I slowly pull my hand from his and spin round to face the room. So conscious of each footstep he takes behind me. ‘Come on through.’ My shoulders tense ready for action. I glance at a perplexed-looking Ruan and try to transmit to him: I don’t even know where to begin but please don’t leave the clinic, please stay close; just for the next hour.
We step into my room, and I shut the solid wood door behind us. There’s no glass in this door, to protect people’s privacy. But with no way for Ruan to observe and without the reassuring alarm buttons I had in the hospital, I feel decidedly vulnerable. I watch him glance around the room. Most people avoid averting their eyes from me, their feet or the floor. Next, he regards my desk and I realise he’s looking at the brown A4 envelope containing the newspaper articles. Why is he looking at it? I’d meant to hide it, not that he appreciates what it contains. Or does he? I notice a flicker of acknowledgment in his eyes before he returns his eyes to me. Did I imagine it?
I direct my hand towards his chair. ‘Please, take a seat, William.’ We both sit. For the first time, I realise it’s me who sits awkward and with apprehension of what’s to come, rather than my client. He slouches back into the depth of the chair, spreading out his legs as far as he can without touching mine, as he alternately flexes and taps his feet. Self-certainty emanates from him but it’s not arrogance. I feel a little bad – he’s come to me for help, and so far he hasn’t received the best of my attention. He’s been referred through a professional body, but something is not right.
I smile at him uneasily as I reach behind to gather the paperwork from my desk. I feel his eyes wash over me, studying me. Perturbed, I shift in my chair, thrown completely as to how to begin our appointment. Why am I allowing him to make me behave in this manner? People can only affect us if we allow them to, runs through my mind. Now look at me. But he’s good, he has discreetly managed to shift the balance of therapist and client, and a bad therapist at that, one who wishes to have control. I need to break the cycle.
I feel my throat scratch with dryness. ‘Can I fetch you a glass of water? Or a coffee perhaps, before we make a start?’ Desperately hoping he’ll say yes, so I can leave the room to have a word with myself. Re-establish some self-control, and cease behaving like such an amateur.
But he smiles at me whilst pulling a bottle from his jacket pocket. ‘It’s fine, thanks. I always carry water with me.’
‘Always prepared, I see; must be the soldier in you.’ If you are one, that is. ‘Would you mind, though? I’ve such a dry throat today; I’ll pop for some water, if that’s okay with you?’
‘Sure, of course, please, carry on.’ He watches as I stand. Should I move the envelope before I leave the room? Why am I allowing him to get to me so much? I decide it would look ridiculous; I’ve already wasted enough time. Even so, I leave the door ajar behind me, and scuttle across to the water machine, listening for any possible movement. I glance over to the front-desk area where Bea has now joined Ruan; I half smile, half grimace at them. Drumming my head against my hands, I take a gulp of cold water and count to ten. Get a grip, Eve. I head back for my room. Ruan calls after me.
‘Eve, just to let you know – your next appointment has just called in. Cancelled. Said she can’t make it, her partner has insisted she join him instead, something about needing to visit his son. Said you’d understand?’
I don’t, but it will just be something else I’ve forgotten about. ‘Fine,’ I tell Ruan. I re-enter my room, leaving my anxious state outside the door, Bea and Ruan undoubtedly confirming to each other that my behaviour is becoming more insane by the hour.
‘Sorry about that. Right, so, William, I’ve received this referral—’ I flash the piece of paper ‘—and you are ex-forces?’
‘Yes, I am.’
He’s not giving anything away. ‘Okay. Let’s start with the here and now, then work our way back.’
‘Okay.’ He settles further into his chair.
‘Okay, this referral states PTSD. What is your understanding of this, or, more importantly, can you tell me what your symptoms are? How they affect you on a day-to-day basis. I mean in today’s terms.’
‘How long do you have?’ He smiles. Almost teasing.
I return his smile. ‘As long as you need.’ I note, despite mentioning his diagnosed condition, he’s so together and calm. ‘It’s perhaps easier to start with – how you believe your life has changed because of any symptoms. So, if we were to look at yesterday, what did you do or not do, feel or not feel, in comparison to perhaps twelve months ago, two years ago or, if you’ve been suffering for some time, ten years ago. Go back as far as you need to.’
He spends time relaying debilitating symptoms: sleepless nights, panic attacks without warning and the most lucid flashbacks and anxious tendencies – these he keeps well hidden, except for the obvious. A constant wired feeling, always feeling on the edge. Clearly, this isn’t going to be a one-off appointment. Despite empathising with this man who sits in front of me, who has been through experiences which would force you to turn away from a TV screen, I still feel quite uneasy about him. Something doesn’t add up, but I can’t put my finger on it. I admonish myself, but it wouldn’t be too difficult to research and relay typical symptoms of PTSD and trauma-related disturbances, so to manipulate a referral. He continues, composed and precise, conferring with a smooth, educated, but not a la-di-da voice. After a while, I can’t dispute this man has suffered trauma in his life. He is genuine; I’m now as sure of this as I can be. It’s horrifying learning what these servicemen go through; how can they possibly be expected to readapt, without help, into everyday society? But there is more he’s not telling me. Something buried underneath.
‘You’re from Warwickshire?’ Merely articulating the W word sends shivers down my spine.
He holds up a finger. ‘Was,’ he instantly corrects me, as if it had the same effect on him. ‘Sorry. I mean, I was from there, yes. I no longer have any connections to the area.’ This is the first time I notice a flicker of guardedness in his attitude. I watch him as he shifts position in his seat, back to the same position again. Eyes locked on mine.
‘Okay, so now you’re living in Cornwall?’
He shrugs. ‘Kind of, yes, at the moment I am anyway.’ Have I touched on something here? His confident eyes are reflecting a little caginess.
He clearly feels uncomfortable with this line of discussion, but it’s not exactly relevant to his treatment. I decide to leave it, for the moment. Maybe the referral team can throw some more light on the matter. Though it’s odd something so everyday can evoke this reaction. We continue to discuss his symptoms, how they impact on his health and quality of life, then I talk through the treatment options for trauma, the neurobiology of how it manifests and subsists. At all times, William is polite, appearing to take an interest. We talk about the brain and its many disobliging behaviours, physical and psychological; he listens with interest. Perhaps he is here with genuine needs.
‘Interesting,’ he utters.
‘The thing is, I believe, if people have a better understanding of the science, why they’re feeling, reacting the way they are, it allows it to feel more correctable.’ He nods. ‘Your brain is a most powerful computer; your ultimate control centre but also a creature of habit. Like all new learning, we can also learn bad things, even build new neural pathways to support the bad things. Yours possibly manifest from trauma of some form. Not allowing you to move on, always alert. Always hyper-vigilant. Sitting dormant waiting to prod you into action.’
‘Can you change these pathways? Or am I stuck with them for good? Knackered?’ he asks.
I nod. ‘Yes, definitely you can. Your brain’s like a malleable chunk of plastic; it can be moulded and adapted to new learning; new responding and new thinking.’
‘And the old bits? The bad pathways?’