The Only Thing Left…

Alyssa sat in the chair, not knowing what to say or where she was going to start. She didn’t want him to think her mad. She looked at the floor. The carpet was a sort of grey colour, with browny specks on. She wasn’t sure whether they were supposed to be there, but it wasn’t up to her to ask the questions. Even so, she wasn’t sure that she liked them. She got up and walked to the window. She looked out and saw a big, old oak tree, in a little courtyard. There were birds in a birdbath, tweeting happily, and a medium sized pond. Something about the pond held her gaze. She stared at the rippling water, and imagined throwing herself into it. That would stop it all. She just knew it. As she stood there, she could almost feel the icy cold water engulfing her, crushing every last breath out of her lungs. Suddenly, she couldn’t breathe. She knew she wasn’t in the pond, but the image of herself underwater bonded itself to her mind like glue.

Abs entered his consultation room; he had expected to see a quiet, young teen, sitting in one of the chairs. What he actually saw was Alyssa, crumpled on the floor. He rushed over to her and turned her over onto her back. He checked that she was breathing, and worked out that she’d fainted. He picked her up and carried her to the couch in a corner of the room. He laid her down, and having placed a cushion under her head, went outside to get her some water.

She opened her eyes slowly, blinking at the bright light that hit her. She couldn’t remember where she was at first, but then the memory came back. She sat up quickly, and looked around the room in panic. There was a man sitting on one of the chairs, leafing casually through a book. She watched him wearily for a moment and then swivelled her body round with great difficulty. It felt as if she was a lead weight. She got up slowly and made her way over to the other chair. The man looked up as she sat down.

Abs smiled at Alyssa. She seemed nervous: frightened, even. He continued to smile. He’d had this response millions of times before. Most of his new people had the same look. It always took him a while to win them round. He did it in the end though; he had only lost about four in his entire career. He looked at Alyssa. She didn’t look much different from the other people he saw. Not in appearance anyway: she had long hair, scraped back from her face into a tight ponytail. She wasn’t tall, but was very thin. There was hardly anything of her really. She wore jeans and a pastel pink, long sleeved top (which made her thin body look even more fragile) — these were both immaculate. The only thing that betrayed her appearance of normality were the bandages. They were getting grubby, despite what he felt sure were her best efforts to keep them clean. They had begun to fray, and as he watched her, she fiddled with them: smoothing the frayed bits flat, trying to maintain some degree of tidiness. He looked at her face. Her eyes were lowered. He hadn’t yet seen her meet his gaze. Her mouth was tightly closed, as if, if she opened it, she’d say something she oughtn’t. She sat on the edge of the chair, feet pinned to the ground, dead upright. She hardly moved as he looked at her.

Alyssa looked at him through the corner of her eyes. She didn’t know what to say. She waited for him to start talking. He was supposed to ask the questions. All she had to do was give him the answers. If only it was that easy…

He leaned back in his chair and looked at her. As always, he wasn’t sure where to start. He didn’t want to push her. He’d learned very quickly that pushing people often led them over the edge. He decided to ask her about when this had started. He didn’t know much about her. He made it a rule to not be over informed. He wanted to hear about things from their perspective, not from the words of those only in contact with them for two seconds.

The words he uttered flew over Alyssa. She strained to listen, and managed to gauge what he was asking, even though she felt like she was floating in a different time-space. “What happened when this started Alyssa?” he asked. She sat there, focused on the floor. She tried to pull the memory of it back into some order. She hated disorder of any kind, but she couldn’t seem to make sense of it all. She felt the silence all too strongly as he waited for her response. The terror carried on building, as it got louder. She looked around, hoping for a diversion — something to give her a minute to think. Nothing came. She sighed and began to talk.

“I don’t remember it clearly. It was like one day I woke up and my head was screaming. I don’t know when it started or why it happened. Everything was just suddenly amplified. The dirt was everywhere. It still is” she pulled at the threads on her bandages. “Everything’s contaminated — poisoned. Everything and everyone. It hurts. It’s like a physical pain. I know I’m covered in them — germs — and it doesn’t matter how hard I scrub or how much water and bleach I use — it’s not enough. Every little touch is such a huge thing. The slightest speck of dirt sends my head into a mad frenzy. Then all I can do is wash. I keep on and on, until it feels ‘right’ — but it never really does. My head won’t let it. It just keeps screaming — over and over. The grime of daily life just makes my skin crawl and my head scream, it’s been like this forever” she gasped as she stopped for breath, surprised that she’d said so much. She hadn’t meant to. She didn’t normally talk to anyone. That was how she liked it. She had control of things then and could decide what went on in her life.

