The Coldwater Diaries

Transcriptions of Session 04-004002 regarding Patient Ramo, Donald (Patient ID: 01011).

RECORDED SESSION W/R-01011 (Notes Added in Italics)

PREVIOUS RECORDS REFERENCED VIA: R-01011

EXPERIENCE W/PATIENT: EXTENSIVE

PATIENT STATUS: PRIORITY

[Note: After Donnie’s initial visit I seriously doubted a return visit. Much to my surprise, Patient R-01011 has shown himself regularly and never tardy  - citing himself our sessions as his only outlet of late. Due to extensive history with patient his status has been moved to PRIORITY as patterns suggest mental-break without remedy.]

BEGIN TRANSCRIPTION:

Patient begins session without a word as his past few had gone. Patient continues to show signs of self-abuse by way of malnourishment, lack of sleep, and without doubt self-medication (drug abuse).

D: I ran into someone in the parking lot on my way up…

H: A friend?

D: I don’t know.

H: More like a friend of a friend? Or was it a stranger?

D: Like I said, I don’t know… It’s like when I saw this cat it was obvious they knew me – shit the guy approached me – but when we were face-to-face… I mean I looked right into his eyes and I… I just didn’t recall—

H: Forgive me for cutting you off, does this have anything to do with what we’ve been addressing of late – this fear of disconnection from what you call the real world?

D: I don’t fucking know. For all I know this was some fag who tried to pick me up at a bar some time ago… Forget it, I don’t see it being pertinent… forget I brought it up.

H: But you did Donnie…

Patient runs fingers through hair. Rocks in chair. Upset.

D: So I did, what the fuck of it!?

Patient is disturbed. Tears are forming.

H: Let’s switch gears then, is that okay with you?

D: Whatever.

H: Okay then, and I fear we’re about to cross another rocky-road but I have to ask as a doctor… have you been taking the meds?

Patient regains confidence. Matches my eyes. Smiles.

D: Now you’re going to have to be more specific.

H: You know what I mean, the Lexapro, have you been taking it? Earlier you expressed concerns it would hinder your writing.

D: Yeah well I haven’t been doing much of that.

H: The writing or the Lexapro?

D: The writing. After our last session I started taking the Lexapro.

H: And have you been taking just the Lexapro?

D: What do you think?

H: Given our history I’d venture to say I shouldn’t have asked.

D: Nail on the head.

H: Dare I ask what else is in the mix?

D: The usual. Xanax and Adderall mostly.

H: We spoke about that—

D: Now I’m going to interrupt you. We spoke about mixing flake with the Lexapro.

H: By flake I’m assuming you’re talking about Cocaine.

D: But of course.

H: And you’ve curtailed?

D: Been too scared to touch the shit since starting the Lexapro. I’m sticking to Pharmies for now. They’ve always worked out in the past.

H: I see… When you say you’re too scared to touch Cocaine while on Lexapro… What exactly do you mean?

D: I don’t see the fucking relevance of the question…

H: Being as you’ve no problem mixing the Lexapro with Adderall and Xanax, I’m wondering what makes Cocaine any different?

D: I did a little reading up on this Lexapro shit online. From what I gather, Cocaine counteracts the Lexapro neurotransmitter-wise and the last thing I want is to get more fucked in the head.

H: Yet you continue the Xanax and Adderall?

D: I only use Adderall now when I want to write which isn’t all that often anymore.

H: And the Xanax?

D: You and I both know Xanax isn’t a problem.

Patient grins.

H: I don’t follow…

D: Lexapro is often prescribed along with benzodiazepines.

H: True, but usually by a physician.

D: I know my limits.

H: Yet here you are no different – if not worse – than our reunion as you like to call it.

D: Oh I’m most certainly worse off, there’s no doubting that?

H: And do you think maybe your self-medicating may have something to do with that?

D: Do you?

