All About Spike

Chapter: 1  2  3  4  5  6  7

After the Fall
By Elena

Dawn's POV, a little different style than I've used before, rated PG-13, some disturbing talk.



Case #9323

Dear Dr. Schrodenhauer,

I'd like to take this opportunity to mention how impressed and inspired I was by your lecture series at UCLA this past semester. Your reputation in dealing with troubled youth is legendary, and your insights are extraordinary.

My colleague, Dr. Marc Jacobsson, suggested that I write you regarding a troubling case that I am currently handling. I know that you are very busy, but I hope that you can provide me with some guidance. I am at a loss at how to help this poor girl.

If you are able to consult with me I will, of course, send you any information you require. Right now I'll just give you the bare bones of the situation.

D.S. is a fifteen y.o. female. Her medical history is unremarkable, save for two instances of what are suspected to be self-inflicted knife wounds. Her family history is quite tragic. Her mother died after a short illness, and her sister was killed in a recent accident. Her parents were divorced ~5 years ago, and she has had limited contact with her father. In fact, she has been declared an emancipated minor. Her school has required this counselling as a condition of her admission. D.S. is quite resistant to therapy.

Please let me know if you are able to help me with this case.

Thank you,

Angela Maw, MD, FRPC

***

Dr. Schrodenhauer,

Thank you for your speedy reply. I am very pleased to accept your offer of assistance.

D.S. is a very troubled girl, and she needs all the help we can give her.

Per your request I am enclosing the transcripts of our sessions, as well as any observational notes I have made.

Once again, I have to thank you for assisting me.

Sincerely,

Dr. Maw

***

Session One

AM - Come in, please. Have a seat. Are you comfortable, Dawn?

DS - I guess so.

AM - I'm Dr. Maw. It's nice to meet you. I want you to know that you can say anything to me in these sessions. They are completely confidential.

DS - You won't tell the school what I say?

AM - No. I won't release anything without your permission.

DS - Okay.

AM - Dawn, is there anything you'd like to talk about today?

DS - No.

AM - Well, seeing as it's our first session, I'd like to get to know you a little better.

DS - Okay.

(paper shuffling)

AM - What grade are you in?

DS - Ninth. … I have to go to summer school.

AM - And how do you feel about that?

DS - I don't have a choice. I missed too much school last year.

AM - I understand that your Mom was sick. That must have been hard for you. … You don't have to talk about that if you don't want to.

DS - I don't want to talk about that.

AM - That's okay. So, your sister became your guardian. How did that make you feel?

DS - I don't want to talk about my sister.

AM - Okay, we don't have to talk about that. We don't have to talk about anything that you don't feel comfortable discussing.

(pause - one minute, fifteen seconds)

AM - I see that you went to court to be emancipated.

DS - Yes.

AM - What does that mean to you?

DS - It means that I'm an adult. That I can do what I want.

AM - Do you think that you're an adult?

DS - I dunno. … Sometimes I feel really old.

AM - Yes. I think that happens to everybody at one time or another. But it's not really the same thing as being an adult, is it?

DS - I guess not.

AM - Adults have a lot of responsibilities. There are a lot of decisions that have to be made.

DS - I suppose.

AM - Do you find that difficult?

DS - Sometimes. … I have friends who help me.

AM - Do you want to tell me about them?

DS - … I guess. …

AM - Go on.

DS - They're my sister's friends. … They promised her that they'd take care of me.

AM - Do you see them often?

DS - We all live together.

AM - Go on.

DS - They all moved into my house after … When Buffy died.

AM - Buffy is your sister?

DS - Yeah. … They moved in. We all take care of each other.

AM - How do you take care of them?

DS - Well, I help take care of Anya. … She's in a wheelchair.

AM - That sounds like a lot of work.

DS - Oh, Xander does most of it. They're getting married. I just help by bringing her stuff that she needs. Books and stuff.

AM - That's very kind of you.

DS - I'd do anything to help Xander. And I've gotten to know Anya a lot better now. She's very funny. I'm going to be her bridesmaid.

AM - That sounds like fun.

DS - I've picked out a dress. It's pink and has a great big skirt.

AM - It sounds nice.

DS - Oh, yes. It's all satin and has lace sleeves. Anya hasn't decided what kind of flowers she wants.

AM - There's a lot of work involved with a wedding. Have they set a date?

DS - Not yet. Anya wants to be able to walk down the aisle with Giles.

AM - So the wheelchair isn't permanent?

DS - No. … She has exercises to do. … Sometimes I help her with them.

AM - Sounds like she's very determined.

DS - Oh, yes. She says that she'll walk down the aisle and then she'll race Xander to the honeymoon. … I don't think that I was supposed to hear that part.

AM - Well. … Tell me about Xander.

DS - He's the coolest grown-up I know. He's a construction worker, and he has his own car.

AM - And he's engaged to Anya?

DS - Yeah.

AM - And they both live with you?

DS - They sleep in my mom's room.

AM - And how does that make you feel?

DS - I don't understand.

AM - To have them sleeping in your Mom's room.

DS - I don't want to talk about my Mom. …

AM - That's okay. … We're almost out of time anyway. I'll see you next week.

DS - 'Bye.

***

AM - DS is a very self-contained adolescent. It is only to be expected, given the circumstances of her life. She is clearly unwilling to discuss her mother and sister, I hope that in time she'll be more comfortable. Obviously their deaths were a major contribution to what I perceive are her deeply seeded abandonment issues. I will attempt to bring her father into the sessions as well. She hasn't mentioned him, and I think that there must be issues there are well. She is resistant to therapy. The only time she opened up was while talking about her friends. I will draw her out on this. I am concerned that they may be taking advantage of her youth and inexperience.

