Transcript of 8th Session between Charles Balis, M.D. and Ms. Cassandra Evans, Thursday, September 26, 1996 at 5:30 pm.

Ms. Evans: Hey Doctor.
Dr. Balis: Good day Cassie. How are you doing?
Ms. Evans: Oh I guess I am hanging in. Another day, another day.
Dr. Balis: Have the side effects subsided?
Ms. Evans: I think so. Sometimes it is hard to tell because of the symptoms I normally have. I mean, it can be difficult to differentiate between my normal sickness and the reactions to the drug.
Dr. Balis: I think at this point it would safe to assume that the Prozac is out of your system. How was your week?
Ms. Evans: It was quite busy, actually. I went to the performance of Winging It. That was fun, though quite exhausting. Within minutes of being in the theater, my adrenaline began to rush through my body. It was like something in me was screaming, "I am alive! I am alive!" I did get up for one quick performance which was totally cool. The scene was a couple in a theme restaurant, and we just goofed around. Definitely fun! Afterwards there was a party. Although I was really bushed by this point, I was having such fun that I didn't want the night to end. So I joined the crowd. Anyway, this pissy girl comes up to me and asks me where I have been, and who do I think I am just waltzing back and onto the stage whenever I want. This guy, Michael, explained to her that I had an illness. When I originally told him I wasn't sure what was wrong with me. I decided this would be a good opportunity to "come out of the closet." So I said, "I have Chronic Fatigue Syndrome." She laughed and in a very snide voice said, "Honey, everyone gets a little tired from time to time. What are you a princess?!" Needless to say, I was very upset! I tried in vain to explain to her, as well as the rest of the group, all the symptoms associated with this damned disease. I finally gave up and just pretended that it didn't bother me. When they laughed about it, I just smiled. To make things worse, it became a running joke. "Can you grab me a beer" "Nope, I have 'too tired and lazy' syndrome!" I was appalled.
Dr. Balis: What did you do?
Ms. Evans: I eventually excused myself, slipped out, and went home. And then I cried myself to sleep. I couldn't believe how wonderful the evening began and how awful it ended! People can be so ignorant and closed-minded! And cruel! I just don't get it. Plus, tell me this Doctor, who was the schmuck that named this disease? If it isn't all fatigue related, why did they chose that name?
Dr. Balis: Well, I think originally, fatigue was the most common defining symptom of the patients suffering from this disorder. So the consensus originally was to name it around that symptom--something that would differentiate it from other similar disorders, like Epstein Barr. This was in the U.S. anyway. In other countries I think they have different names for this disorder.
Ms. Evans: Really? Huh. I guess I should sit down and read all the CDC information that Dr. Halsey sent me. Everytime I sit down to read it, I get upset and depressed. I don't want this thing anymore. I suppose I was thinking once I knew what was wrong with me, I would feel better about things and could move on. But it seems as though the battle is just beginning.
Dr. Balis: That's true Cassie. But don't lose hope. There are many reported cases of remissions, so you may beat this thing yet. It always helps to have a positive attitude if possible and we can work on that. Have you told anyone else about your diagnosis?
Ms. Evans: Yes. I told my parents. They were puzzled and still don't know what to expect. They kept asking if I will need surgery or chemotherapy or something radical. I tried to explain more to them, but I think it was too overwhelming for them. And me. But they are generally supportive, which is great in my book.
Dr. Balis: Of course, I think their support is important. Have you told Brian?
Ms. Evans: Him? No siree! He came by on Sunday and made me breakfast. It seems the worse I treat him, the better he treats me. Weird. I almost got violent with him too. Not that I am a violent person.
Dr. Balis: What happened?
Ms. Evans: Well, I was very tired--feeling awful and achy all over. He wanted to come over for breakfast and I said I wasn't able to prepare anything. He said he'd do all the work. He came over and proceeded to make a huge mess in the kitchen while making a total racket! My head was throbbing and my bones felt like they were going to explode! He walks over to where I was lying down and asked me something. Actually more like demanding immediate attention. I don't even know what he said, but I was annoyed. I just wanted to be left alone so I could get some relief. He wouldn't let me be. I grabbed a vase and went to bash it over his head. Halfway through my swing, I stopped and just screamed at the top of my lungs! Do you know what he says? "Is something wrong, honey?" Argh! Is something wrong?!