The patient asked the preceding in a tone suggesting he knew the answer. Patient likes to toy occasionally to maintain a sense of control. Knowing full-well Lexapro takes time to affect the brain, I’m at a loss – certain patient is aware of this as well.

H: I’m sure you know your limits. But that statement is in no way meant to be misconstrued as my condoning your self-medication – which I believe to be a major source of your issues…

D: Yeah well… I’m taking baby steps here.

Just over two minutes of silence follows.

H: Let’s talk about something we’ve discussed the last few sessions, your living habits.

D: What about them?

H: Have you gotten out much?

D: I’m here aren’t I?

H: Aside from coming here—

D: Aside from coming here I don’t have anywhere else to go.

H: So it’s safe to say your human interaction has been limited still.

D: My human interaction has always been limited…

H: You know what I mean.

Patient takes a moment to reflect. Eyes to the floor for a moment. Then—

D: I feel like…

Another long pause.

H: You feel like what?

D: I don’t know… it’s like I look out from my balcony and can see the city below me and I scroll through the channels on my TV and see all this shit on the news and reality TV shows and the like and get this feeling as if… I don’t know… somehow the world around me has changed and I don’t fit.

H: So you lock yourself inside… where you feel more comfortable?

D: Who said anything about feeling comfortable?

H: Well… I don’t know… perhaps that’s something to address. Do you feel like a prisoner in your own home?

D: I feel like a prisoner in my own fucking body. My apartment is just a roof over the head. No matter the locale nothing changes.

H: Yet you’ve expressed past sessions your ability to be brutally honest here during our sessions.

D: That’s not to say I still don’t feel like a prisoner within myself.

H: Noted.

D: Okay noted, so what!?

Patient becomes agitated.

H: Well as we’ve touched on before, there must be some core issue behind all of this.

D: Terms like core-issue mean dick to me. I mean I’m putting myself out here for you, I’ve agreed to your terms, I haven’t missed a single session, and yet you fail to cure me… it’s like you’re telling me nothing new.

H: In most therapeutic situations it’s not up for the therapist to cure the patient but rather to open the door for the patient to find their own way…

D: Okay that’s bullshit to me but let’s say I entertain the notion for a moment… when exactly do you plan to open the fucking door?

H: I don’t think I have to in your situation.

D: Again you’re losing me…

H: To elaborate, Donnie, it’s my belief in your particular case at present – forget our sessions before you came back – that you were the one that opened the door…

D: What like figuratively or literally?

H: Both.

D: Why do I feel like you’re fucking with me?

H: Why did you come here, Donnie?

D: You mean today?

H: No I mean specifically a month back. Just after you ripped that friend of yours off.

D: You mean Cal – he’s not a friend.

H: Be that as it may, the question still stands, what brought you here?

D: I’m not moving fucking forward! You know this! I’m losing my fucking mind with every day… and this shit… this turning one question into another isn’t helping…

H: Let’s think back to that day you came here. Something significant to you had happened, do you remember, what was that?

D: I don’t know…

H: You had said you reached a point in your life that day you had been striving toward…

D: You mean stacking my bank?

H: I think so. If by stacking your bank you’re alluding to what you’ve deemed as a new phase in your life…

D: You say new phase in my life like it’s a bullshit term.

H: Isn’t it though Donnie?

D: I’m not ripping people off anymore am I? This is the new phase – time to work on myself and do what I set out to do from the very beginning.

H: Yet here you are.

D: Fucking right. I’m here so I can move on.

H: Yet you continue to get worse – your words not mine.

D: Because we continue to dance around like this.

H: Are we dancing Donnie or are you?

D: Again with the question after a question shit…

Patient fidgets in seat. Suggests discomfort in being called out. From past experience I tread lightly as patients been known to become unstable when not in control and vulnerable.

H: Do you recall our very first session?

D: Yeah you thought I was a sociopath.

H: Which we both know you’re not. It’s more a front and furthermore a moot issue. I’m leaning toward a different direction…

D: I’m fucking listening.

