Wish Away

The next appointment stepped into the office, looked from guest chair to couch, and did the unexpected.  She sat on the couch, right at the end, as far from his desk as was possible, head turned to regard him.  He made a note of this; noting odd behaviour was exactly the sort of thing the notepad was for.

“Good morning, Doctor.”  Her voice was also unexpected, uncommonly deep, but this had no bearing on what might have brought her there.

“Good morning.  You may, if you like, call me Angelo.  Some people find ‘Dr. Alvarez’ puts a barrier between us.  Some prefer it.  As you please.”

She sat, all the way over at the foot end of the couch, considering.  She did not, he thought, seem particularly nervous, and this was also interesting in a new patient.  He made another note as she nodded.

“Very good.”  Neither form of address.  Uncommitted, or given to concealment?  He didn’t bother with a note, but put the thought in a place where it wouldn’t be misplaced.

“How would you prefer I address you?” he asked.

Another considering pause.  “I think I would prefer Ms. Johar to start off,” she said.  “We’ll see if we come around to first names.”

As he wrote that down, he said, “Now, Ms. Johar– I’m not completely certain why you’re here.  Most of my new patients give me some indication beyond a…”

“Yes,” she said, cutting him off, “and I appreciate that you made room in your schedule under the circumstances.  However, until I am certain that we will get along, I prefer to keep what is troubling me to one side.  If we do not agree well, I really cannot see you again.”

Alvarez added another mental note.  The last words had been oddly emphatic, and he hoped he would find out why eventually.  He made a small production of putting down his pencil and setting aside the pad.

“As you wish.  We will simply get to know one another in this first session.”

For nearly an hour, they chatted about very little.  Current events, and only in what Alvarez found a sadly shallow way, the weather, the local sports teams’ prospects, and the cost of living’s strange recent antics all passed between them.  The mental note-keeper took two more items before the gentle bonging of his timer began.  The first was that she might have become slightly less distant figuratively as they spoke, but she remained perched in her upright posture  at the end of the couch the whole time, not even turning her shoulders in his direction.  The second was that she did not once call him by anything other than the second person pronoun after the initial “Doctor.”

“Ah, our time is up,” he said, over the last of the chime’s reverberation.  “Shall I see you again?”

Once more, a long pause.  He thought of a small bird of prey, not seeking a target, but merely directing its ferocious attention across the landscape.  “I think we may,” she said.

“Excellent.  Please talk to Brenda… I’m sorry, to Barbara, on your way out to arrange a convenient time.”

She left, and in the pause before the next patient, he made external copies of his mental notes.  Apart from a slight and certainly non-clinical social awkwardness, he could not tell why she was seeking therapy.

Alvarez found it encouraging when Ms. Johar took up the chair across from his desk, rather than resuming her distant outpost on the couch.  She was, as last time, dressed conservatively but well, and he would say, allowing for his own inclinations, she was reasonably attractive.  And yet, “Ms.” and no rings; choice, failure of opportunity, or inclinations that ran more in the same non-traditional direction as his own?  It might have bearing on whatever her matter was, whatever the truth of it.

“How are you today, Ms. Johar?”

“Well, thank you.”  No reciprocal interest, another small item of social mis-function.  Sociopathy?  Not impossible, even if it was unusual in women, but sociopaths almost never thought they had a problem.  He was looking forward to unraveling her mysteries.

“Glad to hear it, and glad to have you back.”  There followed a period of silence, which Alvarez allowed to spin out.  It was a way of examining the patient, and it usually ended with the patient saying something.  This time, he judged Johar was not going to be the one to begin, as she just sat there, composed, not quite making eye contact but certainly looking directly at his face.  A datum, but not very informative.  He let a few more seconds pass as he squared his notepad and examined the amount of lead extended from his pencil.

“Let’s begin,” he said as if he hadn’t let such a gulf of silence develop, “with your family.”

“I have none,” she replied, and it was not without emotion, but very subdued, something long since scarred over.  “My parents both died when I was a teenager.  It was a terrible accident, and both…”  She let the sentence hang, unfinished.  “I am an only child, no siblings.”

Alvarez waited, making sure she was done.  “And no other significant relationships?”

“No.  I dare not make friends easily, as I think you can see.  Friendship is the most important foundation of any relationship, is it not?”

Alvarez sat quietly.  An empty life would certainly feed back upon itself, a lack of friends impairing the capacity to make friends.  More likely, if more mundane, than sociopathy.  But… I dare not?  That was worth pursuing later.

“Of course,” she went on, “I speak.  You ponder.”  The hint of a smile briefly lit on her face.  “This is not the sort of therapy I will be seeking, I’m afraid.  You will see that I do not have a great deal of subconscious baggage that needs addressing.”

