The Naked Lady Who Stood on Her Head Read Online Free PDF Page A

sicker than either Lochton or I had appreciated. She was a borderline psychotic who could not tolerate the anxiety of probing psychotherapy. Borderlines are patients whose psychological state straddles the line between normal anxiety and psychosis. When under stress, they tend to distort reality and have delusions and hallucinations. All my delving into Sherry’s past and not answering any of her direct questions about me had pushed her into a psychotic delusion that I was having sex with her by looking into her eyes. She didn’t need probing; she needed support and nurturing.
    Sandler suggested I take a closer look at Sherry’s medical history. I looked up her old hospital medical records and found that her lab tests were all normal, but she had never had a head CT scan or an electroencephalogram (EEG). It was a long shot, but maybe Sherry had a brain tumor or some kind of neurological problem that was contributing to her psychosis and erotomania.
    I knew Sherry needed help, and I got some referrals for her in case she wouldn’t continue therapy with me. Despite my anxiety about working with her, I felt bolstered by my new supervision and wanted to try again.
    After a week, I gave Sherry a call. I encouraged her to come back and talk about what happened. She was snippy at first but willing to listen. I told her that I really did want to help her and that a different approach might make sense at this point. But she would have to follow the rules—no hitting and no gifts. I told her that we would not need to explore her past so much but would look for ways to help her cope with the feelings that brought her to therapy in the first place—emptiness and loneliness. We could also slow things down and meet just once a week. I wanted her medical doctor to get some additional tests so we could possibly start her on some medication to help calm her nerves. Finally, I assured her Iwould not stare into her eyes and reiterated that I had not meant to make her uncomfortable. I think she sensed I was back in the driver’s seat as her psychiatrist, and she agreed to come back.
    Sherry returned to weekly therapy, and I started her on a low dose of an antipsychotic drug. It quickly dampened her eroticized transference delusion, and she also toned down her wardrobe.
    “I don’t know what I was thinking, Dr. Small,” she said. “I was just stressed out because Eddie was traveling so much and you seemed to be interested in what I had to say.”
    “I’m just glad you’re feeling better, Sherry.”
    “I can’t believe how stupid I was going to that bar. I could have taken home an axe murderer or something.”
    “I think the medicine is helping you cope better with your anxiety,” I said.
    In the meantime, the results of her medical evaluation came back. Her EEG revealed no evidence of temporal-lobe epilepsy, a condition sometimes caused by a brain tumor under the temples, which can lead to personality changes and hypersexuality. Sherry did have a pattern of hypersexuality, but the scan ruled out a possible neurological explanation for her symptoms. A diagnosis of borderline personality disorder turned out to be the best explanation for her symptoms and her negative response to the insight-oriented psychotherapy Lochton had recommended.
    Sherry continued to see me weekly for supportive psychotherapy and medication follow-up. In general, she was less anxious and seemed to have a good grip on reality. Whenever her husband would leave for an extended business trip, I would increase her dose of antipsychotic, and she didn’t relapse into her old barhopping behavior—as far as I knew. In fact, she was progressing so well that I started to delve a bit into her past, and she revealed that her parents had separated when she was twelve—Lochton had been partly right about her having an early trauma. But at the next session, Sherry showed up wearing a miniskirt and pumps, so I backed off digging into her early childhood, and focused on