New Patient: Where should I sit? Or should I lie down?
Psychologist: You can sit or lie down wherever you like, however you like. That’s why I have so many options. I have one patient who prefers to curl up against the wall, because it makes them feel safer.
New Patient: Okay, thanks.
Psychologist: So, what brings you in today? The way I understand it, you’re having mixed feelings about something?
New Patient: Well, that’s one way to put it. I would describe what I’m experiencing as bad thoughts. I just keep—not seeing things; I don’t have hallucinations—but I have these urges to do things I know are wrong.
Psychologist: Things like what?
New Patient: Well, the other day, the cashier at the grocery store got upset with me, because I’m apparently supposed to scan my rewards card before I pay, so now there was nothing she could do about it. I can’t say that I wanted to do this, but I just had a vision—this flash—where I shoved the card in her mouth, and told her to scan it now. Oh my God, that’s so terrible. I can’t believe I’m telling you this.
Psychologist: That’s okay. This is a safe space. Everything you say is confidential, and I’m not here to judge you. Mine is only to help.
New Patient: I sure hope you can, because this isn’t even the worst example. I can’t explain it. Like I was saying with that one, I don’t have a desire to hurt people, but I can’t help but think of these alternative responses. The normal thing to do is just open the door that’s just been accidentally shut in my face, but a part of me wants to get them back for that; to physically drag them back to the threshold, and slam it in their face too.
Psychologist: So your thoughts are more about exacting justice, or revenge, on people who have wronged you.
New Patient: Yeah, I guess that’s probably an accurate limitation. I don’t walk past someone on the street, and think about randomly slitting their throat. It just seems to bother me more those little annoying things that people do. I mean, I would almost rather just be the kind of jerk who snaps at others, because then at least I wouldn’t be hurting them. I’m worried I’ll one day just lose control, and actually act on these thoughts.
Psychologist: Well, I wouldn’t be worried about that just yet. Simply by acknowledging that these are, and would be, irrational reactions, you’ve taken the first step in changing your perspective.
New Patient: I’ve just never been like this before. I grew up totally fine, but now it’s all I can think about, at least for a few moments after something frustrating happens to me. It’s making it hard to focus on everything I need to do.
Psychologist: There’s probably some reason it’s happening now. When people change their moods like that, it’s usually due to newer, stressful situations. Let’s talk more about who you are, what you do, and what has changed in your life recently that could cause you to feel a little more temperamental than before.
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