***

Session Two

AM - Good morning, Dawn.

DS - Good morning.

AM - How are you today?

DS - Fine.

AM - That's good. … Is there anything you'd like to talk about today?

DS - No.

AM - Okay. … I was hoping to learn more about your friends. Do you feel like talking about them?

DS - Okay.

AM - So, you mentioned a Giles last session. … You said that he would walk Anya down the aisle. Is he her father?

DS - (laughter) No. … He's a friend. He was the librarian at Buffy's school.

AM - So he's older?

DS - He's way old. But he's good to have around. He knows just about everything.

AM - He lives with you too?

DS - Uh huh. He takes care of us.

AM - How does he do that?

DS - Well, he, umm. … He has a store, and Willow and Tara work there. He helps me with my homework. He went to Oxford.

AM - Willow and Tara?

DS - Oh, they live at my house too.

AM - Really? You must have a very large house.

DS - Oh. Um. Willow and Tara share a room.

AM - Well. …

DS - Willow is Buffy's best friend. She's the coolest person. She's so smart, and she's really good at sp.. … Um. She's really good at public speaking.

AM - I see. And Tara, was she a friend of Buffy's also?

DS - Well, Buffy liked her.

AM - And what do you think about her?

DS - Tara's neat. She's teaching me to cook.

AM - Do you enjoy that?

DS - Oh, yes. It's a lot of fun. I like helping Tara. She has so much to do.

AM - Does she do all the cooking?

DS - Well, I help, and so does Anya. Xander makes breakfast all the time. We don't let Giles cook anymore. (laughter) He made this horrible moose thing for dinner one night.

AM - Moose? … So, is that everyone? No one else stashed in the house? Lurking in the bushes?

DS - Um. … No. … No one.

(pause - two minutes eighteen seconds)

AM - How's school?

DS - It's okay. It's school. Learning and stuff.

AM - I guess I don't have to ask if you're enjoying it.

DS - None of my friends are in summer school. But at least I'll get to see them all in the fall.

AM - You mentioned that Giles helps you with your homework.

DS - Yeah.

AM - Are you having any trouble with your classes?

DS - No. … It's just that I sometimes don't see the point.

AM - The point?

DS - You know. … Why should I study and get good grades. Why does it matter?

AM - Why don't you tell me why it doesn't matter?

DS - … It doesn't matter because it doesn't change anything. …

AM - Doesn't change what?

DS - Anything. …

AM - I don't understand what you're saying.

DS - … Being smart doesn't stop you from dying.

AM - … No, I suppose that it doesn't. … But Dawn, everybody dies.

DS - Don't you think that I know that!

AM - … I think that you know that better than a lot of people.

(sound of crying)

AM - Have a tissue.

DS - (muffled) Thank you.

AM - I think that it comes down to the kind of life that you lead.

DS - What?

AM - I think that's why what you do matters. It does matter what kind of life that you lead.

DS - Buffy thought so. … She said that living was hard. … She told me to take care of her friends. (crying) She's counting on me. …

AM - Do you think that was fair?

DS - What?

AM - Do you think that was fair of her? To give you that responsibility?

DS - Don't ever say anything about Buffy. Buffy is a hero.

AM - What makes her a…

DS - Don't talk about Buffy.

AM - Okay.

(pause - one minutes thirty-two seconds)

DS - I'm sorry.

AM - You don't have to apologise for your feelings, Dawn. Not to me. It's why I'm here.

DS - I'm still sorry.

AM - You can make it up to me next session. … I have some homework for you. (laughter) Don't look so appalled. It's easy.

DS - Okay.

AM - I want you to tell me the best thing that happens to you during the week.

DS - Okay. That sounds like fun.

AM - I also want you to tell me the worst thing that happens.

DS - … Okay. …

AM - Time's up.

DS - See you.

AM - Good bye.

***

AM - Dawn seems to have great affection for her friends. While this will almost certainly help her heal from the loss of her mother and sister, it doesn't preclude the possibility that they are taking advantage of her. I am concerned about her exploitation, both financially and sexually. While I have seen no evidence of any inappropriate behaviour, I am not comfortable about her living arrangements. It's quite clear that she is hiding something. I am also concerned about the almost worshipful attitude she has toward her sister. She's a very tough little girl. I hope that I can begin to get closer to her.

***

Session Three

AM - Good morning.

DS - Hello.

AM - I like that sweater you have on.

DS - Thanks.

AM - That shade of blue is very becoming.

DS - … It's Buffy's.

AM - Pardon?

DS - This sweater is Buffy's.

AM - Oh.

DS - She hates it when I borrow her things.

AM - I think that all sisters feel like that. Do you think that she would mind you wearing it now?

DS - … It doesn't really matter, does it. …

AM - Okay, I gave you an assignment.

DS - Yeah.

AM - What was the best thing that happened to you last week?

DS - Xander and I played house tag.

AM - House tag?

DS - It's like regular tag, but you play it in the house. And you can only be tagged it if you are on the floor.

AM - I see.

DS - It was a lot of fun. Xander was it and he chased me all through the house. He almost caught me in the bathroom, but I jumped up on the toilet. (laughter) Giles said that it was a good thing that the seat was down or I would have gotten a soaking. (laughter) And then Xander finally caught me in the kitchen because I couldn't get up on the stove since Tara was cooking.

AM - Sounds like fun.

