Alexis had come to me sometime in mid-October. The generally feeling was this wasn't a serious case, that was why she was seeing me after all, but her grades had fallen seriously over the past year and her RA suspected depression. At the time I'd thumbed through her file. Age 20, sophomore. Originally from Seattle, came to Boulder on a full ride academic scholarship. Played one year of tennis for CU. Nothing unusual in her medical history.
The only thing that caught my eye as being out of the normal was a hand-written scrawl at the bottom of the page: "4/14 – Requested prescription for Claritin and was informed that Doctor Aldridge would see her. She was unaware that filling a new prescription required a check up. Informed her that it was the Student Medical Center's policy to require a checkup on file before any issuance of prescriptions. Patient nodded and sat back down. I was distracted by a phone call but later when I looked up, I saw she had left."
Shy around doctors, I noted in my pad; very understandable and it would help dictate how I would handle our session. The general idea is to be as welcoming and as non-judgmental as possible, but with certain clients it was best to work the session more as an amiable conversation between equals rather than the classic psychologist-patient relationship. Y'know, the old cliche with the wizened old Freudian psychoanalyst sitting rigid and cross-legged in his stiff-backed chair while the patient expounds on his ills; well, I didn't run my practice that way. I didn't even like the word patient; to me they're clients, and they're not "sick" as the term patient implies, just individuals needing someone to talk to, and if all went well, by the end they were just friends, not even clients anymore.
True, I was only a grad student, 32 years old, sadly still renting and paying my student loans. I had to run my practice out of the office/living room in my apartment. Nevertheless I only saw these as advantages to really establishing strong bonds with my clients. I wasn't so far removed from college myself. I could understand what my clients were going through, the anxiety of classes and the pressures of deciding which first step to take in their respective paths through life. Any period of transition by its very nature is stressful and really can you think of any more crucial transition than from student to citizen in the real world? I can't. Further my apartment was small and homey and less sterile than a clinical office, it helped my clients to feel comfortable and to open up more easily. I had only recently started seeing clients, and being so young the school would only pass along to me those students suffering seemingly mild symptoms: simple anxiety, borderline depression, relationship advice, that kind of thing. Anyone showing the signs of schizophrenia, bipolar, OCD would be referred on to more "accomplished" professionals. That first session, I still remember like it was yesterday.
There was a knock on my door.
I opened it and smiled warmly extending my hand "Alexis, welcome. I'm Sam Madison, come in." She smiled a little hesitantly, taking my offered hand but remained outside my door, peering at the apartment behind me.
She was very pretty, very fair-skinned her seemingly delicate features only marred by a smattering of faint freckles across her nose, a cute imperfection, long chestnut-brown hair pulled back and upswept in a double braid, revealing a slender white neck accentuating by a tight black interwoven necklace. But it was her eyes, that you couldn't help but notice: radiant, expressive pools of blue highlighted by the mascara and black eye liner she wore, perhaps to bring out her eyes, perhaps just to make her look older, and yet at that moment in those eyes all I saw was the flicker of uncertainty. Even in that first meeting I could see the girl she was, and the woman she was to become fighting for control.
"That's a pretty necklace," I said gently, reaching out to finger it lightly "was it a gift?"
"I got it on a trip to Peru," she said softly her eyes downcast. I realized I'd made her self conscious.
"It's lovely," I said, motioning to the apartment, stepping back from the doorway to appear less imposing. "C'mon in, Alexis. Can I make you some tea? Coffee perhaps?"
"No...thank you," she said, her voice barely above a whisper. But she stepped in and quickly sat down on the black leather couch, smoothing out the front of her jeans primly.
I sat back down in the accompanying chair and smiled reassuringly "Did you find your way here ok? I know when I say it's on Adams, I should really just say it's on Baseline because that's easier to find." Clients often relaxed when I'd chitter away inanely. She nodded. "But at least you had decent weather on the way over. Mid 70s in October, makes it hard to believe it's going to snow by this weekend, only in Colorado, I guess. Drives me almost..."
"I'm not crazy y'know." She interrupted softly, eyes intent on her hands as she fidgeted.
"I know you're not crazy, Alexis." I said as gently as possible before resting my intertwined fingers against my lips and pausing for effect. "I also know you're very smart. I saw you have a full ride here."
"I just lost my focus for a little while," she said with a slight shake of her head. "Next semester will be different."
"Anything on your mind, Alexis?" And her eyes rose to mine for the first time, and she just looked at me for awhile and I right back at her. She pressed her lips tight as if debating saying something. "I'm not here to judge, Alexis. By all means if something is troubling you, it might help to get it off your chest."
"I.........can't," she whispered her blue eyes glimmering. There was so much just beneath the surface she couldn't say and it was eating her up inside. "I can't" she whispered again.
"I understand," I continued earnestly as she turned her near tearful gaze to the window and the sunlight filtering through the canopy of oaks outside my apartment bay window. "You can say as much or as little as you want around me. I know you don't want to be here, Alexis. The terms of the scholarship require that because your grades slipped under a 3.0 that you spend an hour every week just talking with me." Her eyes flickered and she nodded. "But they don't require what we talk about," I was smiling warmly now. "What would you like to talk about Alexis? What indeed? Would you like to hear about my little girl Tammy? She just turned 5 last week and in kindergarten she's now learning how to write her name. That's her right there. She's with her mommy right now but I get to visit with her every weekend. It seems like she grows a foot every time I see her," I said handing her a small 5 by 7 frame of a little redheaded girl in pigtails I had on the table next to the couch.
As she held the frame I could see her expression soften and she looked back to me and nodded then, wiping her eyes and I even caught the faintest touch of a smile at her lips. The rest of that session, I just spent talking, telling her about Tammy and how everyday she looks more like her mother, but how she'll always have her daddy's Irish red hair. I talked about myself, my experience at CU and why I came to Colorado from DC and why I wanted to be a psychologist. I just chattered from one subject to the next, and she said very little, but she listened earnestly and I could see her relax a little more as the session went on. By the time the session ended and she left, I felt like the roots of trust had been sown and that at least she liked me if not the forced sessions.
And I was right. In each of the next few sessions she opened up a little more, feeling more and more comfortable with opening up and revealing her self to me. Her whole face lit up when she talked about home. She told me about how her mom was a reverend and her dad was a schoolteacher and how she missed how green it was in Seattle.