Chapter 2 - In Session
Paul arrived the following morning around 8:15 AM. He spent some time charting patients sessions from the previous day and reviewing his case load. Just before 9:30, he entered the waiting area and saw three people that took places at opposite corners of the room. Seeing that two of them were men, he turned to a girl to his left.
“Good morning, you must be Kristine?”
“Yes I am, good morning. Are you Dr. Ghent?”
Paul smiled.
“Technically I’m not a doctor so just call me Paul.”
“Paul it is then.”
She followed him down the hallway to his office taking a seat in a large chair. Paul sat down at his desk and picked up the pad of paper he used to collect notes during his sessions.
As always with new patients, he took a moment to look at them as they settled in. Kristine looked young for her age with light brown hair that bordered on blonde. She was professionally dressed and had a warm smile that made her seem very approachable and kind. She glanced up at him and smiled.
“Sorry about the doctor thing. I knew you were a Psychologist but I guess I’ve been dealing with Dr. Keeler for so long, it’s just a habit.”
Paul smiled back.
“Don’t worry about it, I think that happens more than not when people meet me for the first time.”
Kristine nodded and smoothed out her skirt with her hands.
“I have a pretty good idea about the answer to my next question but, what’s biggest difference between you and Dr. Keeler? Other than the beard.”
Paul chuckled running his hand over his freshly shaven face.
“Well the beard is a big difference that’s for sure. Truthfully we really have a lot in common. Both of us have the same goal of helping patients cope with mental illness so they can live happy and rewarding lives. We just have different methods. Dr. Keeler treats chemical imbalances hoping you leave his office with the correct prescription.
I treat thought patterns and behaviors hoping you leave my office with the correct understanding. Does that clear it up a bit?”
She nodded and smiled.
“So that’s it?”
“Well, that and about a hundred thousand dollars a year. Then again, I never had his student loans or insurance costs so I can’t hold that against him.
Don’t tell him I said that.”
Kristine laughed and whispered,
“Not a word, I promise”
Paul gave a small laugh.
“I’m just joking around, Dr. Keeler and I have known one another for many years.
So what do you do for a living?”
“I’m a professor at Five Lakes University. I teach advanced calculus and physics, and don’t worry about your reaction. This is just about the time people look at me funny.”
“Really? That’s a fascinating profession, why would people look at you funny?”
“I think people are a bit surprised when they see woman in my career. I’ve been told that I look more like a realtor than a physicist. I also know that people have a notion that mathematicians are a bit “off” if you know what I....”
She stopped talking for a moment and dropped her head.
“Damn. I have to stop using that line now that it’s so relevant to my current mental health. I take it Dr. Keeler shared what’s going on, right?”
Paul nodded.
“He shared his notes, but it sounds like he really isn’t sure what going on with you. I think that if you and I take to time talk about it, maybe we can find out.
Let me rephrase that, I know we can find out.”
The smile returned to her face again and she nodded her head appearing pleased.
Paul picked up his note pad and began to ask her some basic questions, mostly innocuous inquiries about her family and her experiences growing up.
He found out that she was unmarried but came from a large family. Discussions about her job and daily routine made up the majority of the hour they spent talking that day. The exchange of seemingly common small talk made Kristine feel less apprehensive, and gave Paul a better insight to who she was.
He made notes that she was friendly, confident and liked to laugh.
She had a notably logical way of approaching problems and daily conflicts and he found no negative symptoms that a mentally ill person would generally display.
It wasn’t until the last fifteen minutes of her session that her actual problems became part of the discussion. After talking about her routines at school, Paul asked,
“So when you arrive home at night, give me an idea of your typical evening.”
As he spoke those words, Kristine became visibly upset.
Her posture changed from leaning back in her chair to straight and more rigid. She unconsciously began to fiddle with the fingers on her right hand as if becoming nervous and uncomfortable.
Breaking eye contact with Paul, she dropped her head before she spoke.
“I was waiting for us to get to the heart of things.” and took in a very deep breath before continuing to speak.