DS - Oh, and then I had to catch Xander. I think that he was taking it easy on me, because I almost caught him tons of times. (laughter) I almost got him outside of Buffy's room, and then he had to jump up on the bed and he woke up Spike. (laughter) And then Spike threw him on the floor and I tagged him. (laughter)

AM - Who's Spike?

DS - What?

AM - You said that Xander woke Spike up. Who's Spike?

DS - … Umm. … He's sort of like my, umm, bodyguard? … He watches the house.

AM - You have a bodyguard?

DS - … Umm. … Buffy asked him to take care of me.

AM - Seems like people listened to Buffy.

DS - … Yeah. … I don't want to talk about Buffy.

AM - Okay. … What was the worst thing that happened to you last week?

DS - Ugh. My stupid English teacher is making us read a Shakespeare play.

AM - You don't like Shakespeare?

DS - Uh, no.

AM - Why not?

DS - It's so boring! And it's not like it's even in english.

AM - I see.

DS - I'm going to read it.

AM - I never doubted you for a second.

DS - … Umm, are you being funny?

AM - Apparently not.

DS - Oh.

AM - So, Spike lives at your house too?

DS - … Yeah.

AM - How does that make you feel?

DS - What? How does Spike living in my house make me feel?

AM - Yes.

DS - Well, it makes me feel safe.

AM - Did you feel unsafe before?

DS - Before what?

AM - Before Spike came to live with you. I assume that he's a recent addition?

DS - … Before Spike I had Buffy. …

AM - And you felt safe with Buffy?

DS - Of course I felt safe with Buffy. Nobody would mess with Buffy. She keeps everyone safe.

AM - Did she keep you safe?

DS - What? What do you mean?

AM - You were hurt. The night Buffy died.

DS - That wasn't her fault. She did her best to save me.

AM - Save you? Did someone hurt you?

DS - … I fell. … I fell on something metal. …

AM - What did you fall on.

DS - … I don't know. … Something metal. …

AM - And Buffy was killed.

DS - … She fell. …

AM - But she told you to take care of her friends before she … fell?

DS - … I don't want to talk about this.

AM - Okay, you don't have to. I just wanted to know h…

DS - I don't want to talk about this.

(pause - three minutes six seconds)

AM - You never talk about your father.

DS - So.

AM - I was just commenting.

DS - Well, I don't need to talk about my father.

AM - Why not?

DS - Do you see him around? He didn't even call when Mom died. He didn't even call when Buffy died. He doesn't care.

AM - And how do you feel about that?

DS - How do I feel about that? I don't care. I don't give a damn. (crying) Why the fuck isn't he dead. Why couldn't he have died instead of Mom? Why does Buffy have to take care of everything? (crying) Why can't he (garbled)…

(sound of crying)

AM - Here's a tissue.

(sound of nose blowing)

AM - You talk of Buffy in the present tense.

DS - Huh?

AM - Present tense. She is, she does. Like she's still alive.

DS - … I don't want to talk to you anymore. …

(pause - ten minutes twenty-six seconds)

AM - Maybe we should call it a day.

***

AM - I perhaps pushed Dawn a little too hard today. I was hoping to force a breakthrough, but I may have alienated her. I do think that I was right about abandonment issues, she seems particularly angry with her father, but I suspect that there is much anger toward Buffy. I note the hesitation when she described Buffy's fall. Could this be a case of suicide? Or is it just survivor guilt? Dawn's explanation of how she came by her stomach wounds is also suspect. Self-inflicted or something worse? There was no indication of third party involvement in the police report. But why would a fifteen-year-old need a bodyguard? And who is this Spike person? On the bright side I am less worried about her relationship with Xander. It seems like a healthy attachment, a brother/sister sort of thing.

I think that I need to bring in outside help.

***

Session Four

AM - Good morning.

(pause - two minutes forty-six seconds)

AM - It's okay if you don't feel like talking.

(pause - two minutes thirty seconds)

AM - Dawn, I want to help you.

(pause - one minutes six seconds)

AM - I think that we're having trouble communicating.

(laughter)

(pause - two minutes nine seconds)

AM - I'd like to bring another doctor in on this case.

(pause - fifty-eight seconds)

AM - He wouldn't join the sessions, I'd just send him transcripts of our conversations.

(pause - forty-two seconds)

AM - Would that be okay with you?

(pause - forty-nine seconds)

DS - Would it matter?

AM - Of course it matters. I told you before that our conversations were confidential. I would never say anything about you unless I had your permission.

DS - I guess.

AM - You guess that this is confidential or you guess that I can get another doctor to consult?

(pause - one minute twenty-three seconds)

DS - Both. … You can talk to the other doctor.

AM - Thank you. I'm here to help you, Dawn. I want you to know that.

DS - Yeah. Whatever.

AM - So, how are the wedding plans going?

DS - … Anya wants a small wedding. … She says that the one we were planning is too expensive.

AM - Are you disappointed?

DS - … Not really, I guess. … I still get to have the pink dress. …

AM - That's good.

DS - Anya says that we need to tighten our belts.

AM - Are you having financial difficulties?

DS - Giles says that we aren't. … Anya's just really careful with money. …

AM - Well, that's a good thing, don't you think?

DS - … I guess. … But she and Willow had a fight. …

AM - Go on.

DS - … I don't think that Willow likes Anya very much. …

AM - Why do you think that?

DS - … Willow seems to be making fun of Anya. … Anya doesn't know a lot of our traditions. …

AM - Is she from somewhere else?

DS - … Yeah. (laughter) You could say that.

AM - What do you think about that?

DS - About Anya being from somewhere else?

AM - Well, I was thinking about Willow making fun of Anya, but you answer whichever question you want.

