‘Can you remember what was going on in your life when the anxiety first started?’ Luke asked after he’d completed the admin part of the session.

As he waited for her to answer he discretely looked her over, searching for clues to her life. We all wear a disguise, or in this case a hat, but often that attempt at camouflage gives away more than we intend.

Luke had been around a fair few gyms in his time and it looked like this young woman was no stranger to them either. She was all in black: leggings, T-shirt, gilet and baseball cap, her black hair in a ponytail, pulled through the hole in the back.

‘My last boyfriend left me…’ She coughed. ‘For another man.’ She laughed and shook her head. ‘When it’s another woman and you still want him, there’s a chance you can compete. Or you kid yourself you can. Lose a few pounds, get a new haircut, you know, all those surface, shallow things? But it’s never about you, not really. That stuff is just grasping at straws. We know that.’ She said the word ‘we’ as if speaking for her female peers. Then she stopped – as if she was afraid she was rambling.

Luke motioned to her to continue.

‘We can’t stop ourselves from making that effort, eh? So much of what we read and see is about projecting the perfect image. How to get yourself a man, and once you’ve got him, how to be a good wife. All that shite.’ She tossed her head as if mimicking a perfect-ten model in an ad campaign, and Luke found himself warming to her self-deprecation, to the glimmer of attitude that showed she was a fighter.

‘But when your competition’s a man?’ Jenna continued. ‘You can’t suddenly grow the right body part, can you?’ She paused as she gathered her thoughts. ‘Is that offer of a drink still on?’ she asked.

Luke got to his feet and stepped across to the drinks corner, asking her what she wanted as he did so.

‘Water will do, thanks.’

He retrieved a drink for her and held it out. She took it with a small smile of thanks.

She sipped.

Luke moved back round to his chair, and as he sat it occurred to him that this might not have been the first time Jenna had been let down by love. And while she appeared to be upset about this particular situation, he couldn’t help but feel there was something else going on. He’d only been working as a therapist for eighteen months, but he’d quickly learned that more often than not the problem the client initially presented with wasn’t really the issue they needed help with.

But he couldn’t rush it or he might lose her. He’d have to trust that by providing a non-judgemental ear she’d come to trust him and really open up.

‘And there’s my mum,’ Jenna said after a long silence.

‘Yeah?’

‘We have a woman who comes in, but I’m her main carer. She was such a vibrant woman. Full of vim. The life of the party.’ She paused, her expression lapsing into candour. ‘Actually, she was a judgemental pain in my arse. All that money she spent on my education, and I end up working part-time in a bookshop. What a let-down. But she was also very kind. Very caring.’ She stopped talking as a wobble appeared on her lower lip. Her head fell and her shoulders shook. ‘She was there for me when I really needed her. And now it’s my turn to look after her, and it’s just so hard.’

Luke retrieved a box of tissues from the shelf behind him and pushed it across the table top. Wordlessly, Jenna helped herself to one and dabbed at her eyes.

‘God, you must think I’m a horrible bitch. My mother’s had a bleed on the brain, and all I can do is complain about how she’s making my life difficult.’

‘You can still be a caring person while struggling with your obligations,’ Luke replied.

‘Yeah, well, that’s a nice thing to say, but it doesn’t make me feel any less of a cow.’

‘When you started talking about your mother, you talked about her in the past tense.’

‘I did?’ Her eyes were large with surprise.

Luke nodded.

Jenna looked away, and bit her lower lip, as if considering Luke’s statement.

‘There’s just this old version of her and the new, post-injury version.’ Jenna tugged at her left earlobe. ‘She’s very much alive.’ She looked into Luke’s eyes. ‘But, God she’s hard work. Used to be she’d rather die than be heard swearing. Now she swears like a navvy.’

Luke realised that allowing Jenna to remain stuck on the track of her perceived failings wasn’t going to help her. So he thought back to her first answer – when she’d responded to his question about when her anxiety started. She’d paused before answering, the movement of her eyes suggesting that shadows were chasing her thoughts. Then she’d arranged her features into a non-committal expression.

There was more here. He had to decide whether to press for it now or to let it unfold over the next few weeks of her therapy.

Instinct had him bin the cautious approach and press on.

‘Can you tell me the very first time you felt this level of anxiety?’ he asked.

She looked up at him, startled, as if worried he’d read her mind.

Eventually she broke her silence.

‘It happened a long time ago.’ Her eyes were heavy with shame and self-recrimination. ‘Someone died.’