Transference: Positive, but guarded.
Counter-transference: Positive. Kicked up my maternal instincts. Worried about his level of comfort.
Relevant issues: I felt significant feelings of dread, eeriness before sessions started. Took panic alarm out. Gave me his paper cup to throw out. What’s that about? Is it something symbolic or just a fleeting disregard of noticing where the trashcan was? Feeling exhausted after the session.
Diagnosis: Deferred, but considering Panic Disorder or other anxiety related disturbances. Need to rule out depressive disorders as well.
Prognosis: Deferred at this point. No real clinical data to consider.
Monday Night
T
he elevator groaned slowly three floors to down to the ground level, and I listened to my heels echo on the marble lobby floor. I liked how the sound clicked above and below me as I walked.
It was a warm, humid day so the ride home would be the same as the one to work—convertible top down. I left the building and got in the car as Steve, the security guard, waved to me from his truck. I tooted the horn as I rolled away, feeling the thick air float across my face and through my long hair as I hit the gas.
The way home took me down the tony thoroughfare of Route 107 in Brookville. As a young girl, I loved seeing the mansions and sprawling estates along the highway when I went boating as a kid in Oyster Bay. I dreamed of living there one day, and while it wasn’t a surprise to family and friends when I moved there—finding a crumbling barn and fixing it up with was. The house itself was a carriage house in the 1900’s, part of a family-owned, multi-acre horse farm. Years later, the property was subdivided, and Ryan, my husband, and I bought it when we were in graduate school and moved in just after we married. It wasn’t a big house, only 1800 square feet, and the parcel of land was considerably smaller than the other homes in the neighborhood. But what it lacked in sheer size was overshadowed by its charm. It took a few years to restore it, but was a labor of love. We kept the original beams and studs, which were visible throughout the house, and the interior was painted a copper white patina. With an open floor plan and an overlooking loft, it was spacious yet cozy. Ryan and I filled it with eclectic things, mixing century’s old with millennium’s new. We lived in it almost a decade before he got sick.
As I veered off to the private road to the house, the squeaky peeps of the frogs and trills of the katydids lulled me into a peaceful ease. I tried to stay in the moment and not think of Ryan, but by the time I reached the driveway, my eyes blinked back tears. I listened to the gravel pebbles lining the driveway move, clack and shift under the car tires and reminded myself how important it was to dwell in small things since Ryan died. The smell of the morning air, the feel of the wind, and the sound of the night creatures—and now the sound of rocks against rubber. Sensory experiences. Life affirming moments.
I parked the car in the unattached garage and walked into the house through the side door. For a moment, I regarded the house, its space, and its sounds like a sentry guard as I disarmed the security alarm. Deciding I'd be in for the night, I reset it and clunked my belongings onto the floor. My cat, Elvis, a black tabby, bounded out from a corner.
“Hello there, mister,” I said, as he pirouetted around my feet.
He followed as I walked to the front door and collected the scattered mail on the floor and as I moved to the bedroom. I placed the stack on my bedroom dresser, along with the rest of the week’s mail, undressed, and checked the answering machine.
“This is operator 2416 with a relay call for Alicia. Hi sis. Haven’t heard from you. Call me. Nicole.”
Beep.
“Hey, it’s Mary. Wanted to know if you’re going to the psych association luncheon next month. Gary, Charlie, Manny, and Robin are going. David and Denise are a definite too. Give me call and let me know.”
Beep.
“Alicia, it’s Chris. We’re watching “School of Rock” tonight. Wanna join us?”
Beep.
I didn’t hear the rest of the messages as I changed into a pair of flannel shorts and pulled on one of Ryan’s T-shirts. I tuned them out as I did most nights, promising myself that come the morning, I’d call them all back. I threw my hair up in tousled ponytail while Elvis continued to snake around my legs.
“Hungry, huh?” I said to him. “Me too.”