Abs looked at her as she spoke. She played with her hands. Gently. Obviously, they must still be very painful. She glanced up at him occasionally, but never maintained eye contact, as if, if she did, he’d be able to see straight through her mask. For he knew that she had one, not a physical, visible one, but one under which she hid all of the thoughts and feelings, which weren’t acceptable for anyone to see. He’d seen many like her before: just hurting youngsters, desperately clinging to an invented, protective façade, which shut everyone out.

She looked up at him again. He seemed nice, she thought, but she’d trusted other people before and that had all turned out bad. Why would he be any different? She regarded him edgily. He looked different though, she mused. He was young and had curly, floppy hair. He was thin, yet muscular, and was casually dressed in jeans and a white v-neck T-shirt. His face was kind, and he had soft features. His eyes seemed caring too. As he looked at her, his gaze didn’t waver, and he seemed comfortable with the silence. She found this strange. Most people who had found out about her had bombarded her with questions.

Abs looked at her as she left the room. She looked strange, stood bolt upright, walking stiffly, yet nervously out of the door, holding one hand in the other as she went. She was rigid: like a tightly coiled spring.

* * *

Alyssa sat in her room, staring at the bandages. She cringed as she looked at them. Despite trying to keep them clean, they’d still dirtied. She looked at them, rage and despair mingling to leave an agonising ache inside her as the voices screamed and rampaged on. She traced her eyes along the bandage. They had moved, slipping to show parts of her reddened flesh. Threads stuck out at all angles, and they were a blacky-grey colour, rather than the white that they should have been. She rocked back and forth as she tried to pull her eyes away from them, disgusted at the sight — at her own filthiness.

Suddenly, she couldn’t take it anymore. She tore angrily at the bandages, ripping and hurting her hands as she pulled at them. It felt like there were germs crawling all over her as she did this, and the screaming in her head got louder and louder until she thought it would deafen her and she screamed “GO AWAY!!” she hated it when the voices got this loud. She got up and walked to the gleaming stainless steel sink. She picked up a tall glass and poured herself a glass of water, being careful to wipe everything with kitchen roll, which she then put into the pedal bin. She took a long gulp from the glass, and then tried to calm her shuddering breath.

As she tried to breathe more slowly, the voices merely became louder. “Go on, do it. You know you want to. The scrubbing brush is right over there. Think of all those germs. You don’t want them all over you do you?” She clapped her hands to her ears, (wincing in pain as she did so), in an attempt to shut out the voices… “Shut up!!” she screamed at the top of her voice, losing herself momentarily. Suddenly, she came to her senses, the need for control coming over her. She knew there was only one way to shut the voices up, but she knew she shouldn’t do it. That she should fight these ‘compulsions’ as they’d called them, but the voices… they were so persuasive, and so clear about what needed to be done. She hated these germs. In a sudden mad rush, she grabbed the scrubbing brush and turned on the hot tap. As she watched the steam, a sudden feeling of calm flooded through her, and she just knew that all of the germs would be purged once she was done.

* * *

Abs watched her, she looked in quite a bit of pain. He was worried about her. He asked “Are you ok Alyssa?”. She nodded. She fidgeted her hands uncomfortably in her lap. He regarded the bandages; they were new ones — pristine, white. He knew that she didn’t have another hospital appointment until tomorrow. She winced as she shifted her hands again. He looked at her knowingly, “Alyssa, has anything else happened to your hands?” he asked her. She shot him a glance, and he thought he saw a shade of nervousness in her eyes; having said that, she always looked nervous. “I…” she trailed off.

Panic had settled to roost in Alyssa’s mind. She didn’t want him to find out, but somehow, she knew that he knew already. He carried on looking at her, and with this, the voices in her head started up again. She put her hands to her ears. She knew it would do little good — how do you stifle the noise when it’s inside your head? She could feel the tears welling up inside of her, waiting to burst out. She bit at her bottom lip trying to force them down.

