The Sessions - 2. Visit #2

The Sessions: Visit #2

“Josh, good to see you again; come on through.”

“Thanks”

“How are the nerves today? You seem more relaxed?”

“Yeah, I had a run before I got in the car to try and clear my head.”

“Excellent, well take a seat and make yourself comfortable; I’ll just be a sec.”

“Sure.”

“Let me just get those blinds. My last patient likes it a bit darker than you if I remember.”

“It’s a nice day out there.”

“It is. So here we are, your second visit. You’re feeling okay?”

“Yeah, a bit better than last time.”

“Good, Josh, I’m pleased to hear it. So just to let you know, I now have your full medical records, which arrived a couple of days ago. I must say, Josh, I am concerned with some of the readings. And I point to your visits to A&E for head trauma and a fractured wrist.”

“Uh, yeah, they were because of him.”

“Kai?”

“Yeah. I mean, I told them at the hospital that there were accidents at the farm, but I lied.”

“I guessed as much. Something told me in the records that they coincided with the timeline of Kai in your life.”

“I’m all better now, though, healed up and all that?”

“Well, we will discuss these events in your own time. But for now, let's talk about your week after leaving here last time. So how did you feel when you stepped out of here?”

“Hmm, well, it was good to talk, but hard to bring up stuff about Kai and all. I think I’ll need to, though, as you said about the string and stuff. But, Finally, yeah, it’s been an okay week. Busy. Dad’s just brought 16 new cows, and I was with the Vet most of the week, handling.”

“Any anxiety spikes?”

“A few, they’re normally the worst in the morning.”

“This is common, Josh, and I find when my patients understand what their body is doing, this helps to alleviate some of the feelings.”

“So, what's wrong with me?”

“Well, generally, when we wake with early morning anxiety, it’s normally triggered by events or feelings from the previous day. So it’s like a cycle. Your stress hormones create this cycle.”

“And what is this cycle? I mean, I think about things a lot, ye know, about him, work, and school. Seeing him at school.”

“I understand, Josh. Well medically, on waking, the body tenses and jumps into ‘fight or flight’. This starts at the memory and thought of another stress-filled day ahead. It then creates a bout of negative thinking. And the cycle ensues that before the day has even begun, a repeating cycle of early morning dread is created.”

“I think I get it.”

“And Josh, remember that even when you’re asleep, your brain and body is still working away, processing things, releasing hormones and chemicals. So in the latter part of the night and early part of the morning, your body generally sees an increase in blood pressure and cortisol levels.”

“I kind of got the blood pressure thing… What's cortisol?”

“This is the fight or flight hormone which goes into overdrive when we are stressed. This hormone is released for people who don’t suffer from anxiety as the body prepares to start another day. This gets us out of bed in the morning. But for people who suffer from anxiety, the body can increase the amount of cortisol released and leave us feeling very negative and worried.

“So, how do I break the cycle?”

“Well, being here and talking things through can do it. Some people need a combination of talking therapy, helped by medication. Josh, you need to remember you have been in a violent and stressful relationship with Kai. When we talk about what happened, you will also learn about yourself and why you submitted to this violence and how your mind and body adapted to deal with it.”

“Right, I see. I’m kinda blown away all that stuff happens.”

“Your brain and body is a remarkable piece of equipment, Josh, but it can do things to protect itself that can manifest as unpleasant feelings. Does that make sense?”

“I guess, yeah.”

“I’m glad. So today, what do you say to exploring more about Kai?”

“Yeah, that's fine; you might release a monster, though, ha.”

“I’ve dealt with many monsters my patients let out, Josh.

“Well then, let’s do this! God, clammy hands already.

“It will pass Josh, just settle into the sofa and remember I am right here with you. So last week, you mentioned he was in his car, and you felt a little bit confused about the situation, right?”

“Yeah, he just sat there with the door closed. I didn't know whether to knock or stuff.”

“So, what did you do?”

“Uh, well, I had stuff to be getting on with, so I walked away. I think I was kind of hoping he would call out, but he never did.”

“And your next encounter?”

“That was at the pub. There's a pub near the farm, just sits alone. We have a few public access ways that run through the fields, so we get walkers and bikers that come through, and of course, all the farm workers go there. It's an okay place to go if you’re bored. Ye see there ain't much to do where I live.”

