“What about your brothers. Was she cruel to them?
“Wilson and Jackson, no.” Lucas flicked a stray thread from his pants. “They were her pride and joy.”
“Why do you say that?”
“They were identical twins. A built-in conversation piece for her. Like a magnet for attention. She lived for that. The attention and all.”
“Do you feel any animosity toward your brothers?”
“They’ve always been good to me. Protective of me.”
I leaned forward inviting him to speak more.
“I remember one time, when I was a kid, I wet the bed. My mother said she wouldn’t have the maids change my sheets. But my brother, Jack, helped me take them off and wash them. He told me mom was just being mean and to ignore her. But when Wil found out, he went ballistic. He was all in her face, telling her she was a lousy mother. She just laughed at him and walked away.”
“How old were you when this happened?”
“Like six or something. My brothers, thirteen.”
I registered the pain he must have felt and shook my head in disapproval.
“When we were all together, she’d look at us and say our names. Jack-son, Wil-son and Luc-ass. She always found it funny, but it wasn’t. None of us ever laughed.”
“Sounds like you got the short end of the stick.”
“I fucking hated her for it.” The sudden burst of emotion caused him discomfort. Lucas clenched his fists and huffed in lungful of air. “Aw, shit. I’m sorry.”
“For what? Being angry and showing it?”
“I’m not good at it.”
“I think you are. You expressed it pretty well right now. Maybe you feel discomfort afterwards for showing your real feelings?”
Ferro was quiet, nodding to himself, seemingly taking in what I had just said.
“It was always easier never to ask her for things. I avoided a lot of drama learning to get by on my own.”
“So you learned very early her needs were not to be disrupted. Your needs had no worth.”
“Something like that.”
“That’s tough to live with, Lucas.”
The origin of his panic attacks could be rooted in his relationship with his mother. Not being able to be authentic, not having his needs met, and holding in negative feelings for the sake of self-preservation was a heavy burden for a little boy. And it would translate into a variety of unhealthy psychological forms as an adolescent and an adult.
“Where was your dad when all of this was going on?” I asked.
“If my mother was in the factory, he’d be in the office. If my mother was in the office, he’d be in the factory. If she was home, he tried his best not to be. He avoided her. He’d fly his plane to Atlantic City for the day or tinker with the muscle cars he bought over the years. He’d go and smoke a cigar in the orchard or say he ate a big lunch and wasn’t hungry for dinner. Stuff like that.”
“His staying away from her resulted in staying away from you too?” I asked.
Ferro narrowed his eyes, measuring my words. “I guess so.”
So much multitasking goes on in analysis. I was listening to Ferro, indexing my own thoughts, wording my inquiries, and registering his conflicts. It occurred to me that addressing his father’s abandonment was too premature. I wanted to pace the entry of unconscious material so it wouldn’t overwhelm him. I returned to his mother.
“You mentioned your mom gave you looks,” I said.
“She’d make this face like she thought I was so far beneath her.”
Again, my diagnostic skills were busy working, but I showed him nothing beyond interest in what he was saying.
“You know, she slipped on some ice in the docking area, hit the ground, and died. The autopsy said death was instantaneous.”
“Broken neck?”
“No. Brain hemorrhage.” Slowly, Ferro leaned forward and engaged me with his eyes. “Okay. Time to be honest.” Like telling a secret, he said in a hushed tone, “I hoped she suffered when she died.”
I was quiet for a moment and offered my thoughts. “That makes sense to me.”
“It does?”
I nodded. “Why do you think it makes sense to me, Lucas?”
Ferro was quiet again. But it was a quietness full of activity. “I wanted her to suffer—because she made me suffer,” he said.
Knowing how rejection, hurt, and abandonment creates anger and rage, I didn’t hesitate. I nodded in agreement. “She hurt you too deeply and too often,” I said. “And when she wasn’t hurting you, you saw her hurting others.”
Ferro moved his shoulders forward and closed his eyes.
“Maybe you have these paralyzing attacks because you don’t give yourself permission to feel this kind of anger.”
Lucas said nothing. He stared at his sneakers, suddenly subdued.
“What you’ve mentioned so far suggests there wasn’t a lot of room to be real with your feelings, especially the negative ones like disappointment, anger, frustration.”
Lucas nodded.
“It didn’t occur to me till now, but what do your friends call you?”
“Luke. They call me Luke,” he said. “I hate Lucas.”
“Why didn’t you correct me when I kept calling you Lucas?” I delved deeper. “Do you feel I’d give you a look or embarrass you?”
“No, I don’t think you’d ever do that.”
“I’ll call you Luke, then.”
He looked at me for a moment, narrowing his eyes. “I’d like that.”
We lapsed into a long silence. Often silence has its own texture, and this one felt like a shared space where one moment was going to link to another in a powerful way.
“Are you married?” Luke asked, noticing the gold ring on my left hand.
His question took me by surprise and made my stomach pitch. In therapy, patients often ask therapists personal questions. Sometimes these questions can distract from the patient's treatment. While other times, personal questions can enhance the therapy. I decided to answer Luke because I sensed he needed to know more about me in order to trust me.