“Night time is when things can get a bit frightening for me.”
She rolled her eyes and let out a little giggle.
“Listen to me describing this as a bit frightening. The truth is I’m absolutely terrified sometimes.”
Paul looked concerned.
“When I hear words like terrified, that’s not fun to experience. Terrified is a very powerful word. What happens in the evening to make you feel that way?”
She looked directly in his eyes and said,
“I know I don’t have to make excuses or preface my discussion before I tell you the things that are happening to me, but it’s important for me to tell you about the type of person I am.”
“Whatever you feel the need to say is fine with me Kristine.
To be quite frank, when you say whatever you need to say, it makes it easier for me as well.”
“Good. You see, the thing you need to know is how embarrassing this is for me. As I tell you about all of the things that I’m about to, I know all too well how crazy they sound.
I tend to need proof of the things that I see around me and when I know they aren’t real, well…”
She paused and thought for a moment.
“I guess this is why I’m terrified.”
“I can see by your body language how much anxiety this is causing you. Don’t worry about what you think is going through my head. Just remember, I’m here to help, not to judge you or make assumptions.”
She looked down at the floor and spoke in a quiet voice.
“I know, the only person that’s judging me lately is me.”
Paul nodded.
“Tell me about what happens at night.”
“Is it too late to get that drink of water you offered earlier? Suddenly my mouth got very dry.”
Paul pulled a bottle of water from a small mini-fridge next to his desk. After a few sips, she seemed to settle back into the chair and began to explain.
“Alright, I think I’m ready to tell you about my evenings at home. This whole weird set of events started a few years back when I was twenty seven. I started to get into yoga back then.
It started as an activity from my Wii Fit. I used to enjoy the yoga part of it so much, I decided to take a class and really learn about it. That’s also when I got really good at it and made it part of a daily routine. The odd thing was finding out how much I enjoyed the mental benefits more than the physical ones.”
“Why was that odd?” Paul asked.
“Well let’s just say that when you look up agnostic in the dictionary, it pretty much describes my religious values. Yoga’s philosophy of balancing Chakras and mind, body and spirit sounded like magic pixie dust when the instructor started down that road.
As time went on however, I found a completely unexpected benefit from the meditation. This sounds odd to some people, but my hobby is running equations.
Have you ever heard of string theory?”
Paul nodded,
“Unified theory, quantum mechanics, of course, I love stuff like that. So did you have your money on a the Higgs Boson or gravitons?”
Kristine’s eyes widened and she placed her hand over her mouth with a gasp.
“Oh! Oh my gosh, you actually follow the debate? That’s amazing!”
Smiling warmly she said,
“When I tell people I work equations on my days off, most of them scream “nerd alert” and change the subject. Wow, I can’t believe you follow this stuff.”
Paul laughed a bit.
“Don’t get too excited. My love for it is passionate, but pretty basic. I made it as far as Trig in college and squeaked by with a C minus.”
Kristine now beaming with excitement said,
“No matter, I’m impressed. I feel like you’ll understand what I’m going to explain. I was about to say that I’m very analytical, but when you get right down to it, working with equations the way I do takes a creative side as well.
That’s where the yoga and meditation gave me an edge. After I did my yoga breathing and deep relaxation, I was able to visualize math concepts and connections that were amazing when I put them onto paper.”
Suddenly the radiant glow on her face disappeared and she began to look uncomfortable again.
“At least that was what happened at first. Then things got frightening.”
“What happened?”
She took a deep breath and said,
“The voices started.
The voices and the visual distortions started to take place. At first I just ignored them but they became more frequent and then finally I would slip into…”
She let out a nervous giggle.
“Oh my god, I don’t know how to say this, it’s just so strange.” She looked down trying to collect her thoughts.
“Kristine?”
Paul spoke her name in order to get her complete attention and as she looked in his eyes he said,
“I know this must be both difficult and scary, but just tell me whatever words will make me see it the way you do. What does it feel like?”
