Part I
Dreams And Nightmares
Chapter 1
MEL
It’s my last therapy session of the day. I’m tired, and the smell of the psych ward has taken up residence in my sinuses.
But I paste a welcoming smile on one last time. It’s important.
The puffy-eyed woman who sits down opposite me has the doughy complexion and suddenly gained weight of the heavily medicated.
This is our first session together. I experience the same thrill I feel whenever I have someone new to work with. It’s an intoxicating mixture of anticipation and, if I’m honest, nervousness. I am hired by the psychiatrists who run this place to work with their patients and make them well. Failure, I tell myself, is not an option. Though this adds unnecessary pressure to what is already a pretty stressful job.
Don’t get me wrong. I love my work. I know, I know, it’s such a cliché to say it, but I do genuinely believe I was put on this Earth to help people.
I introduce myself, as I always do, with a simple sentence followed by an even simpler question. A rudimentary social exchange that even very young children manage to work out for themselves.
‘Hello, my name’s Mel. What’s yours?’
I know, of course. But giving clients an easy way in to what can be a long and troubling conversation is vital to the therapeutic process.
‘Em,’ she says.
I smile. ‘Hi, Em. Is that short for something?’
She bites her lip, then nods.
‘Emaline. But I hate that name.’
Em it is then.
‘Tell me why you’re here, Em,’ I say.
And we’re off.
An hour later, Em leaves and so do I. Though while she returns to the rounded corners and locked doors of the psychiatric ward, I drive to my consulting rooms at the Lavender Therapy Centre in Richmond.
Altogether, there are six of us. There’s me, with my specialisation in the emotional and psychological problems that can affect new or soon-to-be mothers. Alan Ogilvy, a psychotherapist specialising in PTSD. Charmian Bernbach, German, as her name suggests, who’s a Reiki healer and naturopath. Suzannah Saatchi, aromatherapy massage. Henry Abbott, a lovely old Irishman who offers Jungian psychoanalysis. And Alicia Trott, a hypnotherapist.
We see each other in the mornings and evenings as we arrive and leave after the last of our clients has departed. Occasionally a free hour will coincide and one or two of us will meet for a coffee and a sandwich in a nearby cafe. But on the whole, it’s a fairly solitary life.
Solitary! I know, that sounds strange, right? How could it be solitary when every hour is spent in the company of another human being? One who really needs us to be there for them?
Of course, it isn’t solitary in the physical sense. Although, sometimes, I do find myself wishing, just for a moment or two, that I could have some space.
What I mean is, each of us, me, Alan, Suzannah, Charmian, Henry and Alicia, we exist in our own parallel words within the centre’s four walls, each listening, massaging, questioning, healing but never truly in company. We’re with our clients but they’re not really with us, if you know what I mean? They’re with themselves, or, more usually, with the person or persons whose words and actions caused them such pain and trauma that they’ve beaten a path to our door.
* * *
I have been seeing Em once a week for two months now. Dr Silverman has adjusted her medication and outwardly, at least, she’s regained a little humanity. With her hair washed and brushed, and a little makeup, she is an attractive brunette. She has darting, intelligent eyes and a quick temper.
Leaving aside the psychiatric diagnosis that led to her being sectioned, she is very like me. In fact, she’s similar to a lot of the women I have worked and socialised with over the years. She is a married, middle-class, professional woman. She is articulate. And she presents as perfectly normal.
Our initial sessions were long silences, punctuated by bouts of crying and agitation. Twice I had to call for an orderly to restrain her. Once, during a particularly bad piece of acting out, Dr Silverman had to come and administer a sedative.
But gradually, I think she learned to trust me, and therefore to relax. As she did so, she began to tell me about herself.
Sometimes, as I probe the stories she tells me, she lashes out, not physically, but with a sharp tongue. Asks me what gives me the right to rootle – her word – around in her psyche like an old woman scrabbling through the bargain bedlinen in the Harrods sale.
And I tell her, patiently, about my qualifications; the diploma that hangs in a black frame on the wall of my consulting room. I explain that our weekly sessions are under the supervision of her psychiatrist, Dr Silverman, and he would hardly hire me if he didn’t trust me.
And what a tale she tells me
She says she was abused as a child. By her stepfather. It left her with a conflicted attitude to sex. On the one hand she finds it terrifying, because it stirs up all those awful, traumatising memories of the abuse. On the other hand, she craves it because, for her, it symbolises affection and is bound up with her ideas of self-worth and self-esteem.
Em tells me that her husband is controlling. Within a month of the wedding he had, and I quote, ‘got me pregnant’. She says he saw it as a triumph. Vindication of his manhood, which, needless to say, is what we in the psychotherapeutic world classify as toxic.
After her baby was born, she succumbed to deep post-natal depression. Her husband tried everything, up to and including a private GP, who prescribed a range of medication, but to no avail. Finally, feeling he had no option if he was to save her and protect his child, he had her sectioned.
Or at least, this is her story. Dr Silverman has explained to me that, in fact, it’s all inside her head.
We covered it during my training. It’s a variation of Munchausen’s Syndrome. In the classic presentation, patients make themselves physically ill, or at least claim to be, so they can receive medical treatment. It’s a cry for help, really, a way of becoming the centre of attention when normally they’re ignored, unseen, invisible.
In the psycho-emotional presentation, patients, though we call them clients, present with a range of psychological symptoms – anxiety, depression, feelings of hopelessness or paranoia. They engage a therapist and, for an hour a week, or more if they can afford it, they become the centre of the therapist’s universe. But it’s all false. A fake. A con. Saddest of all is that the people they’re really fooling are themselves.
I don’t think this describes Em. I think she really does have a range of interconnected, deep-rooted problems. Of which her delusions are a part.
I also believe that with my help she can work through them and discover her true self.
In time.
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