Abs remained silent as he watched her mask slowly crumble. Part of him felt it was cruel, but then again, he knew that the mask needed to be removed if he was to get through to her. He had merely hoped (as he did with all his patients), that there might be a less traumatic way of doing it. Deep down, he knew it would take a full blown breakdown to get through to her, but the purely human side of him wanted a magic wand to make it all better instantly. He knew he needed to be very careful about how to move forwards.

He just sat there as she collapsed into a river of silent sobs, wishing he could comfort her, but knowing that she needed to let this out. That it was probably the first time that she had actually cried in years.

“You do it because it’s the only thing left. The only control you have. You hate yourself for it, but deep down, you know that without it, you’re nothing, and you have nothing. And that’s what really hurts” she paused, and looked down at her bandaged hands. “These..” she gestured to them…; to the bandages. “They don’t mean anything”.

Alyssa pulled gingerly at the ends of the bandages. She could feel Abs looking at her, his eyes piercing into her. Slowly, she unravelled them to reveal two blistered, cut, and bleeding hands. She looked down, unable to look at him.

Shock flickered on Abs’ face for a second. He quickly pushed it off and nodded encouragingly at her. He wanted her to know that she’d done the right thing. “How did this happen Alyssa?” he asked calmly. He looked at her, and she shrugged. He sighed silently, fearing that she’d clammed up again. “I… they were arguing… telling me what to do. Telling me what would happen if I didn’t… I had to do it… I had to stop them” she suddenly blurted out. He smiled brightly at her. “Ok… I’ll call the hospital and arrange to get them looked at — today. In the meantime, I want to thank you, Alyssa. You’ve taken a huge step today in letting me in. Well done!”

Alyssa couldn’t believe that the mask she’d been hiding behind for so long had just disintegrated. She felt scared and fragile without it. It was like no other feeling and she wasn’t sure that she liked it. She sat there in silence, taking in what Abs had just said, while he went and made the call.

Suddenly, she worked out that her head wasn’t shouting. The voices were still there, but they were more like a dull roar in the background. She didn’t know how long this feeling would last, but for now, the slight dip in the screams was nice.

A smile crept to her lips, and she looked up…

***

The rain pounded down on Alyssa as she walked from the bus stop to the center. She couldn’t believe that in the space of her getting on the bus and getting off it, the skies had opened. She hadn’t even put on a coat. All she had on was a thin, blue hoodie. She hurried up the steps to the center. Just as she was shutting the door, she saw Abs. He smiled at her and gestured for her to follow him. She cursed silently to herself. She’d been planning to go to the toilets and smarten herself up. She sighed, she knew she had no choice now. He’d seen her. If she went and cleaned herself up, he’d know why, and he’d know that the thoughts were back.

Abs looked back at Alyssa. She was hesitating. Looking at her disheveled appearance, he was pretty sure, she wanted to go and make herself neat and tidy. This was the first time he’d ever seen her look less than perfect. He smiled at her, trying to make her feel comfortable, but inwardly, he knew the battle that was going on in her mind. Again, he wished that he could help her, but he knew if he said she looked fine, not only would she not believe him, but it would undermine all the work that they had done this far.

Why hadn’t she thought to bring an umbrella, or at least check the weather? She couldn’t believe that she’d been so stupid. She took one last, longing look at the bathroom, turned and followed Abs up the stairs and into his room. He closed the door behind her, and she walked stiffly to the chair she always sat in. She wished she could turn and run. Run all the way home and climb into a red hot shower and scrub the rain off her. She felt violated. She felt angry with herself and with Abs. She missed the bandages. She missed having control. She watched Abs pick up a pad of paper and a pen, and walk to the chair opposite her. She still wasn’t sure she trusted him, but she did know it was too late for any major doubts.

Abs sat down and clicked his pen on. He decided to give Alyssa a minute to collect herself. He knew her need to go and tidy up must be almost overwhelming. He looked at his pad, and wrote the date and her name down at the top of the page. When he looked up, he saw Alyssa looking out of the window intently. It was as if she was trying to pretend that she wasn’t actually there. He coughed, “So, how are you doing?” he asked her, unintentionally making her jump.

