“Why do you want to be a psychotherapist?” This was one question that left Chester Fullest in a protracted silence. While he seemed to fumble around for an answer, he was always able to come up with a simple truth. “It’s always been easy for me. I’m good at it. I’m a people person. Discovering what’s beyond the façade is what I live for!” He was a natural, but there was one case, however, that left an indelible impression, a case that forever humbled his passion for “getting beyond the façade.”
His interest was piqued when he saw her name, “Mary Jane Smith,” penciled in his appointment book. “With a name like that, she could be anybody or nobody. It’s probably an alias.”
Something about her struck him odd from the get-go, but he couldn’t put his finger on what it was. When he greeted her with an introductory handshake and received the paperwork she had filled out in the waiting room, he was struck by her appearance – so childlike, yet an adult. Dressed in a flannel shirt and overalls, her hair in pigtails, big brown eyes, her face dotted with large freckles, wore no make-up or lipstick, had no handbag, nothing, she looked as though she had just come from a farm, in a world of her own.
The first thing he did was check to see what she wrote down for her age, 27. She had filled in the demographics, but left almost the rest virtually blank. When he brought this to her attention, she just looked at him blankly. He pointed to the form. “What’s this say?” Realizing that she must have had her reasons for not answering those questions and not wanting to discuss them in the waiting room, he proceeded, “Let’s talk in my office.”
Extending her hand, she got up with a huge smile, “Thank you so much for seeing me.”
“Could you tell me about why you’re here?” he asked her. Her eyes scanned the room as if she hadn’t heard the question, finally settling on him. He couldn’t tell whether she didn’t want to answer, was suspicious, overwhelmed or what she was feeling. It seemed a bit out of context, almost cryptic when she blurted out, with an incongruous smirk, “You never saw anyone like me before, did you?” The thought crossed his mind, “Is this some kind of seduction?”
Undaunted by her strangeness, Fullest remained on track. “Could you tell me what brought you here?”
“Yes. It was hard. My whole life.”
“Could you be more specific? What happened?”
She began whispering. “I’m not allowed to leave the house. Ever.”
Adrenaline began surging with curiosity as a mystery was unfolding before his eyes. It took quite a bit of effort to not push the conversation, but rather let her be and come out in her own way and at her own pace.
As he was wondering to himself, he had no idea how old she was, forgetting that he had checked the paperwork only five minutes earlier, he nervously made sure he knew her exact age, “How old are you?”
“Twenty-seven.”
He believed her, but had his doubts because she was so childlike. He had, up to this point, taken her seriously, given her the benefit of the doubt. He was trained to validate the client’s experience, “whether real or imagined, it was real to her.” At the same time, he had a professional responsibility to make sure she was safe, wasn’t being held against her will, not in some kind of danger.
Just so he could hear her answer the question, he asked, “Who is holding you prisoner?” She sounded so bizarre, yet so matter of fact.
“If I leave the house, she’ll do bad things to me.”
“Who’s she?”
“I’m not supposed to tell.”
While Fullest’s curiosity was further piqued, Mary’s fragility was becoming increasingly more evident. His instincts were telling him not to run the risk of her opening up too much too fast and scare her off. He felt satisfied enough at that point to conclude that she was not at imminent risk.
“Who do you live with?”
“Mary.”
“Who’s Mary?”
“My mother.”
“Your name is Mary too?”
“That’s what she named me.”
“You don’t call her ‘Mother’?”
“We don’t have that kind of relationship.”
This was the first time in young career he was stumped. He wasn’t sure what was happening, what he was dealing with, so he just kept asking her questions and tried to join with her, until he got a better handle on what to do with her. “You’re right about one thing, I never did meet anyone like you.”
“I do have more questions and concerns, but we’re running out of time. How do you feel about coming back next week same time?”
Mary’s face collapsed like a popped balloon. “But we just started.”
“Filling out the paperwork took more time than I would have liked. We’ll just pick up from where we left off next session. Next week, same time?”
