day one
14:30
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the sun is high in the sky, and the grey clouds have finally dissipated. patient 141, dazai osamu, has been referred here by an old political friend of my father's. a young man, with messy brown hair and brown eyes, covered in bandages. upon the service, he does not seem particularly nervous or in any way interested in this meeting, but this is nothing out of the ordinary.

he sits in the armchair opposite me, with a bored yet relaxed smile.

"good afternoon, doctor."

his speech is of average speed, not erratic or slowed, but it's somewhat formal, perhaps from upbringing?

"good afternoon, mr. dazai. how are you today?"

"i'm a lot happier now it's sunny! i thought i was going to be trapped in the rain forever!" his tone is cheerful, yet his eyes do not seem to match his tone.

i explain to him the concept of doctor/patient confidentiality, how i will not pass on anything discussed in these sessions unless dazai himself or someone else is in direct danger. furthermore i cannot pass on information without his consent. he agrees verbally.

"so, how can i help you?"

dazai does not respond for a while, before letting out an annoyed sigh. "i don't understand why i need "help"."

it seems he is somewhat resistant to the session already. "okay, then, what would you like to talk about? i'm curious to learn why you've been referred to me."

"why don't you tell me? aren't you the therapist?" he says this somewhat jokingly, yet there seems to be some underlying resistance to opening up. this is normal for new patients.

"you had the option to not come, and yet you showed up. would you care to tell me why?" dazai seems surprised by this question, as though the thought never occurred to him. i continue. "do you perhaps think a part of you was at the very least curious to see what would happen?"

dazai crosses his leg, staring curiously. "perhaps."

"then maybe talking to me would help you alleviate the curiosity you feel?"

he seems to stare, unblinkingly. finally he speaks, and it seems as though his demeanour changes. his posture crumples a little, and he almost looks like a timid child, as opposed to the calm, almost confident air he held before.

he speaks quietly, "i...have thoughts that i can't control." he doesn't look at me, his eyes staying glued to the painting above my head. "and i know everyone has intrusive thoughts, but i...they don't go away. they're always there."

"can you elaborate on these thoughts?"

"it's the usual intrusive thoughts." he seems to dismiss it, leaning back in his chair and straightening in a way to reassert his calm demeanour. "the self harm variant."

i simply nod in acknowledgement. "when did these thoughts begin?"

dazai looks away from me once again. "a long time ago. nine years, at least."

"nine years ago..."

"i was thirteen. it was my first suicide attempt. i was picked up by a...doctor, lets say. as a result, i got involved with a particular group of people."

he speaks purposefully, making an effort to leave out specifics, i reiterate that he can talk freely, and that, due to confidentiality, nothing said would be repeated outside of these sessions, but i do not push further for specifics.

"and your parents?"

"i'd rather not talk about them."

i nod. "is there anything in particular that happened when you were thirteen that made you feel like that?"

i notice he's become more withdrawn, more quiet and avoiding eye contact. he doesn't respond for a while, staring blankly between his shoes. i wait for him to feel comfortable enough to respond. "there was nothing...in particular that happened..." his words become more languid, and his eyes seem distant.

"i think it would be good for us to meet again next week, when will be okay for you?"

we set up the next appointment. he bids me goodbye and leaves.

working diagnosis/diagnoses:
depressive disorder (unspecified)
emotional dysregulation

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haha what do you mean i'm avoiding my problems by writing a new book?