JOSEPHINE

Something lit up in Dr. Bradford's eyes as I finished the sentence, and he leaned back. A small smile appeared on his face. "Good."

I waited to see if he would say anything more, but it seemed to be all he wanted to say. I looked at him nervously while he continued to be silent and smiling at me. Embarrassed, I focused on something else and watched out the window. The silence was uncomfortable for me, as it always was when I wasn't alone, but at the same time, I noticed how I was starting to loosen my built-up tensions. Couldn't he say something? Or maybe he was angry because I was so harsh? "I'm sorry for my tone; I didn't mean it."

"Thank you for the apology,"Dr. Bradford began. "But it's not necessary. I don't feel hurt or attacked in any way. On the contrary, I think that of all the things you were willing to share with me, this was the most honest. By that, I don't mean that I have any doubt about your story; by no means. But it shows me something inside you that can and wants to fight, and I think that's very good."

Hope flared up in me, and even though I was already sitting upright, I sat up even straighter. "Does that mean you think I can be cured?"

His smile changed. It still looked honest, but different. "The way you put it, no. Therapy can support you on the path to healing, but you're the one who has to take this path. How far you get or want to get depends on you. I don't want to lie to you: it won't always be easy. There may be days when you will feel worse than you do now, and there will be days when you feel like you're not making any progress. That is normal and frustrating at the same time. If I understood correctly, you experienced things in the last six years that no one, especially no child, should experience. We will not be able to erase these years; they are and will always remain a part of you. To claim that everything has been processed within a few sessions would not be fair to you."

"You're not encouraging me," I whispered quietly, but I decided to pull myself together. He was just being honest, and if I was the same with myself, then I couldn't agree more. "Thanks for the honesty. What happens now?" I needed a plan, something to hold onto. Plans were good; they provided security.

"Should we bring Mr. Marini in for the rest of the conversation, or would you like to discuss this with me alone?" Dr. Bradford asked, and I thought about it. Either way, Vito would ask later what the conversation had resulted in. If not him, then certainly Domenico, and I wasn't prepared for that sort of interrogation. So, better to ask Vito.

"Should I get him?" I asked, and after Dr. Bradford nodded, I was already at the door, looking cautiously at Vito. "Would you come to us?" I asked him carefully, in case he was busy with something else.

Vito stood up and smiled at me as he walked the few steps toward us. 'So many smiles in one day,' I thought to myself. "Of course."

I scurried back to my spot. Dr. Bradford was setting up another chair, which he sat on, and Vito offered the other seat with a hand gesture. I let my gaze wander around the room again, glanced at the clock, and was shocked to see that we had been talking for almost an hour. In fact, I had spoken for an hour, which was even more unusual. Did he perhaps have other appointments?

"Josephine and I had the chance to get to know each other a little, and I would like to discuss what happens next. First of all, I have a request for you, Mr. Marini. Once you have custody of Josephine, you will have the right to inspect the files. I would appreciate it if you don't make use of that right. Josephine can and must have the certainty to speak freely in this room without having to consider potential reactions from others. An exception would, of course, be suicidal intentions. Are you okay with that?" Dr. Bradford began, and I felt great gratitude toward him.

Vito's face was expressionless as he remained silent. Then he looked at me and nodded. "Agreed. However, if you find something where we as a family could further support her, be it horse therapy or something else, then I would like to be informed about it."

Dr. Bradford smiled again. The man really smiled often. I didn't smile; horses scared me. "We'll manage that. Josephine said she'll be homeschooled starting next Monday. Are there any fixed times?" Vito said no, or rather he made it clear that therapy was a priority and that the tutor first wanted to get an idea of my level of knowledge before drawing up a plan with me. Even though this wasn't new information to me, it still made me feel uncomfortable. I didn't want the others to think I was stupid, but maybe that's exactly what she would say. I'm sure she would sigh and say that I was a difficult case, and I've had problems with math before—not to mention reading. She would definitely—

"Okay, then Tuesday afternoon at 3 p.m. and Friday morning at 8 a.m. Should be fine—"

"I can't do it at 8 a.m.!" I interrupted Dr. Bradford, and four surprised eyes looked at me. I looked at my hands in embarrassment. "I have to feed the dogs at 8:30," I added meekly, and blood rushed to my cheeks. Stupid. I was so stupid.

Vito cleared his throat, probably to scold me, but before he could say anything, Dr. Bradford preceded him and looked at me seriously. "I can understand that this is important to you. Would Thursday at 11 o'clock be better for you?" I nodded hesitantly. "Good, then that's settled. Now to what I've been thinking about. My plan would be that we first work on recognizing and acknowledging your feelings. Although you named the panic attacks and the sleep disorder as the main problems, you mainly mentioned negative feelings that accompany you. Given the circumstances, I can imagine you didn't have the opportunity to really get to know your emotions since you had to survive. But the more you learn to assess your feelings, the better you will become at meeting your own needs, and in a later step, recognizing triggers more quickly. Would you agree to that?"

