I'm a Therapist, and My Patient is Going to be the Next School Shooter

by Dr Harper

  As Officer Donahue rambled on about his passive-aggressive wife and their unsatisfying sex life, I pretended to write in my notebook. My mind was somewhere else entirely. If Eric really was The Zombie, he was still out there driving Ubers. And it wasn’t like Jane was in any position to stop him.

  “So that’s why I think I need help,” Officer Donahue finished his story with a dramatic sigh.

  “Spousal spats are completely normal,” I said, trying to hurry along the discussion. “Perhaps you could bring her in next week for a couple’s appointment? And while you’re here, I actually have a potential lead on The Zombie–”

  “No, I seriously need help!” he raised his voice, face going red. “You have to help me!”

  I was surprised to see Officer Donahue’s eyes brimming with tears.

  And then, without warning, he bolted up from the couch and began screaming:

  “I. DO. NOT. NEED. HELP.”

  Then he lifted his fist into the air and punched himself in the face.

  “No fucking way,” I whispered, eyes going wide.

  I scrambled to find a pen on my desk, and then I scrawled the start of a new patient file in my notebook:

  “Patient File #220: Officer Donahue”

  End of Patient File #219

  A Note on Patient #220

  Before we get to Patient #220, there is one more patient that I need to share with you:

  Patient File #109.

  This patient is from my earlier days, and they are undoubtedly the most dangerous person I’ve ever worked with. More than the school shooter, more than the cult, even more than #220.

  You may be wondering if #220 will be the end of my patient files. It is my last patient file with Noah, but I do have other stories I can share with you someday.

  It will all make sense soon.

  Abusive Couple

  “The most reliable sign, the most universal behavior of unscrupulous people is not directed, as one might imagine, at our fearfulness. It is, perversely, an appeal to our sympathy.”

  - Martha Stout, The Sociopath Next Door

  PART ONE

  They had to be the youngest married couple I’ve ever worked with.

  Her eyes were red with tears.

  His eyes were exhausted and defeated.

  “I think I should start…” Kierra sniffled through tears. “It’s just so hard to ask for help, you know?”

  “I understand,” I said. “Why don’t you begin by telling me what brings you to my office today?”

  Kierra took a deep breath and nodded slowly. “He–” she stammered. “He hurts me.”

  I was surprised to hear Lucas groan from the corner. “Here we go again…”

  “Don’t do that!” Kierra shrieked. “You promised you would be honest here!”

  “So did you,” Lucas shot back. “But apparently we’re just here to agree that I’m an abuser – like all of your other abusiveexes, right?”

  Kierra let out a loud sound – a mix between a sob and a shout. “They were abusive!”

  “Right, and I saved you from them,” said Lucas bitterly. “Until I became your latest abuser.”

  “DON’T DO THAT!” Kierra screamed. “You are invalidating and minimizing my experience!”

  Good lord…

  “Let’s just take a step back here,” I said, scooching my chair closer to distract them from each other. “Lucas, would it be okay if we let Kierra finish her story? I understand these are extremely serious allegations, but I assure you I will not rush to judgment until I hear your side too, okay?”

  He nodded, although his expression was not one of agreement.

  “Thank you,” Kierra stammered. “It is so hard to speak my truth when he belittles me.”

  Lucas opened his mouth, but I gave him a sharp look and he backed down.

  “Kierra, you just said that Lucas hurts you,” I said. “Can you tell me more about that?”

  She nodded and her eyes started welling with tears again. “It’s a type of– a type of punishment.”

  “Punishment?” I asked. “What kind of punishment?”

  She winced and whispered, “The Slicer.”

  “The Slicer?” I repeated. “What does that mean?”

  She shook her head and buried her face in her hands. “I don’t want to talk about it.”

  “That’s okay,” I said quickly. “Kierra, can you tell me more about what leads to this punishment?”

