The Final Session

TRIGGER WARNING

Thursday, April 26, 2018

3:00 p.m.

Nicole is sitting in the counseling center waiting to go back into her counselor’s office. She is very nervous as this will be her last session with Taylor, and she doesn’t know how well she will handle the summer without a clinician. She’s been more depressed and anxious over the past week, and her suicidal thoughts have increased and have become more persuasive.

3:03 p.m.

Their session begins just as each one has before with an exchange of greetings. After this, they begin discussing the past week including the emergency visit with Tiffany a few days prior and the potential of meeting with a clinician over the summer. Taylor asks about what happened with the emergency evaluation, so Nicole explains the situation and the circumstances. He listens attentively, then asks her how she has been doing since that day. Nicole confesses that she hasn’t been doing well, that she’s actually been doing worse. He asks what she means and how things have been so.

Nicole then wishes she could speak and tell him the truth, but her mind is frozen telling her not to say anything, that she’s going to be hospitalized, and she’s going to ruin everything. She can’t say a word, and Taylor can see this, so he suggests she type it up instead. Following his suggestion, Nicole takes her laptop out and turns it on. There are a few moments of awkward silence, then the clicking of keys fill the small room. She hesitates after writing not wanting to be this vulnerable with anyone. Her mind is racing, and she doesn’t know how initiate handing it over. She pauses for another second or two waiting while her anxiety continues to rise. After she manages to pull together the strength, she finally hands the laptop to Taylor, and he reads it.

“Thoughts about dying and how I would do it have been more persistent. I have felt like I might lose control and end up killing myself. Both Sunday night and Monday night, I almost lost control. Most of it was a blur and when I came back to my senses, I found myself with a knife sitting on my bed holding it near my wrist wanting to be dead.”

After Taylor reads it, he doesn’t show any surprise or concern and keeps himself well composed. Nicole was hoping that he wouldn’t freak out and send her straight to the hospital. Instead, he repeats the main idea of what Nicole wrote so he can make sure he understands her correctly. Then he asks her a few questions about what happened.

“Does this scare you?”

Nicole nods, “Yeah.”

“Okay, that’s good. Normally, when people are serious about ending their life, they aren’t scared. They are actually quite calm and have peace about ending their life. The fact that this scares you is good.”

Taylor pauses for a moment. “Was the knife large enough that you could have cut deep enough?”

“Yeah, I think so.”

“What kind of knife was it? You won’t be in trouble or anything; I won’t tell campus police or anyone like that. I mean I carry a knife on me. I just need to know for your safety.”

“It’s an Exacto knife.” Nicole can barely breathe, but she does her best to answer Taylor’s questions.

“Okay. Where did you get it from?”

“From my art class. My art professor gave it to me.”

“Okay, and where is it now? In your room? Or in your bag?”

“I don’t know.” She knows exactly where it is, but her mind freezes and makes her say she doesn’t know.

“I don’t believe that.” He pauses. “This is one time I won’t accept that answer. I need to know where it is.”

“I’m not sure if it’s in this bag or in my other one in my room.”

“Will you check your bag?”

Nicole slowly rummages through her drawstring bag, hoping not to find it but knows it’s in the front pocket. After she finishes searching in the main body, she reaches into the front pocket and nervously takes out the Exacto knife. She stares at it for a second, her mind racing and thinking about a what happened a few days before. Her thoughts are interrupted by her counselor’s voice.

“Can I have it?”

Taylor leans forward prepared to take the knife when she is ready to surrender it to him. Nicole hesitates for a moment, staring at the knife in her shaking hand. Her mind contemplates all the horrible possibilities that could happen in this moment.

“I could slit my wrists so fast and deep there’d be no way you could stop me, I could try to cut wrist for relief from my anxiety, and you may try to prevent me from hurting myself resulting in you calling campus police to have me restrained, so they could call the rescue squad or an ambulance to transport me to the hospital.”

She tries to break away from those awful thoughts. Finally, she hands the knife over and puts her bag back on the floor next to her chair.

“I’m going to put this in here and take the key so Tiffany won’t be able to take it out on Monday.”

Taylor reaches over to put the knife into the desk drawer beside him, locking it and taking the key to put in his shirt pocket

“Is there anything else in your room or bag that is potentially dangerous? Any other knives or pills, anything that you could use to hurt yourself?

“Well technically, I could hurt and kill myself with anything in my room if I tried hard enough, but I’m not telling you that or about the scissors or medication or anything that I could use to potentially cause serious damage. I wouldn’t use anything else because that would require ingesting something or a lot of force. Basically, the other ways take too much effort, and I’m not doing anything that way.”

“No, I don’t have anything else.”

“Okay, good. Alright, I’m going to go ask my supervisor a quick question, and I’ll be right back. Sit tight.”

Taylor leaves the room, and Nicole is left there alone and anxious.

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