Olivia diagnosis Laura
|Laura went to Olivia’s office for their appointment at 10:00am. She sat there and waited for 20 minutes.
Olivia finally showed up. She was a bit frazzled. Instead of going into the office alone she let Laura enter entire directly behind her so they could get straight away to work. Olivia apologized profusely for being late. She said she had to take her dog to the vet and that she had forgotten to bring her cellphone so she could call Laura to tell her she’d be late. Laura just acted like it was no big deal. A non a event. Twenty minutes made no difference to Laura’s day whatsoever it was more just being unsure if she had come at the right time.
Ten minutes into their session a woman barges through the door without knocking. Laura recognizes her as Olivia’s suite mate.
Oh my god, I am so sorry. I didn't realize you were with someone.
“I am so sorry I completely forgot Today is Wednesday and we were supposed to meet for coffee,” Olivia said.
It's ok we can reschedule. The woman left as quickly as she had come.
Laura was always instinctively instantly slightly jealous of anyone getting to have coffee with Olivia.
“I am going to need a diagnosis for the insurance”.
The only thing my insurance will cover is OCD.
OCD is kind of a subset of having a Borderline Personality. It's a way it can manifest. Olivo reassured her. I would say you
r behavior definitely qualifies as OCD.
“Yes, there are two kinds of OCD and they kind of get confused with each other. There is regular OCD and there is OCD as a Personality disorder. This is the regular OCD.”
“How come no one has told me this before? I remember Bender telling me she felt I was too young to give me a diagnosis. I remember Altheim asking me questions that were indicating that she thought this might be OCD. But nothing ever came of that. Granted she never gave me any diagnoses. She hid them from me until the last week of therapy.
“I was told that you threatened Dr. Bender”.
“Well, I didn’t!”Laura protested.
“This therapy has to end”.
“Why? Why would you even believe her over me?” Laura was becoming exasperated.
“It just has to end. I'm giving you two weeks notice to wrap things up here with me”.
Followed by a firm “Yes” from Altheim.
I called the head of Bellevue but apparently, it's not the right fit. I’m recommending the intensive personality disorder institute at Lincoln. Laura hated almost anything with word institute in it.
They specialize in Borderline Personality disorders there.
Why would Altheim be recommending somewhere for Borderlines?
Wait you think I am a Borderline?
Why have you never mentioned this to me before?
I was protecting you.
“I felt like the term had too much stigma associated with it.”
Suddenly it all started to make sense as to why Altheim had always from the very beginning treated her like she was toxic. Laura was thinking this entire time you have treated me like crap. I can’t believe you hid this from me. If you had told me maybe I could have actually participated as an equal in my therapy.
Laura didn’t say these things to Altheim. She just stared with astonishment. It was really all too much and too late.
What Laura had randomly read about Borderlines had always sounded awful. They were like dealing with people who “were like emotional third-degree burn victims”. They were manipulative and unpredictable and to be avoided at all costs according to one youtube therapist. Laura went to Barnes and Noble and sat there on the floor as she cried doing research. They were the most discriminated against population within the mental health system. As in more discriminated against than schizophrenia and those suffering from Bipolar Disorder. And the worst part about what she read was that it wasn’t society at large that was discriminating so much as many mental health professionals who should know better. The very people they sought treatment from. One of the more insightful blogs summarized it by saying the reason why BPD was so discriminated against was that when therapists were not great at treating it they just blamed the patient.
All of this information had hit Laura hard. Like she had been knocked on the head with a baseball bat. The world froze and she shrunk. So Altheim thinks I am a Borderline - wow.
“I don’t self-harm. I don’t cut myself. I never have. I don’t even really understand that”
“there are different forms of self harm Laura. For example, do you drink?”
“Yes, but I am no alcoholic”
“Well, that is good”.
“As I am sure to know by now there are nine different criteria for borderline and you need to have at least 5 of them to qualify for that. What that also means is there are 256 permutations of how being borderline can manifest”.
