Page 19

5 March 2019

Me: “Do you ever talk about your anxiety with anyone?”

Patient X: “God no. Speaking to you like this, it feels like a huge step. Like nothing I’ve done before.”

Patient X holds my gaze and I try to break eye contact but there is something in their expression that is so eager to engage, to acknowledge me, that I find it difficult to look away. In these early sessions I think it is crucial to build on that trust. I’m mindful of a new feeling right now, of wanting to really step into someone else’s pain with them rather than experience it only within myself. Finally. I’m not as egocentric as I thought, ha. What a relief to help, to feel seen and appreciated for more than just my own condition.

Me: “That’s so good to hear. I want you to know I’m here for you, witnessing, hearing all these experiences you’ve been through.”

We sit for a moment in quiet reflection, smiling at one another until Patient X breaks the thoughtful silence.

“I’ve been having nightmares. You see there’s something that’s been nagging at me lately, a sort of secret that’s been weighing me down.”

“That must be psychologically tough for you. The feeling of keeping a secret can often be so much worse than the content itself.”

Patient X nods in recognition. “It’s just I’m very afraid of the person who could expose it, expose me.”

Me: “You mean they’re using the secret to...blackmail, or control you in some way?”

Patient X hesitates: “I think that maybe it would be so helpful if I could talk to you more than once a week?”

I sense Patient X is on the verge of a breakthrough here. I know how significant it is to feel understood by a therapist, how transformational it can be, so of course I agree.