One advantage to travelling on a ship hurtling through space on a long voyage is that the climate is carefully controlled. Having lived in both Ireland and Britain, Stephen had grown up in a unique biosphere. There were people onboard who were used to Scandinavian winters, or humid summers in Southeast Asia, even the arid Middle East, but the British Isles had managed to sell gloom as a desirable destination. Cloudy skies, heavy rain and a cold wind that could cut through the heartiest individual. It was deceptive too, you can prepare for deep snow and penetrating frost, for blazing heat and heavy humidity. You cannot prepare for a day that looks fine at first but where all four seasons could change on a whim. The room was pleasantly warm, the air had been initially too dry for Stephen, but he adapted, Betty was useful in tracking hydration and one thing he did commend such an invasive system on was the tremendous tailoring to specific needs relative to each passenger based on their origin, lifestyle and culture.
The voyage had been advertised as inclusive, with an asterisk, there would always be terms and conditions that applied. Stephen had not given too much thought to this in his initial few months on board but as time progressed, he was becoming acutely aware of the fragility of the ecosystem aboard. This was both fascinating from a research perspective but verging on the dangerous from a survivalist point of view. He did not expect the crew to suddenly murder each other, Sam Neil was not on board, and no one was missing any eyes so he was fairly convinced Event Horizon would not be acted out during his journey. He was however mindful of power dynamics, cliques and other social caste systems forming aboard. He knew himself that as an observer whose only active participation took place in the structured cage of a therapeutic room, he enjoyed an exclusive position, but this in turn left him more isolated at times. Erica was a welcome break last night, even if they did just talk work. Finishing his shave, he surrendered himself to the shower, allowing the warm water to open up the blood vessels and coax life into limb and limb into life.
“Betty, could you please go through my messages for the day” Stephen shouted from the shower, drying himself off.
“Certainly, your appointments for today have all confirmed in attendance, no changes have been requested. You have supervision with one of the clinical team later today, Doctor Mulsanne is still unavailable due to personal illness, but she has arranged for one of the medical staff to fill in as you are still required to attend your supervision and she is unable to advise on when she will be able to return to appointments.”
Stephen nodded to himself, making his own mental notes that would end up redundant anyways as he knew he would inevitably be checking in with Betty to remind him of these updates later. It was still important to Stephen to be engaging cognitively anyways, for his mental acuity and health from a behavioural perspective.
“There is a message from your patient Marcus Kelly, requesting their session to be moved up to today. In summary they have been wanting to run some reflections by you.”
Stephen sighed, he struggled with Marcus, and he knew it. He felt awful the first time he admitted he struggled with Marcus, Stephen knew he needed to be there for anyone in front of him, but he was also a problem solver, he loved a puzzle, and Marcus was someone who liked to repeat his actions hoping for a different result each time.
“Add him in after my last appointment, I will grab a snack on the go and just go straight into supervision after Marcus”, Stephen said with reluctance, a small part of him echoed countless talks on boundaries but another part felt guilty for his attitude towards Marcus and he wanted to try and make an effort.
Along with his notepad, Stephen picked up his data pad from its charging station and set off. He was clean shaven, with a fresh jumper and ironed shirt, a new person today, with hopes and ambitions, even dreams. This was his character armour an old term coined by Wilhelm Reich, his projection onto himself through which his immediate world could interact. Today he wanted to project the look of someone who was stable, supportive and had their shit together. While dressing he had reflected on whether this was more for his patients today or for himself. Uncomfortably he concluded, it was for himself, he needed to wear the mask of a therapist today in order to help believe that he was one. A difficult passenger on this voyage was doubt, it stowed away and hid in every nook, in every shadow, and creeped into the back of the mind. It grew like an undiscovered cancer, then, when realised, a secret cancer that no one wanted to share lest they admit to others that they were vulnerable and needed support. People are great at offering support but will always be reluctant to heal themselves. This is where Stephen came in, and today was also his turn to do a bit of self-healing.
***
Entering into Wellness Space early, with the intention of getting on top of work he had been putting off, he was surprised to find his first patient waiting, 30 minutes ahead of their scheduled appointment. Dominic was Canadian but had received the majority of his education in the States. He had a mother who was Canadian according to his file and Stephen had wondered to himself if he had decided to join this voyage through the Canadian stream rather than American. The United Nations Space Agency had listed criteria for volunteers, but they could not prevent individual nations from apply extra criteria for their citizens. A new life from America would have been an attractive offer; a guaranteed
“Yeah, I actually wanted to get in before anyone from the next shift saw me”
“Next shift? Oh, so you are from…have you been staying awake just to have this appointment?”.
