The 5 Stages of Grief

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Chapter 7, Dr. Reichmann

“How are you doing this week, Holly? I am so glad you could get away for a few moments to see me. Sit down please, make yourself comfortable. Can I get you anything? Water perhaps?”

“No, thank you Doctor, I’m fine.”

He was already out of his chair and filling a glass for her before he’d even asked the question. He knew she would never say she was in want of anything no matter how much she might need it. That kind of free-will had been beaten out of her by this point in her life. He placed a glass of water in front of her and returned to his desk. Total recovery for this poor creature was entirely out of the question, there was far too much damage done ever to be undone. No, the most he could hope for would be to reconnect her with herself and even that was a long way off, though one had to remain hopeful. It was best to keep a positive attitude about these things or what was the point?

“How is the search going dear – any potential? In a city the size of this one, you would think there would be at least one decent place available to rent. Or is your mother giving you too much of a hard time to do the searching?” She was still staring at her folded hands upon her lap. No movement, no response, nothing, not the slightest hint to give notice that she’d even heard the question, yet all the answer needed. “I could still get the authorities involved you know. Just give the word.” Though phrased as a statement, he knew the rise in his phrasing making it a question, was not missed by the intelligent young lady sitting raw-nerved and beaten in front of him. It was a shame that a delightful creature such as this was forced to endure the horrors of this world at the hands of another, her own family. As a matter of fact, it was just these types of situation that enticed Dr. Fredrick Reichmann into his practice of personality disorders to begin with. Not that it was his only area of practice, but it was undeniably his area of expertise.

Take Holly for instance, she first came to him under the diagnosis of Avoidant, or as some call it, Anxious Personality Disorder or AvPD for short. With AvPD the afflicted person becomes so preoccupied with their inadequacies or shortcomings that they fear any criticism or rejection, whatsoever. Ridicule, rebuff, even a negative assessment – though not pleasant for anyone – have debilitating effects to people suffering from AvPD, compelling them to avoid social relationships and interaction with the outside world. At first glance, Holly had all the required symptoms for a diagnosis. So much so that he too believed and without a doubt, that Holly suffered from AvPD.

But why? Why did she have it?

Many doctors prescribe the patient away with cocktails of antianxiety agents and antidepressants, treating the symptoms instead of the cause. Although it rarely worked, it was a hell of a lot easier than dealing with the patient long-term and actually getting to the root of the disorder. Some would even prescribe group therapy – a treatment he found particularly ridiculous considering the nature of the malady – an oxymoron if you will, like military intelligence or anarchy rules. Dr. Reichmann was not of that mind, either. He believed the only way to reach this type of patient was with one-on-one psychotherapy from a qualified professional. Building trust with the patient first and then finding out what the core or root of the disorder might be. As with many disorders, indeed most, there was usually a triggering factor. Of course, the patient with the disorder, being genetically predisposed, was more susceptible to it than the average person, though that went without saying. But what triggered it? In his mind, it was the same medical puzzle tossed about in genetic labs for as long as people studied it – which came first? Or, alcoholics are alcoholics because it’s in their genes.” A foolish statement if you think of it. Is the alcoholic simply born that way? Or does it take the consumption of alcohol to trigger the alcoholic genes? What if this person never has a drink in their life? Are they still alcoholics? What if a person without dysfunctional genes, blessed with normal genes, drinks to total inebriation every day? Are they, he or she not an alcoholic? How do we tell this alcoholic apart from the one with the problematic genes?

The argument was not saying that alcoholism was not a disease. It was simply stating: in order to get it off and stumbling you needed a drink to trigger it and more than one at that. Left untreated, like any disease or disorder, the end result, though minor at first, become problematic over time, much the same as AvPD or any other personality disorder. At least that is what he believed and treated his patients accordingly.

It had not taken him long to put his finger on the problem, the trigger as he preferred, though unfortunately, the cause was Holly’s mother. It hadn’t come out right away. Holly was exceedingly reserved and never spoke anything but good about the abusive parent – but he could read between the unspoken lines and after a while, through the process of elimination, there was no doubt left in his mind. Who else could it be? he’d asked himself. Holly had no other relationships, it had to be her mother.

Bit by agonizing bit, he earned her trust and she began to open up to him. It went slow – as if to speak negatively of the woman put her in fear for her life – even though he assured her and reassured her that anything she told him was strictly confidential and would never get back to her mother.

To make it more difficult, she would only visit him sporadically, when sent about on errands, so her mother would not find out they were meeting. He would have said no but her need was so great, her disorder so advanced that he did not have the heart to shut her out.

“There is no need for the authorities Doctor, really. Things appear to be changing, somewhat. Mother is becoming frail with the arthritis. And though I am not positive, as she would not allow me to bring her to a hospital, I believe she has suffered a minor stroke or something as she seems to be favoring one side and has greater difficulty getting around. Either way, she appears to have softened a little. She’s a lot less demanding, less sure of herself.”

“You are still getting your own place though, I hope. I’m sorry if I sound unsympathetic my dear, but my concern is for you and your treatment, not for your mother. We can always send someone over to make sure she is okay. I will go myself if you wish. I could at least look at her current condition and get her help if she needs it. I believe your best course of action is to stay on plan and find your own place.” She was staring down at her hands again. That was a bad sign. “Do you not agree, Holly? Or have you changed your mind?” He tried to keep the concern from his voice, to keep it even, though he knew he wasn’t fooling her. She was too smart and he wasn’t doing a good job. If she stayed at home with her mother, he feared it would be like starting again from the beginning, that they would lose all the painstaking progress they had earned. She raised her head timidly, he had to smile. At least she raised her head.

“No, Dr. Reichmann, not right now. Mother needs me and I could never bring myself to abandon her in her time of need. I know what you’re thinking – that it would be the best thing for me. But how can it be best if I could not live with myself over the decision?”

She had him there, he had to give her that. “You will keep me posted then Holly? Contact me daily so I know you are safe, that she hasn’t done anything?” He could hear the concern and desperation in his voice, he didn’t bother to correct it.

“Of course, but you have no need to worry, mother is no longer capable of hurting me, not physically. As for other ways – that’s what I have you for, isn’t it?” She smiled at him then rose from her chair to leave.

She might make it after all, he thought as she closed the office door.

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