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Authors: Jenny Blackhurst

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BOOK: Before I Let You In
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Part One

1

Now

Where would you like to start?

Hmm.

Is something funny?

That’s what I always used to say to my patients. It gives them a sense of control over the session. Except we both know I’m not in control here, don’t we?

Is it important for you to believe that?

I know what you’re trying to do. You’re trying to put me at ease so I open up and confess my darkest fears and then you can tell them I’m crazy. I feel crazy. You can write that down.

Why don’t you start at the beginning, Karen? When you first met Jessica Hamilton.

That’s not the beginning. It’s where all
this
started, I suppose, but it’s not really the beginning. It started way before all that, before I met Bea and Eleanor, Michael. It started with what happened when I was four years old.

Would you like to talk about that? What happened to you when you were a child?

No. I don’t want to talk about that, and they don’t want to hear about it. They want to know about how she died.

Go on.

You can’t fix me.

Pardon?

Those were some of the first words Jessica Hamilton ever said to me, the words I still hear on a loop in my mind. I remember thinking she was wrong: I fixed people all the time, it was my job. What I didn’t realise then was that she never wanted to be fixed in the first place; that was never her intention. I didn’t know it yet, but she was there to fix me.

2

Karen

25
th
October

A standard session at the Cecil Baxter Institute was three thousand seconds long. Some patients spent the entire time in silence, a fact that often confused most of the junior psychiatrists – why spend £150 to sit mute for fifty minutes? Not Dr Karen Browning, though, she understood. She understood it in the same way as she understood professional men who visited prostitutes; it wasn’t about the money or the silence, it was about the control.

The soft click of heels on wooden flooring alerted Karen to the presence of her secretary, Molly, just outside her office door.
Our
secretary, she reminded herself – Molly worked for all six of the junior psychiatrists on the second floor; only the directors on the top floor had personal assistants. There was a light tap on the door. Karen ran some gloss over her lips, slipped the tube back into the top drawer and waited for Molly to come in. All the offices were set like a stage and Karen was particularly proud of hers, a symbol of everything she had achieved.

And don’t they say pride comes before a fall.

She’d spent an hour before work that morning reading over her case notes for this session, making sure she knew as much about Jessica Hamilton as possible before she even walked through the door. Miss Hamilton was her only new client that week – all the others were ongoing cases – and she had little information about her, which irritated her beyond words. Whoever had done the initial referral notes had been nowhere near as thorough as she herself would have been. The scrawling signature on them could have been any of the others, and she made a mental note to bring it up as non-accusatorily as possible at the next team briefing.

Age: 23

Medical history: no diagnosed history of depression or generalised anxiety disorder. Family background unknown. No medication at present. Self-referral.
Reason for visit: tension headaches and irrational cognitive activity.

As she always did from the initial notes, Karen couldn’t help putting together a picture of the woman about to walk through the door. Probably well off, judging from the amount of money she was paying for fifty minutes of Karen’s time. Karen did a certain amount of pro bono work but Jessica Hamilton was self-referred and self-funded. She imagined that her friends called her Jess and her family called her Jessica.

There was a second knock, which was unusual for Molly. If Karen’s ‘In Session’ sign wasn’t on the door, she usually entered straight away. Karen got up, smoothing down her suit jacket, and opened the door to find not the smiling face of her assistant on the other side but a slight, timid-looking girl with a pale face, blossoms of red spreading out over her cheeks.

Karen hoped her own face had not revealed her surprise, doubted it had. Eight years of psychiatry had taught her reactions to hover below the surface, never breaking through to the onlooker. The ultimate poker player.

The young, attractive, rich-girl image the name Jessica Hamilton had conjured up couldn’t have been further from the reality standing opposite her now. Karen put out a hand for her to shake, registering quickly the chipped, bitten nails and the grip as weak as the smile she herself offered.