DS - … It seems kinda mean to make fun of Anya.

AM - Did you tell Willow that?

DS - … No. … I'm sure Willow isn't trying to be mean. …

AM - Sometimes people can hurt you without meaning to do it.

DS - … Yeah. …

AM - Has anyone ever hurt you without meaning to do it?

DS - … Yeah. …

(pause - three minutes twelve seconds)

DS - Some of the girls at school, regular school, they make fun of me.

AM - That sounds mean.

DS - Yeah. … A rumour went around that I cut myself. …

AM - Rumours can be painful. …

DS - … Yeah. …

AM - Were they true?

DS - … Yeah …

AM - Why did you cut yourself?

(pause - four minutes ten seconds)

DS - I wanted to see if (garbled)

AM - I'm sorry? I didn't hear that.

DS - I wanted to see if I was real.

AM - What do you mean?

DS - I wanted to see if I would bleed. … If I was real. … If I was here. …

AM - Why would you think that you weren't real?

DS - I don't want to talk about it.

AM - I think that it might be imp…

DS - I don't want to talk about it.

(pause - six minutes thirteen seconds)

AM - Our time is up.

DS - 'Bye.

AM - Dawn, I'd like to start seeing you more often.

DS - Why?

AM - Because once I get the consultation from Dr. Schrodenhauer I think that we'll have a lot more to talk about.

DS - … Okay. … 'Bye.

***

AM - I think that I've managed to win back a bit of Dawn's trust. I was surprised that she told me about the incidence of self-mutilation. Her self-professed doubts about the reality of her existence are telling. I would not have thought that she had a self-image problem, but I guess it's to be expected of a teenage girl. I am pleased that she agreed to allow me to consult with Dr. Schrodenhauer.

***

Dr. Schrodenhauer,

Here are the transcripts of our sessions to date. I look forward to your input.

Dr. Maw

***

Dear Dr. Schrodenhauer,

Further to our telephone conversation on Tuesday, I'd like to go over the points we discussed re: Case#9323 (D.S.)

· D.S. is clearly very conflicted regarding her sister. I do not know if I agree that her self-image problems (which caused the instances of self-mutilation) are due to an unconscious competition with her sister, but I will try to explore this avenue.
· While her living conditions are not ideal, when she speaks of her roommates her tone is very fond. She clearly loves them, and while that is not a guarantee of a healthy environment, it is perhaps better than the alternative of D.S. living in a group home or on her own.
· Father issues.
· She is clearly reticent about her sister's death, and other elements of her life. I am not sure if this is a self-defence mechanism or if she is hiding something traumatic. I agree that pushing her will not provide a breakthrough. My last attempt was a clear failure, and I do not want to risk alienating her.

To summarise, we certainly do have a lot of work ahead of us. Thank you for your insights.

Sincerely,

Dr. Maw

P.S. David, I've just had some distressing news. D.S. will not be able to keep our next appointment. It seems that one of her roommates, Anya, has died. I hate to think the effect this will have on D. I'll keep you apprised, Angie.

***

Session Five

AM - How are you Dawn?

DM - Okay.

AM - I'm sorry about Anya.

(sound of crying)

DS - I'm sorry.

AM - Cry as long as you need to. It's all right.

(sound of nose blowing)

AM - Do you want to talk?

DS - Anya's dead.

AM - Do you want to talk about it?

DS - She died. She had an embolism. …

AM - She wasn't very old, was she?

DS - (crying) She was twenty. … I guess she was twenty. … It's complicated. …

AM - It's hard when people die. Especially when they are young.

(crying)

AM - How are you holding up?

DS - You'd think that I'd be used to it. … You think that I wouldn't have any reasons to cry. … The worst thing in the world has happened to me already. (crying) Twice. … I don't have my Mommy and I don't have Buffy. (crying) And now Anya is gone, and I really liked her. …

(pause - two minutes fifty-six seconds)

AM - How are things at home?

DS - Bad. … Xander is so upset. He came home from the hospital, after Anya. … (crying) He came home without Anya and he went upstairs. (crying) He was shaking and Spike tried to calm him down and he was fighting (garbled). … And then he was making these horrible sounds. (crying)

AM - It's okay, Dawn.

DS - And. … Huh-huh.

AM - Put your head between your knees. Breathe deeply.

(pause - seven minutes twenty-eight seconds)

AM - Better?

DS - Yeah. …

AM - It must be hard for Xander. To lose somebody he loves while she was so young.

DS - Yeah. … He came down to breakfast the next day. … He was so sad. … He's usually such a happy person. … It's like he wasn't even Xander anymore. (crying) It's like I'm losing him. … I can't lose anyone else. …

AM - Xander just needs time. It's what you need, too.

DS - … I feel so bad. …

AM - Of course you do.

DS - No. … I feel bad about how I thought about Anya. … Before. …

AM - What do you mean?

DS - … Before, when I first met Anya. … I didn't like her. … I was jealous. … I like Xander so much. … He treated me like a grown-up. … I didn't like her. … I wanted her to go away. (laughter) Guess I got my wish, huh? …

AM - Dawn, you are not responsible for Anya's death. Thoughts can't kill.

DS - (laughter) But they can. … I took a pair of her earrings once.

AM - Earrings?

DS - I stole them. … I wanted to see what kind of hold she had on Xander. … I wanted to see if she had put a spell on him. …

AM - Spell?

DS - So I put the earrings in a circle, and I said a charm. … And there wasn't any spell. … Do you want to know what kind of hold she had on Xander? … Do you want to know?

AM - Okay.

