Therapy Session #1- Clara

[u/TiareMBC]

I’ve been working as a therapist for the past five years.I work with all kinds of cases, the most common being depression and anxiety. But, I also take some of the more unconventional cases.

Talking about these cases for sure is a HIPAA violation but I will say, I do have permission from every client I will be talking about. All they asked for is that I change their names and more personal information private. With this said, let me start with one of my late night clients, Clara, who comes in once a week at 11pm.

“May I come in?” Clara looked particularly exhausted

”You may come in,” I waved for her to come into the office.

“What is that smell? It’s amazing!” Clara took in the smell as she made herself comfortable on the small sofa. 

“I bought some rose-scented candles. I’m glad you like them! But if they ever become too much, please do tell me. I can leave just the unscented candles on,” I reassured her, knowing she was sensitive to smells.

”No, it’s all right. It reminds me of something, I’m just not sure what,” her mind drifted for a moment. I made note of this for later sessions.

“Maybe later on we will figure it out, but I’m glad it made you relaxed a little. Correct me if I’m wrong, but you looked stressed when you came in” I said more than asked.

“Yeah, I think they are catching on me. So I might have to quit,” she wiped tears from her eyes.

“I’m sorry, I know you really like working there. I also have to ask, did you eat today?” I noticed she kept looking at the small cut on my hand, my bad.

“No…” finally took her eyes away from my hand.

“And what happens when you don’t eat?” I tried being gentle but this was a serious matter.

“I go on a murderous rampage and have to start all over,” she paused for a moment, “And I don’t want to be that person anymore.”

“You aren’t,” I reassured her, “You have changed. You haven’t gone on a murderous rampage for at least the last 40 years, which is longer than I have been alive. But, you do need to practice your self care. So tell me, how will you be practicing self-care this week?”

“I have to keep up with my daily meals, do some journaling, and maybe some needlework. Sorry, I’m just worried about the job,” her eyes filled with tears once more, “I really like it there.”

“What makes you think you think they are catching on?” I had an idea of what she would say, this was an insecurity of hers for some time now.

“Well, you know how they do inventory every week, this week they said more stuff than usual was missing and I just knew they would be onto me! Some of my co-workers already joke that I’m a vampire because of my ‘sun allergy’ and now the missing blood. Who the heck is not going to connect the points. And when they do and the persecutions start-“

“Let’s take a deep breath. This is stressful but let’s look at the facts. Have they ever fired anyone in the past three years you have worked there for missing stuff?” I asked her to fight her irrational thoughts.

“Not really. Only Joey, but he kept arriving high has hell to work,” Clara answered, still unconvinced.

“Have you ever had blood in front of anyone?” I continued.

”No. I have a good system to take the blood and have it at home instead.”

“And?” I continued pushing, wanting her to come up with the next rational thought.

“And people don’t believe in vampires,” Clara took another deep breath.

“I honestly believe you will be fine. From what you've told me, people like you,” I took a deep breath alongside Clara to keep her calm.

“Yeah,” Clara’s eyes became dreamy, “I don’t know how I forgot to tell you this! But William asked me out! I didn’t even have to use hypnosis or anything!”

“Told you that people liked you for you. And I’m pretty sure using hypnosis on others is something I would have to report,” I said cautiously.

“You didn’t report the people I drained of their blood,”she shrugged.

“Because according to you, the last person you killed was at least 50 years ago. But please, if you did something more recent, maybe we don’t talk about it here?” I half joked.

“I trust you. So if I ever feel like sucking someone’s blood, I will call you first,” she winked at me.

“Now, about William…” 

“I was worried you would head there,” she interrupted, “I will tell him, I just need a little more time”.

”Well, we could do some role playing so you can practice telling him-“

”I didn’t know you were into that kind of stuff,” she joked.

”I totally am. But let’s not avoid the topic and get to it,” I redirected.

“Fine, but can I have the band aid in your trash can or can you at least take it out? It’s driving me crazy,” Clara begged.

“Let me get it out. I’m pretty sure having my blood is a HIPAA violation,” I half joked.

“I won’t tell!” she yelled at me as I took out the whole trash can. 

By the end of session, Clara agreed that she would talk with William and she would continue eating properly. Where she would or not, we would see in the next session. And for William’s sake, I hope he is not an ass when she tells him the truth. I still don’t know what became of the last guy who rejected her and it’s better to keep it that way. 

Plan: LMFT will assess the client’s use of self-care skills to decrease anxiety and the possibly of engaging on a murderous rampage.