I scooped Elvis, walked into the kitchen, and gave him a bowl of water and a can of his favorite salmon mix. Then I brewed some tea and toasted a day-old corn muffin. I sat down in the kitchen chair and let Elvis jump up, waiting for him to coil alongside me after he devoured his evening meal.
I ate in silence as I did most nights now. The only sounds were the humming of the refrigerator and the ticking of the clock. Sounds that reminded me of my childhood home. Where thrums, clinks, and other rhythmic sounds made feel safe.
I was the only hearing member of my family, a Coda—a child of Deaf adults. My dad, Carl, was born Deaf, as was my mother, Vivienne. My parents met at Mill Neck Manor School of the Deaf where they worked—my dad as a teacher of the Deaf, and my mom was the bookkeeper for the school. After a few years of marriage, my sister, Nicole, was born, and she was Deaf too.
When I entered the picture, life didn’t change in a drastic way for my family. As a hearing baby, my first words were in American Sign Language, or ASL as it's been shortened to—and I signed long before I ever spoke a word. But as I got older, I went to hearing schools instead of Deaf schools—and learned to speak, just like any other hearing kid did. We were like an ordinary family. Talking, sharing, fighting, and laughing—except in sign. It was a loving home, where touch was a frequent form of communication, and busy hands signed in expressive ways.
But since Ryan died, the house was a soundless place. As a child of Deaf parents, a Coda, silence was always a companion of sorts for me. It never made me feel alone or afraid. It was a comforting space. But this stillness was a heavy haze of loss and grief. Of death and endings.
Wanting to head off the mounting despair, I hiked my shoulders back and rose from the chair. Elvis bolted away.
“Time for House,” I said to him as I turned off the lights and headed for the bedroom.
Looking over my shoulder, I saw Elvis crouch down, his tail arching and bristling in the shadows. “What is it?”
Elvis let out a slow throaty growl. His ears twitched as he skulked into the darkness.
“Okay,” I said as I heard him play with some of his toys.
I grabbed the remote on my way to the bed, slipped into the sheets, and turned on channel thirty-eight. I heard Elvis again as my head hit the pillow. This time, his cry was louder. He hissed several times, racing up the hallway and then back with lightning speed. Then he began caterwauling.
“Damn it, Elvis.”
I plunked the remote on the nightstand and flipped the covers off. I walked down the hallway, leveling my eyes for a quick once over in the darkness and found him perched near the window in the living room.
“Okay, buddy. Come with me.”
Elvis stiffened as I picked him up and pressed his front paws against me. All at once, he clawed deeply into my skin and batted my face.
“Hey.” I yelled and dropped him to the floor. I winced as the caterwauling started again.
Stupid cat, I thought to myself.
I moved into a pool of light to get a look at Elvis' handiwork but felt my heart squeeze tight and then stop dead a beat.
Outside the window was a long, black sedan in the apron of my driveway. Its lights were off, and smoke rose from the exhaust. A flush of heat rushed to my cheeks when I parted the blinds to get a better look.
And as I lifted the horizontal slats with my fingertips, the sedan backed up and jetted down the street.
“Who the hell was that,” I said as I walked back to bed.
Supervision
Tuesday, June 6
T
he trip to Manhasset to Dr.
Prader’s office at the North Shore Medical Center was only fifteen miles from Oyster Bay. The trip always took more than an hour because traffic on Long Island was inevitable—making it one of the worst places to live. I’d usually treat myself to an Americano at the nearby Starbucks when I arrived early but knew that wouldn’t be happening today. The Northern State Parkway was more congested than usual, and I was already late for my appointment.
I passed the time in the unavoidable traffic listening to some Miles Davis but couldn’t get the vision of the sedan out of my mind.
Why was I thinking about Ferro after that happened? I wondered. I felt this uneasiness before my session with him and again before I saw the car. “Just a coincidence?” I asked aloud.
