Saturday, October 19, 1996 |
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Sunday, October 20, 1996 |
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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. 2 pm. Sixth Session with Sarah Wright. Sarah discovered that her husband and Robby have been conducting a long-time homosexual affair. She heard a message from Jeff to Robby setting up a meeting when he was supposed to be playing golf and went over to Robby's place with a friend and watched as Robby kissed Jeff goodbye at the end of their rendezvous. When confronted, Jeff walked out the door without a word and hasn't been seen since Saturday afternoon. Sarah believes that her marriage to Jeff and the last fifteen years of her life has been a set-up orchestrated by Robby and Jeff. She is enraged and said that she is plotting violent revenge, although she assured me at the end of the session that the violence is just a fantasy of what she'd like to inflict upon Robby and Jeff. I suggested St. Helena or at least a tranquilizer, but Sarah was having none of it. I don't think that Sarah is really a danger to Robby or to Jeff, but I begged her to contact me this week and let me know how she is doing. 4 pm. Twelfth Session with Joseph Mazurka. Joseph continues to display absolutely no remorse for his assault on Jack and his rape of Phylis. He believes that his actions were completely justified--in fact, he sees himself as the hero of the story. He even spoke approvingly of rape, although he said that he was too old. Then he launched into an outrageously racist diatribe against homosexuals, blacks and interracial marriages--a "they're going to overrun us" type argument. He talked about how he was allied with a group of white men who were going to do something about all the ills they perceive--some dramatic, "front page" type of gesture. I'm afraid that I completely lost it. I just couldn't listen to it anymore and I lost my cool. I told Joseph that I thought he was a pathetic loser trying to compensate for his own inadequacies by abusing those around him. And I told him that therapy wasn't going to work at all as he is completely uninterested in turning around his life, instead wallowing in paranoid misogynistic, racist fantasies. I told him that I thought he was just trying to indulge every evil impulse he could come up with. Joseph was a little taken aback--he thinks of me as completely spineless, I'm sure. But actually my outburst was probably therapeutically valuable. For anything to work with Joseph, it will have to jar him out of his standard thought patterns. Joseph ended by asking me for a favor--to hold off on my suspicions regarding his activity with his group of shooting range, bar types. He said that maybe what they are planning isn't such a bad thing after all. What are the chances that what he has in mind is a random act of kindness? |
Tuesday, October 22, 1996 |
11:30 am. Telephone Call with Cassandra Evans. I got a call from Cassandra. She's been at her grandmother's house at 555-9801. I was getting frantic with worry over her since she wasn't at her last session, Dr. Halsey hadn't heard from her and they hadn't heard from her at work. Apparently, she has suffered a fairly serious relapse, including several seizures. Her speech is slurred and she sounded almost drugged and very lethargic. She has trouble putting together her thoughts. And she sounds like she is in a lot of pain. I contacted Dr. Halsey and he said that he would call her right away. Cassie says that she hasn't been able to sleep for days, which would account for the disorientation and some dementia. I suggested to Dr. Halsey that he might consider a sleeping pill, but he seemed doubtful. He told me that CFIDS patients often have bizarre atypical reaction to drugs, especially to sleeping pills and that he was afraid of over-medicating Cassandra. He did think that it might be appropriate to bring her into a hospital setting especially with seizures. He said that he would very much like to run some EEG studies on Cassandra to see if she might be suffering from another undiagnosed disorder on top of the CFIDS. I wish there was more I could do for her, but her problems are primarily physiological rather than psychological. I can help her deal with the consequences of her illness, but I can't do much to treat her illness itself. It makes me feel inadequate, like I've failed her somehow like so many other doctors before me. 4 pm. Fifteenth Session with Sylvia Bows. Sylvia was in a weird mood during our session. She realizes that troubling things are happening for her, but there was a sense of unreality about it--like reading about characters you are fond of in a novel. She was disturbed by events, but responded somewhat lightheartedly. Tom is seeking sole custody of her unborn twins. During an unpleasant confrontation where Sylvia might have lost full consciousness at one point, Tom served her with a set of legal papers which claimed that she has demonstrated her unfitness to be a mother by, among other items, daring to have children at all given her poor medical state. Somewhat circular in reasoning, and an outrageous position for Tom to take, unless he is trying to utilize the custody of the children as some form of bargaining chip over Sylvia. Legally, of course, he is the father of these children even though he had nothing to do with their conception. Sylvia was counting on that legal principal when she got pregnant during their marriage. She wanted Tom to be financially responsible for them. Now, she is being hoist with her own petard. Sylvia seems to think that the whole matter will go away in a couple of days, but from what I know of Tom, I think she is underestimating him. He wouldn't have taken a step like this unless he knew what he wanted and thought there was a reasonable possibility of getting it through this maneuver. Sylvia is having trouble facing adversity--her pattern is that of running away unless forced to confront a situation. We should work on this, otherwise Sylvia will be subjected to a series of dramatic confrontations where she is forced to reckon with those from whom she has fled. |
Wednesday, October 23, 1996 |
Received another fax from the anonymous faxer this morning. This makes fourteen, and not a Wednesday missed. This person is a bit anal retentive and certainly has a need to explore this creative outlet for his or her anonymous angst-ridden communication. This image is a Frankenstein patchwork of different limbs and pieces of torso collaged together to form one, vaguely female and vaguely human figure. The gross physical deformities are obviously manifest. Some of the torso pieces appear to be anatomical cut-away drawings (one of kidneys) while others are old photographs or sculptures. Some of the pieces are clearly female while others are not gender specific. The figure stands on a pedestal. While the pieces make a whole, there is a strong sense that none of the parts really belong to this figure. The pretty female head which tops this monstrosity is the same female face which peered from the mirror in a previous fax. The face looks serene--content with what she is. But the faxer clearly does not share that serenity. |
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. 4 pm. Seventeenth Session with Anna Green. Anna is still smarting over my interrogation during the last session. But I can tell that she has been doing some deep thinking about the nature of fantasy and reality. I don't think she'll be telling me her fantasies as if they were reality any time soon. She accused me of trying to trap her into admitting that she never slept with Caren when I just assumed that premise in our session--I wasn't as artful as they are in those old detective movies, I guess. But I do think it is clear that Anna and Caren did not consummate a sexual relationship, nor did Anna, Caren, and Caren's boyfriend engage in a ménage à trois, although I haven't touched on that issue. Anna professed her love for me yet again, and again I explained the obligations of a therapist to his patient. But Anna invented convoluted hypotheticals where she suffered amnesia after a plane crash and had plastic surgery and I didn't recognize her and then we both fell in love with each other, got married and had children before we discovered, a la Oedipus, what had happened. I guess if I say that this situation is okay, she will push me to have a relationship with her without all those conditions--I can just hear it now: "You don't want me to be in a plane crash, do you?" Anna explored her feelings around the time of her abortion. She waited until the end of her first trimester and then apparently had some problem with her progesterone level after the abortion which was improperly handled by the medical staff who were administering to Anna. Finally, she was placed on birth control pills as a means of stabilizing her menses. I should ask her if she is still taking those pills. She also mentioned that she knew that Helen was my patient. Previously, she had mentioned that she saw Sylvia in my office. Anna is obviously spying on me from her vantage point at SII. It makes me a little nervous about what she knows and doesn't know. Apparently part of Helen's paranoia at least is justified. Anna didn't know anything about Helen's whereabouts, but said that the police had been at SII asking questions. |
Friday, October 25, 1996 |
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