Alyssa jumped as Abs spoke. Looking at him, she couldn’t work out what to say. Eventually, she couldn’t take him looking at her intently, in silence anymore. “I’m. Um,.. I’m ok” she stammered, glancing at Abs before focusing on the window again. There was a small spider in the corner of it, busy building a web. She watched him abseil from about halfway up the window to the windowsill. “How are the compulsions?” she heard Abs ask. She sighed inwardly, ‘like you don’t know. Like you can’t see’ she thought to herself. He knew exactly how much her skin was crawling right now, and she knew he was just enjoying tormenting her.

Abs looked at her, curled up into an uncomfortable ball. Just looking at her made him feel uncomfortable too, but he knew he couldn’t give in. If she asked to go and freshen up, he would let her, then encourage her to talk about it, but it had to come from her, and he had a feeling that she was getting to the point she’d been at not long ago, where she was tightly wound. Too tightly wound. It worried him that if she didn’t find a way to let go, she could end up back in hospital. It wasn’t that he was scared of failing, he just wanted to make sure she was ok. He wanted to help her to get back that smile that she’d had during the third session. He knew it had only been a small smile, but from her, he knew that a small smile was an enormous achievement. He opened his mouth to speak.

“Do you have anything to ask me Alyssa?” she heard Abs’ voice and glared at him. He knew exactly what she wanted to say, and she wasn’t going to give him the satisfaction of hearing her say it. She turned away again, trying to make her leg sit still, as it had started twitching. It always did that when she was nervous and at that point, she hated her body for betraying her. She could feel little beads of sweat on her brow. She couldn’t believe it. She’d been soaking wet only a few minutes ago. Now, she was sweating. She didn’t feel hot. She knew that this was her body letting her down. Focus Alyssa. Don’t be so weak she told herself.

Abs looked at the sullen girl, She was so angry. He was almost worried that she would have a meltdown right there and then. He tried to work out how he could get her to talk. She looked so lost, but he knew he couldn’t suggest it. Inwardly he was praying that she would ask him.

Alyssa looked out of the window, tears brimming in her eyes as she mentally berated herself for not being strong enough to resist Her skin was crawling. She could feel her hair knotted, and stuck out at all angles as it dried. Her hands played with the zip on her bag. She knew she had her hairbrush inside it. If only she could get it out.. She knew she could ask to go to the bathroom, but she had him believing that she was doing so well. She didn’t want to ruin that. She let go of her bag then, and let it fall to the floor.

Abs continued what had seemed to become a staring contest. Alyssa was looking at him unblinkingly. She hadn’t asked him, and he could feel the anger that she felt towards herself and him, carry across the room as she seethed in silence. He looked at his clock. He had just twenty minutes to go. He knew that he had to do something. He hated to leave a session without having achieved anything, but he knew that nothing would calm Alyssa except letting her go and freshen up. “I think you need a minute” he said. “I’m going to get a coffee, why don’t you take a minute, and I’ll meet you back here when you’re ready” he finished.

Alyssa looked up at him surprised, and thankfully left the room clutching her bag. She felt so relieved, the tears that had built up while she was in the room, fell silently down her cheeks. She walked stiffly to the toilets, and opened her bag. She pulled out a brush and ran it through her hair. She gasped as it caught on knots, where the rain had dried into the hair. Finally she had unknotted it. She pulled it back into a tight bun, and fastened it. Then she busied herself, in tidying her clothes and face. She didn’t know how long it had taken her, and she didn’t care. She was almost neat. One more thing to do. She pulled out a nail brush, turned on the hot tap, and watched the water begin to steam.

Abs watched the kettle boil, and steam rise from the spout. As he poured his coffee, he hoped to himself that he hadn’t made too much of a mistake. This was a clear breach of boundaries, and he hated doing it, but he hated the thought of a wasted session more. His decision to break session was more of a gamble than he would have liked, but he now had to make the most of it, and try and use the break as a talking point. He picked up his cup, and walked back to his room. He saw that Alyssa still wasn’t back, and settled at his desk to wait. He still had a good twenty minutes of the session, to go, which he intended to run over, to make up for the break, so he needed to work out what he planned to say.