“But I have this secret I shouldn’t tell you.”
Taken by her coy abruptness, he felt compelled to ask, “Are you going to tell me what it is?” but he refrained and waited for her to respond.
“I can’t.”
“Why?”
“You won’t see me.”
Fullest was more than curious, and possibly got hooked by her dare. Incredulously, “What could you possibly tell me that would make me not see you?”
“I’m not sure what the secret is. But I can tell you this. Unless you’re a threat to yourself or someone else, you could tell me anything and I will continue seeing you.”
“No matter what?”
With some trepidation, he continued in his efforts to assure her, “No matter what.”
“You will…stop seeing me. They all do.”
“There is nothing you could say that would make me stop seeing you.”
“Promise?”
“Absolutely.”
“It’s about my name.”
He was again dumbfounded. “Your name?”
“It’s a secret.”
“Are you going to tell me?”
“Nobody.”
“Nobody is your name?
Fullest stopped dead in his tracks, and felt pressured with a patient in the waiting room. He thought better of asking her whether she was serious, again, giving her the benefit of the doubt that she was serious. “Okay. If that’s your name, I’m still going to see you. But I can’t call you Nobody. I just couldn’t do it. It wouldn’t be therapeutic.
“It’s my name.”
He reminded himself that he was the therapist and she the patient, and it was up to him to take charge, “Look. I’m going to see you next week and need to call you by the name you signed on your paperwork.”
Acquiescing, in a soft submissive tone, she said, “Okay.”
“You think you’ll be able to get here okay next week?”
Taking a moment to think about it, she responded, “Yeah. Mary is doing an aerobics class. She’s not going to be home.”
“Is that a good thing?” Despite her disclosure, Fullest remained skeptical. His instincts were telling him that things were still not adding up.
Mary was there the following week, right on schedule. Same childlike appearance—pigtails, freckles, big brown eyes, flannel shirt and overalls, eagerly awaiting the start of the session.
Fullest picked up from where they left off.
“Tell me about your relationship with your mother.”
“She’s mean and I don’t like her.”
“Why doesn’t she want you to leave the house?”
“She tells me I’m bad and that she doesn’t want anyone to ever know about me.”
“You never leave the house?”
“I’m afraid to. One time when I thought she wasn’t going to be there, she saw me outside of the house. Then she chained me to the bed.”
“When was this?” “At different times. I try so hard to be good. No matter what I do, it’s never enough. I’m afraid of what she’d do to me if she found out I was here.”
Fullest was growing increasingly uncomfortable as her story and presentation were simply incomprehensible. She didn’t appear to be psychotic. He thought that she could be in an abusive situation. But she was an adult. While her dependency, fragility, naiveté and innocence were so clearly apparent, he wasn’t close to a diagnosis.
“What would she do to you?”
“Try to teach me a lesson.”
“What’d she do?”
“I can’t say. Please. I don’t want to think about it.”
“Take a moment. It’s important that you tell me.”
“She’s burned me with cigarettes…in places you can’t see. I have
scars.”
“She burns you with cigarettes?”
“Not recently.”
“How does she treat you when you’re good?”
“Sometimes she reads me stories, which I like a lot.”
Trying to imagine what her home-life was like, “Do you have any sisters or brothers?”
“Sisters. Mary controls them all.”
“Who controls them?”
“Mary.”
“Mary?”
“My mother.”
“You’re both named Mary?”
Her tone turned frightened, almost desperate. “You’re not going to tell Mary I’m here, are you?”
“Of course not.”
After two sessions, Fullest still hadn’t zeroed in on the problem. Mary was something different from anything he had ever encountered. Maybe it was all a façade, some kind of trick, maybe some kind of research project, but he wasn’t going to let his impatience and frustration get the better of him.
