twenty minutes.”
“I’m concentrating.”
“On what?” He is incredulous; he is noticing. He is supposed to be crazy and I am supposed to be able to get away with my mind wandering sometimes.
“If you’re not going to work on your file or talk about treatment goals, then please, read your papers and let me do my work in peace.” Calmly, softly, defeated.
“I’ve never seen you in peace.”
What are you, my therapist? You’ll never see me in peace, Richard; stop looking.
We resume ignoring each other, and I sit quietly wondering what I’m doing with my life. Richard is shifting and wiggling uncomfortably in his chair. He reaches his crooked left arm out in front of him, as if trying to straighten it out properly. He huffs, and he’s distracting me.
“Something bothering you, Richard?”
“Yeah, what’s going on with that kid from the group you were running the other day?”
“I’m not sure what’s going on with Devon. Why do you ask?”
“He always does this contortionist act when he’s in group. I find it very distracting. And he always wears a jacket even though it’s practically boiling in here. He leaves confetti wherever he goes. He’s making me uncomfortable. How am I supposed to get better in an environment like this?” It seems it’s his size that’s making him uncomfortable, but I’d rather hear him complain than continue to avoid speaking altogether.
“Okay, what exactly is it that you would like me to do here?”
“I don’t know—you’re the shrink, not me.” Richard waves his hands at me dismissively.
“This seems like more of an administrative problem. Or even a janitorial issue. I can ask that he refrain from contorting in groups. But, you have to remember, this is an institution, and we need to live with the foibles and behaviors of others.”
“Within reason.”
“Yes, Richard, within reason, but a little shadow boxing never hurt anyone. Maybe what we need to talk about is your ability to tolerate frustration.”
“I tolerate it fine. I’m just not interested in being in groups with a man in a leather jacket who leaves confetti and makes himself into a pretzel.”
“Noted. I will follow up, and should I discover anything, I will let you know. Fair?”
He raises his eyebrows at me, unconvinced, and returns his gaze to his newspaper.
“And he stinks, too. Just sayin’.” One last jab and now he’s finished.
Jenni is nervously twisting the hem of her shirt in my patient chair. She has a long history of being abused, and associates anyone in a position of authority with fear and danger. She hasn’t been at Typhlos for very long, and she is still healing physically from the abuse she experienced before she got here.
“How are you getting along with your roommate?” I usually try to start sessions with something light and administrative so patients can get comfortable before we address anything serious.
“Tashawndra? She’s good. We make good roommates, I think. She’s clean and she keeps her stuff on her side, and I try to keep my stuff on my side, too. She’s been here for so long now, she knows all about everything, so she’s helping me get used to stuff. She lets me use her lotion.”
“I’m glad to hear that. Tashawndra is very nice. I’m glad you are comfortable in your living space. How have you been feeling since detox?” Jenni had to go to detox before being admitted to Typhlos because she was addicted to heroin and going through withdrawal.
“Better, but it still hurts. I’d never been so sick before. The smack just takes the life out of you, and when you can’t get any, it takes the life out even more. I thought I would never get better. It’s scary, when you get heroin sick. It’s very scary.” She holds her stomach and rocks back and forth as she says this.
“It is, and you’re very brave for committing to treatment so you’ll never have to have those withdrawal symptoms again. Now that your physical addiction is under control, we are going to be spending more time focusing on the psychological and the emotional components of the addiction. I’ve changed around your group schedule a little bit to include some recovery groups, and some dual-diagnosis groups, as well. You and I are going to spend time in our sessions talking about your addiction, too. You think you’re ready for that?”
“What’s duo diagnosis?” she asks, scraping at the edges of a scab on her head.
“Dual diagnosis. That’s when you have both an addiction to drugs or alcohol and a diagnosed disorder or mental illness. When you’re struggling with both those things at the same time, you’ve got a unique set of circumstances, and we want to make sure that you can get all the support you need.”
“Okay, that sounds good. What are we going to talk about in our sessions with you and me?” Jenni rolls up the sleeves she’d been tugging on and I can see the track marks still dotting her arms, from the crook of her elbow all the way down to between her fingers.
“Well, I wanted to start today by asking you to tell me a little bit about your history of drug use. When did you start, how did you use, those kinds of things. You ready for that?”
“Yeah, I’m ready.” She takes a deep breath and pulls what’s left of her hair into a stringy knot on top of her head. “I started doing drugs when I was really young. I was still in school, and I dropped out in tenth grade, so I must have been twelve or eleven or something like that.
“My mom was always out of the house; she worked two jobs and when she was finished working, she would go to the bars, so my sister and I were alone at home a lot. My sister, Jackie, is four years older than me. She had her friends and boyfriends over to the house all the time, and they would sit in her room and smoke weed and cigarettes and drink alcohol and listen to music. Her room was the garage.
“Sometimes I would come to the garage when she was with her friends, and I would just sit there and watch them, but I wouldn’t smoke or anything. She didn’t mind. Some of her friends were nice to me. There was one boy who came over who liked me, I think. His name was Ronnie.
“One time, he came over and sat next to me while they were all hanging out. I was in the corner next to the garbage cans, and he came over and asked how old I was, and if I had ever smoked weed before. I said yes, even though I hadn’t because I didn’t want to look like some lame kid.”
I silently smile at this notion, remembering being a kid among the older crowd, claiming to have personally experienced adventures I had seen on after-school specials.
“So, he handed me the joint and he told me to prove it. I took a hit that was way too big because I thought it was like smoking cigarettes, and I had smoked a cigarette before. I started coughing really hard, and I knew I was going to get sick, so I ran out into the driveway and I barfed all over the place. Ronnie came out after me and was rubbing my back. He told me I did good, and I could come and sit with them.” She looks at me and smiles a sad, nostalgic smile. “I don’t know why but I remember that night really well. After that, it all sort of gets hazy and blends together. I started sitting with them whenever they came over, and I started smoking weed every day. I was scared at first because I know you’re not supposed to do drugs, but they all told me that weed was a plant from the earth and that made it natural and only the chemical drugs were bad for me. They made it all sound like everything we were doing was okay. It was normal. Ronnie was always sitting next to me and rubbing my legs and my back.
“Sometimes he made me uncomfortable because he was so much older than me, but I liked the attention, too. I knew Jackie would never let anything bad