  She looked back up. “Yes,” she said. “He becomes angry when I call him out on his manipulation.”

  “What kind of manipulation?”

  “It’s subtle,” she said. “It’s called covert narcissistic abuse, and he fits all the red flags. Insensitive to my feelings, never apologizes or admits fault, needs constant attention from others–”

  “Oh, for Christ’s sake–”

  “Just another moment, Lucas,” I said, holding up my hand. “I promise we’ll get to you soon. Kierra, can you give me some examples of the manipulation?”

  “Well, he’s bisexual,” she sniffled. “And he spends almost all of his free time with his gay friend.”

  “Do you see what I’m saying?” Lucas turned to me, exasperated. “This is her version of abuse.”

  “Who spends that much time with a gay guy!” she shouted.

  “He’s my friend!”

  “No, you do it to punish me!” she said. “It’s a reminder that I’ll never be enough to fully satisfy you. A warning that if I step out of line, you can always replace me in a heartbeat.”

  “Has there been infidelity?” I asked.

  “No,” said Lucas. “I would never–”

  “Who knows!” Kierra interrupted him. “He’s like your little pet. You parade him around on social media just to make me jealous. You never post pictures of us.”

  Lucas looked at me incredulously. “Do you get it now?” he said. “Do you see how crazy this is?”

  Just as I was about to begin asking Lucas some questions, the door to my office opened.

  “Oh, sorry.”

  A young, awkward looking man in a FedEx uniform stood in the doorway, holding a few brown Prime boxes.

  “Your front door was open. I heard voices in here. Wasn’t sure if you wanted to sign, or…” He looked around the room, finally noticing Lucas and his tearful wife. “Oh, it seems like this might not be a great time?”

  “You don’t say…” I muttered, standing up to sign for the packages. “Just leave them in the lobby please.”

  He blushed and nodded, closing the door behind him.

  God, I needed an assistant.

  “Sorry about that,” I said, sitting back down. “I just moved into this office, so things have been a little chaotic. Anyway, Lucas, I’d like for you to share your side of the story now.”

  “Okay,” he said quietly. “Well first of all, I think she might be the one abusing me. She grabs me sometimes.”

  “I DO NOT!”

  “Kierra,” I said firmly. “Now we’re going to give Lucas a chance to share.”

  She looked like she was going to explode.

  Lucas rolled up his sleeves, revealing a series of bruises. “She grabs me when I try to leave after a fight,” he said. “She accuses me of abandoning her.”

  “HE’S LYING!” Kierra shrieked. “He does that to himself!”

  “I’m just really afraid,” he continued. “I asked for help on a forum, and a lot of people suggested she might have Borderline Personality Disorder. I Googled it and she has almost every symptom – crazy mood swings between sobbing and rage… thinks everyone is abusing or traumatizing her… a new crisis story every hour… and I swear to God, any ‘slicing’ is 100% self-harm.”

  “More armchair diagnosis!” she cried.

  “Are you serious?” He threw his hands into the air. “You just called me a narcissist!”

  “Look, you’ve obviously both done some research on the internet,” I said. “But perhaps it would be better if we met separ
ately? That way you each have a chance to share your side, uninterrupted?”

  “No!” They both protested at once.

  I raised my eyebrows.

  Then, at the same time, they spoke nearly the identical sentence:

  “He’ll manipulate you.” / “She’ll manipulate you.”

  My eyes scanned back and forth between the two of them curiously.

  Hysterics versus irritation. Tears versus eyerolls. Slicer versus bruiser.

  Were their online diagnoses correct? Was this really the age-old dance between The Borderline and The Narcissist?

  Or was one of them lying?

  For the rest of the session, I listened to them make more accusations – and more denials. To be completely honest, I still had no idea what was going on with them. If either of them was really in the Cluster-B spectrum (narcissist, sociopath, borderline, histrionic), it would take far more time to unravel the truth among all the manipulation and gas-lighting.