I nodded. Vito nodded too, although I didn't get the impression that Dr. Bradford asked for his consent. If I was honest, the thought of confronting my feelings scared me. They were rarely good feelings; when I thought about it, the only good feelings I had were from when my parents lived. Could I even feel good feelings anymore? Had I perhaps forgotten something like that? Much more important: could I relearn it again? My gaze swept across the room again. Was this a place where I could feel safe enough to even feel again? Someone pushed me lightly.

"Josephine." Confused for a brief moment, I looked at Vito. "Do you still have questions?"

"Is it an aesthetic reason why there is a picture of a semicolon hanging there?" I asked, wondering about my surprising behavior today. Why couldn't I focus and really say what was on my mind? What should Dr. Bradford think about me when I was so inattentive? He was probably already wondering how things would work out in the sessions.

If he was irritated, at least he didn't show it. "A patient of mine painted this. Do you know what it stands for besides its grammatical meaning?" I shook my head. "It's said that the author could have finished the sentence at this point but decided not to."

_________________

Patient Name: Josephine E. Parker

Biographical History: The patient is 15 years old. Her parents died when she was 9 years old in a car accident. She describes the relationship between them and herself as loving. She can speak calmly about death and is less reserved when asked. There was a godmother with whom contact was broken off after she was placed in a foster family. She doesn't know why she couldn't go to her godmother, but she suspects that her godmother didn't feel able to raise a child. From the time of their death until she was 12, she lived with a religious couple who homeschooled her. The patient reports little about this time, but it seems as if she was isolated from other children. The foster father is a priest, and the foster mother occasionally supports her husband in preparing for Mass and otherwise takes on the care work in the household. At the age of 12, J.P. ran away from them. She cites a difficult relationship and an unfinished grieving process on her part as reasons. From the age of 12, she lived homeless on the streets. According to her stories, she had a mentor who helped her survive. She doesn't go into further detail about this person; it seems he has died. She describes existential crises such as long periods of hunger, unsafe living conditions, violence, cold, and heat, and drug use by other people in her immediate surroundings. She has been living with Vito Marini and his siblings for a few weeks. The transfer of custody is currently being processed; in the long term, she will be adopted. She describes difficulties in adapting but also the support experienced in many areas such as therapy, medical support, or school education. Her future guardian accompanied her to the appointment and appears genuinely motivated to support her. In conversation, she appears cautious about comments regarding the family but takes on tasks in the home setting (feeding the dogs). Homeschooling starts next week with the aim of attending school as soon as she catches up with the topics.

Psychological Assessment: The patient can classify individual experiences as traumatic, but she takes other things as given. It is important to determine the extent to which the mourning process took place when her parents died. She seems to feel guilty toward her parents. The patient has said little to her foster parents, but there is suspicion of some kind of abuse. The patient may no longer remember this. The isolation does not appear to have promoted age-appropriate development. She describes difficulties in social contacts and relationships. She sees homelessness as the trigger for her sleep disorders; she cannot see any further consequences related to the unsafe living environment.

Her primary wish is to reduce the panic attacks and, secondarily, to improve her sleep. During the conversation, a limited emotional experience becomes apparent, as well as strong mistrust in herself and other people. Due to growing up too early, she clearly lacks parts of finding her own identity and body awareness. Physical development is obviously disturbed. She cannot perceive the possible traumas as such; as above, it is questionable whether these are anchored in her consciousness or have been repressed for self-protection.

She cannot recognize the amazing feat of survival as her achievement and keeps looking for other reasons for it, a sign of her reduced self-confidence. The self-efficacy experience is also reduced in conversation. She tends to zone out mentally during the conversation but doesn't notice it herself. She refocused after a few minutes without external intervention. In the context of homelessness, the patient wasn't asked about her potential drug use; this needs to be done in the next sessions. Miss Parker credibly distances herself from suicidal thoughts and threats to others. She appears motivated to continue therapy.

Bradford leaned back and rubbed his face exhaustedly. He considered revising his report again to give his thoughts more structure but decided against it. It was late; his husband was waiting for him at home, and he still had to think about what to tell his husband about why he had taken on this case.



Hello there,

I'll be honest, Bradford's excuse is my own. Normally medical histories are a bit more sorted, but I'm too tired to go over that. I hope you're all doing well and thank you for the comments, votes and reads! It makes me so happy that my little project catches so many different people. Unfortunately, I can't keep up with writing to each and every one of you individually to thank you; So again: THANK YOU!

See you soon!