DS - She loved him. (laughter) That's all. … That simple. But I loved him, and that didn't make a difference, and I couldn't understand why. (crying) And so I asked him, and he told me that no one had ever loved him before. … That it was the first time someone he loved loved him back. (crying) And I told him that I loved him. … And he hugged me and told me that he loved me too, but he was treating me like a kid. … Like I was just some stupid girl with a stupid crush. (crying) And I wanted him to hurt. … I wanted him to hurt as bad as I was hurting. (crying) And he's in so much pain now. … I've lost him. … He's not even my friend anymore. … I got my wish. … I'm just a selfish little girl and I hurt everyone around me. … I should never have been created. (crying) If I didn't exist Buffy would be alive, and Anya would be alive, and Xander would be happy. (crying) I want my Mom, and she's not even my Mom, but she loved me. … (garbled)

AM - Dawn, you are not responsible for this. Accidents happen, illnesses happen. People die. Sometimes there aren't any reasons. Dawn, are you listening to me? … What you are feeling is guilt. … You feel bad about your negative emotions, but they can't hurt anyone but you. … Dawn?

(sound of crying)

AM - Dawn, drink this.

DS - Thank you. …

AM - Go into my bathroom and wash your face.

(pause - two minutes twenty-nine seconds)

AM - Feel better?

DS - A little. … Thanks.

AM - Dawn, you've had a lot to deal with these past few months. … I'm going to write you a prescription for a medication to help you.

DS - Medication?

AM - An antidepressant. … It's going to make it easier for you to deal with everything that's going on.

DS - I thought that's why I came here.

AM - It is. … And I'm going to see if we can increase the number of our sessions, but this medication will help you deal with things a little better.

DS - Okay.

AM - I'm going to start you on a low dose. We can increase it if it isn't helping. You might get a little sleepy on it, and it might upset your stomach a little.

DS - Okay.

AM - Here. Take this to the pharmacy on your way home.

DS - Okay. 'Bye.

AM - Take care of yourself Dawn. I'll see you in two days.

DS - Okay.

***

AM - Prescribed sertraline 25mg OD mitte 14 days. I'm seriously worried about Dawn. Her crush on Xander, which would be a healthy expression of love under normal circumstances, is leading to a horrendous level of guilt. She seems to feel herself responsible for not only Xander's unhappiness, but also the deaths of Anya and Buffy. Her comments regarding her unworthiness to be alive are alarming. I think that she is at risk of suicide. I hope that by increasing her visits and starting the medication we can avoid that. I am also worried about her comments about spells. I don't know if this is symptomatic of a psychotic break or if it is a faddish response to popular culture. I will try to sound her out about this.

***

David,

Thanks for getting back to me so quickly. Who knew that the FAX machine would be such a boon to psychiatry?

I think that you're right. If Dawn doesn't show improvement over the next few sessions hospitalisation is inevitable. The separation from her friends would be traumatic, but she is a genuine suicide risk now. I think that much will depend on the support that she receives at home.

I appreciate you insight regarding the 'witchcraft' comments. It seems likely that her belief in this is not genuine, and is inspired by proximity to our rather large new-age community.

As for the alprazolam, I prefer to avoid anxiolytics when possible. I feel that there is too much risk of habituation, even in the short term. A sub-lingual lorazepam would certainly have come in handy during the last session, I must admit.

I will be seeing her tomorrow; I will send you the transcripts ASAP.

Thanks,

Angie

***

Session Six

AM - How are you Dawn? Feeling better?

DS - Yeah. ... I slept a lot. ... I think the medication is making me tired. ...

AM - That can be a side effect.

DS - ... Yeah. ... I remember you said that. ...

AM - But how are you feeling?

DS - Better. ... I guess. I miss Anya. ...

(pause - two minutes, forty-two seconds)

AM - Have you been thinking about your mom?

(pause - one minute, eight seconds)

AM - Sometimes people find that a new tragedy makes older grief seem fresh.

DS - ... I suppose. ... I keep thinking that she'd be able to help. ... Xander always liked Mom. ... I don't think that his own mother is very nice. ...

AM - And Buffy?

DS - I don't want to talk about Buffy.

AM - Okay. ... How is Xander?

DS - ... I can't tell. ... He's not crying. He's not even talking to me. ...

AM - What about the others?

DS - Huh?

AM - How is Spike handling things?

DS - ... He's worried. He's worried about Xander. ... I guess that he's worried about me.

AM - Does he have reason to worry about you?

DS - ... I think that he's worried about how Xander is treating me.

AM - And how is Xander treating you?

DS - (sigh) I guess that he's ignoring me. ... It's like he doesn't even see me.

AM - How does that make you feel?

DS - ... It hurts. ... I want him to play tag with me. ... To make me laugh. ... I want him to make me feel better. ... That's pretty selfish, isn't it?

AM - What's selfish?

DS - Wanting him to take care of me when he's so sad. ... I should be trying to make him feel better.

AM - What would you do to make him feel better?

DS - ... I don't know. ...

AM - Well, what would make you feel better?

DS - (laughter) To have Mom and Buffy back. ... But I am not going to try that again. ...

(pause - one minute, twenty-three seconds)

AM - What do you mean?

DS - ... I don't want to talk about it. ...

AM - Dawn, last session you were talking about spells.

DS - ... Yeah? ...

AM - Do you want to tell me about that?

DS - ... About what? ...

AM - About spells.

DS - ... Um, what did you want to know?

AM - Well, I guess I want to know what you think about them.

DS - ... I ... What I think? ... I guess ... I don't know.

AM - You said that you wanted to see if Anya had cast a spell on Xander.

