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"I'd like to make an appointment, please," she murmured softly into the telephone.
"Certainly. May I have your name, please?"
“No, I’d rather not…”
"I'm sorry, but we need your name in order to schedule you with a therapist."
"I don't see why that's necessary. Don't you people have some kind of thing about
"Yes, we don't give out information about our clients without their written permission. Still, we
need to have your name in order to set up an appointment."
"I suppose if I had the money to pay for a private therapist, I wouldn't have to go through all of
this. My name is Roberta."
Roberta arrived fifteen minutes late for her first appointment. Her therapist, Dr. T., was
impressed with how thin and gaunt the young woman appeared. When he inquired as to why she had
requested counseling, she said that her boyfriend had told her to come - the choice was his, not hers.
She didn't feel she needed any help. Dr. T. asked her why she thought her boyfriend had decided she
needed counseling. She replied, "because of these," and rolling up the right sleeve of her white
blouse, she revealed a line of small circular burn marks that started about three inches above her
wrist and meandered up her inner arm with an inch or two space between each burn.
"Are those cigarette burns?" Dr. T. asked.
"Yes," she whispered.
"Where else do you have them?"
Silently, she touched her chest and her belly and then drew her fingers lightly up the inside of
her left arm.
Dr. T. paused and then said, "Your boyfriend thinks you should get help to stop burning
yourself, but you're not at all sure that you agree. Is that right?"
"Very perceptive, doctor."
Noting the sarcasm in Roberta's voice, Dr. T. knew that his next comment would have to be
chosen carefully. In an instant, he decided against commenting upon her apparent anger and said
instead, "perhaps we could explore together the meaning and value that the burning has for you so
that you can become clearer in your own mind about whether you'd like to give it up. Would that be
Roberta considered before replying, "maybe. We'll see."
Over the next seven months, Dr. T. met with Roberta twice a week. Their sessions were
unpredictable and stressful for the therapist. Sometimes Roberta was almost mute, seemingly too
depressed (or sometimes too angry) to speak. At other times she was sarcastic and demeaning
towards everybody and everything, including Dr. T. Occasionally she seemed lively and energized,
quite normal in fact. Her warm, engaging behavior in these sessions bordered on the seductive. Even
then, she could turn in an instant, becoming angry or hurt. Through the storms and the silences, Dr.
T. learned some of Roberta's history.