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Ms. Evans:
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Hello Doctor.
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Dr. Balis:
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Good day, Cassie. How are you doing?
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Ms. Evans:
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Okay, I guess. Well, not really. I am a mess, a walking disaster area. I feel terribly sick and achy. I didn't make it into work today. I almost canceled our appointment. But if I had to sit all alone in my apartment feeling like this, I would be crying hysterically. I don't know what to do with myself anymore. I'm terribly exhausted, but I can hardly sleep. I have trouble walking because of the pains in my joints, muscles, and skin. I'm terribly uncomfortable standing still, sitting, and lying down. I have chills and hot flashes. I'm falling apart at the seams!
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Dr. Balis:
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The tissues are on the table beside you, if you want them. Take a deep breath and we'll go on.
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Ms. Evans:
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Okay. I'm sorry for crying like this. I don't know who else to turn to. You've been so good to me and I really appreciate it.
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Dr. Balis:
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That's what I'm here for. Don't beat yourself up for not feeling well.
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Ms. Evans:
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I'm so scared to lose my job. How will I support myself? Did you hear about SII's medical reviews? They are looking into people's files or something. It can't look all that well that I am seeing a psychiatrist, and now an internist, plus missing work so regularly. What am I going to do?
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Dr. Balis:
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Take each moment as it comes, one problem at a time. We are here to try to help you work things out.
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Ms. Evans:
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Have you ever heard of Serenity Prayer?
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Dr. Balis:
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"God grant me the serenity to accept the things I cannot change, the courage to change the things that I can, and the wisdom to know the difference." Is that the one?
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Ms. Evans:
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Yes, that's it. Sometimes I just feel like giving up to a higher power. But it's one of those things that are easier said than done. It's so unfair! Life was not supposed to be this way! I worked hard to get where I am and I'm a good person. So why is everything so messy, so difficult? I don't understand. And if I don't understand, how the hell am I supposed to accept it?
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Dr. Balis:
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It's important for you to come to terms with the fact that you have an illness, and a disabling one at that. Do you think you can ultimately accept that?
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Ms. Evans:
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If I knew what was wrong with me then yes, I think I could accept it.
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Dr. Balis:
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Do you think you'll feel better after you have been properly diagnosed?
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Ms. Evans:
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I suppose it would make me feel better. A couple of years ago, I was friendly with this girl. I told her everything. All about my high school-home instruction experience, being ill, and so on. Anyway, she asked me what I was suffering from if I was so sick. I told her it was undiagnosable at that point, and told her about the hundreds of doctors I'd seen, the different tests and treatments I had tried. She asked me if I was suffering from Munchausen's Syndrome. Have you heard of it? I wasn't sure what that was, so I simply told her I didn't think so and looked it up when I got home. Do you know what that is? It is some disease that you pretend to have in order to get attention from being sick. I was so hurt and so angry at the same time! What kind of an idiot would choose this lifestyle? How insensitive can a person be? And the thing is, right now even if that is what I'm suffering from, I'd be thrilled. At least I would have a diagnosis, a prognosis, and a treatment plan. Now I have nothing!
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Dr. Balis:
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You're talking about something that we call Factitious Disorder. It's a conscious effort to deceive doctors so that they can assume the sick role. But it's done on purpose. From what I can tell, Cassie, you're a very smart young woman. Are you pretending to be sick?
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Ms. Evans:
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No! Not at all! I want to be normal so badly. What I would give to be average. I don't want this attention! I want a regular life!
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Dr. Balis:
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That's what I thought, Cassie. I have no doubt that you are generally suffering and that you aren't pretending to be sick to gain attention. Have you heard back from Dr. Halsey yet?
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Ms. Evans:
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I spoke with his office this morning. I have an appointment with him tomorrow afternoon. I'm feeling a bit ambivalent about the whole thing. Each time I go through the process of seeing a new doctor, there's this great hope that an answer or a clue will be uncovered. I just don't want my hopes to be dashed yet again.
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Dr. Balis:
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There is nothing wrong with cautious optimism. I believe that Dr. Halsey is a very responsible and thorough doctor. He'll do his best to help you.
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Ms. Evans:
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I suppose.
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Dr. Balis:
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Tell me, how was the rest of your weekend? Did you see Brian?
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Ms. Evans:
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The weekend was truly yucky, to say the least. Feeling this way and not being able to shake it is the pits. I did see Brian. He came over with a pizza on Sunday. Actually, he called Sunday morning and did his usual invite himself over to dinner thing. I was in such pain that I had no tolerance or patience to deal with his crap. So I told him that he obviously just didn't have a clue as to what I'm about and to fuck off. Then I hung up on him. I think he was slammed by my reaction. I never did anything like that before, so he knew he was in the doghouse in a big way. He tried calling back, but I was screening my calls. He must have thought at first it was a joke because he was giggling saying, "C'mon! You can't be serious, Cassie." The next thing I know, he is at my door with a dozen red roses, a video, and a pizza. I was flabbergasted! The guy actually bought a clue! Go figure. We didn't watch the video, I wasn't up for it, but the pizza was good.
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Dr. Balis:
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Did you have a good talk with him?
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Ms. Evans:
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I don't know. I wasn't thinking all that great, and half of what I say goes into one ear and out the other anyway. I was ready to call it quits. Sometimes, I don't think he's worth all the trouble. I don't have enough energy to get my things done, why add frustration and aggravation to that?
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Dr. Balis:
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But how do you feel about Brian? When we first talked, you said you thought you loved him. Do you still feel the same way?
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Ms. Evans:
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I do care very much for Brian, and I'm sure I always will. I think I may be in love with him. I don't know for sure. Right now, I just don't want anything too complicated or emotionally draining. Is that wrong of me not to want to make any commitment to him?
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Dr. Balis:
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As long as you are honest with him, no. That is simply what you feel right now. It does not require a good or a bad label.
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Ms. Evans:
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I know. I wouldn't want to hurt him or anything. I just have this huge thing hanging over my life right now. Plus I had this really weird dream the other night. I was walking through a long hallway, and there were two doors. One door was slightly ajar, so I peeked in. Brian was sitting at a desk taking notes off a blackboard. The room was empty, but spit-balls kept flying toward the front of the room and handwriting magically appeared on the blackboard. I backed off and bumped into a door behind me. This door was locked. I crouched down and tried to look through this peephole. Then I felt a tap on my shoulder. It was this man who took me in his arms and kissed me passionately. It was so intense! All I could recall when I woke up were his eyes, these smoldering blue-gray eyes. It just got me to thinking, what if Brian isn't the right man for me?
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Dr. Balis:
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Hmm. I think it's more important that you're happy with the way he treats you and the way you feel with him.
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Ms. Evans:
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Well, I think this weekend gave him some food for thought. That I need and want him to respect me as well as treat me properly.
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Dr. Balis:
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Very good. That is certainly a step in the right direction. Unfortunately, our time is up for today, Cassie. I do want you to let me know how everything goes with Dr. Halsey. Let's schedule a meeting for the same time next week. That's Tuesday, September 10th at 1 pm. If anything new happens, and you need to talk, please call me, okay?
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Ms. Evans:
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Yes, Doctor. Thank you. Have a good week.
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Dr. Balis:
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You too, Cassie. Bye.
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Ms. Evans:
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Goodbye.
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###
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Doctor Balis' Notes on this Session
Transcripts of Cassandra Evans' Therapy Sessions