Dr. Balis: I am glad you were able to control your violent impulse. Have you felt this way before?
Ms. Evans: Sometimes when the pain gets so bad, I just want to scream and break everything in sight. You know, be like Godzilla and stamp out the pain. Other times, the pain is so bad all I want to do is curl into a ball and cry. My tolerance and frustration level just drops immensely after long periods of feeling really ill.
Dr. Balis: I will talk to Dr. Halsey about getting you on a pain killer. I think that may allieve some of your discomfort.
Ms. Evans: Oh, I am sure it will. When I take over-the-counter medication, it helps a little. I've also been drinking some herbal teas recently. I signed up for a newsletter for CFS patients and it recommends all these alternative healing techniques. The tea tastes great but I don't think it does anything. It's soothing, but anything warm to drink usually is. At least for me.
Dr. Balis: Well, I'm glad that you are reaching out to a community of people suffering through similar problems and building up a support structure. And almost anything that helps is worth trying. How is work going?
Ms. Evans: Okay. It is difficult for me to hang in and pay attention all day long. I almost feel as if I have this camaraderie with Ms. Bows. You see, she's pregnant but I think I am the only one at work who knows. I'm sure there's more than meets the eye there but I totally respect her need for privacy. I almost want to tell her about the CFS thing. It would be great if we could confide in one another. What do you think?
Dr. Balis: That is something for you to decide. Perhaps you can suggest spending some time with her away from the office.
Ms. Evans: That's a good idea; keep socializing out of the office. I think it might be helpful if my supervisor knew what I was going through. I don't know. I'll play it by ear.
Dr. Balis: Have you had any more problems at work?
Ms. Evans: Well, there is one guy who constantly mutters things under his breath. I think he's the jerk who caused that letter in my personnel file. Anyway, he said something while I was getting some coffee, but I just ignored him. If he has something up his butt, that's his problem. I am not in the mood for a big confrontational scene.
Dr. Balis: I understand. However, it might be wise to address this issue before it gets out of hand. You may want to politely ask him if there is anything he would like to discuss with you.
Ms. Evans: Thanks for the suggestion, but I really don't want to deal with him right now. He has a major attitude to begin with--he's a "in your face" kind of guy.
Dr. Balis: Hmm.
Ms. Evans: Now that we have essentially played the "good news/bad news" game, ready for more good news?
Dr. Balis: Sure.
Ms. Evans: I had the dream again--several times this week. This guy is totally amazing. I wish I could remember more of his face. I have been trying to sketch him when I wake up, but I can't recall anything concrete. I do have the doodles I made when I was working on it last. Would you like to see them?
Dr. Balis: Of course, thank you. Tell me more about the man in your dreams.
Ms. Evans: Or of my dreams? Same difference. Well, in one dream we sat on a grassy hill sipping champagne. The stars were out and the night sky was truly majestic. It was one of those skies that look too beautiful to be real. We were discussing literature. And philosophy. And science. And entertainment. And everything. It was so delightful. Quiet and romantic. Every once in awhile he would grab my hand, look into my face with these incredibly smoldering eyes, and smile... I have the chills just thinking about it. I know this is pretty stupid thing to ask, but...
Dr. Balis: Please continue.
Ms. Evans: Well, do you think it is possible that there is really someone out there like this? I mean he seems too real to be just a dream.
Dr. Balis: Well, it is possible. But this is a fantasy, Cassie. Perhaps you are compensating for Brian in your dreams with this mystery man. I would like you to try something. Write down all the qualities in the dream man that you like. On a separate piece of paper, write down all the qualities you like in Brian. Compare and see what you find, okay?
Ms. Evans: Okay.
Dr. Balis: Well our time is up for today. Will you be able to come in again next week?
Ms. Evans: I would like to but I never know when I am going to crash.
Dr. Balis: Let's schedule an appointment next Thursday at 5:30 pm and if something comes up, we can make it a phone consultation. How does that sound?
Ms. Evans: That sounds fair enough.
Dr. Balis: Fine. Okay, that's Thursday, October 3rd. Goodbye Cassie.
Ms. Evans: Bye.
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