(pause - forty-one seconds)

DS - I guess I was speaking ... metaphorically? Like, what kind of feminine wiles did she use to entrap him. ... You know, like that.

AM - Okay. ... And then you said that you spoke a charm over Anya's earrings.

(pause - fifty-two seconds)

DS - Um. I was trying to charm Xander? You know, with feminine wiles?

(pause - one minute, seventeen seconds)

AM - Dawn, I am trying to help you. ...

DS - I know.

AM - But I can't help you unless you're honest with me.

DS - ... I'm trying to be honest with you.

AM - Are you? Then why don't you try to answer my last two questions again.

DS - ... It's silly. ... I didn't want you to think I was stupid. ... Giles owns a magic shop. ... He sells crystal balls and tarot cards. ... And ... And love spells. ...

AM - Go on.

DS - And I just wanted to make Xander love me.

AM - You thought that you could make him love you using magic?

DS - No. No, of course not. ... Yeah. I guess I did. ... It was at least worth a try.

AM - I suppose.

DS - It might have worked. ... No, I guess not. ... See what I mean about stupid?

AM - You aren't stupid Dawn. Plenty of people who are older than you believe in magic.

DS - Giles says it keeps us in house and home.

(laughter)

AM - You see how much easier it is when you tell the truth?

DS - I guess I'm used to doing things the hard way.

AM - Easy or hard, it's up to you.

DS - One of those adult decisions?

AM - (laughter) I guess so.

(pause - one minute, twenty-six seconds)

DS - … I talked to Willow.

AM - What did you talk about?

DS - … She was crying. … I asked her what was wrong. …

AM - Go on.

DS - She said that she was crying because of Anya. … I always thought that she didn't like Anya. …

AM - What made you think that?

DS - Well, she would tease Anya. … She used to wonder what Xander saw in her.

AM - She said that?

DS - … Yeah. … A couple of times. … Sometimes she and Tara would be talking about it. …

AM - So what else did you and Willow talk about?

DS - Willow said that she was crying for Xander. … That she felt very sorry for him. …

(pause - fifty-eight seconds)

DS - I told her about my wanting Anya gone. …

AM - Dawn, you know that thoughts can't hurt people.

DS - That's what Willow said. … That thoughts can't hurt anyone. … Unless you have (garbled)

AM - Sorry? I missed that last part.

DS - Nevermind. … She said that if wishing Anya gone was enough to kill her, she never would have made it out of high school. …

AM - So you feel better about that?

DS - … Yeah. … I guess. … There were times when I wanted to die. … If thinking about bad things made them happen I guess I wouldn't be here.

AM - You've thought about killing yourself?

DS - What? No. I wouldn't do that. … Sometimes I just think that things would be better if I wasn't around. … If I had never showed up. …

AM - How do you think Buffy would feel about that?

DS - What?

AM - Would Buffy wish that you hadn't shown up?

DS - … No. (crying) She wanted me to be here. … She wanted me to be safe. … But I'm not as important as Buffy. … I should have died. … People need her. …

AM - Did Buffy think that way?

(pause - two minutes, eight seconds)

AM - Did Buffy think that she was more important?

DS - … No. … (garbled) … She said that I was the most important thing in the world. …

AM - And isn't Buffy always right?

DS - (laughter) Yeah. About important stuff, anyway. Some of her clothes are really ugly.

(laughter)

AM - We've run a little long today.

DS - I'm sorry.

AM - No, it's okay. … Have a good weekend.

DS - You too. 'Bye.

***

AM - Dawn's outlook seems to have improved. Willow's comments seem to have made a big impression on Dawn; she doesn't appear to be as guilty about her feelings toward Anya. If things continue in this fashion I don't believe that hospitalisation will be necessary. The death of her friend has certainly been a setback, but I am confident that we have made progress. I think that this is the most she's divulged about Buffy. I am confident that her therapy will proceed more smoothly now.

***

David,

Yeah, I know. Never get too optimistic. But I think that real progress has been made. I hope that we can dig a little deeper into her sister's death, which seems to have caused a great deal of damage.

I'm glad that you agree with me about hospitalisation. I think that it would be more traumatic than beneficial at this point. Give her medication a couple of weeks to kick in and I think that we'll see some improvement in her overall mood.

I guess I am counting my chickens prematurely, but I have a good feeling about this girl. She's resilient. Watch, now there will be another major upheaval in her life.

Angie

***

Dave,

I'm beginning to believe that I can cause things to happen just by thinking them. Jesus fucking Christ, what else could possibly happen to this poor girl.

Angie

***

Session Seven

AM - How are you? … Dawn, are you okay?

(sound of crying)

AM - Dawn, what's wrong?

DS - It's Giles. … He's gone. … He's (garbled)

AM - Dawn? What happened to Giles?

DS - He left us. (crying) He went back to England. … He said he wanted to go home. … He left me. … He doesn't think that (garbled) … But I need him. …

AM - Dawn, I can't understand you.

(pause - two minutes, fifty-one seconds)

DS - (clearing throat) Giles left yesterday. … He's going to England. … Spike says. …

AM - What did Spike say?

DS - He said that Giles needs comfort, and sometimes you have to go home to get it.

AM - How did that make you feel?

DS - … I dunno. … Being at home doesn't make me feel better.

(pause - one minute, eight seconds)

AM - Giles was Buffy's … teacher?

DS - … Yeah, something like that.

AM - And he ended up staying with you?

DS - Yeah.

AM - He must have been very fond of you and Buffy.

DS - He loves Buffy. … He loves me too.

AM - Did he have a relationship with your mother?