  I actually have an optimistic view of Cluster-B recovery, but it’s not going to happen with talk therapy, and it’s certainly not going to happen in the midst of a dramatic relationship. That’s like asking an alcoholic to begin recovery in the middle of a liquor store.

  At the end of the session, I stood up to walk them out of my office. Lucas exited first.

  Then, in the doorway, Kierra quickly leaned into my ear and whispered:

  “He’s going to kill me.”

  I’ll admit, that sent chills down my spine. When it comes to domestic violence, you never want to take statements like that lightly. So when I closed the door to my office, the first thing I did was reach for the phone to involve the police.

  But before I finished dialing, something caught my eye.

  There was a piece of paper sticking out from the couch cushion – where Lucas had been sitting. I really didn’t want them to come back later for a forgotten belonging, so I hurried over to examine it.

  But when I unfolded the piece of paper, I didn’t find a forgotten belonging.

  Instead, I saw a hand-scrawled note:

  “She’s going to kill me.”

  PART TWO

  The following week, I set up my office for Lucas and Kierra’s return.

  But only one of them showed up.

  “Lucas,” I greeted him. “It’s nice to see you. Will Kierra be joining us?”

  He looked down and mumbled, “Not today.”

  “I’m sorry to hear that,” I said, trying to mask my anxiety. The police hadn’t found anything of concern last week, so I just needed to have faith that she was safe. “Did something come up?”

  He took a seat in the couch and sighed. “We had a big fight last night.”

  “I see,” I said. “About therapy?”

  “Yeah.” He nodded. “I wanted to come back, so we could work on our relationship. But she said you’ve already taken my side, so she didn’t want to come back.”

  “I’m not looking to take sides,” I said. “This isn’t about winning or losing. A relationship should be a partnership, not a battle.”

  “That’s what I keep telling her!” he said. “Sometimes it seems like she understands – like she wants to work on things with me – but then an hour or a day later, she does a 180 and thinks I’m trying to hurt her. I never even know what I did to make her switch.”

  I let out an uneasy breath. I still didn’t know who to trust, but Lucas was the one who came in today, so he was the one I would try to help.

  “You can spend a lifetime trying to manage her emotions – tweaking your own behavior to avoid her outbursts – but it won’t make any difference if she still has a wound inside of her.”

  “What do you mean?”

  “It’s the difference between symptom management and root cause identification,” I said. “Imagine a bucket with a hole in the bottom. What you’re doing is repeatedly trying to fill the bucket, and then feeling inadequate when all the water leaks out.”

  “So how do I patch the hole?”

  “You can’t,” I said firmly. “It’s an internal problem that only she can solve, with the help of a professional. Right now, she’s doing symptom management too. Her illness is convincing her that if she can arrange her surroundings just right – find a knight in shining armor, a perfect romantic partner – she will finally feel okay. But that is just using external distractions to fill her internal void. Her emptiness.”

  “She talks about emptiness all the time!” he said.

  “I’m not surprised,” I said. “Emptiness and boredom live under the surface of almost every Cluster-B disorder. I believe that’s where the true wound lives, numbed out by all of these distractions. I would need far more time with Kierra to make any diagnosis, but if your suspicions are correct, you will have a long and rocky journey ahead.”

  He looked down. “You must think I’m an idiot for staying.”

  “I don’t think that at all,” I said. “But instead of focusing on Kierra today, I want to focus on you.”

  When it comes to abusive relationships, I try not to convince the victim that their partner is bad. Often times, that causes them to stop seeking help – especially early on, when they’re dealing with cognitive dissonance about their abuser. Instead, I try to help the victim see their own value. Once we rebuild the self-respect and self-worth, everything else tends to fall into place.

  I didn’t have enough information to keep talking about Kierra, but exploring Lucas’s self-esteem couldn’t hurt – regardless of who was telling the truth.

