Hayley curves her mouth into the briefest of smiles as she enters the room and sits down. She seems shy in her seat. She’s wearing jeans and a T-shirt with a dog on the front. Her wavy hair is loose around her shoulders. She looks young.
She talks freely and easily about things at home. How she went with her dad to watch her brother’s football tournament at the weekend. “Zak’s team came second,” she says proudly. She tells me they stopped for pizza on the way back to celebrate. She talks about how she’s been reading local news stories, watching the national news, and noticing how the world is full of these small, random events. “It’s everywhere,” she says, “a train accident. A faulty wall that falls on a passerby. That coach crash in the Alps—those schoolkids . . .” She trails off and looks out of the window. “All these random decisions people make every day of their lives. Sometimes things go well.” She shrugs. “Sometimes they don’t.”
As I listen to her speak, I notice her voice sounds different. Less harsh. Less accusatory. She turns back toward me. “I understand it wasn’t my fault. That someone having a stroke at the wheel of a car is beyond my control. Beyond anyone’s control. I just wish we weren’t arguing when it happened,” she says. “I wish we’d been having a laugh and a joke—that her last moments were full of fun.”
I nod. “And how would you feel now if that were the case?” I ask.
“Terrible. We’d all feel terrible,” and she looks down at her lap for a moment. “But you know, it would be a terrible thing out there,” and she twirls a hand in the air. “Something unconnected to me. The thing I can’t get away from is that she never would have gone to Wood Green that day if it wasn’t for me. She didn’t want to go. I made her. I wanted to get the dress. It was all about me.”
She pauses, then looks up at me. “Everything aches,” she says suddenly, pressing her hand to her chest. “It all hurts. I miss her,” she says simply, tears filling her eyes. “Poor Zak. He’s only nine.”
There’s kindness in her voice. She sounds less blaming. There is none of the bitter fury of the earlier sessions. What I hear most is a sense of resignation. A real feeling of sadness. And with this, I have the sense that she might be ready to begin the long process of grieving.
“You agreed to come for the six sessions, but I have been thinking that it would be good if you had some further work—some bereavement counseling—to just think about your mum. It can be helpful,” I say, “to have someone to talk to. Someone outside the family. Someone—just for you,” and I can see her eyes are misting over as I speak.
She blinks back and nods. “I’d like that,” she says slowly, clearly pleased at the suggestion. “That would be good. So we’ll just carry on with that after next week?”
There’s a beat. She has assumed it will be me.
I shake my head gently. “In terms of our work here, we have one more session left. This new work will be with someone else—”
As I am speaking, I can feel her body stiffen. Her face drains of color.
“It won’t be you?” she says, her brow drawn into a knot of confusion.
“No,” I say, “one of my colleagues. As I said in the beginning—our contract was for six sessions, specifically around the trauma. It’s the same for all the people we see. And then sometimes we refer on to other people.”
“Why?”
“It’s the way we work here at the unit,” I explain. My voice is calm, even, in spite of her change of mood.
I could tell her about the budget cuts. That we used to have more resources. That we’ve lost staff. That even a few years ago, there was more flexibility to carry on seeing the person you’ve started with, and for a longer time span. But I don’t say any of this because it’s not relevant. What’s relevant here is that Hayley Rappley needs therapy for her bereavement, not her trauma.
“So, are you saying you never see people here for more than six sessions?”
I hesitate for a moment and can feel the tension in the room.
“No,” I say carefully, “that’s not what I’m saying. Sometimes that’s enough, sometimes people need more. And I think you would benefit hugely from some more sessions, some bereavement work.”
“These sessions, they’ll be with someone else? In a completely different place?”
“Yes,” I say, “that’s right.”
She looks back at me incredulously.
“And how many sessions will that be for? Until I say I want to stop?” I can see there are tears forming at the corners of her eyes. She blinks them away. “Or will that be someone else’s decision?” she asks, twisting the silver charm bracelet on her wrist.
“That will be something to work out with the new therapist,” I say. I pause and fold my hands together in my lap. “I think we have done some very important work here together, Hayley. You have been courageous in coming here and talking about what has been a most incredibly traumatic and stressful—”
“You’re lying,” she cuts in. “This ‘we just offer six sessions’ crap. It’s simply not true. A while ago, you told another patient he could have ‘as many sessions as he needs.’ Why can’t I?” Her eyes are ablaze.
I feel a flush spread quickly up my neck.
“I’m not sure I understand—”
“That bloke who comes after me. Dan. How come you told Dan he could have as many as he needed? Did he score more points than me? Is that how it gets worked out? Three of his family died and only one of mine . . . is that how it goes? Points for people? Or does arson trump a car crash?”
I keep my voice even and calm. “I’m not at liberty to discuss other patients’ treatment plans,” I say. “We make decisions on a case-by-case basis. Our initial offering is six sessions. Some people need more. Some less. That’s it.”
As I’m speaking, repeating the same instructions, my thoughts are scattered, trying to get a handle on what she’s talking about. Dan? Losing three members of his family? Arson? Most of all, I’m trying to regain some control. Her rage is quietly simmering, heating up to a boiling point. I know I need to move beyond this focus on sessions, to an understanding of what all this really means for Hayley. The pain and distress of endings, in the midst of so much loss. The loss of her mother. The loss of me. But as I go to speak, she bats away my words.
“So that’s what you do here, is it? Make us talk about the worst thing that’s ever happened to us, then say fuck off. Go and talk to someone else.”
I try to speak, but she’s gathering momentum. Her body upright in her chair. Her hands clasped, white knuckled in her lap. Her voice has hardened, her face has twisted into that old defiant stare.
“Bring your photos, Hayley. It’s not your fault, Hayley,” she says, mocking my voice, “I really want to be there for you, Hayley.”
