Post by Dr. Josephine Hudson on Sept 4, 2010 1:31:36 GMT
Jo regarded the open file in front of her with some confusion. Well, her next patient - well, patients, apparently - would be quite interesting. Kitty, her actual patient, was electively mute, with a history of abuse and rape. Chris, her twin brother, had conduct disorder and intermittent explosive disorder, with the same history of abuse and rape.
They also shared the diagnosis of severe separation anxiety, for each other. Hysteria if they were separated. She was slightly nervous about Chris being in the same room while she tried to convince Kitty to talk; with his IED, he might get upset if they thought she was 'hurting' his sister, and being upset meant he was quite likely to punch her. She was going to instruct him that he could remain in the room only if he didn't speak throughout the entire session. She'd prefer it if he sat in the corner, apart from his sister, but they wouldn't react well to that. The two were usually holding hands, or having physical contact in some way.
Jo wondered if it was a form of control. Chris, controlling his slightly younger, vulnerable sister, who was mute. He communicated for her entirely, apparently, and she was reported to speak to him very rarely, only when they were in private, and only when it was essential. He could be lying about that; it was sad to contemplate that a child would do that to their sibling, but it had happened before. She'd seen mutes controlling other family members - often parents, who didn't realize they were being emotionally manipulated, but sometimes siblings - but she'd seen a few cases of the family members controlling the mutes. It was interesting; mute children always seemed so...self-processed, somehow. Calm. And when you burrowed beneath the silent exterior, there was often a history of abuse - often sexual.
The twins were late. Five minutes late, now, and she wasn't in a good mood. Unlocking her desk drawer, she shoved her file in - it was illegal to leave confidential information lying about - locked the drawer and stood up, deciding to go hunting for Kitty, and Chris, apparently. She didn't usually search, or get security to search, for the child until at least fifteen minutes had passed, but her head was aching and she couldn't be bothered to go through waiting. Crossing her room quickly, she opened the door and stepped out, almost falling over two children who were standing hand in hand, a few steps away from the door. Ah. There was her mute.
Had they knocked and she'd missed it? No, unless they knocked with a feather instead of their fists. " Ah, Kitty and Chris. I'm Jo, your psychiatrist. Come in, please. " Holding the door open, she stepped back inside, gesturing to the two chairs behind her desk. She sat down herself, and looked at the two children in front of her, trying to match the information from their files to their faces. It was so hard to think that such hideous abuse had been committed, to these two innocent kids. Blinking, she reminded herself not to get so...emotionally involved. That never went well. When she thought of the abuse Francesca had suffered, it made her want to hit things, and hitting things wasn't good. Francesca; that reminded her. Maybe she should have a group therapy for all the mutes? It'd be interesting. She almost laughed at the thought - Kitty and Chris sitting silently, Francesca looking terrified. She'd made some progress with the latter - she'd talk, almost inaudibly and only to talk of revenge for her father and uncle - but she still clammed up in group settings.
Crap, she needed to stay on track. Looking at Kitty, rather than Chris, she lent forward and spoke gently. " How have you been settling in? " Would Chris answer for her? She pulled a notepad and pen from the side of her desk and sat, poised to take notes.
They also shared the diagnosis of severe separation anxiety, for each other. Hysteria if they were separated. She was slightly nervous about Chris being in the same room while she tried to convince Kitty to talk; with his IED, he might get upset if they thought she was 'hurting' his sister, and being upset meant he was quite likely to punch her. She was going to instruct him that he could remain in the room only if he didn't speak throughout the entire session. She'd prefer it if he sat in the corner, apart from his sister, but they wouldn't react well to that. The two were usually holding hands, or having physical contact in some way.
Jo wondered if it was a form of control. Chris, controlling his slightly younger, vulnerable sister, who was mute. He communicated for her entirely, apparently, and she was reported to speak to him very rarely, only when they were in private, and only when it was essential. He could be lying about that; it was sad to contemplate that a child would do that to their sibling, but it had happened before. She'd seen mutes controlling other family members - often parents, who didn't realize they were being emotionally manipulated, but sometimes siblings - but she'd seen a few cases of the family members controlling the mutes. It was interesting; mute children always seemed so...self-processed, somehow. Calm. And when you burrowed beneath the silent exterior, there was often a history of abuse - often sexual.
The twins were late. Five minutes late, now, and she wasn't in a good mood. Unlocking her desk drawer, she shoved her file in - it was illegal to leave confidential information lying about - locked the drawer and stood up, deciding to go hunting for Kitty, and Chris, apparently. She didn't usually search, or get security to search, for the child until at least fifteen minutes had passed, but her head was aching and she couldn't be bothered to go through waiting. Crossing her room quickly, she opened the door and stepped out, almost falling over two children who were standing hand in hand, a few steps away from the door. Ah. There was her mute.
Had they knocked and she'd missed it? No, unless they knocked with a feather instead of their fists. " Ah, Kitty and Chris. I'm Jo, your psychiatrist. Come in, please. " Holding the door open, she stepped back inside, gesturing to the two chairs behind her desk. She sat down herself, and looked at the two children in front of her, trying to match the information from their files to their faces. It was so hard to think that such hideous abuse had been committed, to these two innocent kids. Blinking, she reminded herself not to get so...emotionally involved. That never went well. When she thought of the abuse Francesca had suffered, it made her want to hit things, and hitting things wasn't good. Francesca; that reminded her. Maybe she should have a group therapy for all the mutes? It'd be interesting. She almost laughed at the thought - Kitty and Chris sitting silently, Francesca looking terrified. She'd made some progress with the latter - she'd talk, almost inaudibly and only to talk of revenge for her father and uncle - but she still clammed up in group settings.
Crap, she needed to stay on track. Looking at Kitty, rather than Chris, she lent forward and spoke gently. " How have you been settling in? " Would Chris answer for her? She pulled a notepad and pen from the side of her desk and sat, poised to take notes.