Dominic nodded and looked around, as if checking to see if anyone was listening in. Stephen opened his door and offered the space for Dominic to head on through. “We may as well make a start since you are here then” he said cautiously. Stephen did not like this fresh day to begin with a compromise on boundaries, but he was decidedly curious and tacitly accepted long ago that this curiosity cut both ways.
“Betty please switch to therapeutic mode preferences, begin session recording”
“Session recording?” Dominic exclaimed in alarm. “Yes, all sessions are recorded, this was stated on the intake form document you would have signed when engaging this appointment. You read this, right?” Stephen was mindful to be neutral in tone here, he knew Dominic likely did not read the terms but he wanted to give him the space to ask questions and maybe arrive with his concerns addressed at least, because he certainly could not just pop down the road to the next intra-solar therapy clinic.
“Umm, yeah I did have some questions first, if I could just check before we go ahead, that form was a bit much to be reading through”. Stephen gestured towards the couch and took a seat himself, acknowledging Dominic with a nod, inviting him to speak.
“So like, with the recordings, who gets to see them, do they have to be recorded?”
Stephen shifted, as though switching masks, taking off his therapeutic mask and donning his formal, legal, terms and conditions mask. A mask Dominic could reject and leave his therapeutic mask intact. “Yes, the sessions do need to be recorded, think of it this way, it is for your safety and mine. Out here we do not have much in the way of alternative choices with care, so it is very much me and you here. If you say something, or act abusively towards me, or if I come across similar to you, the recordings protect us”. He allowed for a pause, mentally adjusting the mask that sat slightly uncomfortably on his face. “The recordings are only viewed by myself or where it is deemed in the interests of your continued wellbeing, like in the case of a complaint, by the senior clinical team, though, there is also potential for senior ship crew to also view the records in the case of your demise or if there is a credible threat to the wellbeing of the ship, which I hope you can appreciate? That is, as you said, a lot to try and take in by reading alone”. Stephen noticed a shift in Dominic’s body language, he was bouncing his leg, and was shifting in the couch, spreading his arms out, as though trying to release pent up frustration and tension through his fingertips.
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“I’m not okay with it though, and I think that it is shit we do not have an option for privacy, like the stuff I want to talk about is of a personal nature and I don’t want anybody except for my therapist and myself to know about it, do you get me?”
“I can appreciate where you are coming from Dominic but there are rules and it is not for me to bend or change them, they exist for a reason, and yeah I get it, they can seem restrictive and maybe you need to take a bit of time here to think about what you could be comfortable with doing?”
“What am I meant to do in the meantime though?” Dominic stated with aggression firmly centred in his tone and body language now. He was leaning forward, his leg continuing to bounce, head swaying as if he was trying to subtly release tension in the neck.
“What do you mean?” Stephen did not shift in composure, he knew not to acknowledge the aggression here, he had learned that long before he learned to sit in this chair.
“My mind has been racing and I have been finding it so difficult to sleep, like I’ve been trying to just get on with my work and be around mates but lately I have been feeling intense pressure and I cannot explain it. I even get vivid nightmares and wake up panicking and like this is not normal at all for me, I’ve no idea why it’s happening, and I don’t want anybody then coming in and trying to take shit away from me, like I want to just get on with things as is, do you understand?”