“Yes, I am—was married.”
“Are you divorced? Separated?”
I drew in a slow breath and felt the numbness begin to take form. “My husband died not too long ago.”
“That sucks.”
“Cancer,” I said, hoping my disclosure would ease the awkwardness that filled the room.
“Got kids?”
“By the time we were ready, he needed chemo, and, well, it just wasn’t in the cards.”
“Maybe that's a good thing. It’d be hard for kids to go through that.”
“Mmmm. Would’ve been difficult. “
Luke sat back in his chair, seemingly stirred by my brief, yet personal offerings. His posture softened, and his eyes widened. “I guess you could say death is something we have in common.”
“Has it been hard for you? Moving through your mother’s death?” I asked.
“Nope. My mother dying was a relief.”
Death can summon a myriad of emotions in a person. Loss of a loved one can flood an individual’s psyche with pain, anguish, and despair. For another, death can be a freeing experience, liberating a once-tortured soul. Losing Ryan collapsed my world, but Luke’s mother’s death brought relief to his. In my line of work, I never judged how a patient experienced death. I only sought to understand and to learn.
“There’s your honesty again,” I said.
“Well, you said it’d be important.”
“It is. And will continue to be important, Luke.”
And with that, the session ended.
Notes
Excellent second session. Signed releases and completed medical, mental health and family history.
At present, reports sleep disturbances, poor appetite. Chronic neck and back pain. Last physical December 2016, no allergies, surgeries, or hospitalizations. Ulce
r in college.
Denies any current substance use, but drinks on occasion. Not taking any medication for anxiety. Denies any suicidal or homicidal thoughts or intentions. No previous mental health treatment with other therapists before working with Dr. Karne. Reports not being honest before in treatment. Prefers being called Luke.
Transference: Still positive.
Counter-transference: Positive. Though I wondered if patient followed me home, he didn’t seem too offended when I asked if it was him. Find Luke likeable though. Insightful with a sense of humor. Find myself feeling invigorated by session.
Relevant issues: Mother’s death January this year. Moved back from Florida to New York. Living alone for first time in his life, Condo in Dix Hills. Also new job—all significant stressors.
Luke details early life with his mother as cold, critical, neglectful, and emotionally abusive. Will further explore mother-son bond.
Father absent, aloof. Need to find out more here too. Good connection to older twin brothers. However, attachment injuries from parents leave Luke angry, disappointed.
Could early childhood trauma be related to panic? Is this Luke’s way of getting the nurturance he needed? Or does panic rise because he has trouble with anger and rage? What other unfulfilled needs are there?
Diagnosis: Panic disorder, but will look to rule out borderline personality, depression. Will continue to assess.
Prognosis: Good.
Wednesday Night
I
was surprised nearly an hour passed since writing my clinical notes, but dwelling in such analytic moments often suspended me in time. I went through the motions to lock up, but as I shut the blinds, I saw it again. A long dark sedan in the parking lot.
“What the hell...”
It crept slowly across the empty spaces and disappeared around the bend. Without hesitating, I ran out of the office, slamming the door shut. I hurled myself down the each of the stairwells to the proceeding landing and emerged from the lobby exit like a bat out of hell. There was only one way in and out of the office complex, and I knew I’d get there before the car did.
I barreled onto the pavement as the headlights emerged from the building’s corner. The beams curled in the humid air and slowly inched upward revealing my presence. It took a second, but I saw it wasn’t the dark sedan I’d seen, but rather Steve in the security truck.
“Dammit.” I dropped my briefcase and bag in defeat.
“Out for a late night jog, Doc?” Steve asked as he rolled up.
“Did you see a long black sedan?”
“You expecting someone?”
“I saw this car—from the window.”
Steve looked over his shoulder toward the far end of the parking lot, shining his flashlight in one sweeping stroke. Then he walked a few steps in the other direction.
“For the last hour, it’s been just your car and my truck here in the lot. Before that, a red Porsche.”
“My last patient,” I said, nodding.
“You okay?” Steve sensed my fear and put his arm around me.
I brushed away his concern and stepped back. “You might not have seen it if you were making your rounds.”
“Seen what? Another car?” Steve clipped his flashlight to his belt.
“Yes,” I said hiking my hands on my hips.
“Listen, I’ve been in the kiosk for the last hour. And I would’ve passed any vehicles in the lot as I made my rounds. No way a car came in and left without me knowing.”
I considered his words as I looked around the parking lot again. Before I turned back to Steve, my eyes lingered on the security truck.
Dark gray can look black from far away, I thought. And Steve drives the perimeter at a turtle’s pace.
“Someone bothering you, Doc? Any trouble I gotta know about?”
“Just seeing things, I guess.”
“Lemme walk you to your car.”
“No, I’m good now.”
“Sorry. Not taking no for an answer,” he said, pressing his thick hand against my back.
I picked up my bag and briefcase and slung them over my shoulders. I fiddled for my car keys and chirped the alarm off.
“You ain’t watching any of those slasher movies now, are you?” Steve raised his eyebrows. “Saw...Son of Saw...The Saw That Ate Manhattan. My grandkids can’t get enough of them.”