“Why do you say that?”  A question of mere habit, of course.  He’d nearly said how would you know that instead, but that was too confrontational.

“I am extremely honest with myself.  I must be.  If I had more friends, I imagine this would come across as bluntness, but I cannot have illusions about my internal state.”  Alvarez penciled another small note, marking the repetition of the emphatic negation.  If what she was saying was true, she was probably looking in the wrong shop; his whole stock in trade was hauling subconscious baggage into the light.

He pursued history with her, with little to show for the effort.  She worked mainly online, an editor for a major publishing firm, which was financially rewarding but was also an insulated position, especially as she worked primarily in non-fiction.  She was not a recluse, though, going out into the world for shopping and entertainment.  She did not hoard, or, he corrected himself, did not perceive herself as hoarding; those who were hoarders seldom thought it of themselves.  She did not self-injure.  As they approached the end of the session, Alvarez found his thoughts circling the question of why she had come to him.  Hers was a somewhat solitary existence, but also a seemingly consciously chosen one without clear evidence of regret.

“Ms. Johar, we are nearly at the end of our time, and I think I should ask as a matter of fairness:  are you sure the help you seek is something I can offer?”

Another of her rare, brief smiles.  “No.  I am not at all sure.  But, as with most things, we do not know until we try.”

As she spoke, the timer gave out its mellow noise.  Alvarez set his pencil down on the pad, and tilted his head slightly.  “That is true.  I shall be happy to give what help I can, next time.  Barbara will set up another appointment for you.”

Spring had given way to summer when Johar’s next appointment came up, and both doctor and patient had dressed for it in much the same way.  Each wore a pale linen suit, tailored to gender but otherwise nearly matching.  Alvarez was pleased to see genuine amusement on Johar’s face, even if it did knock anhedonia from his list of possible reasons for her visits.

“I see we should have consulted about wardrobe,” she said.

“So long as we don’t go to lunch together,” he replied.  “People would wonder what branch of the service we’re in.”

She sat in the chair again, which was neither here nor there diagnostically.  Some of his OCD sufferers could not face the thought of putting their head down where untold previous dandruff-covered noggins had lain.  Other patients eschewed the couch thanks to acid reflux.

“Are you ready to begin, Ms. Johar?”

She waved a dismissive hand, still smiling.  “I think today you should call me Radha.”

Oh ho.  But still just a pronoun from her; the opening only ran in one direction.   She trusted him, but not herself.

“I believe,” she continued, the merriment slowly leaving her face, “that last time I mentioned I do not make friends readily.”

Alvarez nodded, glancing at his notes.  Time, perhaps, for a nudge.  “Yes, you said you didn’t dare to.”

A shadow passed over her face.  Regret?  Anger?  It had been too brief.  “Yes.  That’s exactly true.  There is a good reason for that, and it is why I come to you, specifically.  You conduct hypnosis, I understand.”

It was nearly a non-sequitur, and a part of him felt professional pride that he passed it so smoothly, without a confused gape.  “Yes, but… Radha, I can’t hypnotize you into being more outgoing.”

Another smile, but it was attached to a look that spoke eloquently of regret.  “Of course.  That is not the issue.  Last time I told you I had few friends.  I think it is time to tell you why.”

He nodded encouragement.  The pencil hung in his fingers, ready to set down his impressions.

“On my first visit, you recall, I was extremely tentative about establishing even this sort of relationship.  I must be extremely careful about all my interactions.”  She stopped.  She was, for the first time he could recall, not looking directly at him.  She seemed to be taken by the sort of nervousness he was used to in a first session, and it surprised him after all the self-assuredness he’d seen.

“I follow the news only in a cursory manner, and avoid politics altogether, both for the same reason.  I dare not become annoyed with anyone whose name I know.  It is why my parents are dead.”

Alvarez felt shock stiffening his face, and this time he was sure the effort of smoothing it away showed.  Johar was still looking down, fortunately.  He hoped he was not about to receive a confession.

“This is very difficult.”  She pressed the bridge of her nose with her left hand, the nails of her first two fingers going briefly white under the pressure.  “I remember every instance, you see.  Every one.  But my parents are more upsetting, of course.”

She looked over at the couch.  “I think I will move over there.  Excuse me.”  She sat rather than lay on it, back against the head bolster.   From his desk, Alvarez could see only part of her profile, while the framed print on the opposite wall he used as a surreptitious mirror showed none of her face.

“I want you to withhold judgement… but your profession is not judgemental, is it?  What I am about to tell you, the reason I have come to you, sounds like utter madness when I just say it, and I can offer little proof.  However, it is important to me that you accept it as real.  It is not a delusion.”

