Chapter Three
Maya
My stomach is full of butterflies as I slide into the chair behind my desk. I carefully check that my pens and notebooks are in order and take a deep breath before opening my laptop.
I don’t know what is wrong with me today.
It’s been years since I felt this anxious about meeting a new patient.
Completing my pre-licensure hours in community mental health services threw me right into the deep end, and thankfully, I learned how to swim instead of drowning.
Private practice has been relatively tame by comparison since I opened my doors six months ago.
But still, I haven’t been able to shake this nervous energy all morning. None of my usual techniques have helped. Not the run I went on before work and not the breathing techniques or the rituals I follow every morning to create order.
What would I tell a patient to do? I guess that would depend on the patient.
If they were a worrier in general, I might encourage them to notice the feeling and practice letting it go.
If they weren’t predisposed to general anxiety, I might ask them to question what their body could be trying to tell them.
But letting it go isn’t working, and I learned a long time ago not to listen to my body. I’m such a fraud. A therapist incapable of practicing what they preach. But my mind tells me to do things that I never could. Things that would get me incarcerated, or worse.
So instead, I push down the voice in my head and ignore my instincts, the way I have trained myself. I steady my thoughts with routines and rituals, focusing on grounding myself.
Breathe in for four seconds.
Hold for four seconds.
Out for four seconds.
Hold for four seconds.
Notice where my body connects to the chair and push back against the firm points.
Repeat until I settle and ground myself.
I can do this. I am in control.
I read over my notes for my new patient, Ryan Rivera. His sister, Sofia, contacted me to book him in, so this will be my first contact with him. Not how I normally operate, but she mentioned he has been resistant to starting therapy despite struggling with his mental health for a while now.
I want to kick myself when realization dawns on me.
This is it. The reason why I’m feeling like this.
I’m not doing things in the proper sequence.
Of course I feel out of sorts. My life revolves around things playing out in the right way and in the right order.
It helps me maintain control and composure.
But once the first session is completed, everything else will follow the treatment plan I create for him. I’ll be back in my happy, controlled routine. Back in my lovely, albeit small, comfort zone.
Let's see, what do I know about this man? He’s thirty-one years old.
His sister told me he needed to get married, but he was hung up on waiting for the perfect woman, whom he couldn’t find.
She said that if he didn’t marry, he would lose his position as CEO over his family business, and the strain was having a dramatic impact on his mental health.
I don’t blame him. God, rich people are awful. I can’t imagine ever putting my future children in such a position. Marry by a set date or lose everything? It seems so cruel. But judging his situation isn’t going to help him. And imagining how I would do better isn’t going to help either of us.
One last round of breathwork, and I connect to the telehealth call.
“Hello, Ryan?”
The man sitting across from me fixes me with a stare so intense I feel a prickle of unease crawl across my skin.
His eyes, deep pools of a brown that seem to flash almost golden in the light, bore into my soul, dissecting me with a silent scrutiny.
He doesn’t blink, doesn’t move, just maintains that unwavering gaze, like he’s a predator assessing his prey.
He’s so statue-still that I begin to wonder if his screen has frozen. Except, a vein in his temple is flexing under his copper skin, and his eyes are full of fire. Almost as if he’s annoyed to be here.
“Ryan?” I say again. “Can you hear me?”
He finally blinks, then shakes his head and clears his throat. “Sorry, yes. I’m Ryan Rivera. I wasn’t expecting… well, you.”
“Okay,” I say, unsure what he means or how to respond.
Everything about this appointment is off, and I hate it.
I don’t feel in control, and that just won’t do.
Needing to get things back on track, I launch into my usual introduction.
“I’m Dr. Maya Moore. You may call me Maya.
I have had some brief contact with your sister, Sofia, but I want to make it clear that from here on, everything you say will be between you and me.
Would you like to start by telling me why you have decided to begin therapy at this time? ”
“No.”
“No?”
He stares at me unblinkingly, like he’s looking into my soul and trying to decide if I’m worth a response. He’s intimidatingly intense but something else is there too. Something that draws me in.
“Look, I’m sure you’re very good at what you do, but I don’t believe in all this mental health stuff.
I’m only here because my sister needs to believe I’m still trying.
I don’t think I actually need to turn up to the appointments.
As long as you don’t tell Sofia, she can believe I’m still coming. Win-win.”
My jaw drops. Actually drops. What the hell is this?
And why do I feel so angry about the dismissal?
I’ve worked with people before who didn’t want to be here—court-ordered or going through the motions—but it’s never created such a strong reaction in me.
I’ve also heard people make comments about mental health not being real, and that’s never gotten to me either.
Mostly because people can’t just decide something isn’t real because it doesn’t suit their narrative; it’s not a unicorn.
“Are we done here?” he asks, his jaw twitching as he glares at me.