“Nah. I stay away from the blood and guts ones.”
“I’m partial to the Buddy Movie genre, myself. Martin and Lewis. Hope and Crosby.”
“Hepburn and Tracy,” I added.
“Matthau and Lemmon. Don’t make ‘em like that anymore.”
“They sure don’t.”
Steve opened the door and waited for me to climb into the driver’s seat.
“Thanks, Steve. I don’t know what I’d do without you.”
“No thanks needed. It’s what I’m here for.”
Steve waved me off as I left the parking lot. I had the intention of heading home, but seeing Steve in the truck didn’t satisfy me. My mind leapt to Luke. And this was the second time my thoughts linked Luke with feelings of dread.
I doubt Luke could’ve driven home, changed cars, and been back to my office in under an hour. My reasoning didn’t settle the eeriness I felt. I knew what I had to do—and I caught my reflection in the rear view mirror. It seemed to scowl back at me as I recalled Luke’s address.
“Just driving by isn’t a bad thing,” I said to my reflection. “I’ll put an end to these worries once and for all.”
It didn’t take long to get to the Long Island Expressway and head east to Bagatelle Road to Dix Hills, where Luke lived. Though it took a few turnarounds, I found my way to the Townhouse Colony Estates. My heartbeat was rapid, and my breathing was heavy as I entered the development.
Moving down the softly-lit street, I tried to recall Luke’s house number. Was it twenty-two? Or two twenty-three? I thought as I rolled into the maze of townhouses.
Feeling open to the elements, I clicked the car lights off and dimmed the Saab’s dashboard. I never crossed any boundaries with a patient and worried its glow would expose me and my sudden lapse of my reasoning. As I edged past number twenty-three, I saw a silver mustang in the driveway. No Porsche.
In the minutes that passed on the way to the two hundred’s section, I felt more self-consciousness. I reached into the back of the passenger seat and grabbed Ryan's Mets cap. I threw it on and tucked my long hair under its rim. I snaked around each of the curves in the road and peered at each house’s number.
“Two hundred fifteen. Two hundred seventeen. Two hundred nineteen,” I counted aloud, hoping my own voice would ground me somehow. As I passed two hundred twenty one, I saw it. A red Porsche was in the driveway of two hundred twenty three. I cruised slowly, noticing that, through the windows, the lights were on. I saw a flickering television too. In the darkness, it was hard to see more, but I felt relieved.
“Just my imagination,” I muttered as I made the drive home.
Session Three
Friday, June 9th
L
uke was pale when I opened the door.
“You okay?”
He remained in his seat in the waiting room, seemingly unable to move. “I’m...I’m feeling anxious right now.”
“Right this second?”
“Yeah.”
I moved into the waiting room, but he held his hand up toward me.
“Just...just gimme a minute.”
I watched as Luke closed his eyes tightly. He remained still but slowed his breathing. It was quite a while before he stood up and walked into the consultation room. As he passed, I saw a worn, brown satchel slung over his shoulder, the kind college students use to carry books.
I closed the door and walked to my desk. Luke sat down slowly, shifting his body in small tight movements. He seemed so fragile—like at any moment he could break into pieces. He hesitated where to put the sa
tchel.
First, he set it on the floor, then the other side of his chair. Finally, he picked it up and put it in his lap, leaning it slightly against his chest.
“You’ve been practicing the breathing skills I taught you.”
“I’m getting better at it.” Luke swept his hair away from his eyes and cleared his throat. Then he looked directly at me. “I’m ready to talk about what’s bothering me.”
“Hold on a second now. If you’re feeling this panicked, maybe you’re not really ready.”
“No, I am.”
“Well, okay then.”
“I’d like to show you something.” Luke unzipped the satchel and pulled out a thick folder. “It’s a piece I wrote for The Miami Press.”
Luke leafed through the portfolio of his professional work and handed a clipping to me.
“Concern Grows for Missing Broward County Man,” I read aloud. “Luke Ferro, Staff Writer.”
“I don’t like to show this piece.”
“Why’s that?” I glanced at the article again. It was a short feature on page two, a prominent placement in any newspaper, and a jewel in the crown for any young writer. I read it in full to myself:
Miami, Florida: The search for a twenty-two year old man resumed Monday after heavy rains delayed the investigation. Police and several dozen volunteers continued looking for any signs of Donald Gallin, who was last seen at Club Camber, a trendy nightspot in South Beach, one week ago. “Authorities have many clues but no leads, yet feel strongly foul play is involved,” said Karen Marie Eeds, a family friend involved in the search. Police confirm Gallin’s blood-smeared car was found in a wooded area, two miles from Club Camber. “An obvious struggle took place in the vehicle and we know robbery was not a motive,” Dade County Sheriff John Perembrooke said. A $50,000 reward has been posted for any information that can help authorities in the case.
“I. . . I know...” Luke’s voice trailed off to a whisper.
I lifted my eyes back to him. “I couldn’t hear you Luke. What did you say?”
“I said, I know where he is.”
Confused, I looked hard at the article again. My eyes caught the words nightclub—struggle—blood. “You know where he is?”
The Ninth Session Page 4