Laura rolled her eyes. Laura just felt like if you have been through what I have been you’d understand why I am sensitive. She resented psychologies way of trying to minimize her by labeling her which is what this always felt like. She was just a graduate of some emotional variation of child abuse. Not so extreme that she was starved or raped but this was middle class or upper-middle-class child abuse hidden behind a nice colonial in Scarsdale. Her father just wasn’t in control of his emotions and Laura got the brunt of that. It was like a three-year-old tantruming in the body of a 6’4’ 45-year-old man. She comes to realize her mother’s emotional neglect was just as significant. It was her mother who called her father in to back her up when she and Laura would squabble. Her father would just come in and hit her - no questions asked.
I am going to take notes. Olivia pulled out a notebook as she balanced her MacBook on her knee.
Tell me about your sex life.
“Well.. for starters I can tell you about the time I lost my virginity when I was 25.”
“I lost my virginity in Switzerland. His name was Christopher”.
It was her last night in Zurich. She was staying near the airport hotel. Laura loved staying in hotels, especially luxury hotels. She could not believe how expensive the food was there. She was sitting at the hotel bar wearing just jeans and a t-shirt. He was curious if she went upstairs and changed her outfit if it would make her feel sexier. She went upstairs and changed into a black cocktail dress She was generally shy about showing any cleavage. Tonight would be different. She sat at the bar and ordered buffalo chicken wings and a salad which would be her dinner. She was minding her business sipping a cocktail when she noticed three young men in the corner of the room smiling at her. She smiled back at them. One of them wagged his finger in the air inviting her to join them. So she decided to go and sit with them. The Italian guy whose name was Martin had invited her over. He was ok looking but he had fucked up teeth. He was initially the one showing the most interest. Laura was flattered. Another was named Ben was the mix of half Asian and swiss german and third guy who spoke the least English was a swiss german guy named Christopher. Immediately Laura knew she was most interested in Christopher. They worked together nearby in the business district and had recently had gotten off work. They sat and chatted for a while and then offered to take her to a bar in the city and show her the lake. She agreed to go along with them. The bar was loud and crowded and overlooked a lake. She sat next to Christopher and Ben at the table. She wasn’t expecting it and was very excited when Christopher put his hand on her knee under the table. Christopher bought her a gin and tonic. They offered her to go skinny dipping but she declined. Martin had to go home to walk his dog. He offered for Laura to come and spend the rest of the evening at his place but she declined. On the way back to Christopher’s car in the parking lot, Christopher turned a little to the side and took out his dick and peed in the parking lot. Watching Christopher grab himself more so than the actual peeing part turned Laura on.
“You want to see?” Christopher said almost daring her.
Laura could kind of see him out of the corner of her eye as she tried to not look. She grinned.
They climbed back into the car and dropped off Martin. She was now in the back with Christopher. Christopher started fondling her. She was enjoying every moment wondering what he would do next considering Ben was still with them and had a view from the mirror. Christopher had his hand fully in her dress grabbing at her breast. One was nearly popping out. She wasn't sure what Ben could or could not see. And that somehow made everything hotter. They Drove her back to the hotel. They both wanted to come upstairs. Ben was also a handsome specimen. Laura wanted to be alone with Christopher so much to Ben’s disappointment she declined the threesome idea.
When they got up to her hotel room Christopher took a shower first then Laura. The hot water soothed her. They then stripped down to their underwear. He had a beautiful lean tall muscular body. She felt beautiful and confident. Soon the underwear came off and they lay together naked their bodies were warm and slightly still wet from the shower. It felt heavenly. It wasn’t lost on her that he was not circumcised. They explored each other's bodies. Christopher spoke little to no English. The kissing alone was amazing. They were interrupted by a call. It was the middle of the night.
“My girlfriend” he admitted.
“You have a girlfriend?”
That might have bothered Laura on any other night. It was too late at this point for Laura to care. It was his business.
Laura didn’t speak any German but she could tell he lied to her about where he was and ended the call.
He then turned to Laura.
“You are more beautiful” he uttered as he looked her over and they returned to their kissing.