DS - Relationship? … You mean? Eww. That's gross.

AM - (laughter) Sorry. So they weren't involved?

DS - No. … He was Buffy's, umm, mentor? Is that the right word?

AM - Well, a mentor is someone who gives guidance.

DS - Yeah, that's the right word.

AM - And what was he to you?

DS - What?

AM - He was Buffy's mentor, was he your mentor?

DS - Umm, no. I guess not. … Maybe when I'm older. …

AM - So, is he your friend? A father figure?

DS - (laughter) Well, I always thought he was my friend, but he left. I guess that makes him a father, doesn't it?

(pause - two minutes, eighteen seconds)

AM - We've talked about your father before. … How would Giles compare to your father?

(pause - one minute, three seconds)

DS - I don't know. … I'm tired. … I don't feel like talking anymore.

AM - That's okay. We can sit here quietly.

(pause - fifteen minutes, forty-seven seconds)

AM - Dawn, we're almost out of time.

DS - Okay.

AM - Before you go, maybe we can try a little homework for next time.

DS - … Okay.

AM - I want you to think about your happiest memories. I want a happy memory about your mom, your sister. … And about your dad. Do you think that you can do that?

DS - … I don't know. … I don't know what's real. …

AM - What do you mean?

DS - I don't know when my memories start. … I don't know what's real and what's put there.

AM - Put there?

DS - I don't think that I can trust my memory.

AM - Would you try?

DS - … Okay.

AM - Good. I'll see you in … three days, okay?

DS - Yeah. 'Bye.

***

AM - Dawn has serious abandonment issues. Her father, who seems to be completely absent from her life, her mother, her sister, and now her substitute father. I'm not sure how she's handling this. She has withdrawn considerably. I am concerned about her statement regarding memory. Is it more than a crisis of self? Most teenagers are remarkably self-centred, but Dawn's centre was Buffy, and now she's gone.

***

Dave,

I don't know how many more times this girl can put her life back together again. I don't know where she gets her strength. She's just a tiny little thing. I wish that you could see her. She's probably grown three inches and lost ten pounds since she started seeing me. Shit. I suppose I should ask her about that. I've seen too many kids become anorexic when their life spins out of control. Shit.

I'll keep you apprised,

Angie

***

Session Eight

AM - How are you doing, Dawn?

DS - I'm okay.

AM - I asked you to think about some good memories. …

DS - I didn't. … I didn't want to.

AM - That's okay. … Maybe we can try that for next time?

DS - … Maybe. …

AM - Dawn, I need to ask you something, and I need an honest answer.

DS - … Okay.

AM - You've been losing weight.

DS - That's not really a question.

AM - No, it's not. Have you been eating well?

DS - … No. … I suppose not. …

AM - Why not?

(pause - forty-six seconds)

AM - Sometimes, when everything else is out of your control, you try to control how much you weigh. … Is that how you feel?

DS - … No. … I can't control it.

AM - What can't you control?

(pause - fifty-nine seconds)

DS - I'm still growing.

AM - Yes. … Of course you're growing, Dawn.

DS - I don't want to grow.

AM - Why not?

DS - … I don't fit (garbled)

AM - You don't fit? Where don't you fit?

DS - (sigh) I don't fit into her clothes anymore.

AM - I don't understand.

DS - I can't wear her clothes anymore, they don't fit.

AM - Whose clothes? … Buffy's?

DS - … Yeah. … I guess I'm bigger than her. … I can't wear her clothes. (crying) And (garbled)

(pause two minutes, eighteen seconds)

AM - How does that make you feel?

DS - … It's like she's not here. … It's like she's never coming back. … And I don't have a reason to keep her clothes anymore. (crying) They'll get packed up and put away. … In the basement, with Mom and Anya.

AM - … You keep your mom and Anya in the basement?

DS - (laughing) Their stuff. … And now I guess all of Buffy is going to get put away.

AM - Not all of her. … You still have your memories, and so do your friends.

DS - … Yeah, and some of them are real. …

AM - Can we talk about that?

DS - Um. … I remember Mom called me pumpkin belly.

AM - Excuse me?

DS - That's a good memory, isn't it?

AM - Do you think that it's a good memory?

DS - Yeah. … And, um, Buffy used to play vampires with me.

AM - How do you play vampires?

DS - Buffy would chase me around and … um … try to … um … to, um, slay me.

AM - And that's a good memory?

DS - Oh, yes. It was always a lot of fun.

AM - So, that's two good memories. … Do you have one of your father?

(pause - three minutes, twelve seconds)

DS - Well, I remember once it was thundering, and I was scared. … And I couldn't sleep. … And I went to Mommy and Daddy's room to sleep with them. … And I woke Daddy up. … And he picked me up and carried me to the living room. … And he sat in the rocking chair and he sang to me. …

AM - Do you remember what he sang?

DS - … It was … I don't remember. …

AM - Is that a good memory?

DS - … Yes. I feel good remembering it. … I don't know if it's real. …

AM - What do you mean when you say that your memories aren't real?

DS - I don't know if things really happened or if they were made up.

AM - Why do you think that they're made up?

DS - … I can't trust my memory. …

AM - Why do you th…

DS - I don't want to talk about memories anymore.

(pause - two minutes, twenty-three seconds)

AM - You know, sometimes it can be helpful to write memories down. … Have you considered keeping a journal?

DS - … I had journals. …

AM - Had?

DS - … I burned them. …

AM - Why did you burn them?

(pause - one minute, three seconds)

DS - They weren't real. …

AM - The journals weren't real? You just pretended to burn them?

