn't going to miss this session. |
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Wednesday, November 27, 1996 |
10 am. Tenth Session with Phylis Birch. Phylis, who has just been a no-show for the past two scheduled sessions, just showed up wanting me to have a session with her and her husband Jack. My flight was leaving at noon, so I had barely the time, but I agreed to talk with them. Jack immediately blurted out that he blamed Phylis for Mazurka's physical assault. Phylis was taken aback and said that Jack had never blamed her in their private conversations--she referred to her surprise at having Jack say something embarrassing in front of "company." In any case, the dialogue that resulted between Phylis and Jack was clearly beneficial--obviously these issues had been brewing for some time and were just seeking a catalyst to bring them forth. Jack believed that Phylis had been having an affair with Joseph Mazurka and Phylis swore that she was not. When Jack cornered Phylis on what she was doing at the sleazy bar, Phylis tried to avoid answering the question. I strenuously encouraged her to tell Jack then and there and finally she complied. She told Jack that this gave her an outlet from the sheltered life that she normally leads, in addition to some other ideas about the dives that we've talked about in earlier sessions. I thought Jack took it quite well. He seemed to understand immediately what Phylis meant by dives and, although he didn't quite understand the fascination they held for her, he did not seem appalled. Actually, he seemed a little relieved that she had some reason other than having an affair. Like I suspected long ago, if she talked to him about these issues--really talked--I think that he would understand. I believe that she has underestimated his ability to really know her. Although Jack was a bit brusque, I liked him. He seemed caring but direct. I had the sense that even if she had an affair, he would be the type who would try to understand why she did, rather than just blowing up completely. The dialogue between the two of them was flowing freely, but I really had to catch my noon plane--so I cut it off quickly but encouraged them to continue at home. I hated to stop when they were doing so well, but the plane wasn't going to wait. In retrospect, Phylis might have brought Jack by more to show me how Jack dominates her in social interactions rather than for Jack's benefit. Although actually, I have the feeling that Phylis was giving lip service to Jack about wanting to include him in the sessions and was hoping to find me unavailable. |
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Monday, December 2, 1996 |
9:10 am. Telephone Conversation with Phylis Birch. Phylis called me to cancel her session for today. Apparently, Jack and Phylis decided on the spur of the moment yesterday to take several weeks off and fly to Mexico. They leave tomorrow. Phylis thinks it will be good for their marriage and I agree. Phylis' major complaint was that things were too predictable in her relationship with Jack. A trip to an unknown foreign land sounds like just the prescription. |
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Phylis Birch's Patient File
Charles Balis' Notes by Patient