Small bubbles of spittle are gathering in the corner of her mouth.
“How do you live with yourself?” she demands. “People like you make me sick. All smug and above us all with your perfect life. Your poncey consulting room—” and as she speaks, saliva sprays over the case file in front of us.
“Hayley—”
“Your perfect leafy life,” she says again, spitting out the words. “Bet you live in one of these big fuck-off houses around here. People like you make me sick. Literally. In fact, I want to puke. Right now,” and she mimes poking her fingers in her throat and retching. “I want to puke my guts up over your carpet.” She takes a breath. “Look at all this,” and she jabs a finger around the room. “These silly chairs. The box of tissues at the ready. That stupid picture,” and she turns toward my desk. “I mean, what is that?” she says. “Looks like it’s been drawn by a five-year-old.” I follow her gaze. It’s one of the sketches that Carolyn had drawn at the cabin in Devon.
“Cherry-picking,” she continues. “That’s what you’re doing. Choosing who you want to be with—and you’ve decided not to choose me. Are you worried that something bad might happen to you? Are you scared of me?” she says, and she wiggles her fingers in the air, “Woo-hoo,” like a ghost. “Is that why you’re palming me off to someone else?” she continues, without taking a breath.
“Hayley,” I say, quietly, “I can see you are angry and—”
She cuts in again. With her clasped fists and a mean face, she sits rigid in front of me.
“I’m glad I won’t be seeing you,” she snaps. “You’re evil. It’s you who has the problem. My mother’s dead. But at least she was kind. At least she wasn’t selfish, like you. Thank God I had a mother who was kind. Thank God I didn’t have you.”
Thank God I didn’t have you.
The priority is to bear her fury. I know how to do this. The four walls of my consulting room have been splattered with rage over the years. Most of the time it’s been raw, but not such a personal attack. The important thing is to contain it. Then try to understand it together. As she continues to berate me—a relentless assault on my room, my clothes, my very existence—I realize there’s no space to intervene. For a few moments, I simply watch her mouth move. Her arms and hands flicking back and forth. Her jaw set. When she takes a breath, I say her name.
“Hayley,” I say calmly, “when you are shouting, it’s impossible for us to talk. And it’s hard for me to listen.”
“You’re useless,” she snaps, “useless, stupid, and unhelpful. In fact, you make me feel worse. I feel worse coming here. Is that what you want?” she says, looking at me.
I let her words go over my head. I know she feels abandoned, alone, and rejected. And I know that all her rage is being funneled into this small moment with me. All I can see is her taut angry face leering in at me. All I can hear is her hatred.
“Hayley,” I try again.
Perhaps it’s the calmness in my voice that ignites her further, because she lurches forward. Her eyes are a bright, flared blue, and I’m close enough to smell the cigarette smoke on her breath.
“I hope to God you don’t have kids,” she says, pushing her face close to mine. “What kind of a useless cunt of a mother would you be?”
These are the words that don’t drift over my head. Instead they land hard, like sharp slaps across my cheeks.
It’s at this point she stands up. I’m aware of a strong desire to get her to stay, and I stand up, too. It’s all I can think about. Finding some way to get her to sit down, and a way to contain her anger before she leaves.
She hisses with venom, “If I was a child of yours, I’d get as far away from you as possible.”
It’s like a body blow.
As she turns away, I move toward her. I reach my hands out. Palms down, a sort of fanning motion. A soothing gesture. A way of trying to calm things down. And as she moves away, the hands that are fanning and placatory reach out. I want to try to get her to sit back down with me.
“As far away as possible,” she repeats very slowly.
I hear her words thundering in my ears. I see my hand reach for her. My fingers touching her skinny white arm.
She startles.
“What the fuck are you doing? Don’t touch me,” she shrieks, spit landing on my cheek. The exact sequence of events is a little hazy. I remember how the emotion on her face seems to course right through me. It’s like a sudden and unexpected flaring of my own blind rage. Then, seconds later, we’re both staring down at the tangle of our arms. She says something. I let go, quickly. She jerks her arm away, shock on her face.
“Bitch,” she says, leaning into my face, “you’re a fucking disgrace,” then she grabs her bag, slams the door behind her, and is gone.
I slump down into the chair. My hands are trembling. Her rage. My rage. I wash my face at the sink and open the window. I gulp in fresh air. I feel jittery and panicky, but I make myself sit at my desk and take some slow, deep breaths and then I realize I have twenty minutes until Dan is due to come.
It’s four o’clock. No phone call. At ten past four, I ring through to Paula. There’s no sign of Dan. It’s a relief. I sit with my hands clasped together almost willing him not to come.
At 4:45, it’s clear he’s not coming, and I start to gather up my things to go home. The phone rings.
“It’s Dr. Jane Davies. Dan Griffin’s GP?”
She tells me she had a call from an A & E department to say Dan was waiting for treatment, “but then he up and left. He’d given the doctor your name.”
“What happened?”
“Not sure,” she says. “Wasn’t local,” and I can hear the sound of the shuffling of papers.
“Bristol,” she says.
“When was this?”
“Couple of hours ago. That’s all I’ve got. Seems it was a physical injury.”
I walk home quickly. Already the episode with Hayley has taken on a surreal quality. It plays and replays in a loop in my head, spooling back and forth. I feel ashamed by my feelings of anger. Ashamed that I let her words get to me, and I realize my mistake. My focus was on getting her to stay, but it was wrong. She was too angry. I should have simply let her go. Sometimes the most containing thing to do is to let someone leave. Let them calm down. My thoughts flit back and forth between Hayley and Dan. I feel jumpy. When I shift away from the image of Hayley and the enraged look on her face, my thoughts turn to Dan. To his trip to Bristol. And then my feelings of panic are free floating, exploding like fireworks, way above my head.