DS - The memories weren't real. They were put there. They were made up. … They weren't mine. …

AM - Dawn, wh…

DS - I'm going now.

***

David?

Yes, I'm here.

Can you hear me okay?

Yup.

I've got us on speakerphone so I can record the conversation, is that okay?

Sure, send me a transcript when you get it done.

You got it. Look, Dave, I'm really worried about Dawn. Something really disturbing came up in our session today.

Do you have a transcript?

Not yet, hang on, I'm going to play you the relevant section.

The memories weren't real. They were put there. They were made up. … They weren't mine. …

Did you hear that?

I heard it, Ang. I'm wondering what she means.

That's the thing, I'm concerned that she's disassociative.

Yeah, sounds like that could be going on.

Dave, I don't think that this is a psychotic break. It sounds like this has been going on for a while.

Yeah, if we can trust what she's telling you.

I think that we can. We have confirmation on at least one of the self-mutilations, and she's talked about her memories not being real several times before.

It might be time for the hospital.

No, I…

Angie, listen, I know that you like the kid, but she needs more help than you can give her. She needs round the clock care.

I know that she needs more than me. That's why I contacted you, isn't it? (sigh) Sorry, I'm on edge. Look, I can't just commit her, she's a legal adult, and I don't think that she's a danger to herself or to others. (sigh) And I don't think that she'd go voluntarily

Okay, I forgot about that. You're right. That complicates things. Can you add an anti-psychotic to her meds?

That's what I was thinking. You have more experience with this than I do. What do you suggest?

Well, let's start her on risperidone point five. We can adjust the dose upwards every three days until we get a good response.

Okay, sounds good. … Dave, look, thanks. I don't know what I'd do without you.

I just hope we can help the kid.

Amen. … I'll send you the transcripts soonest. 'Bye.

Ciao.

***

Session Nine

AM - Good afternoon, Dawn. How was school?

DS - Okay. I'm sorry about last time.

AM - What are you sorry about?

DS - Well, I yelled and walked out.

AM - It's okay for you to do that.

DS - It was rude. I'm sorry.

(pause - forty-one seconds)

AM - Dawn, I wanted to talk to you about last time.

DS - … Okay.

AM - I want to change your medications.

DS - … Um, okay.

AM - I'm going to write you a new prescription for your antidepressant, it's going to be stronger.

DS - Okay.

AM - You might have more side effects from it.

DS - Okay.

AM - And I'm going to add another medication. It's called risperidone.

DS - Okay.

AM - And what risperidone does is help with emotional disorders.

DS - What?

AM - It helps keep you calm, and it will help you tell the difference between what's real and what's made up.

DS - What?

AM - It helps the chemicals in your brain work properly.

DS - There's nothing wrong with my brain.

AM - Dawn, these medications are tools to help you.

DS - I don't want to take it.

AM - Dawn, if you had diabetes you wouldn't refuse to use insulin, would you?

DS - … I guess not?

AM - No, you wouldn't, because it's giving your body something that it needs. And your brain does need these medications, you just can't tell. When you've been on them for a while you'll feel better.

DS - … Okay. …

(pause two minutes, thirty-eight seconds)

AM - How are things at home?

DS - … Xander was crying. …

AM - What happened?

DS - He was fighting with Willow and then he started crying.

AM - Why was he fighting with Willow?

DS - … They were fighting because of me. … Willow said he was ignoring me. …

AM - Go on.

DS - … He broke a glass. … He cut himself. … And Spike, um, cleaned it up. … And then Xander started to cry. …

AM - How did that make you feel?

DS - … I don't know. … He was crying so hard. I felt so bad for him. … He was hurting so much. … But it hurt me to hear him. … I wanted him to stop. … Not because I wanted him to feel better, but I did want him to feel better … I wanted to stop hurting. …

AM - That's a perfectly normal reaction.

DS - Yeah, that's me, perfectly normal girl. … Anyway, he cried for a long time. Tara and I went upstairs while he was still crying. …

AM - How were things this morning?

DS - Xander smiled when he came downstairs. … He started to make breakfast. … Then he just left. …

AM - Left the house?

DS - No. He went to the basement.

AM - Why do you suppose he did that?

DS - I don't know. … Maybe he was embarrassed. …

AM - Do you think that he was embarrassed about crying?

DS - Maybe.

AM - Because crying isn't anything to be ashamed of, it can be a cathartic experience.

(pause - one minute, twenty seconds)

AM - Catharsis is when you purge your emotions.

DS - Willow told me that he threw up on Spike. That sounds pretty catharsisy.

(sound of laughter)

AM - I suppose that it is.

(pause - one minute, two seconds)

AM - What else is going on at home?

DS - Nothing. Xander cried pretty much all night. …

AM - Okay. Dawn, for next session I want you to tell me some things about Buffy.

DS - I don't want to talk about Buffy.

AM - It's okay, it's just little things.

DS - … Like what?

AM - Well, I want you to tell me what she was like in the mornings.

DS - … Okay.

AM - And I want you to tell something she did that made you laugh.

DS - Okay.

AM - And I want you to tell me something she did that made you cry.

DS - … Okay. … I'm going to go now.

AM - Wait. You forgot your prescriptions.

DS - … Oh.

AM - Get them filled at the pharmacy before you go home.

DS - … Okay. …

AM - See you next week.

DS - … Okay.

***

David,

You will have noticed that I haven't enclosed the transcript of my last session with Dawn. I'm sending my files to Dr. Allen at Sunnydale General, who'll be taking over the case. He, apparently, is not a 'drug pushing git'.

It was nice working with you. That poor kid.

Angie



--End--



Continued in Ingression

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