Alyssa ran her hands under the scalding hot tap for the third and final time. She could feel them throbbing, and her skin almost bristled from the scrubbing, but that didn’t matter. She felt clean. She turned off the tap, returned her soap and the brush to her bag, then she dried her hands with a towel from her bag, before checking one last time in the mirror, and leaving the room. She saw Abs’ open door, looked at the main exit, and wished more than anything that she could turn and walk away, but instead she made for the doorway, and closed it behind her.

Abs looked up as he heard the door close. Part of him was surprised, as the thought had crossed his mind that she would just leave, but he was impressed to see that she’d come back. While he had been waiting for her, he had managed to work out a plan to try and reach her. She walked into the room, and she looked much better, though she still wouldn’t look at him as she sat down.

Alyssa focused on the carpet, and tried to concentrate on a spot right by her feet. She didn’t know what was coming next, but she knew Abs would not fail to notice the difference in her appearance. As she was thinking this, she heard Abs start to speak.

“Well, you look a little different” Abs said, stating the obvious. He didn’t really know what to say. He knew she was very touchy and self conscious about her appearance, and didn’t want to upset her too much if he was to try and make some success out of this session. He watched her closely, and noticed her sneak a look up at him. That look gave him the courage to plunge in and try to reach her. “Thoughts are back huh?” he said.

Alyssa looked at him in surprise. Sure, she wanted to get clean, but she didn’t want him guessing her thoughts. She quickly returned her gaze to the floor. “Alyssa…” she heard Abs call her name. ‘Why didn’t I just leave when I had the chance?’ she asked herself, frustrated. ‘Because you want to be in control’ she thought. Abs was still looking at her, She nodded her head without looking at him, and could almost feel her resolve crumble. She tried hard to bite back the tears, and after swallowing a couple of times, managed to get control.

Abs watched her, he knew that if she looked up at him, he would see tears in her eyes, but she was so strongly locked down he wasn’t sure if he could reach her. He needed to get her to let go, but he had a feeling that it would be a good few more sessions before she would come in and be prepared to openly talk to him. He sighed inwardly as the clock signalled the end of a very awkward session.

“Goodbye Alyssa” she heard Abs call after her as she almost ran out of the room, thankful to be released. As she walked to the bus, she started thinking, and felt a heavy weight settle on her shoulders as she thought of everything she had to do before she could rest. Part of her wished she had spoken to him more. And part of her was angry with herself for thinking that..

* * *

Abs sat down at his desk and leafed through his notes. Pleased as he was that his previous client was only weeks away from their final session, he knew that he had a lot of work to do with his next client before she would be even halfway ready to stop seeing him. Alyssa was so closed down. He had thought that he had gotten through to her a little bit, but the last session, had proved to him that he was no where near getting through to her. She was closed down, and she didn’t want to let him in. He was sure of that. For her to let him in, would be seen as weakness on her part.

Alyssa sighed as she walked into Abs’ room and he looked up at her. She hated the way that he looked at her, like he could see right inside her. She didn’t want anyone knowing what she was thinking. She didn’t want anyone to see the weak, pathetic person that she was beneath the mask. She sat down in her usual seat, and watched Abs walk to his chair and sit down. She could feel his eyes on her and wondered if he could tell that she had spent the whole day until the session, cleaning and tidying.

Abs looked at Alyssa, a normal person wouldn’t even have noticed it, but he did. It wasn’t obvious, there were only a few things that gave her away. Red, charred hands. Slightly flyaway hair, and she kept glancing around the room nervously. She was always nervous, but this was different. He didn’t like how twitchy she was, and decided to confront her. He didn’t normally confront people. He normally let them set the pace, but Alyssa was on the edge, and he could tell that if he didn’t do something drastic, then she was going to go over the edge.

“You’ve been cleaning, haven’t you?” she heard Abs’ question, and felt her cheeks flame, as she realised that he already knew the answer. She wanted to shake her head and lie to him, but she knew it would be a useless effort. She shrugged. She didn’t want to admit it instantly. He didn’t deserve to know all about her straight away. Not even her parents know this stuff. She didn’t feel that he should. “Admit it Alyssa, you’ve spent the day scrubbing, wiping, dusting, mopping, tidying and organising haven’t you” he said, in a hard voice, which made her look up in surprise. She didn’t understand why he was being so harsh.

