There she lingers, a vague and involved expression on her face. Her eyes searching the jutting cliffs and circling gulls, the inky strait of Dover’s shoreline foaming at the edge of its beach. We sit quietly. The clock’s tick on my desk as clear as a bell. I note her comfort with silence and do nothing to disturb it. I, however, feel a surge of loneliness in my gut and wonder what she is thinking, what she is lost to, why her attention has left our therapeutic dance.
Be patient, I tell myself. Wait.
Eventually she looks away from the oil painting, but catching my expectant eyes, diverts her gaze south to her feet.
I clear my throat.
“Labels can pathologize,” I say, revisiting her previous thoughts, “but sometimes a diagnosis can be helpful. One would be foolish, reckless even, to prescribe an aspirin for brain damage, a bandage for a broken wrist, or homeopathy for severe depression.”
She scrunches her forehead.
“I fear being misunderstood,” she replies, “that I’ll be stuck with a label. Branded with a certain kind of madness.”
“You think you are mad?”
She shrugs.
I lean forward.
She leans back.
“Madness is a state of mind,” I say, “scary if given legs. Maybe you’ve always believed yourself mad. And now, being here is evidence, proof, right? You can’t hide it anymore. People will find out. Me included. And with that fear comes shame and guilt because you also think it’s your fault—that you’ve brought it upon yourself. Even if you can’t always remember what it is you’ve actually done. So it’s not just a case of the whole world seeing just how crazy you are, but now you’re evil and destructive too. Labeled. Branded with a certain kind of madness.”
She looks at me, eyes wide.
“I just don’t want everyone thinking I’m nuts,” she whispers.
“Everyone?”
“Well, my stepmother mainly.”
I look down again at the form.
“You live with your stepmother—Anna. What’s that like?”
“A drag. She still treats me like a kid.”
Her breath quickens.
“She moved in after my mother killed herself and cared for me, well, me and my father—until he took off and left us. I was sixteen.”
“He didn’t take you with him?”
“He didn’t want me.”
A pause.
“Tough?” I ask.
“Pfft. I saw it coming.”
“How so?”
“He got bored. I watched Anna try to win him back, but the harder she tried the more he despised her. Then he met someone else. Someone younger.”
“I meant, was it tough that he didn’t take you with him?”
She shrugs, dismissing my attempt to access feelings.
“Anna assumed the worst, of course. That I’d go off the rails, have a breakdown. But I was relieved when he left. Well, part of me was.”
“We’ll try to steer clear of assumptions here,” I say. “Here we’ll work with feelings, thought patterns, behaviors, and dreams. It might be difficult at times.”
She shrugs again. Sits up straight and clears her throat.
“I was taking Seroquel, but it didn’t agree with me,” she says, pulling back her shoulders, her voice strengthening. “It made me tired and I put on weight. A nasty rash appeared on my hands.”
“And now?”
“Now I take risperidone.”
“How much?”
“Four milligrams, twice daily.”
“That helps?”
“It seems to, but I want to reduce it. Eventually stop taking it.”
“This ties into what you and the rest of the world believe is madness? That if you medicate, you are mad?”
“Something like that.”
“I see.”
“I also don’t like the idea of being dependent on anything.”
“Anything?”
“People, places, things.”
“And Joseph—Dr. Applebaum, your previous therapist?”
She stares at me, defiant. “I became dependent. He retired.”
I take a moment, and stare down again at her forms.
“You’re a photographer?” I inquire.
“Kind of,” she says. “I recently graduated. Like I said on the phone, I’m looking for work.”
“In photography?”
She nods.
“What kind of photography?”
“Photojournalism.”
“Interesting,” I say. “Why are you drawn to that particular area?”
“I like taking photographs.” She smiles. “Always have. On my thirteenth birthday my father gave me a disposable camera and I just got into it. It’s been a way for me to absorb truth and beauty. It soothes me.”
“How so?”
“I guess it helps me to reorient myself. I get caught up in the moment and embody what I’m looking at. There’s a kind of magnification of life. A groundedness. It’s like everything in my head—the noise, the disorientation, the confusion—it all fades into oblivion.” She pauses. “Sorry. That sounds so pretentious.”
“I don’t think it does,” I encourage. “Sounds like it’s been important for you. Like a life raft.”
She smiles.
“When I take a photograph, I know what I see is real, and considering how forgetful I am, it feels comforting. I trust it.”
“How forgetful?” I ask.
“Very.”
I note the in-turn of her left foot. Her slight body twisting in the chair.
Silence.
“Last week,” she continues, “I was walking on Hampstead Heath. A man ran toward an elderly woman and sheltered her with his umbrella. I caught her smile on camera. It made me happy. I might have forgotten that moment if I didn’t have my camera with me. Recording these small acts of kindness helps me feel better about the world. More at peace.”
“Like a balm?” I suggest.
“Exactly.”
“Observing the man’s kindness, what did that feel like?”
“Tender. Like the world wasn’t such a sad, lonely place.”
