“I beg your pardon?” Dr. Mitchell’s pen pauses in its note-taking.
My voice is clear and each word enunciated. There’s no reason to repeat myself, but I do it anyway. “I have one younger brother, Jason, who was born when I was eight.” Since that doesn’t seem to be enough, I explain to the silence. “I know you want to be thorough, but I can assure you that I have no issues with my family. My parents were wonderful, my little brother is great, and I had a happy childhood.”
The pen taps against the page. “Forgive me for bringing in outside information, but I understand from Katherine that you also had a little sister?”
I cross one leg over the other and rest my clasped hands on top of my knee. “Oh, that!” Now that I understand his confusion, I hasten to clarify. “Yes, not exactly a little sister but my mom had a miscarriage. Mom has been much happier since she can talk to Kat about it. They have a special connection, both having lost family members. Kat always cheers Mom up when she’s sad about it.”
Instead of looking pleased, Dr. Mitchell frowns. I wonder whether he unnerved Kat this much when she talked with him. I wish he would understand I came to sort out the present-day, not decades ago.
He clears his throat. “I asked how you felt about your family, not how many siblings you have. Did you ever feel pressure, for example, to take care of your little brother or to live up to your parents’ expectations?”
I clear my throat, too. “With all due respect, Dr. Mitchell, I don’t think a psychoanalytical approach is necessary. As I wrote in my intake questionnaire, I’ve been having nightmares that I’d like stopped. A cognitive-behavioral approach makes more sense because it’s more efficient, problem-focused, and—“
“Six to eight sessions should be more than enough to set up a plan and work through sleep issues so I can return to full productivity. I’m sure there are others who need the time with you much more than I.”
He leans back in his chair, setting the pen in his lap. He waits, silently, until irritation gets the better of me.
If he hears the exasperation, he ignores it. I glance at the clock. We’ve wasted too many sessions with meandering, open-ended questions, and it’s time to get started with solutions.
“I’d like a plan drawn up by the end our hour today, and I read this study saying people slept better if they removed distractions from their bedroom. I thought I could start a sleep journal and keep track of what time I go to bed and when—“
“If you’re not going to listen to anything I say, there’s the door.”
I stare at him. He’s never spoken to me with such disrespect. Ever since he found me at Kat’s beside years ago in the hospital, Dr. Mitchell has come across as an intelligent, thoughtful psychiatrist who understands his patients. He worked wonders with Kat, and she enthusiastically agreed to let me see him. After all, she finished her own counseling ages ago. “You weren’t saying anything,” I point out.
“I can’t talk when you refuse to listen,” he says, and a memory flashes into my mind.
“I won’t talk with him!” Kat screamed as I took the paddle to her, after I brought her home from the hospital on an afternoon pass. Frustrated by the reports of her lack of cooperation, and terrified she would find a way to take pills in the locked ward, I spanked her as I laid out my expectations for her.
“You will talk with your doctors, you will participate in the activities, and you will interact with others instead of hiding in your room.”
“He makes me so mad!” She struggled as I held her down, but the pain did her good. Instead of lying limp and sullen as she had for the past few days, she had the energy to fight. “He treats me like I’m stupid, and he tricks me into saying things I don’t want to.”
Kat had whimpered the rest of the afternoon and all the way back to the hospital, but the reports changed the next day. She was talking, Dr. Mitchell said, and she was eating more than a few bites. I would have done anything to keep her alive, and I never thought twice about her claims that Dr. Mitchell tricked her into talking. Whatever it took, he helped to save her life. It was worth it.
That was Kat, though. She tried to kill herself twice and nearly succeeded. I, on the other hand, have a little trouble sleeping. That’s all. I don’t need the full-on treatment, not the way Kat did.
“I just want to be in and out,” I explain. “Fix my sleep, and then I’m done.”
He shrugs. “You’re a competent, professional adult who has researched sleep issues and therapy. If you’ve got all of the answers and haven’t been able to solve it on your own, why do you think you’ll fix yourself by telling me your diagnosis and treatment plan?”
Stumped, I stare again. It’s wrong to stare, but he’s caught me off-guard. He’s right. I have spent hours, if not days, searching for information without implementing change. “I just need—“
“Last time I checked, I was the psychiatrist and you were the client. So unless you’re willing to let me do my job, you’re wasting your money and my time.”
I might be impolite to stare, but he shouldn’t speak to me that way. “I didn’t come here to be treated with such rudeness.” I start to stand up, but he stops me.
“Tell me about your nightmares.”
At last, he’s acting like a real psychiatrist. Or, at least close to it. “They’re not every night, or even every week. Sometimes, I can go a whole month or longer without having one. I think they come the most when I’m worried about something else, or—“
“Tell me what happens in your nightmares,” he corrects me, and I shake my head.
“That doesn’t matter. I…”
“Is it something that’s happened to you in the past, or something you are afraid will happen? What about your nightmare makes you feel vulnerable?”