  “Lucas, do you feel hyper-aware of other people’s emotions?” I asked. “Perhaps you can sense when someone’s getting unhappy – or a conflict is brewing – so you step in to defuse it?”

  “Yeah, exactly!” He lit up. “How did you know that?”

  “The most common partner of someone with Borderline Personality Disorder isn’t the Narcissist,” I said. “It’s Codependency. Caretaking. People pleasing. Rescuing. People who feel responsible for the emotions of others, burdened by constant guilt and worry when conflicts arise.”

  “Can I change that?”

  “Of course,” I said. “But before you can change it, you have to explore where it came from. Usually these habits start in childhood.”

  “Well, I had a really good childhood,” he said, leaning back. “Both of my parents loved me. There definitely wasn’t any abuse.”

  “It doesn’t have to be abuse,” I said. “Just someone who took up a lot of space. Emotional outbursts, constant fights, rigid rules, drinking issues, unpredictable moods… Anything like that?”

  I know it’s important not to ask leading questions, but codependents are likely to tell you they had perfect childhoods. With this approach, at least something might resonate with him that he wouldn’t have otherwise considered.

  “Holy crap, that’s my dad!” he said. “He always had to be right about everything. Things would escalate from 0 to 100 for no reason. I think sometimes he actually enjoyed arguing.”

  “And how did that make you feel?”

  “Well, it really upset my mom,” he said. “She would get sad and cry. Sometimes they’d even shout at each other.”

  “But how did that make you feel, Lucas?”

  “Bad,” he said quietly. “I just wanted them to stop. So I’d make jokes, and I’d usually comfort my mom afterwards to make her feel better. She was a lot more sensitive than him.”

  “You learned to sacrifice your own needs to take care of others,” I said. “To prevent conflicts and keep negativity at bay. And now that’s how you approach relationships. But it’s never enough, is it?”

  “Never.”

  “That’s because their issues have nothing to do with you,” I said. “You can’t change or save them.”

  “So what can I do?”

  I reached into my desk and took out one of my favorite diagrams.

  “This is the Karpman Drama Triangle,” I said, handing it to him. “It has 3 corners: Victim, Perpetrato
r, and Rescuer.”

  “I’m the rescuer?” he asked.

  “You’re all of them,” I said. “When we carry these wounds, we continue entering relationships and repeating the same story. Maybe we start as the rescuer, but our victimized partner inevitably comes to see us as the perpetrator. So we become the bad guy in their eyes. Then we’re so exhausted and drained that we start to feel like the victim ourselves.”

  He shook his head in disbelief. “You’re describing all of my relationships.”

  “Right, and it will keep happening until you see the triangle for what it is,” I said. “A false version of love. Love is not heavy and sad. It is not pitiful and tragic. Love is light – infinite and open. It flows freely from within.”

  “But my heart feels so heavy,” he said, “Like a big ball of dread and self-doubt. How can I ever change that?”

  For the rest of the session, I provided him with books and printouts about codependency. I’m a big fan of the firehose approach when it comes to introspection. Eventually, something’s bound to click.

  When our time was up, I stood up to walk him out of the office.

  “If you can, please bring Kierra with you next week,” I said. “I’m confident that we can help her too.”

  He nodded. “I’ll try.”

  I opened the front doors for him and began unpacking some of the boxes in my lobby. I still hadn’t found an assistant, but at least I would be ready when the right resume appeared.

  Before I could make much progress, someone knocked on the front door. It was the FedEx guy again, and he was carrying two more packages.

  I let him in and signed for the delivery.

  “Did you turn your patient gay?” he said with a laugh.

  “What are you talking about?” I asked.

  “Uh, sorry.” He went red. “It’s just, last week he was with a girl. Today he left with a guy. And they kissed. So I guess I was making a joke?”

  I frowned. “He kissed another man?”

  “Yeah, right after he got into the car,” he said. “One of those old PT Cruisers. Man, those are goofy looking cars–”