H: Do you remember why you first came here – to Los Angeles not this office – in the first place?

D: To write. Stupid question.

H: Okay. And instead of writing what did you do?

D: Before I started coming here I’ll have you know I wrote like mental. It’s just after time I needed to survive.

H: And what did you resort to as your means of survival?

D: What are you talking about? The cons?

H: In a sense yes.

D: Okay yeah, we’ve been through this, conning was what seemed to be the best way to stack chips so I could eventually get to a point where writing would be my main focus.

H: And haven’t you achieved that financial stability now?

D: Yeah but—

H: And still you’re looking for another hurdle to jump so you can finally find yourself in that place where—

D: I don’t see how any of this shit makes—

H: Why conning? Why take that path?

Patient leans back in seat. Interested where I may be taking him.

D: What you mean like why not be a telemarketer to earn a living? I’ve been there. Need I remind you I was thrown on my ass at fifteen! Conning is what I knew, I was good at it, and it was a fast track… you think I’d be able to afford you if I were some dipshit telemarketer or writers assistant or anything of the like?

H: So conning was no more than a means to get you to where you are now?

D: Of course not. I mean in the beginning I thought it would all pan out differently.

H: By that you mean what exactly?

D: Christ we’ve been through this. I didn’t think I’d end up fucked in the head. It was supposed to be simple.

H: But life never is.

D: You’re telling me.

H: And here you are now, done with your cons, wondering why you’re unable to write?

D: That and other issues such as not knowing what’s real any more like that hooker I told you about a week or so—

H: Let’s not veer off Donnie. I’m going somewhere with all of this.

D: Don’t let me stop you.

H: Do you remember what you first told me of your life when we first met?

D: It was so long ago—

H: The first day you came to me you were suffering from panic attacks.

D: Given my lifestyle at the time totally fucking understandable the panic attacks were…

H: And what was it you told me your lifestyle was at the time?

D: Fuck if I remember…

H: More specifically, when we began to address your family, do you remember what you told me?

Patient freezes up. Eyes to the floor again.

D: I don’t see… I mean… I don’t remember… Why is this so important anyway—

H: You told me your father had died and your mother was out of the country.

D: Okay? So what?

H: Yet later you admitted your father was still alive. And your mother had been trying to contact you despite your ripping her off for over—

D: Why is any of this important?

H: Do you remember how long it took for you to address your father and the situation between the two of you—

D: My father isn’t the fucking issue here. Do you see him around? I’m living my life and my life is a fucking mess…

H: And I’m trying to address your life and the mess it’s become but doesn’t by any means have to continue… there’s a way out if you’d only swallow some pride and listen rather than yell your way out of looking in the mirror.

D: My fucking father, my way of making a living, whatever I told you in the past is irrelevant—

H: To you maybe because you’re unwilling to face it. If you’d only allow me to present an—

Patient goes cold. Shoots fire into my eyes.

D: Get to the fucking point already.

H: You and I both know you’re far too intelligent not to see what you’ve done to yourself. When we first began seeing one another it took months for you to put your cards on the table – it was one fable to the next – as if you accepted these fallacies as truth to protect yourself.

D: Protect myself from what?

H: Who you were…

D: Again making no sense—

H: Think about it Donnie, why do you suppose it is you’re so good at conning people?

D: I don’t know… my irresistible charm and good looks.

H: You’re veering again but I’ll give you that. My observation lies within another of your talents.

D: And what might that be?

H: Your writing. Storytelling. All this time you were conning people in order to achieve some self-delluded sense of comfort where you’d be able to write, while all the while you were writing in a different way. With every con, with every story you told me and I’d imagine many others regarding your past, all of these things were your way of using that outlet of writing only in real-time. In your life… Where although you couldn’t write on paper, you were able to create these worlds and situations that didn’t exist to the point people bought into it all and eventually suffered the consequences.

D: I never took anything from anyone, they gave it to me.