But as I wove into faster lanes and out of slower ones, I reminded myself how my imagination intensified when Ryan died. It was easy to recall such moments. The times I thought the phone rang only to discover nobody on the line. The moments I swore I saw Ryan in a crowd—or heard his voice echo in the house. Instances when I called the neighbors thinking someone was breaking into the house—only to discover it was just the trees scraping against the windows. Or the times I thought the garbage cans by the curb were kids playing in the street.
In many moments grief clouded my senses. Distorted from fatigue. And as I thought about the sedan in the driveway, I wondered if what I saw was real.
Was the car really there? I wondered.
My thoughts faded as I looped onto Lakeville Road and pulled into the hospital garage. I glanced at my watch and quickly jogged along the pedestrian pathway that led to the hospital’s lobby atrium. I zipped through the doors that led to the psychology department’s offices and hurried down the hallway.
Dr. Susan Prader was Chief of Psychology at the hospital, but she was also my supervisor. For the last ten years, we had a standing appointment at the same time each week. It was a time I cherished—an experience that was both invigorating and educating.
Psychoanalysts valued clinical supervision more than any other clinicians in the field of psychology. Born alongside Freud’s discoveries of the psyche, analytic supervision with an esteemed colleague provided a therapist, like myself, with an extra set of senses. It was a way to broaden, deepen, and enrich the work I did with patients. A way to check-and-balance issues in sessions. Supervision offered profound and unique bond. Part parent. Part sibling. Part colleague and friend.
Though Dr. Prader and I didn’t go to the same schools, we had similar clinical experiences. Both of us treated patients from a psychoanalytic perspective. She worked in a hospital setting while I worked in a private practice. And we shared something perhaps even more important—we were both a Coda.
Prader grew up in the outskirts of Washington, DC and was the only child born to Deaf parents. She took to learning with a passion and was a natural leader growing up. By the time she was a teenager, she was a local Deaf advocate. In college, she took part in the groundbreaking Deaf President Now march at Gallaudet University and continued lending her spirit in Deaf legislative actions on state and federal levels in graduate school. Her parents thought the field of law would suit her better, but Susan Prader found her niche in psychology. She was fierce and yet gentle, possessing sharp instincts and insight.
“Sorry, I’m late,” I signed, entering the office. “How are you?”
She brought her hand to the middle of her chest and signed, “Fine. Fine.” Her silver bracelets jangled as she moved her arm back to her side.
Prader was a beautiful woman, tall and elegant. She wore her brown hair shortly cropped, which revealed the gentle angles of her face. Her skin was smooth and flawless, and her eyes were sparkling brown. Only the reading glasses hinted at her age.
“How far along on the clock are we?” I asked, moving to spoken language. It wasn’t unusual for Prader and me to interchange speaking and signing. Codas did that often with each other, moving from ASL to Pidgin English to spoken English.
“We’ve got a half hour,” Prader said, closing the office door.
I slid into the empty chair by her desk. Then I waited for her attention and signed, “How was your week?”
“Good, Busy. But I wish Friday was here already,” Prader signed with fast hand movements. “You?”
“Yesterday I had a first session with an interesting patient.”
Prader picked up a pen and started writing. “What was the presenting problem?” she asked, no longer signing.
“Well, I’m not entirely sure. The patient had a full-blown panic attack, which took up the whole session.”
“A most unusual first meeting,” Prader said. “Gonna put him on the couch?”
“Not sure. I’ll see how the next few sessions go.”
Prader guided me with her experience and wisdom but always let me apply the treatment. “So does this patient have a name?”
“l-u-c-a-s,” I finger spelled.
I watched Prader as she jotted some notes. In supervision, last names were never used. It was a way of protecting a patient’s privacy.
“So, you have this unusual session, little clinical data, can’t say too much about this patient—but are bringing him in today,” Prader said with a remote, absorbed look. “Something else is going on, right?”
“You’re amazing, y’know.”