“So you met in the pub, yes?”

“That's right. Uh, I think he was playing pool with one of the pickers we had in the summer. I was standing at the bar, and out of the corner of my eye, I could see him smiling at me between shots.”

“And how did that make you feel?”

“Why?”

“I’m curious. Did you feel anxious or happy, for example?”

“Nah, it was quite off-putting. I mean, sure, I liked him, but no one knew, and having another boy smile at you in the pub it felt pressurising for me.”

“Pressurising, that's not a word I was expecting you to use, Josh.”

“Well, you know, kinda scared in a way. Like I should move somewhere else.”

“Then what happened?”

“I went and sat outside on one of the benches with my pint, just scrolling through Facebook and stuff, and he came out for a cigarette. I could see him leaning against the wall, just staring at me. His eyes were… I dunno, captivating. Deep-set brown eyes and I felt like I wanted to run, ye know?”

“And this running away was because you were not out to anyone?”

“Exactly, and it felt like he was going to...uh, Jesus, this sounds stupid, but like blow my cover. But while I was thinking of running away, I wanted him so badly to talk to me.”

“Continue.”

“So he finishes his cigarette and walks over to me, and he just says it….”

“Says it?”

“He just sits down opposite me… it was one of those benches where you can sit on the other side too… I dunno why I’m telling you that; it’s stupid.”

“Haha, go on.”

“Yeah, so he sits down opposite me and just says, why am I playing hard to get. So that sends my anxiety levels through the roof. I felt sick.”

“Because?”

“Because he knew… he knew that I liked… him… boys. Like he knew I was gay, and I didn’t know what he would do with that information. I mean, I could deny it to him and say what the fuck was he talking about, but if I did that, I would of….”

“Put an end to what could be?”

“Yeah, so I felt trapped, and I was red in the face and trembling. He made me feel so many emotions.”

“What emotions? Let’s talk about them?”

“I dunno, Kind of uneasy, warm inside, but kind of angry, a little bit of rage. Fuck, maybe even ashamed.”

“You list quite a few there; would you say you felt overwhelmed?”

“Uh, well, I guess.”

“So let's continue. So he's sitting there, and he’s asked why you are playing hard to get. What do you do?”

“I just sat there looking at him like some dumb idiot. I asked what he meant, and he just smiled at me, then said I was cute when I looked nervous. Then with a snigger, he just walked back into the pub. It felt like a hit and run. I downed my pint and drove one of our rovers back to the farm, and chucked myself on my bed. Then for some reason, I felt so hungry, like I could eat and eat; that was weird and… and unsettling.”

“Have you had this before?”

“What is the feeling of eating? Uh, well, I may have done but nothing like this; I just felt like if I didn’t eat, I was going to shut down or some shit like that.”

“Okay, now that is interesting. So, want me to tell you what's going on there, so you understand it?”

“Sure.”

“Well again, you are not going to keel over, so don’t worry. So when you put yourself in a stressful situation, your body puts itself into a defensive mode. Your blood pressure will rise, and the brain diverts blood away from non-essential parts of the body and places it to the brain and muscles. This would have caused a sharp drop in sugar levels as the body has to work overtime to keep this up. After the danger has been averted, your brain tells you you need to refuel, hence the hunger fest. It’s preparing you in case you need to tackle something or someone.”

“Weird.”

“Think of a car you’re driving. You’re about to go on a long journey. What’s essential for that?”

“Uh, well, Petrol?”

“Exactly, you’d fill up, wouldn't you? You can't leave and rev the engine with no fuel.”

“Wow, I didn't know that. But it makes sense.”

“Well, now you do, and as I said. Explaining why things are happening to you… having that knowledge will help you understand that nothing bad will happen to you, just like when you described your panic attack. That is the extreme version of what I have just explained. But it is not dangerous; finally, and you just have to go with it.”

“Yeah, that was bad; I felt like there was no air to breathe and that my chest was tight. Shit, yeah, I really thought I was going to die.”

“During a panic attack, most people feel that they are having a heart attack because the panic attack displays very similar features to one. Some people even go to the hospital. But Josh, listen. You are a fit and healthy young man. Your medical records show this. So you can take it from me, if you ever have an attack again, it will pass, and you will be okay.”