This was a well-spoken version of a very familiar line, and Alvarez felt on firmer ground.  He leaned over a little, hoping to see her face, but only her ear and the tip of her nose were visible.

“When I become annoyed with people, angry with them, I frequently wish them out of existence.”  She paused for the space of a couple of breaths, then angled her head toward him slightly.  “No reaction?”

“How long has this been happening?”  Professional habit, once again.  It was a pretty extravagant fantasy, and he wondered whether it was more in the line of a purely cognitive conversion disorder, an unwillingness to face unpleasant people so effective that it removed them from her perceptions, or whether it was some strange variant of an organic agnosia, with an actual deformity of her brain working to extract people from her life.  The former could be a real bear to deal with, but the latter had a hint of more serious trouble.  After all, if people were disappearing only after she had met them, the suggestion of a growing tumour was present.

Whichever it was, it would go a long way on the road to explaining her socialization problems.  If she kept acting like one person in a group was not there, this would alienate not only that person but the others who didn’t understand the basis of the snubbing.  Depending on how she reacted to others trying to insist on the existence of her erasures, she could easily be ostracising herself on a regular basis from all but a very forgiving handful of friends.

“Oh, it has been going on as long as I can remember.  In school, a child would disappear from class, and when I asked about them, no one seemed to have any idea who I meant.  I was very young when I realized that every time this happened, I had quarreled with the child sometime in the previous day or two.  I began to avoid anyone who seemed unfriendly and to make peace as best I could before I was ten years old.”

“That must have been difficult.”  Notes about time and form of delusion scraped onto his pad.  If she were reporting accurately, which was not necessarily the case, it would be very hard to shift such a long habit of thought.  He wondered if there would be time before some falling out saw Johar remove him from her perceptions and put an end to treatment.  On a positive note, if she had been experiencing the effect from childhood, it was unlikely to be a malignant tumour.

“It was impossible, really.  Children have so little emotional control.  Then, as a teen…”  She heaved a profound sigh.  He wished he could see her more directly, as tears at this point would be informative.

“The argument was foolish.  Even when it began, before it became rancorous, I knew it, but I was sixteen.  That age when one knows all and wants everyone to admit it.”  Another, lesser sigh.  “And then they were gone.”

“That was just before the accident?”  A note, reminding him to try an Internet search for the right year, to see if he could find any details of her parents’ death.

“Oh, no.”  She sounded slightly amused.  “No.  The accident happened several weeks before that.  I suspect it happened that way to avoid paradox.”

This was the sort of minefield a patient might present.  Effect follows perceived cause, and if you suggest that’s not really the way it works, they lose trust.  Alvarez began to consider what path through the mines might present itself, when she continued.  “This was not the usual way.  But I think it was the way it had to work.  If they were merely removed, they could not have created me, I then could not remove them, and there sits the paradox.  So they remained a part of existence, but were removed from life.  When I realized this, I realized how complete my wishes were.”

“How so?”  A thought occurred to him; she may simply have run away from home.  He almost hoped there really had been an accident, as the less sad alternative to parents written out of their daughter’s life by mental disease.  If this were a recent development, they might only just be starting to wonder why their Radha never called anymore.  If it were of long standing, it would mean decades of mysterious absence.

“Because my parents got special treatment, there must be a reason.  That’s when I started to check on some of the others, although this was quite difficult before the Internet, especially for a young person.  Everyone else to whom I had done this has left no trace in history.”

A sweeping statement indeed.  Alvarez was a little surprised he had not seen some hint of so extensive a psychosis in the previous sessions, but it was so well-defined, so specific, and she had clearly developed some very muscular if misguided coping strategies.  He could salve his professional conscience.

“For example,” she went on, “If you now look at the obituaries for my parents, you will find no mention of my sister, even though it was not until two years later that we had our fight.”

She fell silent, and after a considered pause, Alvarez said, “In our last meeting, you said you have no siblings.”

“Yes.  I do not, and so far as can be discovered I never had.  But up to a certain date, I did.”  Johar spoke very evenly.  Alvarez was impressed, because her voice lacked the edge of anger he was used to hearing when a psychotic notion was contradicted.  “I told you– I remember them, which makes this much more of a curse.  I’m the only one who remembers any of them, no matter how famous they were.”

“Such as?”  This was a break with his standards, and Alvarez scolded himself inwardly.  Pure ape curiousity, and he’d interrupted her flow into the bargain.  The fear grew in him that he’d derailed her completely, but after a few seconds when she spoke again it was clear she was not particularly troubled.  She had merely been working on remembering, or rather, manufacturing an example.

“Ah.  Just the thing.  How about Jennifer Aniston’s husband, the model?  He should be memorable from the massive advertising campaign he was in just after the turn of the century for some fragrance or other.  His face was everywhere, and there was something about the photograph that made him look so smug and so… greasy I just couldn’t stand to look at them.  One day they were all gone and she was married to Brad Pitt.”  Another sigh.