“Yeah, yeah, I’m all-knowing.”
“Well, last night, a car pulled in the driveway and stayed there a while. I have a feeling he followed me home.”
“You’re certain?” she signed with one hand as she continued writing with the other.
“No, I didn’t see the driver.”
Prader said nothing and peered over her eyeglasses.
“I could be totally wrong, but I got this feeling he was in that car,” I said.
“Tell me about this feeling.”
“I felt this dread right before our scheduled session. I was spooked before he arrived, I think. So I took out my panic button. Felt it again when I saw the car in the driveway.”
Prader grew quiet and sorted her thoughts. “Let’s say you’re right. It was him. If so, you’ll have to address things. Boundary crossing is never good.”
“I know.”
“Now let’s say your instincts aren’t correct. Let’s say it’s just some lost driver in the driveway. Now your uneasy feelings aren’t related to this patient but are something else. Something within you.”
I stared off for a moment. “No one’s in the building besides me at night when I work.”
“Go on,” Prader encouraged.
“Sometimes I'm nervous at home. Thought I’d get used to it by now.”
Prader said nothing, using silence as a tool.
“I've been having flashbacks. Some good—like remembering how Ryan and I met, our wedding, places we traveled. But others aren’t so great.”
“You met in college, right?”
“Yes. I was a teaching assistant at NYU in an ASL class. Helped students learn the signs as the professor taught. I remember noticing Ryan because he was such a terrible signer. His signs were awkward and sloppy, but there was something so sweet about him.” I felt my heart beat heavily. “The day class ended, he asked me out.”
“Sweet,” she said. “Any others?”
“I was thinking about when Ryan met my parents and my sister. That was such a great day. At first, I thought it’d be hard for him. You know, how some hearing people are when they enter the Deaf world.”
Prader smiled and signed, “Afraid. And nervous, yes.”
“Right.”
“But not your husband?” Prader signed.
“No. Ryan was so warm and funny.” I closed my eyes as I gathered more of my thoughts. “But I have other flashes. The green plaster-chipped walls of the hospital. How drawn and thin he looked when Hospice arrived. Seeing him dressed in his suit in the satin-lined coffin. And the friggin’ morphine drip that never seemed to work.”
“Mm
m,” Prader said.
“There’s more bad than good ones.” I hesitated a moment, piecing together a sudden realization. “The car last night—it was a dark, long sedan. Looked like the limousine we sat in when we buried each of our parents.”
Prader nodded, seeing the symbolism. “How long ago was that?”
“Mom was October 2014. Buried my Dad six months later. Then a year later, Ryan died.”
“Multiple losses. One right after the other.” Prader shook her head registering the chain of traumatic events that moved through my life. She paused a moment and offered her interpretation. “These flashbacks could be influencing your reactions.”
“I hadn’t considered that.”
“Yes, well, you need to take this into consideration personally and professionally.” Prader leaned forward in her chair. “Important for you to take care yourself. Maybe you should consider referring this patient out,” she signed.
I waited a moment before I spoke. “I appreciate your concern, but there’s no need to refer Lucas to another therapist.”
Prader widened her eyes.
“If he did follow me home, I’ll address it. I’ll set limits.” I paused again and looked at my wedding ring. “I do have moments when it’s tough, but I wouldn’t be working if I felt fragile.”
“Alicia, you are fragile,” Prader said speaking.
“My caseload isn’t demanding. And I’m doing all right.”
“While that may be true, you should reconsider this case. It might require more than you have within you.”
“Well, let’s see how things go in the next session.”
“Fair enough.” Prader glanced at the chrome-plated clock on her desk. “It’s time for us to stop today.”
“Okay. See you next Tuesday,” I signed.
Prader let her head fall forward and softly closed her eyes. Then she brought her index finger up to her lips and extended it outward. “Yes,” she signed.
Tuesday Night
B
The Ninth Session Page 2