Time for change (Dr.Neville)

One didn’t go through medical school, residency, and almost thirty years of having a psychiatric license without being aware of the impressions that the general public held of his profession. Sean knew that, for many, the notion of requiring psychiatric assistance was viewed as a weakness, if not also downright terrifying because of the acknowledged vulnerability. The casual, relaxed sessions he had provided to Josh last autumn further solidified that.

Often, all the psychiatrist could do was be as non-threatening as possible, while still remaining professionalism. Also, he tried to help people get past the notion that every little action was a test, and that they were being judged for every decision that they made.

As such, when Kessa knocked on his door, he called for her to come in. And rather than do so, she simply paused in the doorway; unfortunately, that was a common enough reaction. Sean offered her a warm, welcoming smile and gestured at the chairs in front of his desk. “Please, come in, shut the door behind you, and make yourself comfortable. I promise you there isn’t anything to be nervous about.”

That was true, even if she still felt nervous after his reassurances. He added, for the sake of levity, “I promise that I don’t bite.”

The psychiatrist returned her nod with a polite smile and nod of his own, before gesturing at the abundance of furniture in his office, an indication that she could sit where she liked. His furniture policy was that he would move around the office accordingly to facilitate conversation, but visitors were allowed to sit wherever they liked. Unless they were here for a disciplinary session, at which point they were confined to the chairs by his desk.

Once she had chosen the sofa (which was an excellent choice, as it was by far the most comfortable piece of furniture in the office), Sean moved from behind his desk to seat himself in one of the chairs closer to the sofa.

Her discomfort was apparent, but the psychiatrist wouldn’t comment on it, thus drawing attention to it. If she persisted in being uncomfortable, he would offer more verbal reassurance, but for now, he used non-verbal cues. Primarily, a soft smile to show that he meant no harm, while also not crowding her by sitting next to her on the sofa. As well, he didn’t prompt her; he waited for her to speak first. Even though that resulted in silence for a few minutes, it proved worth the patience.

“I have no set script,” he replied, steadily meeting her eyes. “We could begin with small talk, if you’d like. Otherwise, you could tell me about how you’ve been feeling. Otherwise, we can play cards if you’d prefer.”

Sean wouldn’t force playing card games on her, particularly if her concern was that she lost. While he could remind her that it was just a game, the purpose was to create a relaxing atmosphere, not to cause additional stress. And since he had a tendency to win card games, without the telepathy, it was best to let that suggestion fall to the wayside.

Unfortunately, the suggestion had already triggered stress and tears. While she curled up, Sean rose from his chair. He didn’t go far, only far enough to retrieve the box of tissues he kept in the office and to bring it back. He set it down on the table and nudged it closer to her, offering as many tissues as she needed.

“You aren’t a loser,” he said, his voice gentle but sincere. While he and Kessa hadn’t worked together before, he still had complete confidence in his assessment. Sean didn’t believe that any person was a loser, and that was particularly true during adolescence, when the entirety of one’s life was ahead of one. The notion that she could do nothing right was common enough for this stage in life as well.

Settling down across from her again, he continued, “And I would be happy to help you.” His voice remained gentle, as he asked, “Why do you feel that you can’t do anything right?” He assumed she would have an example they could use as a jumping point.

Sean hadn’t intended to put pressure on her, and he was trying to be as gentle about the matter as possible. Unfortunately, helping students who displayed low self-esteem was always a delicate situation. He didn’t want to patronize her or make her feel patronized by calling attention to her crying more than he already had; at the same time, he couldn’t let the situation go by without further notice or discussion.

They needed to get to the bottom of these feelings and her self-perception.

So he waited for her to answer his question; the psychiatrist didn’t crowd her in doing so. He simply waited patiently while maintaining eye contact with her. After a moment, he gave him an answer, which he acknowledged with a nod.

While her answer did provide cause for concern, he didn’t believe it meant that she was incapable of doing anything right. Then again, he was also four decades out of puberty, and this wasn’t his social circle that was involved. That always gave weight to the situation, and guilt was to be expected.

“I’m sure you didn’t,” he replied gently. He then continued with, “Have you spoken to Ari recently?” That would explain how she had come by these perceptions about her.

And then, the inevitable, “I think we should talk a bit about what happened that led to all of this. If you’re able.”

There was always a risk when asking difficult questions, but there were only so many ways through which Sean was capable of finding information. Discussing matters, which included asking questions and giving the other person the ability to control the discussion somewhat, since she could choose to reveal that which she wanted, or had the opportunity to shift the topic of conversation. His other primary method was through telepathy, and while that was more reliable, it also removed all feelings of control from the other person.

Additionally, as he had said time and again about therapy, while it was important for them to have a common frame of reference, imparting backstory wasn’t the only reason for discussing events. There was value in talking through events and feelings as a means of absorbing them.

As such, the psychiatrist didn’t pressure her to answer. And when she finally did begin to explain, he listened patiently while she spoke without interrupting. He met her eyes to show he was engaged and he nodded when appropriate.

Only when it was apparent that she had finished talking did he take the opportunity to do so. “I understand how all of that is distressing.” He was honest in that reply, and he didn’t intend to patronize her by saying as much.

He also understood why Ari would avoid another confrontation, even though it was Sean’s belief that, generally, discussing situations was for the best. “Have you gone out of your way to talk to her since then? Or have you been giving her space? Because in a situation like that, sometimes respecting boundaries are all that we can do to try to earn back someone’s trust.”

Asking questions was a key component of offering mental health services. While listening was perhaps the largest component of his job, and an aspect Sean both liked and at which he was proficient, there were other, interrelated components. He had to be able to render fair judgment, he had to be able to offer compassionate and appropriate advice, he had to be able to make proper diagnoses, and he had to be able to direct conversation and draw out important information. That required asking questions.

It also required using his skills of perception, which included his telepathy, even if he wasn’t actively probing her mind at the moment. He could hear her distress, the exaggerated answers to his questions that she didn’t verbalize. All of that was understandable, although he didn’t want to comment on that which she didn’t state aloud.

“But staying away from her is still causing you distress,” the psychiatrist pointed out. He had brought up the topic of boundaries because well-established boundaries demonstrated respect for another person, and since trust was at issue here, it was relevant to display.

Sean managed not to sigh as she raised her voice; that was par for the course, given what she had told him thus far. “I could write you a prescription for a sleeping pill, but that’s a Band-aid, not a cure. Medications also come with side effects, and because of those, if you qualified to take them, you would only be given two weeks’ worth at a time.”

One had to be careful when writing prescriptions for minors, particularly for sleeping pills. “The reason we’re discussing what happened in your past is because you think about what happened in your past. And that’s what brought you to me today. I want to help you put this behind you, but that isn’t something that can happen in a day.”