Gildiner - Good Morning, Monster

THE DAY I OPENED my private practice as a psychologist, I sat smugly in my office. Fortified with the knowledge Id acquired, taking comfort in the rules Id learned, I looked forward to having patients I could cure.

I was deluded.

Fortunately, I had no idea at the time what a messy business clinical psychology was or I may have opted for pure research, an area where Id have control over my subjects and variables. Instead, I had to learn how to be flexible as new information trickled in weekly. I had no idea on that first day that psychotherapy wasnt the psychologist solving problems but rather two people facing each other, week after week, endeavouring to reach some kind of psychological truth we could agree on.

No one brought this home to me more than Laura Wilkes, my first patient. She was referred to me through a general practitioner, who in his recorded message said, Shell fill you in on the details. I dont know who was more frightened, Laura or I. I was newly transformed from a student in jeans and a T-shirt to a professional, decked out in a silk blouse and a designer suit with linebacker shoulder pads, de rigueur in the early eighties. I sat behind my huge mahogany desk looking like a cross between Anna Freud and Joan Crawford. Luckily I had prematurely white hair in my twenties, which added some much-needed gravitas to my demeanour.

Laura was barely five feet high, with an hourglass figure, huge almond eyes, and such full lips that had it been thirty years later, I would have suspected Botox injections. She had masses of shoulder-length blond highlighted hair and her porcelain skin contrasted sharply with her dark eyes. Perfect makeup, with bright red lipstick, set off her features. She was chic in spike heels, a tailored silk blouse, and a black pencil skirt.

She said she was twenty-six, single, and working in a large securities firm. Shed started out as a secretary but had been promoted to the human resources department.

When I asked how I could help her, Laura sat for a long time looking out the window. I waited for her to tell me the problem. I continued to wait in whats called a therapeutic silencean uncomfortable quiet thats supposed to elicit truth from the patient. Finally, she said, I have herpes.

I asked, Herpes zoster or herpes simplex?

The kind you get if youre totally filthy.

Sexually transmitted, I translated.

When I asked whether her sexual partner knew he had herpes, Laura replied that Ed, her boyfriend of two years, had said he didnt. However, shed found a pill vial in his cabinet that she recognized as the same medication shed been prescribed. When I questioned her about this, she acted as though it was normal and that there wasnt much she could do about it. She said, Thats Ed. Ive already ripped a strip off him. What more can I do?

That blas reaction suggested that Laura was used to selfish and duplicitous behaviour. Shed been referred to me, she said, because the strongest medication wasnt limiting the constant outbreaks and her doctor thought she needed psychiatric help. But Laura was clear about having no desire to be in therapy. She just wanted to get over the herpes.

I explained that in some people stress is a major trigger for attacks of the latent virus. She said, I know what the word stress means but I dont know exactly how it feels. I dont think I have it. I just keep on keeping on, surrounded by the village idiots. Not much had bothered her in her life, Laura told me, although she did acknowledge that the herpes had shaken her like nothing else.

First, I tried to reassure her by letting her know that one in six people aged fourteen to forty-nine has herpes. Her response was So what? Were all in the same filthy swamp. Switching tacks, I told her I understood why she was upset. A man who purported to love her had betrayed her. Plus, she was in painin fact, she could barely sit. The worst part was the shame; forever after shed have to tell anyone she ever slept with that she had herpes or was a carrier.