Home > The Eighth Girl(5)

The Eighth Girl(5)
Author: Maxine Mei-Fung Chung

“Yes. Hello.”

“You’re a little early,” I reply, “but come in.”

Boundaries, I remind myself. Keeping firm boundaries is essential for building trust. For some clinicians, the odd five minutes are neither here nor there, but experience tells me a firm framework keeps the patient safe—and the psychiatrist too. I open the door and wait for her to follow, but as I turn, she has stopped.

Captured in the heavy doorframe, she appears small for being, I assume, in her midtwenties. Her face a heart perched above a short red dress that looks like one a child no older than ten might wear. We stand in silence for a moment while she glances over her shoulder—checking for what, I am not quite sure.

She stares again at my collar.

A slight cough.

“Would you like to come in?” I ask.

“Yes, sorry,” she says, tugging at the hem of her dress.

It is standard practice for the patient to lead, to initiate dialogue by opening up and discussing what is currently on his or her mind, but with new patients I tend to sidle over into the driver’s seat. Getting a hold of the therapeutic reins. It can be as simple as an introduction or a question regarding their reason for seeking treatment. Occasionally, there will be tears before either question, and that’s usually when I sit back, allowing the patient’s feelings to breathe. There are no hard-and-fast rules, but I believe it helps to have some sense of the person before your next move. Today I wait.

Alexa finds my eyes, readjusts her dress, and stretches. Her posture now suddenly alert, upright and focused.

“I want to resume my therapy,” she begins.

“You stopped?”

“He retired.”

“Oh.”

“I was in twice weekly for just over four years. We did some good work, I think. But then Joseph—Dr. Applebaum—retired. Moved out of London to spend more time with his family. He had grandchildren. He was old.”

“I imagine that was difficult, saying goodbye.”

“It was. It—”

I sense her unease, aware of her sentence breaking off. The slight drop of her chin.

“It was—?” I encourage.

“It was difficult. Painful. I missed him terribly.”

I shift in my seat, leaning to one side. I must look like a therapy cliché: legs crossed, wry smile, head tilted in deep thought. A box of tissues resting between us.

She twirls a strand of her long brown hair, smiles, then hands me her set of forms—a requirement for all new patients and residents beginning analysis at Glendown. Scanning her answers, I quickly observe her handwriting—cursive and childlike, signaling arrested development and insecurity.

“I notice you haven’t filled in the section regarding medication,” I say.

A pause.

“Is there a reason for this?”

“I don’t want to be labeled. Or given a diagnosis,” she explains.

Furrowing my brow, I look at her quizzically and ask her to clarify.

“I don’t like labels,” she defends. “They pathologize.”

“I see.”

A less experienced psychiatrist might step in at this point, prick the air with words—fearful of quiet, of the patient’s unwillingness to talk, or of not doing enough. But a shrink who rushes in to rescue forgets to listen. He forgets that this is not about him and the easing of his discomfort.

So, I sit back.

This is when all the good stuff happens. When emotions shake and feelings surface, giving the patient time to reflect and the shrink time to observe. Alexa stares at the oil painting above my head, a landscape of the English coastline.

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.”

Hot Books
» House of Earth and Blood (Crescent City #1)
» A Kingdom of Flesh and Fire
» From Blood and Ash (Blood And Ash #1)
» A Million Kisses in Your Lifetime
» Deviant King (Royal Elite #1)
» Den of Vipers
» House of Sky and Breath (Crescent City #2)
» Sweet Temptation
» The Sweetest Oblivion (Made #1)
» Chasing Cassandra (The Ravenels #6)
» Wreck & Ruin
» Steel Princess (Royal Elite #2)
» Twisted Hate (Twisted #3)
» The Play (Briar U Book 3)
» The War of Two Queens (Blood and Ash #4)