H: Based off the fantasy world you presented to them. Can’t you see, your conning was a way to write without knowing…

D: Assuming I consider that as true—

H: Considering is no longer an option. It is truth Donnie. What you can’t see however is before conning me and all those who you’ve profited from, there was a ground-zero of sorts… your first mark.

D: And who might that be?

H: You Donnie. You were the first person you ever conned. You’ve spent all these years convincing yourself you’re something you’re not – trying so hard to forget who you were – all these other personalities came out of your own design and after time they clashed.

D: And this is what you attribute to my current state?

H: It’s a part of a bigger picture. First you have to ask yourself where the need to con yourself came from. What were you running away from?

D: I never ran away from shit. I was thrown away and went with the flow.

H: Part of that may be true, but in going with the flow, you created these stories to get you through. And now reality hits and you have no idea what to do with yourself.

D: I just want to move on to the future.

H: I don’t doubt that. And even up until this moment you’ve created this image of a future only achievable after getting through whatever present issues may be in the way…

D: Yeah and that’s what you’re for.

H: Assuming the present is where your problems are…

D: What’s that supposed to mean?

H: I strongly believe that you’ve gone through these past years using whatever present you find yourself as means to justify this notion of the future you have while ignoring what may have gotten you in the present in the first place.

D: You lost me. That made no sense whatsoever. And you’re supposed to be educated.

H: Berate me all you want, as is your style, but consider for a moment that maybe all these stories you tell, these lives you’ve lived, the present you’ve passed and the present you find yourself in now – consider all of it was to serve a purpose… a purpose that if properly addressed could resolve all your issues…

D: Again, I’m baffled you’re a doctor. These things you’re saying are no different than the ramblings of a homeless nigger on PCP on—

H: Just shut up for a second and listen to me Donnie (To this patient eases in chair) and consider maybe the reason you can’t move forward comes from not dealing with what still eats you up inside from the past.

The patient becomes very cold – to the point I’m frightened.

D: And just what in the name of fuck may you be alluding to in regards to this past I’ve allegedly conned myself into believing isn’t real?

H: For starters there’s the issue with your father—

D: Off the fucking table. We’ve been over this.

H: And yet you continue to suffer.

D: Not by his fucking hand.

H: Maybe not now, but scars from the past still may—

Patient springs from chair. Throws it.

D: My father is off the fucking table!

Patient makes way for me. I refuse to budge. Confident he wont harm me.

H: Intimidation won’t get you out of this—

D: Who says I’m intimidating?

H: You threw a chair, Donnie.

D: I was upset.

H: And you’ll continue to be. You’ll continue to wallow and swim in this pool of refuse  until you man-up and realize without addressing one or two instances of your past you’ll never be able to move on to this future you so badly desire.

Tears fall from patients eyes. He turns away from me. Puts chair back in place. In tears says—

D: Sorry I threw the chair.

Patient makes way for door.

H: Donnie stop, don’t leave.

Patient takes deep breath. Wipes tears from eyes. Turns to me.

D: Assuming what you’re saying is true and I address my past – what’s to say after doing so I’ll even want a future to look forward to anymore? You say I’ve conned myself to forget, well maybe there’s a reason.

H: Initially there was a reason. But now you’re in a much darker place which I firmly believe is a result of past issues regarding your father—

D: He’s dead to me. I haven’t seen him for years and don’t plan on doing so anytime soon – and if you bring up my mother’s calls of late so help me—

H: I hadn’t planned on it.

Patient opens door.

D: Same time next week.

H: Before you leave answer me this…

D: What?

H: You say you haven’t seen your father in years and don’t plan to any time soon?

D: Bing-fucking-O.

H: How about when you look in the mirror in the morning? Do you see him then?

To this patient says nothing for moment. Turns to face me in tears.

D: Every… single… day…

Patient breaks down in tears. I approach to hug him. To my surprise he accepts the hug. Cries hard. Tears fall on my shoulders. He continues through choked cries to say—

D: Every single fucking day!

END TRANSCRIPTION