Abs watched the look of confusion in her eyes. He knew she was wondering why he was being so confrontational, but he knew he was doing what was best for her. He had to confront her, and find a way to break through to her. He’d tried the softly –softly approach, and she was just shutting down more and more. She was so closed down, he didn’t even know what had happened to cause the ocd that she was suffering from.

Alyssa looked back at the floor, and nodded. She was ashamed, and could feel that shame burning on her cheeks. The voices in her head were screaming at her, chastising her. She looked up at him, she knew he was fully aware of what she’d done. Her hands looked like they’d done four days of work, and while she hated to admit it, they felt like they had too.

Abs watched her nod. “What happened?” he asked, more gently this time. “I.. I don’t know… for a while the voices faded.. shut up. Now, they’re coming back. I hate them! I hate that I can’t shut them off” she finished speaking and looked up at him. He could see the suffering, in her eyes. He stayed quiet, leaving her have a chance to collect her thoughts, before asking her another question.

Alyssa glanced at the window. The warm weather had broken, and she could see tiny spots of rain spattering the window pane. She could still hear the voices berating her. Calling her weak. The self hate boiled up inside her, and she felt hot tears of anger roll down her cheeks. She reached out to wipe them away, but then stopped. The voices were screaming at her, but she was tired of hiding. Her arms fell heavily to her lap, and she winced as the pain shot through them like fire.

Abs watched her fall apart and thanked whatever it was that had given her the ability to let go. “What do the voices say?” he asked her gently. She looked up at him, for a second and then looked down again. “I don’t know… They’re all messed up… “ she tried to shrug it off, but Abs knew he had to push it up. He knew that she was in quite an open, raw and emotional place, and he didn’t know when she would be in this space again. “How?” he asked her. “They tell me things that will happen if I don’t do what they tell me to. That if I don’t clean I’ll get ill like I did before and…” he looked at her as her voice trailed off. “How old were you when you were ill before?” he asked her. “Eight” she said in a monotone. “What was wrong with you?” he asked quietly.

Alyssa was breathing in short, sharp breaths. She was trying not to panic. His words were ringing in her ears. ‘What was wrong’ she didn’t know what to say. How could she tell him… what was she going to say? She looked up at him and then back at the floor. The silence was deafening. She felt like it was screaming at her. “I… I don’t remember. I was tired all the time. I kept being sick. I missed so much school and when I went back…” she trailed off, the pain of the memories overwhelming her. Abs said nothing and she inwardly cursed him, wishing that he would just say something to break the silence that was threatening to drown her.

Abs listened to the few words that Alyssa had said. She wanted to give her a few minutes to see if she would start talking again. When she remained silent, “When you went back…” he prompted her. He visibly saw her jump as he spoke, and waited for her to respond. “I.. when I went back.. it was horrible.. I was shut out. It was like I was a freak. I felt like such a loser. Everyone stared at me. They all avoided me and I thought I was going to lose all of my friends. It took months for them to stop the teasing and to be my friends again. I never want to have to go through that again. Ever.” Alyssa finished talking, and Abs smiled softly to himself. He was proud of her for letting go, but knowing that her issues ran so deeply, made him nervous for her. It was going to be a long, hard road for her to overcome this, and part of him was scared for her.

Alyssa sank down in her chair as the voices resumed their screaming. She hated that she was so weak and that she’d let herself down. That she’d let her secret out. She’d promised herself she’d never tell anyone, and now that she had, she felt more of a failure than ever. A single tear dripped down her cheek and off the end of her nose.

Abs looked at Alyssa’s broken figure. His heart broke for her, but he knew that this was what was best for her in the long run. “Ok Alyssa, that’s it for this session, but if you want to take a few minutes to get yourself together, then that’s fine” he said to her as he got up and walked to his desk. He shifted a few papers around, and attempted to tidy his desk. He didn’t want to make any contact with Alyssa for now. He just wanted to give her a chance to collect herself.

Alyssa sat there, tears falling silently. She felt lost. All the pain from back then was invading every part of her consciousness. She didn’t know how long she sat there, but eventually, the tears stopped, and she felt able to get up. She picked up her bag and left Abs room without a word, though he called out “See you next week Alyssa”.