Slouching now, she lets her legs relax and fall open slightly. I watch her red dress ride up her thighs. Unaware of exposing her flesh, she remains still, not caring to pull it down. I divert my eyes.
“The way I work,” I say, “is much like an alliance. I ask that you show up, work hard, respect and engage with the process, and also inform reception if you can’t make your session.”
She nods.
“How does that sound?” I ask.
“Good. I’d like the form again, please.”
Alexa digs noisily in her denim rucksack and retrieves a pen. She writes something down, then hands the form back. I notice she has completed the section regarding medication, this time in a different hand. No longer cursive and childlike as before, but rather more adult, joined and fluid—this time signaling confidence and creativity.
“Thank you,” I say.
I wonder what the antipsychotics are managing: Disordered thoughts? Voices? Hallucinations? Suicide, maybe? I could ask but instead allow the process to gently unfold. First sessions are as much about building safety as they are about forensics.
Reaching over to my side table I pour myself a glass of water, noticing Alexa’s mouth open and close, like a fish’s. I wonder if she would like a drink but again stop myself from asking. Let her ask, I think. Don’t do all the work. It strips her of agency. Let her come to you.
She swallows.
I take another sip, waiting to see if she green-lights her desire.
She smiles.
“I bet you’re a glass-half-full kinda guy, right?” she says, eyes locked on the glass.
I nod. “You?”
“Same,” she says, notably pleased. Her eyes diverted and glancing again at the oil painting.
“Do you think you can help me?” she asks.
“It’s difficult to confirm with certain
ty,” I say, “but as the glass might suggest: I’m hopeful.”
“Uncertainty bothers me.”
“I’m sure.”
“Joseph used to say ‘One day at a time.’”
“Wise man, your Joseph.”
She smiles.
“He was never mine,” she says, “but he was wise. And he cared. I’m positive of that.”
Aware she hasn’t afforded to ask for a glass of water, I observe her detour to the safety of Joseph, her previous attachment. The security of what is already known quenching any uncertainty with me. She must think I’d refuse her, I think, noting that small risks will be important for our work.
She gazes down at the rug between us. One of her shoes dangles on the tips of her toes. I note the smoothness of her olive legs, her nails painted blood red. For a moment I wonder about the tiny bruise on her knee, how she got it. How long it’s been there. But catching my eyes on her skin, she crosses her legs and pulls down her dress. Looks me straight in the eye.
“So how long will this take?” she asks. “You know, considering I’ve been in therapy previously.”
Silence.
“Six months? A year?”
“It depends,” I say.
“On?”
“How willing you are to seek and be frank. I think twice weekly will be helpful.”
She nods.
“What do you hope to gain this time around?” I ask.
She twists her mouth and stares at the ceiling.
“Confidence,” she says. “I get anxious, particularly with men. I’d also like to talk about family.”
“Oh?”
“It’s complicated.”
“Complicated how?”
“I’m not sure what ‘family’ means exactly. I’d like help figuring out what I want rather than constantly pleasing others all the time. I’m such a useless fuckup at times.”
The phrase strikes me with a startling left hook, but I do not react. If it’s her intention to shock me I won’t take the bait.
“So codependency is an issue?” I ask, meaning it to sound like a statement.
“Yes.”
“You fear abandonment?”
“I guess. I don’t like to disappoint people. I fear they’ll reject me.”
“You wish to be a good girl?” I say.
A pause.
Narrowing her eyes, she leans forward. Her dress now barely covering her thighs.
“Occasionally, Daniel,” she purrs, “it pays to be a good girl.”
I note the switch in tone, her voice deeper now. Seductive.
“You’ve found this to work in the past? Being good?” I say.
She runs her hand through her hair.
“Certainly.”
Leaning back, her torso straightens, her arms relax like two hanging pendants. Deliberately, she crosses her legs.
“At what cost, though?” I ask.
Silence. My challenge ignored.
I check the small gold clock on my desk.
“We have to end now, Alexa,” I say. “I’d like you to reflect on today’s session. If anything comes up, remember to bring it next time. What’s your memory like?”
“I told you earlier, I’m forgetful.” She laughs. “How’s yours?”
I smile, her challenge and acute observation of me duly noted.
“So write it down,” I suggest.
“Sure.”
“It’s time,” I say.
We stand.
“Next Tuesday, same time?”
She agrees and dusts down her dress. Lifts her warm jade-green eyes to mine, then walks to the door.
“Thank you, Daniel,” she says, turning toward me while stroking a heart-shaped necklace tied at her throat. “It was a pleasure to meet you.”
I’m aware of how close we are, that I can smell her perfume. Its scent wafting up to the fine hair in my nostrils, leaving a dizzying tang of citrus. Above her plump mouth, a perfect vertical groove touched by an angel, a fiend.
“Goodbye,” I say.
I close the door, sit back at my desk, and pick up the phone.
“Hello, this is Dr. Patel speaking.”
“Hey, it’s me.”
“Daniel. How are you?”
“Good. You?”
“Exhausted, but what’s new?”
“I have a new patient,” I say, “a young woman. My countertransference tells me bad things have been done.”