“Alright then, I’ll just say it. It feels like I leave and come back. I mean I know I’m still there in my room on my bed or in the chair and certainly don’t really go anywhere physically, but in my mind, I do.
It really feels like I leave my own reality and live an experience somewhere else. Then in an instant, I’m back. It’s such a unique experience and hard to explain. It’s very.. I guess the best way to describe is powerful!”
“So when you have this feeling of leaving, where do you go?”
“OK are you ready for this?” He nodded in response.
“I travel back in time.”
She stopped and looked carefully at Paul’s face to see if she could discern some knee jerk reaction to her shocking claim. To her surprise, he maintained an expression on his face no different than if she’d told him she had cereal for breakfast. He asked,
“Do you end up in a specific time or place, or is it random and out of your control?”
Kristine smiled.
“Hold on. I just told you I have out of body experiences and believe I travel in time. So you’re on board with that? You’re happy with that explanation?”
“Kristine, I’m happy you trust me enough to tell me something that you said was embarrassing and terrifying less than five minutes ago. I’m happy that you’re talking to me at all. That’s the only way we can find out what’s causing these trips.”
She nodded and gave him a devilish smirk.
“Paul, you’re very good at your job but I’m going to put you on the spot.”
She leaned forward in her chair and looked at him intently.
“Do you believe me?”
Paul looked back at her with the same intense stare.
“I believe that you’re telling me the truth about your experiences.”
She laughed and said,
“OK, fine but do you believe I’m traveling through time?”
Paul thought for a moment.
“I’m sorry but I don’t.”
To his surprise, her intense stare became a satisfied smile. She sat back in her chair and folded her arms across her chest and spoke in a playful tone.
“May I ask why not?”
“You’re a vastly intelligent woman of science. If I told you that I could levitate from this chair and float around the room, what would you say to me?”
Still smiling, she immediately replied,
“I would say prove it!”
Paul nodded back at her.
“Alright then, now we are on the same page.”
She laughed a bit and looked at him seemingly pleased with his response.
“That was one hell of a good answer. You know, Dr. Keeler said I would like working with you.”
“Did he? I have to say, I’ve enjoyed talking to you as well. The unfortunate thing about our visits is how quickly they go. It seems that we were just getting started and we’re almost out of time for today.”
She glanced up at the clock.
“I figured as much. By the way, I didn’t get the chance to really mention it, but why don’t you just call me Kris going forward alright?”
“Kris it is then. Dr. Keeler mentioned in an email that you were on spring break this week? If that’s the case, did you want to be on a cancellation list. That way if I have an appointment open up, they’ll call you. The problem is, you might not have a lot of notice but at least you won’t need to take time off from work. What do you think?”
“Sure, I heard it’s supposed to rain all week anyway. I’ll probably be looking for reasons to get out of my loft. That sounds good.”
She picked up her purse, shook Paul’s hand and said,
“Before I go I just want to tell you something important about my claim on traveling back through time.”
“What’s that?”
Reaching the hallway, she turned in the doorway gave him a wink and a smile.
“I can prove it. See you later.”
“Fair enough, we can talk about that next time. You have my number, so call me if need anything before then.”
As she turned the corner and disappeared, Paul sat down and charted the following notes on the days session:
Referred by Dr. Keeler: Possible early stages of undifferentiated schizophrenia. The patient describes events that show positive aspects of schizophrenia including audio and visual hallucinations. There are apparently non-descriptive separations from reality where she is under the delusion that she can travel back through time.
Uncharacteristically, she seems to have full awareness that these experiences lack credibility when she describes them and welcomes skepticism. She displays classic symptoms of anxiety when discussing hallucinations that apparently happen at night, yet she shows signs of pride and enjoyment in the delusional belief of time travel ability itself, claiming that she can prove them.
I found no negative symptoms of the disease. Furthermore she has excellent communication skills and clarity in her reasoning ability. Follow up questions;
Is yoga and meditation connected to hallucinations?
Ask her to describe detailed events that generate feelings of terror and fear.
Begin cognitive and behavioral modification of the delusion.