Christopher wanted to be inside of her. She was tired of being a virgin. She was ready. In broken English, she thought he said he was a virgin too but she didn’t fully trust or believe him.
The problem was neither of them had a condom. Neither knew where to get a condom in the business district in Zurich at 4:00am as logical as it might sound she doubted the hotel stocked them. She still let him enter her for a minute or two before changing her mind and deciding she was too educated and had taken to man sex ed classes to think it was worth the risks. So she made him stop.
They both finally fell asleep. Laura awoke first. She decided she would gently wake him by sucking on him. The grin on his face as he woke made her happy.
When it was time for him to go they had a few more passionate kisses. He had a coke from the minibar fridge and like a gentleman, he insisted on leaving $4 to pay for it. They traded business cards.
Laura finished packing and headed for the airport.
She had a layover in Geneva and then back to the good old US of A. She was thinking about how America felt more advanced than Europe. Ironically, it was the day of the blackout and the entire eastern seaboard had been shut down and she was stuck at the airport the entire day. She actually tried calling Christopher at work to say hello or goodbye but couldn’t get past the secretary at his office who didn’t speak any English. In the airport that entire next day she wondered what if she had gotten herself pregnant or worse what were the odds of an STD. That previous night had been the most sexually exciting night of her life.
When she got home she did tell Altheim about it. Altheim asked her how she knew it was safe to get into a car with them and warned her she could have gotten raped or murdered. Laura felt she could trust her instincts in people when it came to that level of danger. Altheim told her she needed to go to the gynecologist if she was sexually active. In some sense, Laura felt this was the most motherly advice Altheim had ever offered Laura.
“Well, sexual promiscuity does count as a form of self-harm from a psychological point of view so I am going to count that as a yes. I think you are borderline. You are what they call a quiet borderline “
“I’ll see you next week”.
Laura went home. She had a singles book club reading that night.
“How did you enjoy the book?”
“It was ok, what about you?”
“I love how the protagonist..” She started zoning out.
“Unh hunh. Unh hunh”
Laura wasn’t really interested in anyone there. She was making polite conversation while at least enjoying the Pinot.
Laura was thinking about what love is.
Laura’s mother had once signed her up to take a writing course at Tufts University. It had turned her on to writing fiction. They were sixteen years old. His name was John and he was from Montclair. He wore grey t-shirts and knee length denim shorts which made him look shorter than he was. They would sit there in the lecture and just be able to laugh together. Everyone thought they were a couple but it was nothing more than a friendship. They did go out to see a movie together. She thought John liked her but Laura didn’t know what love was. Laura always thought that love was out there somewhere. It was the boy across the room at the center of attention. Always representing what she wasn’t. Something to aspire to. When she looked back on it she wished she had maintained his contact information or even knew his last name.
By the time she got home, she was inebriated.
She saw Paul Schatz was online. That become facebook ‘friends’ in the last year or so. He often posted photos of his wife and their four children. She hadn’t spoken to him in many many years. He had moved to Europe a while ago.
They had spent most of elementary school as pseudo enemies. Their relationship was particularly brutal in 4th grade. He constantly teased her.
Surprisingly he responded right away.
“I'm just a tiny bit drunk right now”
“You look really really good Laura”
She wasn’t expecting the compliments.
“So hot, you know I used to have a crush on you?
“Really?” She definitely didn’t know that! Even as a kid she knew boys could sometimes be mean to girls they liked but Paul used to seem to cross the line into being just downright mean. Maybe she was wrong and there was no line. His admission felt somewhat like a revelation. If he had been attracted to her maybe she had misunderstood much of elementary school hierarchy of social status and affection?
“I remember you once wrote on a desk ‘Laura & Asher’ in Laura’s Dr.eams”. It had at the time hurt her badly - mostly because she believed she was not good enough and that none of the boys liked her.
The alcohol was wearing off a little so she opened her own new bottle of wine”
“I am sorry I was mean to you”
“I was just very insecure back then. I wanted to be cool”.
Laura was open to forgiving him.