Bereft of any clarity or direction, Fullest decided to seek the consultation of a colleague, who proposed that Mary was most likely a victim of severe abuse and encouraged a back-to-basics approach. He gave Fullest a vote of confidence -- to trust his instincts. “Go even slower. Keep her engaged. Find out more. Explore more about what separating from her mother means to her.”
Fullest was relieved after speaking with Brook, that he was no longer in this quandary alone. His excitement returned. He couldn’t wait for the big day, their third session.
That day came none too soon. When he entered the waiting room at the appointed time, Mary wasn’t there. He saw someone he didn’t recognize sitting in a different chair than Mary had sat in, and automatically assumed that that person must be a patient waiting to see someone else. When he came back five minutes later, the same woman was still sitting there, not Mary. “Are you Chester Fullest?” she asked. He was totally at a loss. He didn’t know who she was.
“Yes,” not knowing what else to say.
“I’m Mary Jane Smith.”
Fullest was completely flabbergasted, “Who are you?”
“Mary Jane Smith.”
In a loud and confident tone, “No way. You’re Mary Jane Smith? The same Mary Jane Smith…that was here last week and the week before that?”
“Yes and no.”
He thought he was being played and nearly snapped. “Am I supposed to know what that means?
“Dr. Fullest, let me explain. Could we go into your office?”
They were still in the waiting room when he demanded, “Where’s Mary Jane, the one who was here last week?”
“She wasn’t supposed to see you at all. I am aware that you saw her two times.”
“Who are you?”
“Mary Jane.”
Fullest contemplated throwing her out of his office altogether. He didn’t know who this Mary was and didn’t want to risk betraying his patient’s confidence, as she clearly was not his patient. Her hair was long and straight, down to her shoulders and darker than Mary’s was. She was dressed in a corporate, cosmopolitan attire, carried a shoulder bag, wore light make-up, and her complexion was clear- not dotted with freckles. She had striking features, and there was a high powered and intimidating
sense about her that she wasn’t messing around. He wasn’t sure how to respond.
All he could do was rely on what always worked before, to just be honest and professional. “I’m sure you’ll understand my being a bit perturbed. I shouldn’t even be talking to you. You are not my patient.”
“You’re right. I’m not.”
“I don’t know you.”
“I’m here to tell you that Mary can no longer see you.”
“What! Why can’t she see me?”
“She’s already seeing someone else.”
“But she told me that she wasn’t seeing anyone else. I asked her that specifically.”
“This is the situation, Dr. Fullest. I am a multiple personality disorder and am under the care of a psychiatrist, who is experienced and has been working with me for the past four years.”
“But I am already seeing her. And I still don’t know who you are.”
“Do you want my doctor to call you?”
“Yes. I do. Are you telling me that you and Mary Jane are the same?”
“Yes.”
“But I don’t believe you.”
“You can call him. His name is Dr. Stringer and here’s his number. There’s not much else to say. You are not to see Mary Jane.”
“That’s not even her name.”
“I know she calls herself Nobody. Don’t be fooled by her childish routine. She runs away from me, spreads all these rumors, and is always trying to get back at me for her hard, miserable life,” in a mocking tone. She seemed so cold and hard and abrupt compared to Nobody.
“Dr. Fullest, I have no desire to speak with you further. If she sees you, tell her that you can no longer see her.”
“That’s easier said than done.”
“Dr. Fullest. You don’t know who you’re dealing with.”
“I don’t.”
“You understand, Dr. Fullest, that you could be liable, lose your license if you persist.” That made him even more uncomfortable as he was ever a doctor, but a lowly inexperienced therapist.
“I will have to speak to your doctor.”
“Here’s his card.”
Fullest had a lot to mull over. Up to that point, he had read and heard a little about multiple personality disorder and was fascinated by the concept of different personalities manifesting in the same person, how a person could be two, three or more people at the same time? Three Faces of Eve and Sybil were the only multiple personality disorders he knew about. But Mary was his first real multiple personality - his patient! It was a a once-in-a-lifetime career opportunity. At the same time, he recognized the ethical dilemma he was in, that there was no way he could justify seeing Mary when Mary had already been working with Stringer. The next thing he had to do was to call him, to corroborate her story.