“Thanks, Claire, I’ll remember those words. Cos Sometimes I feel like I can suppress them, but while I know nothing happened the last time, my brain tells me it's different this time and that something is really wrong with me.”

“Yes, that's common, but it is just your brain giving you a massive shot of cortisol and adrenaline because, In the back part of our brain, we still bear those basic instincts to avoid danger or to face it. It's an unfortunate carry-over from our early ancestors. However, it is still important. This is why we do not walk in front of cars or jump off buildings. We sense that danger and avoid it.”

“I thought this would be really boring stuff, but it's interesting, Claire!”

“And, Josh, it will help you.”

“Got it!”

“Please help yourself to water. It’s not poison, honest.”

“Haha, yeah, I think I will.”

“So, regarding Kai. What's next… tell me?”

“Uh, well, God! So my Dad decides about three days later to put us on a fencing project on the Delta field together. We name all our fields. So anyway, he says over dinner that as we know each other at school… something I tried to play down, we should work together. So, yeah, we load up the posts and wire together just making small chit chat while dumping them in the trailer, and then we drive up together in the Land Rover to the field.”

“So you’re in the car together; that’s a pretty confined space. How did that feel?”

“I was all over the place, really. I loved being near him and stuff, but he didn’t really talk much, which made it kind of awkward. So I was sweating a bit by the time we got to the field.”

“But, Josh, you overcame it.”

“Yeah, I mean, I was fine once we got there. We were unloading the logs, and I pulled off the roll of wire, which was heavy, and I fell over and twisted my ankle. Not badly, but it was quite sore, and then he….”

“Go on.”

“Well, I was down on the floor rubbing my ankle, and he came and sat down next to me and took a look at it. He touched me, which made me feel… Jesus, I dunno, like I wanted him and that moment to last forever. It was just us up on that field. Then he said something, like, ‘That's gonna hurt for a while, maybe this will help’… and he kissed me.”

“Wow, so that must have been exciting?”

“I was so nervous. I kinda kissed him back, and then we just sat there staring at each other. I think it was then that I wanted to be…. I dunno, like more than we were.”

“That makes sense.”

“Thanks for the water… So yeah, we were doing this fence alone, up on that field, and he would come up behind me. While I was hammering, he would hold my waist to support me cos of my ankle, and it just felt really nice, you know? Just me and him. And the awkwardness had gone, and I think I finally let go of some of the stress I was feeling.”

“Okay, So, Josh, I want to move us on a bit.”

“Uh, right, okay, sure.”

“So tell me when the violence began.”

“Uh, well, that was like, months later, I think. But, I dunno, it’s really horrible.”

“You know sometimes, Josh, we can't go over or under things; we have to go through them. So let’s do that together. And if it hurts, which it probably will, I will be here. But we’re going to rip that bandage off and let some sun on the wounds you have, okay?”

“Hmm, okay.”

“So, I want you to feel everything you went through and tell me all the details.”

“Fuck, this is so hard!”

“Here, take this box of tissues. And remember what I said. Take your time; if you need a minute, then just say. Go on, wipe those tears.”

“Thanks, sorry, I just… It’s painful.”

“You bet it is, and it will be for a while. Whatever happened could be with you for years or maybe your whole life, but those memories will fade, and right now, here, we’re going to help that process.”

“Pluuuuurr! Okay, so I think the first time things started to go wrong was when I was playing pool in the pub with Brad… Dunno why his name is relevant, but anyway, Brad is someone who has worked on the farm for about three years. He was on the livestock part of the business. I saw him sometimes when we were in shearing season for the sheep. I got on well with him. But, unfortunately, Kai hated him and said he was cocky and stuff. So anyway, when we got outside, he accused me of flirting with Brad, which I wasn't, and he stormed off with the Land Rover. I assumed to pick his car up.”

“So nothing violent happened that night… was it night?”

“Well, early evening. Yeah, nothing happened, but eventually, he outed me to my parents in the vilest way.”

“Tell me about that; you must have felt so many emotions?”

“It was hell. I threw up after my Dad called me into the Kitchen. My Mum was there with one of my brothers.”

“And what happened? How did they react?”

“Kai had knocked on the door and went to the kitchen with one of my brothers and said that he and I had been...Jesus!”