“So, Radha, you want me to find a way to prevent this from happening anymore?”  Just enough of the inflection of a question to keep the ball in her court.  He found himself considering the story she had just told.  Jennifer Aniston’s love-life was a matter of frequent comment in the supermarket magazines, making it an obvious element for fantasy.  He was not interested enough in celebrities to keep track of the specifics, though; had she been married prior to Pitt?

“I hope you can.  I have been reading about hypnosis, which until lately I thought of as mostly stage entertainment.  I know it is sometimes used to help smokers with their addiction, but that isn’t what interested me.

“I read of… well, a trick, really.  A hypnotised person is told that there is no number five.  Thereafter, they are asked to count things, and they always omit the five—if there are six items, they finish at seven, even though they can see plainly there are six.  This interested me very much.”

Alvarez stifled a sigh of his own.  Hypnosis was so misunderstood.  He did not want to contradict her, but he also wanted to avoid giving unrealistic hope for a miracle cure.  There was, he considered, some chance of a placebo effect, and that was where he would hang his own hopes.

“There is a potential for this to work.  I am familiar with the effect you describe.  Obviously, it has never been left in place for any length of time, so the duration of the effect is unknown.  Also, it is thought that the subjects are not so much unable to recall the target as they are subconsciously playing along to humour the hypnotist.”

Johar nodded.  “Yes.  But if it works at all, I am not very concerned how.”

Alvarez also nodded, then smiled at his own unconscious behavior.  She could not, after all, see him.  “All right.  We will first have to discover whether you are open to hypnosis and to what degree.  I will not even attempt it in this session, however.  I need to arrange for an observer, as I don’t image either one of us would be comfortable with that sort of power imbalance in place and us unchaperoned.”

“Very well.”  She drew herself up a little on the couch, directing her gaze straight ahead.  “You are quite right, of course.”  She sat for some time, apparently fascinated by the door.  Alvarez listened to her breathing and realized she was doing a calming exercise.  Apparently she had been hoping for the miracle cure.  After some time, she turned, lowering her feet to the floor, evidently quite composed.  “Will you be able to begin soon?”

“I have a semi-retired colleague I can call.  She is usually very flexible in her schedule.  We’ll make an appointment as usual, and if she has a problem with the time we’ll work on rescheduling as soon as is convenient for you.”

Another silence.  Johar nodded and stood.  Alvarez glanced at his timer.  There were still several minutes left in the session, but if she thought it was time to quit, he was not going to quibble.  She moved back to the chair and sat, remaining quiet, fixing him with her raptor’s stare until he set down his pencil.  When she blinked, it was nearly startling.

“I know what I have said is very difficult to believe.  There is a cliché about a person with a hammer seeing all problems as nails, and I suppose something similar might apply to your profession.  I would like to encourage you to not think of me as delusional.”  Alvarez opened his mouth to protest, but she held up a hand to arrest him and continued.

“I would like you to think about your receptionist, Barbara.  A very pretty young lady, although she probably thinks she has a weight problem.  To judge by the way she has her desk decorated, I imagine she has been with you for some time.”  Alvarez nodded.

“On my first visit, your receptionist was Brenda, a tall woman in her sixties.  I won’t go into detail, but I think you would have been surprised to learn she was something of a racist.  She tried to put me off when I was making the appointment, and when I arrived she was as rude as she could manage without being aggressive.  I’m afraid I wasn’t able to… put it out of my mind.

“Now, if you concentrate, you may be able to remember Brenda.  I hope you will try, as it is the only sort of proof of my condition I can offer.”  The timer rang.  Johar stood, and walked out without a backward glance.

Alvarez reached for his pencil.  He picked it up, held it over his pad, then put it down again.  He frowned.  A persuasive statement of the delusion, of course, and the sort of thing that could easily engage the imagination.  He had known Barbara a long time, hired her seven years ago despite the foolishly plum-coloured hair she’d sported at the interview.  The pencil he used was a gift from her, given on the first anniversary of her employment and the kernel of many jokes about how overpaid she was.  He had met her boyfriend three times.

But he could not, at the moment, picture her out there in the front office, nor the red sipping bird toy she insisted on setting out each morning, nor even her eye colour.  There were other details crowding her out, and he knew they were all mere fantasy.

Persuasive.

He reached for the intercom.  The voice that responded was clearly not the voice of a childless widow who had never quite given up the Scots accent of her youth.  “Yes, doctor?”

“Could you ask Mr. Schubert to reschedule, Br… Barbara?  I find I’m not feeling well.”

“Wish Away” ©2015 Dirck de Lint

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