‘Jessica?’ She cast her eyes around the reception area, but Molly was nowhere to be seen. ‘My apologies. Our receptionist would usually be here to greet you. Come in.’ She ushered the woman inside, mentally cursing Molly and her out-of-character unprofessionalism.

‘Please, take a seat.’

Either Jessica Hamilton didn’t hear her or she ignored Karen’s request. Instead she walked slowly away from the sofa and around to the bookcases on the far wall of the office. She seemed to be drinking in every detail of the mahogany shelves, the leather-bound books chosen for their aesthetics rather than their appropriateness to the setting. For the first time in a long time, Karen felt as though her space was being scrutinised and found wanting.

‘Would you like to sit down so we can start?’

She thought for a second that Jessica was going to ignore her again, but after a moment she took a seat opposite and sat silently, waiting for Karen to lead the session.

Jessica wasn’t unattractive; certainly if her face weren’t so ruddied from the cold outside – or perhaps from nerves – she could pass for pretty. Her hair fell in natural kinks down to her shoulders, and was a blonde so dark it looked devoid of colour entirely, a grey mass that had resigned itself to sit on her head without attracting attention. Her whole look was designed to elicit the least amount of interest, it seemed.

‘My name is Dr Karen Browning. I don’t know if you’ve seen other psychiatrists, but here we like our clients to be comfortable. So I’d like you to call me Karen, though if you don’t want to, that’s fine. Similarly I’d like to call you Jessica, but if you’d prefer Miss, Mrs or Ms Hamilton, I’m fine with that too.’

She threw Jessica a wide smile, hoping to put her at ease. She sympathised with all of her patients; this had to be a daunting experience for them the first time around, sharing their fears and perceived shortcomings with someone who had no reason to care other than the money they were paying them. That was one of the reasons why she tried to look as approachable as possible: no designer labels on her suits like some of the other psychiatrists, no severe bun on the top of her head and no diamonds the size of the Blarney Stone – not that the last one was her choice.

Jessica nodded at the standard spiel as though she’d heard something profound, but gave no indication of what she’d like to be called.

‘Can I get you a drink?’

She shook her head almost imperceptibly. Karen got up, poured herself a glass of water from the cooler in the corner and sat back on the chair facing Jessica. It was purposely an inch lower than the sofa, giving her patients the sense of control many didn’t feel in the outside world.

‘Okay. I notice that the reason for your visit is tension headaches. Would you like to tell me about them?’

Jessica’s eyes locked on to Karen’s, something she wasn’t used to, at least in initial sessions. She’d kept her office sparsely decorated so that people didn’t have anything to focus on or be distracted by – the sofa, her desk and two small bookcases; the one photograph, no trinkets and a large painting of a jetty over a mass of relaxing turquoise water – yet they still found somewhere to look other than at her. Not Jessica Hamilton, though.

‘You can’t fix me.’

There was a vicious challenging tone to her voice that was so at odds with her demeanour that it hit Karen harder than the words she’d used. But she had been shocked in her job thousands of times and she’d got hellish good at concealing her reactions; her face remained an impassive mask without a flinch.

‘Is that what you think is going to happen here, Jessica? That I’m going to try and fix you?’

‘Isn’t that what you do, Dr Browning? Fix the poor little mental cases, make their lives as perfect as yours?’

She didn’t break eye contact. Her eyes were blue, but too dark to be striking, with flecks of brown that dulled the effect further. Unremarkable – like the rest of her appeared to be.

‘No, Jessica, that’s not what we do. I’m just here to listen to what you have to say and try and help you come to terms with what’s going on.’

‘Listen and help, doesn’t sound very proactive to me. Why is it that people pay you so much money just to act as a brick wall? What’s so special about you?’

It wasn’t unusual for patients to be angry or confrontational, Karen told herself, trying not to let the anger that resonated from this girl rattle her on a personal level. Sometimes people were furious at life itself when they walked into their session; sometimes the vitriol was directed at their psychiatrist
.
Jessica Hamilton was no different to anyone else. And yet that was how she felt: different.