Stephen allowed for an audible exhale, he leant forward, a total deception but necessary one. He was letting Dominic think he had won out with his point, and he was being heard and was about to get somewhere. Stephen felt tied by the system but respected the rules and signed up to them willingly. He knew he could give Dominic the experience of being heard at least, but he needed a method to also allow him to come out of aggression, this was not a defeat, it was nudging Dominic towards a more neutral position where they could both sit back and agree how shit the system was together. An ethical deception. “Look, you are right, back on Earth you could totally go and find someone and speak more privately but look I don’t think that would have been much better, like let me level with you, people made the system shit, and it means now that the likes of me and you need protecting. I don’t want to see you lose anything and hey look we can see how it goes, if it gets a bit uncomfortable you can let me know and we can chill, pull back and focus elsewhere. It’s better than not talking, and I mean like the only other option is to just send you into the doctor, who will likely just medicate you and refer you back to this service anyways…” He paused to observe Dominic, who had stopped bouncing his leg, he looked defeated sitting back in the couch, his head bent low. Stephen sat back at this point, uncertain with how this was about to play out. “Why don’t you go and have a think about what you would like to achieve here. You can message if you have more queries and get more comfortable with the idea of showing up. Maybe, you could even just use this time with me to get comfortable and work with someone on your shift? Improving sleep will definitely be a goal of ours and I respect your need for privacy, but sleep certainly takes priority here because eventually this sleep disturbance stuff will catch up with you, and your friends will notice you need help then, would you agree with that assessment?”
Stephen had turned the conversation, and the advantage was his now, not that he was against Dominic, but he had to maintain control without looking like he was actively controlling the session. An art form that every therapist aspires to achieve and is totally dependent on the patient and the mindset and confidence of the therapist to want to be there unconditionally for their patient. He allowed himself a moment of pride, but also reassurance. There was a moment where the conversation could have gone anywhere and Stephen knew how he could have wound up spending his morning filling in paperwork and following tedious but necessary procedures on safety, things that felt counter-therapeutic, a betrayal of this unconditional positive regard, but necessary always. Patient safety first and Stephen would not be so arrogant to presume otherwise, he was just happy to avoid such a test of boundaries, so early in the morning for him, but what he had not clocked was how late it was for Dominic, meaning he was more liable to be in distress, a point that sat with Stephen uncomfortably, he missed this when he first saw Dominic, but told himself he would learn from it, proceeding to then banish it from his mind.
***
“Take care Dominic, you did the right thing in showing up and I hope we are able to give you the space you need, take your time and like I said, if you have any questions…”
“Yeah, thanks…uh, for today”. Dominic left the room, without making eye contact and swiftly made his exit from the clinic. They had started early and finished early; this left Stephen with a solid thirty minutes to himself. As quickly as Dominic had left the clinic, did Stephen close his office door. He turned, pressing his back up against the door, as though he was reinforcing against a wave of emotions that sought to penetrate this space without his consent. This was the price of curiosity and for a moment he reflected. “If I had just waited, would he have grown uncomfortable enough to have left and I would not have had to deal with that tense start”. He knew this was not an ideal thought, nor would he ever admit this out loud to anyone, but it certainly was an honest thought. As much as Stephen tried to be there in session, and as much as he was relieved to have retained control in session, he could not help but feel a hint of resentment.
He left the door and lay down on the couch, throwing the cushions off and putting his feet up in defiance. He resented that session, he felt resentment towards Dominic, as though he had shown up to dump chaos and confrontation on Stephen’s door, as though he was the one responsible for the way Dominic felt. Dominic had issues with the system of which Stephen was a part of and it was difficult to be there as both a representative of a problem and supposed ambassador of peace and wellbeing. “Betty exit recording mode, switch to privacy mode, pause all communication into this office”. An affirmative chirp came from his terminal. Stephen took a deep breath in, closing his eyes for a moment before abruptly opening them. Loudly he exclaimed “Fuck you Dominic, you did not need to be so fucking difficult so fuck you for being that way and fuck you for being so suspicious. Fuck you, you fucking twat, gobshite…” finishing on an exhale, he paused for a moment, staring at the ceiling, noticing the release of tension through his body and across his forehead. Dominic could not help the situation he was in when he came for help, but when he came, he brought a lot and left enough behind. This was not resentment for Dominic, it was resentment for the situation he was in that led him to take things out on Stephen, and compassion. Compassion for what he had suffered, for what both he and Dominic were suffering. Stephen remained on the couch for a good twenty minutes in silence before turning to rise and stretch. Tension had made its home in many joints, but overall, he felt calmer. “Betty, please bring up the next patient profile…please”.
“Certainly Stephen, may I recommend you hydrate before your next appointment. Your blood pressure was elevated, and you did not have the recommended intake of fluids before your session with Dominic”. Stephen was already scrolling through his next patient’s file; he reached for the cup on his desk that had been emptied and cleaned the night before. As he noticed the empty cup he frowned in frustration. The friendly chirping voice continued “Stephen, are you okay?”.