“Let me see you on Skype”
They both turned on their cameras and there they both were.
“You are very beautiful”
“Take off your shirt” I want to see you. It must have been the alcohol. She had spent her late teens and early 20s eating healthy and working out to try and scrape off the inadequacy she had felt as a young girl with few to no friends. She took off her shirt. And then her bra.
“Wow, just wow” was Paul’s reaction.
She wasn’t surprised by this. That was pretty much the reaction she always got from men when she took off her shirt.
She signed off with Paul at 2am.
She was remembering.. some of her fantasies of Altheim that she never shared with Altheim. Laura was picturing Altheim naked and then she started imagining Altheim having sex. Ever insecure about her own sexuality Laura wondered what Altheim looked like deep in the throws of passion? What face did she make when she had an orgasm? Laura would have paid good money to watch Altheim have an orgasm.
I want to quit. Laura sobbed over the telephone receiver. She felt she had grown too attached.
Laura, I really feel you're not ready. If I can’t help you with your boundary issues no one can.
In an alternate universe known as Laura’s imagination, she pictured Altheim having no boundaries and sex was the therapy. Altheim would nurse her patients back to well being with her own bosom and in these fantasies where Laura bore witness Altheim’s loins were the vessel in which male patients found nurture as they struggled with their childhoods, mommy issues, and present adult angst.
Similarly, at this time, Laura could not kiss a guy without thinking of Altheim. The thought ever present in her mind. WWA what would Altheim do? In Laura’s mind although she knew she wasn’t she became some mixture of Jennifer Connelly the actress and altheim whenever things got sexual.
Laura felt so guilty. If Altheim only knew how wet these thoughts made Laura and how inappropriate her thoughts were she'd kill her. Laura sensed that Altheim sensed something was up but Laura could never dare talk about it. Laura was too shy and Altheim already didn’t like her.
Her phone rang. It was Jonathan, Eagle her newest attorney and hopefully her last.
“You need to get into Kennedy or else..”
“Or else what?”
“She is going to put you in front of a grand jury”
“What if the program is just not right for me?”
“She doesn’t care”
“This is so ridiculous and unfair. Why can’t I get the help I actually need?”
“The system doesn’t work like that.”
Laura marched over to the emergency room at Kennedy.
“Well, I am not in an emergency situation but I need an evaluation”
“The doctor on call will see you. Please fill out the questionnaire”
“I can’t tell by looking at you if you have a personality disorder.”
The doctor went through the questionnaire she had filled out.
“I see that you work as a manager in a real estate firm for over a decade. No one who is Borderline could survive working in real estate in New York, therefore, I do not think you are truly Borderline.”
“I am told I have to qualify or else! Can you call the ADA Megan Reilly and see what she wants. The doctor called Megan Reilly right there in front of Laura.
“Is Megan Reilly there, please? Hello, I am the doctor on call at the emergency room at Kennedy hospital psych ward. What is it you want from Laura?"
“Megan says she doesn’t want anything from you but that you had picked this program for yourself.”
What a fucking cunt liar Laura thought to herself.
“Look if you want me to write you have a nonspecific personality disorder I will if that helps you”.
“Yeah, thanks I guess,” Laura said meekly.
Goodfellow calls Olivia
I got a call from Dr. Goodfellow. She told me Megan Reilly subpoenaed all of your therapy work together.
Are they going to forward my records?
As far as I understood, yes.
Laura understood that Goodfellow had worked at a clinic and policies here were not her own.
Dr. Goodfellow is worried for you.
Laura knew there was nothing so exciting about her relationship with Goodfellow as they had gotten on really well.
After she was done with Olivia she called Eagle and told him that her records were subpoenaed.
Well, they are not supposed to forward them. It's a breach of client-patient confidentiality. They could lose their license.
Oye Laura thought. The last thing she wanted to see was Goodfellow in trouble. It would be her turn to protect Goodfellow. She was just surprised that the clinic could be so dumb about the law and intimidated by Megan and it didn’t seem like they knew what was right or how to legally protect themselves.