‘It’s often easier to share our problems with someone who has no personal investment in our lives; it makes people feel less judged and gives them a safe place to air their issues. I’m not here to judge you, Jessica, nor am I here to try and improve you. We don’t see people as being broken and it’s not our job to fix them. If you’re happy to talk to me, I’d like to try and understand what’s going on in your life. Is there somewhere you’d be comfortable starting?’

She saw Jessica processing her words and almost felt her disappointment that Karen wasn’t going to rise to her attack. She couldn’t help but wonder what the girl thought therapy was going to achieve, or why she’d come in the first place if she felt so strongly about the profession.

‘I’m having sex with a married man.’

If her first words were meant to challenge, now she meant to shock. Karen was already writing up her notes in her mind.
Patient is looking to shock as a way of eliciting judgement. Possibly looking to diminish feelings of guilt.
She’d have to look a lot further than she had so far; Karen had heard far worse admissions inside these walls.

‘Is that all it is, just sex? Other people might have chosen the words “sleeping with” or “having an affair”.’

Jessica’s face was blank, unreadable. ‘I’m not in love with him. There’s no point. I’m not some stupid girl who thinks he’s going to leave his wife to be with me.’

Patient is using denial as a defence mechanism against admitting her feelings. Signs of a different problem?

‘Would you like to start at the beginning and talk about how the two of you met?’

It was a difficult profession, being a psychiatrist, but Karen had never considered a different one, and in all the years she’d been practising she had never regretted her choice. It had come naturally to her to treat the client like a wounded bird: no sudden movements, keep a neutral voice, listen, lead but don’t dictate. With some people it felt like one wrong word and they would try to escape, seeing you as a captor rather than a saviour. At first you could be the enemy – especially if therapy wasn’t their choice.

Jessica ignored the question and, placing her elbows on her thighs, leaned in to decrease the distance between them.

‘What makes a person good or evil, do you think?’ she asked, her voice so low that Karen had to inch forward on her seat to hear her. ‘Their thoughts? Or is it just when you actually do the things you’re thinking of? A lack of morals? Empathy?’

‘Are you concerned about thoughts you’ve been having?’

Jessica smirked slightly, her unremarkable face becoming unattractive with the expression. ‘Not exactly. You haven’t answered me.’

‘It’s a complicated question, Jessica, and not one I’m sure I’m qualified to answer. But if you’re worried about your thoughts, I’d say that the fact that you are here trying to get help with them shows that they are a product of your situation rather than an inbuilt cognitive dysfunction.’

‘Do you always sound like a textbook?’

‘I’m sorry—’

‘And do you always apologise so much?’

‘I—’

‘Okay, what does Freud say about hurting people by accident?’

A tiny thread of tension twisted a knot inside Karen’s chest. It wasn’t often she lost control of a session, but it definitely felt as though this one was becoming counterproductive. ‘Have you hurt someone by accident?’

‘Who says I was talking about me?’

The dread inside Karen caused her hand to tremble almost imperceptibly, and she wondered if Jessica had noticed her discomfort. She couldn’t have known the reaction she’d get from that question, and yet the ghost of a smile that settled on her lips before her face reverted to impassive suggested she had.

‘An accident is just that, Jessica. Accidental. It’s often the way we deal with the fallout of our actions that defines our character.’

‘My father always had this funny way of looking at accidents. Not the tripping-over type, but the really bad things that we allow to happen in life because we’ve taken our eye off the ball. He’d say that nothing in this life was accidental, that accidents don’t just happen. He said they were ways of our subconscious allowing us to act out our true feelings under the guise of being unintentional. Do you think that makes sense, Dr Browning?’

The tension tethered them together like a rope, her innocent question thick with unspoken meaning. Karen said nothing.

‘I think you’d like my father.’

BOOK: Before I Let You In
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