“It’s okay, just say it how you’re thinking it; you, Finally, won't make me blush, I can assure you.”

“He um, he said that we have been ‘fucking’ for eight months and that their youngest son was gay and that I was too chickenshit to tell them and that I was the slut of the village, trying it on with any boy my age.”

“And was that true?”

“What? No, it wasn't. I mean the bit about us… well, you know that was true, and the fact I was gay was true, but all the other stuff, no. It was all in his head.”

“So you’re describing what I think is an intense jealousy he had.”

“Yeah, exactly, and what he did to my parents was out of spite because he knew how badly I wanted to keep our relationship a secret. He’d been on at me for about four months to come out and get it over with, and I said no. I said he had to keep it a secret. So on some days, even when he was bad, I begged him.”

“So tell me about your parents.”

“Well, my Dad fired him. My parents were fine after a few days. My Mum did hug me but said she was disappointed in the way she found out.”

“That's understandable.”

“Yeah, and I was gutted too because it should have been me who said it. And I would have left out all Kai’s disgusting words. I just needed more time, dammit!”

“So this outing to your parents, this was the ending of your relationship?”

“This was right at the end, yeah. He was fired from his job, and we split up but briefly tried again, which didn't go well. That was around the time he fractured my wrist with a pool cue. He was drunk and came outside with his cue and pint to get some air. The air made him worse; it must have done; he put his pint down on the bench, right near the edge so he could get a cigarette out. All I did was move the pint, and he took his pool cue and whacked it on my wrist. I screamed out, and then he just went mental with it. He was hitting me on my back and shoulders. Two guys came out and wrestled him to the ground. I was on the bench in agony. The pain in my wrist was excruciating. Someone must have called my oldest brother Alex. I remember him pulling up in one of the Rovers and came to look at my wrist. I was unable to move it so was taken to hospital. The police arrested Kai.”

“Josh, I'm sorry you went through that,”

“Yeah, it was bad. A clean fracture… well, you can see anyway. But yeah, I had to go there and then I came home. And then…”

“And then?”

“Stupidly, I drove one-handed to the police station the next morning and met him. He was crying, saying how sorry he was, and foolishly I took him back. I was so in love, not with him, but who he was, does that make sense?”

“Of course, the more someone hurts us, the more we want to try and fix them. I think what you did is very common. The act might be different for other people, but the reason is always the same, Josh.”

“Phew, this is exhausting.”

“But how do you feel talking about it?”

“It’s hard, and the images are hard to bring back up. It’s harder still because I was so in love with this guy when it was the early days! So in love, I would lay awake dying to drive to his house to be with him. I hated being away from him. And he did that to me. He would play mind games, which at the start, I loved. I loved chasing him, and he knew how to play me.”

“And did you realise you were being played?”

“At the time, I didn't think so, and I didn’t mind anyway. But in the here and now, maybe I did know, but I was enjoying being with him so much it didn't matter.”

“Well, there is lots more to discuss, Josh. You have done well today. Yes, it will be exhausting and tough to relive those dark days, but as you do, you cleanse and clean out the worst. Trust me on this, I do this for a living, and my success rate is high using this method. But as I said. I am here, and we’ll go through your story together.”

“Thanks.”

“But our time today has run out. So, I have your next appointment with me Next Friday at 10 am.”

“Yeah, it's in my phone.”

“Well, it’s been a good session today, Josh. You should be proud of your early progress. I’ll see you next week.”

“Thanks, Claire.”

“Here, let me get that door. You have a safe journey home.”

“Thanks, see ya.”

Patient Notes:
Consulting Psychiatrist Claire Atkins: 2nd session with Josh Fisher. Patient is articulating periods of domestic violence, and prior relationship. Tense and Painful feelings being expressed. Patient perhaps still in love with abuser. To be explored more in the next session. Josh appears to exhibit raised levels of anxiety when discussing abuser. No indication of rape, however not discussed. Abuser arrested for possible ABH, however Josh intervened and Indicated no charges were pressed. Location of abuser unknown at this time. Next session to explore Josh’s understanding of relationship and will be pressing for how abuser (Kai) was able to manipulate Patient. Josh showing mild signs of PTSD and Intermediate Trauma.