I could let it go. I should let it go. It seems obvious he’s not ready for therapy. But a long-forgotten voice inside me is pushing me to challenge him. Not to take this act at face value. And for once, that voice is not content to be ignored. It’s insistent and unwavering.
A part of me is simply unwilling to let him go, and I’ll need to look at that later.
Process these reactions and make sense of what this man is evoking in me and why.
But I have an external supervisor for that work.
I’m so glad I stayed working with Steven even after licensure when I was no longer required to attend sessions.
He will help me unpack my thoughts and feelings so I can still be Ryan’s therapist without bringing my own shit into it.
“You want your sister to believe you’re trying,” I suggest, trying to get things back on track. “Can you tell me why that matters?”
He sighs and looks to the heavens.
“Because I’m her only family. Our parents left us when she was still a kid. It’s just been the two of us since.”
“But you don’t want to actually try for her?”
He scowls at me and lets out a noise that can only be described as a low rumble of a growl. I raise an eyebrow and lean back in my chair, trying to project an image of cool, calm, and collected. Like I normally am when I sit in this chair. I’m the professional here. I am in control.
“I have tried,” he grits out. Like it’s paining him to continue talking to me.
“Have you? Because it sounds like you are ready to throw in the towel here before you even try one session. What are you scared of?” I ask.
I’m normally not so challenging in a first session.
That sort of response is reserved for patients I have built a rapport with.
Those I know will be receptive to some tough love.
But something is telling me I need to challenge Ryan.
“I’m not scared,” he says through clenched jaws. “I know what you’re doing, and it’s not necessary.”
“I’m curious about what it is you think I’m doing?”
“You’re trying to get me talking. It’s pointless. Look, I’ll continue to pay you as long as you tell Sofia I’ve continued the sessions.”
“No.”
“No?”
“Come or don’t; that’s your choice. I won’t be lying for you, but I also won’t be communicating with Sofia about anything. It doesn’t matter if you stop coming to the sessions, confidentiality still applies. I can’t tell anyone either way.”
His breathing comes out in hard pants, and his eyes glare so hard they look like they’re glowing. “Fine, I’ll keep coming.”
My brows scrunch together from trying to understand his words.
No one is forcing Ryan to attend therapy.
It’s not as if I’m going to be sending in a report at the end of twelve court-mandated sessions.
So why does he want to proceed when he so obviously would rather be anywhere but here?
And why can’t I ignore the sliver of excitement at the idea of him continuing to attend sessions?
“I usually recommend starting with six sessions, and then we can review afterward. How does that sound?” I ask, trying to get things back on track. “If you feel like it’s helping, we can continue. If not, we can go our separate ways.”
Ryan gives a tiny, almost imperceptible nod.
I don’t know what’s going on with him, not yet at least. But there’s time to figure that out.
Because for the first time in I don’t remember how long, the unknown is filling me with excitement rather than apprehension.
It doesn’t make sense, but then again, so many parts of my life don’t.
By the time I get home, my head is throbbing.
First sessions always take the most out of me, but that appointment with Ryan Rivera was something else.
It was as if I was doing all the work for him.
He didn’t want to be there, but he also wouldn’t give up.
And something about him made me not want to let go either.
It’s not the fact that he’s having suicidal ideation. Or the way his sister is the only thing keeping him going, even though I recognize what that is like. No, there’s something about Ryan Rivera that makes me want to save him.
I became a therapist because I wanted to help. I wanted to make a difference, the way my therapist had for me as a teenager. But with Ryan, I feel something stronger. Something ineffable and indescribable.
Thoughts of him swirl around my head the entire drive to my home in the suburbs.
I’m usually better at compartmentalizing and leaving work at work.
But today, I’m awash with hypotheses and potential treatment plans.
Right up until the moment I open my door and am pounced on by Jeffrey, my greyhound mix.
Indie is next, followed by Bran, Moto, and Bonnie.
Most people would probably think having five large rescue dogs as a single woman who works full-time is insane, but I couldn’t live without them.
We run at night and in the morning, and then they sleep the rest of the day away.
They’re just big teddy bears, really. They needed a safe home after their backgrounds with awful people, but they do more for me than I could ever do for them. They keep me grounded and sane.
“Okay, okay,” I say between laughs as they run circles around me. “Let me get changed!”
There are collective whines and whimpers, but they wait for me at the bottom of the stairs like they always do. I clip their leads onto my waist belt and head out again for our evening run. Waving to Mrs. Montgomery, my next-door neighbor, I take off on the same route we always do.
I could run for hours, but my poor pooches aren’t able.
Plus, I still need to feed them and myself, check in on my parents, then make a plan to meet my sister tomorrow for our weekly lunch date.
I wish the days were longer so I could squeeze more into them.
There’s never enough time to do everything that needs to be done.
But it’s fine. I like to be busy. Less time for my mind to wander.