“Then listen to it,” he says. “Chances are you’re right.”
While transference deals with feelings that the patient transfers onto the psychiatrist and is often founded on earlier relationships, countertransference is the reverse. That is: similar irrational feelings that the psychiatrist has toward the patient. Occasionally, countertransference can make the work deeply uncomfortable, sometimes impossible. Imagine, for example, a psychiatrist who was sexually abused as a child treating a pedophile, or a victim of domestic violence treating a manic abuser. But in milder form, countertransference is a psychiatrist’s most reliable tool, and without doubt the most effective.
“Age?” Mohsin continues.
“Twenty-four.”
“Signs of trauma?”
“Childhood trauma, if I were to take a guess. Avoids eye contact, a tendency to dissociate. I don’t quite know who was here today; there was some switching. My head feels light, certainly lighter than before the session.”
“Is she attractive?”
“Very.”
“Mm. Family?”
“Her mother’s dead. Estranged from her father. No siblings. Apparently there’s a stepmother. One of her requests, however, was to address family. I suspect what she means is the loss of family.”
“Sounds likely. What about her memory?”
“Useless, she says.”
“A fractured self?”
“Possibly.”
“So most likely compartmentalized. Maybe a false self has been necessary for protection. Boundaries will be important. Medication?”
“Antipsychotics. Four milligrams, twice daily.”
“Heavy stuff. What else?”
“She filled in the standard forms, left out the part on medication, then decided, during session, to complete it. When she handed the form back it was written in a different hand. There was definitely a younger self here. But an older self left, potentially quite seductive.”
“Possibly multiple personalities? DID?”
“That was my thought.”
“You’ll need some help with this one.”
“Why else do you think I called?”
“I thought you might be missing me.”
“Ha!”
“Well, don’t be shy. Call if you need a second opinion.”
“You may live to regret that.”
“No doubt. Well good luck, and be careful.”
“Of what?”
“Deception, manipulation.”
“You sound concerned.”
“They’re not straightforward—patients with dissociative identity disorder—dangerous in the wrong conditions.”
“I’ll be careful. Are we still on for lunch tomorrow?”
“Sure. Usual place?”
“See you then.”
I hang up; stare down at the forms, my eyes lingering over an unfinished question that I hadn’t spotted earlier.
Full name: Ale—
Strange. I take out my fountain pen and finish her answer:
—xa Wú
Outside, morning has fully arrived. The sky now blue and soft, a murder of crows resting on top of the rose brick wall. Staring out at the imperial oak and thick rows of lavender, I wonder if Alexa’s seductress has a name. When and if she’ll return.
4
Alexa Wú
Hazy from the session, I walk along the tacky oatmeal corridor.
That wasn’t so bad, I say, haranguing everyone inside.
Dolly is the only one who responds by smiling. I want ice cream, she insists, scoo
ting into my side.
Later, I say, chucking her under her chin. It’s only nine o’clock.
Dolly makes a face. The overbearing smell of cafeteria-cooked food hijacking any air that might be circulating from the open barred windows.
Stinky, she says, holding her nose.
All doors I detect open outward, making them impossible to barricade. This I learned while watching a documentary on young offenders with Anna, who has a strange fascination for anything involving the captivity of animals or human beings. Sometimes that includes me. I imagine it’s got something to do with keeping me safe. To put right what she couldn’t before my father left, his strong will ruling our home, Anna doing her best to protect me in her nonsword hand as the other defended us from my father’s heavy blows. But she was no match for his vile temper. Was rarely quick enough for his sneaky fists.
I’m suddenly aware of a woman—heavy with unruly blond hair—staring at me from behind a water cooler. As I draw closer she lasers me with a gimlet eye but then quickly turns away, supposedly shy. Ebbing back, she squats farther behind the barrel and taps it repeatedly. Spooked, I rush for the door. Her stare unsettling and eerie, her tapping a thorny and stark reminder of my own obsessive compulsions.
Outside, my attention stays pinned on the pretty gardens and their handsome gardener as he wrestles with a large bush of white lace-capped hydrangea. I head toward Glendown’s wrought-iron gates, while behind me miracle flowers and birdsong disguise what the world labels madness.
On the Tube, I’m rocked by the swaying train and lean my head back. An image of Daniel appears: red hair, broad shoulders, his blue eyes intense, his smile soft and kind.
He knows, Runner declares in my head, he caught the switch when some of the others stepped into the Light. He can read us. He knows.
Do you really think so? I worry it’s way too early for him to know about my other personalities.
I know so, Runner replies.
Ella and Grace are already there when I arrive. Have secured a table at the café beneath the department store where we’ve agreed to look but not buy. Waving as I approach, I note my borrowed mint sweater now draped over Ella’s shoulders. Grace has done the same, only hers is red.
“Alexa!” My Reason sings through the crowd of people. A maroon beret placed on top of her neat Dorothy Parker bob. Her signature look, acquired two years ago when she started work at Jean&Co.—a clothing store for denim nuts, those who use a coat hanger to pull up zippers on the tightest of jeans.
The Eighth Girl Page 3