She wishes for mum to take over, to speak with me instead, so I keep the conversation moving in her direction. A few moments later, Milly agrees to join me alone, wishing she hadn’t agreed to being here at all. How can she explain to a stranger something she doesn’t even understand? I make meaningless chat as we walk the corridor, her nerves buzzing around her like static energy. What connects us right now is the acknowledgment of her not wanting to be with me.
We sit opposite each other; her nails are bitten to the point of being sore, obscured by the chipped emerald-green nail varnish. Fleeting glimpses between me and clenching anxious fists. She has what look like marker-pen tattoos covering her right hand, and reaching up her left arm, as far as I can see. I’m thinking, Milly is not normally an unconfident girl. Low self-esteem maybe, but not shy of craving attention. The nail-biting implies she is anxious, out of control of something. It’s not just because of me, the undesirable stranger standing over her natural sureness. Her hair is cut in a modern style, requiring a degree of nurtured styling. She clearly cares about her appearance, yet chooses to disfigure it. Though, she may not view this as a choice, yet. A cry for attention, of any form. Insecure, definitely. Trauma, a possibility. Historic patterns, age, biology, behaviour and or environment? Last week, I visited a child of the same age, a mathematical genius, but her extreme left-brain dominance made normal daily social interactions so painful, she too turned to self-harm to escape her hostile world. Milly is different; her tattoos and subject biases communicate creativity, right-brain strength.
Confident enough to scribble all over her body, to wear bright green nail varnish, but she is at the moment insecure about something, someone. Did mum appear anxious? Has she learned this? She struggles with direct eye contact; this is in part her age, and also these unusual clinical circumstances. But mostly because she doesn’t wish to be discovered, not by me anyway; only by the rest of her world. Her new temporary world. Often the most outwardly confident prove to be the individuals who seek the most affirmation and security. A confidence in acting the part, even the jester, paired with a low self-esteem. Confidence versus self-esteem. Often mistaken as the same. I’m confident in my ability as a therapist but my self-esteem hangs on something else, and has been smashed over the years. Milly is confident, but her self-belief system is on the floor.
I smile at her.
‘Okay. Milly, tell me if I’m wrong, but I’m pretty sure you’d rather be anywhere else than sitting here with me right now.’
Wide eyes stare at me. Am I setting her a trap? I nod to assure her I’m not.
‘Yeah, probably.’ She nibbles on her non-existent nail.
‘Yep, I think I’d feel the same too if I were you. Completely understandable, I promise you. Still, at least you’re missing some time from school. That’s got to be a good thing, yes?’
She allows the smallest of chuckles to escape.
We continue a little longer with informal chatter, until I receive a few more grins and nods. I already know a little relevant information to break the ice; I asked her mum to email me Milly’s interests. Eventually the mature fa?ade drops sufficiently for us to begin. Milly’s hands have unclenched; she’s gaining eye contact, despite shuffling in the uncompromising chair. But there is something else behind those eyes, an undisclosed heaviness. I have my concerns.
‘Milly, can I just say, this is not the same as being at school. There are no right or wrong answers. I don’t expect you to say or behave in a special way. I appreciate I’m a stranger, but I’m hoping, with time, you’ll be able to talk to me about anything you want to. If I say something you don’t understand, stop me, if I say something you disagree with, tell me, please. Deal?’
‘Okay.’
‘Great. So why do you think you’re here today, with me now?’
She looks slowly to the ceiling, before back to me. Wondering what she is supposed to say, rather than saying what rolls off her tongue.
‘Whatever comes first to mind, Milly.’
‘?Cos they… think I need help.’ She shrugs her shoulders. ‘I think.’
‘They?’
‘Yeah, Mum and her boyfriend. Miss James. They do.’
‘Miss James, she’s your school nurse?’ I ask, making a mental note she referred to her mum’s partner as her boyfriend. I already know they all live as a family, together. Does Milly not get on with him? I’ll ask mum about this one, at some point. It could be Milly’s way of reaching her mum’s attention, or something more sinister. Or pure defiance.
‘Yeah, she used to be, like, nice. But then she rang Mum. And it’s caused loads of trouble at home. So I kind of don’t think she’s nice any more. She should have kept out of it.’
‘Ahh, right, okay, I see. Do you think she may have been worried about you, though, Miss James? It’s a difficult situation for her, Milly. I’m sure she thought she was helping you, that she was doing the right thing.’
‘That’s what Mum said, yeah.’ She shrugs again, adjusting her seat. One thing I dislike about not being at the Lemon Street clinic. It’s really hard to relax when you’re so uncomfortable.
‘Okay, we’ll come back to why perhaps mum and Miss James think you need help. I’m only really interested in you and what you think. This is about you, Milly. This is your time. Do you think you need help? This is what is important to me.’
Milly’s body language and demeanour tell me the answer; the words are almost irrelevant now. But then again, she needs to hear herself say it.
She shrugs, looking to her feet, inspecting them as they flex backwards and forwards.
‘Milly, are you happy at the moment? As happy as you used to be? If you can think back to maybe last year?’
‘Sometimes.’ She pauses. I wait. ‘But… no, not really. I’m not, no,’ she divulges to the floor.
‘Well, I’m guessing, it must be pretty horrible for you to feel unhappy?’ I should know, I cannot help thinking. ‘Even if it’s only for some of the time. No one wants to be unhappy. But if there is a chance I can perhaps help you with this, Milly, would you like me to try, and help you? Together we can attempt to undo things, the bad bits, I mean. You needn’t be alone. I will try and help you all I can. But this has to be something you are okay with.’
She nods, just a small child. I notice her algae-green eyes grow moist with tears.
‘What do you do when you feel unhappy?’ It’s not always so obvious, when covered by layers of protection. Sometimes this is the first time the client hears themselves speak the behaviour; until this point, it is easier to ignore.
‘I do stuff.’
I nod. ‘Okay, what kind of stuff?’
‘I hurt myself.’ She subconsciously touches the tops of her thighs.
‘So, when you’re unhappy, you hurt yourself,’ I repeat softly. ‘What do you hope to achieve? What do you think hurting yourself will give you?’
‘It makes me feel better about stuff.’ She uses pain to relieve pain.
‘Does it last, this feeling better?’
She shakes her head. ‘No.’
‘Do you believe it does help? You know, with whatever it is making you unhappy?’
‘No.’
‘This is what most people say, Milly. That little voice in your mind, the one that tells you you’ll feel better if you hurt yourself. It tells you lies. It’s nothing more than a bully. It cannot help you. It will only make things worse. But still, it convinces you each time, that it can help? Are you saying, it’s the thinking about hurting yourself that sometimes makes you feel better, rather than hurting yourself actually stops you from becoming unhappy?’ I expand in more detail on the difference.
‘Yes,’ she agrees.
‘Who would you have turned to before, Milly, whenever you were unhappy, before this bully came along?’
‘Mum.’
‘So what has changed? Why not talk to mum now?’
‘I can’t tell her what I need to say.’
‘What makes you think that?’
‘I don’t want to hurt her.’
‘You think if you talk to mum, she’d be upset?’
‘Mmm.’
So pain is better than the truth. How bad does the truth have to be?
‘And by hurting yourself, Milly, do you think maybe that may upset mum, even more?’