“I don’t feel vulnerable,” I snap, for some reason breathing more quickly. I pick up the water glass next to my chair and take a sip as I try to steady myself. “They’re an irritation, that’s all, and I have trouble concentrating at work when I’m tired. Kat…”
“Sometimes nightmares are a way our subconscious works through traumatic events in the past. Things like a car accident, or early childhood trauma, or,” and his gaze shifts toward me, “rape.”
Water spills onto my lap, but I clutch the glass in an effort not to lose control. He doesn’t know. He can’t know. “Nothing like that,” I lie, but my voice cracks.
“You seem afraid,” he says. “What has triggered this fear?”
“I’m not afraid.”
“You’re shaking,” he points out. “You’ve lost half of your water onto your pants. I can see your chest heaving up and down, and your entire arm shakes. You won’t look at me, and you’ve broken into a sweat. That looks like a fear reaction to me.”
“I’m not afraid!” I could punch his lights out, but I can’t. I try to take another sip of water and choke instead. I pound my chest to swallow, and I force myself to meet his eyes. No one has ever provoked such a strong reaction before.
“This is a safe place,” he says, leaning forward. “Nothing you say will go out the door unless you want it to. Tell me, Natalie, what makes you so afraid that it terrifies you at night and causes you to come unglued at the mere suggestion of telling me?”
“No!” My voice comes out in a shout, and I slam my cup against the coaster on the end table. Only I miss, or else I misjudge the distance, because the thin glass shatters on impact. Water splashes everywhere, but it turns a faint pink. It takes me a few seconds to realize the color comes from the blood in my hand. Stupidly, I clench my hand into a fist. The pinkish water turns darker as the blood wells up on my hand. I pick the chunk out of my palm and set it inside the broken glass. I can’t look at him, despite Mom and Dad’s intolerance of avoiding eye contact. I should look at him and smile to show I am fine, but horror washes over me. How could I do this? I’ve taken worse nettling elsewhere, and I never crumbled.
“It’s okay to be afraid.”
Dr. Mitchell moves toward me, but I whip out my miniature first-aid kid. Kat laughs at me for carrying it everywhere, but I knew it would be needed someday. I blot the liquid with gauze, bite my lip as I use an antiseptic wipe, and tape fresh gauze over the wound. I put everything into a small plastic bag and use an antiseptic wipe on the table. “I’m sorry,” I say. “I’ll pay for the glass, and if there’s any damage to your table I’ll pay for that, too.”
“It’s cheap.” He watches me, his expression unreadable. “I don’t care about the glass, Natalie. I care about you.”
I burst into tears, holding my bandaged hand to my forehead. Kat’s the crier, not me, but my head aches with the effort to hold in the sobs. Dr. Mitchell hands me a tissue from the pink floral box on the coffee table, and his voice warms with something that almost sounds like affection. But how strange is it when I barely know him? “I’m terribly sorry,” I gulp. “I can’t believe I lost my temper. It won’t ever happen again.”
“I pushed you,” he says, and I look up. “You were working so hard to keep me at bay that I had to convince you to give me a chance. You’re a strong woman, and you’ve survived more than people know. I won’t make you weak, but you have to trust me. If we’re going to help you get back on track, you have to let me do my job.”
I could slide underneath his area rug. “I’m sorry,” I say, sounding like Kat. I used to think she gave knee-jerk apologies to get out of a well-deserved spanking, but maybe it’s more than that. I wonder if Dr. Mitchell made her feel the way I do now. I’d rather be hard and cold, but the pain coursing through my hand makes it difficult to maintain the anger.
“I’m on your side, Natalie,” he says, and I believe him despite myself. “When you fight me, you’re fighting yourself. You deserve to be here, and you deserve to get help.”
My mother would be ashamed to see me cry, but he doesn’t seem to mind. “I’ll do better next time,” I mumble. I’m not sure whether there will be a next time. “I’ll take care of things.”
“Don’t make any changes,” he warns me. “We’ve opened up something painful, and you don’t need the stress and anxiety of trying to change your sleep routine. I want you to go home, be with Kat, and eat dinner with her. Do you feel strong enough to do that?”
“Of course,” I say, but the inside of my chest quivers. I won’t tell him about the ringing in my ears.
He takes out a gold-tipped fountain pen and scrawls something on the back of his business card. “This is my cell number,” he says, and I recoil. “You can call me at any time of day or night before our appointment next Wednesday at 5 PM.”
I will never call, but I take the card at his insistence.
“I promise you,” he says, touching my shoulder as I stand up to leave. “It will get better.”
As I walk outside, the late afternoon sunlight bathes my face in a glowing warmth. It’s ridiculous to spill your guts to a stranger, I tell myself, but I close my eyes and take a deep breath before unlocking the side door. For the first time in many years, the iron band around my chest loosens.