With some trepidation, he began dialing the phone. All he got was his answering service, so he left a message for him to call back. When Stinger called, they had a brief conversation. Stinger confirmed that Mary Jane was indeed his patient and that he was treating her multiple personality disorder. He sternly emphasized that he was the treating physician, ordering Fullest to never see Mary again.
When asked what the treatment consisted of, Stinger sounded a bit pompous and condescending, but to the point. “As you might imagine, treating multiple personalities is quite complicated. There’s a host, the dominant personality and any number of sub or other personalities. And at any time, switching from one to another can occur. The goal is to get the dominant personality in control and in charge, to render the subs non-factors, so she could live a more normal life.”
Fullest relented. “Okay, Dr. Stinger, I guess I have to get out of the way.”
Fullest was dreading his four-o’clock slot the following week. “What if she shows up again?” He was praying that she doesn’t show up.
With worries about his career and fears of facing a malpractice charge, the last thing he wanted to do was to face Mary after breaking his promise. When she hadn’t shown up for the next two weeks, he thanked his lucky stars, relieved to have escaped what could have been a far worse fate than never knowing whether his client was okay.
His relief, however, was short-lived. By happenstance, he had no-one scheduled in that four pm slot the third week. When he strolled from his desk to the waiting room to get some water, he was caught completely off guard to see Mary sitting there, business as usual; waiting for him to come out to greet her. He was dumbfounded.
“Mary?”
With that same happy-go-lucky smile on her face, she said, “Dr. Fullest. You weren’t expecting me?”
“Uuuhh…You missed two weeks. You didn’t call.”
As if she had already explained to him she’d sometimes have to miss a session if necessary, “I couldn’t.”
It was apparent that Nobody was unaware any communication from Mary him ever took place.
“Let’s go in. We need to talk.”
Now he was visibly nervous and sweating and his voice cracking.
“Do you know that Mary came to see me?”
“She did?!”
“You didn’t know?”
“She didn’t tell me.”
“She was here three weeks ago.”
“She told you not to see me, right?”
“Yes. And that you are already under the care of another doctor.”
“And now you can’t see me. Right?”
“I’m sorry. That’s right.”
“I need to see someone for myself. Someone else. Not Stinger, he doesn’t care about me or believe me.”
“But if I continued to see you, I’d only make it worse.”
“I want to see you.”
“I can’t. I could get into a lot of trouble.”
“But you promised.”
“I had no idea you were seeing someone else.”
“But you promised!”
“I’m sorry.”
Mary stared at Fullest intently, her eyes welling up, looking as though she had just lost the only friend she ever had. She slumped back into her chair. She suddenly seemed vacant, and pale. Her face began to contort. Her eyes seemed to disappear into her head. She tilted her back and her face turned chalk white. Fullest had no idea what was happening, nor what was going to happen. He wasn’t even sure she was conscious. The hair on his arms stood straight up and had goosebumps all over his body.
Finally, after about two long minutes, Mary came to. She opened her eyes and color returned to her face. She looked disoriented.
As if she was seeing him for the first time, she was wondering, “Who are you?”
“Chester Fullest.”
His name didn’t register.
“What am I doing here? Where am I?”
“In a therapy office in Chicago.”
Still not registering, as if she had amnesia, “I don’t know you.”
“Who are you?” Fullest asked her.
“Lorna.”
He couldn’t stop his hands from shaking. He never saw Lorna before and had no idea what she’d do. “Do you know what time it is?”
Looking out of the window, she said, “It’s dark.”
With no intention of engaging her further, “Do you know how to get home?”
“I’ll find my way.”
As relieved as he was to see her leave his office, and perhaps never have to deal with her again, questions kept bubbling up in his mind. He wondered what impact his broken promise would have on her. He told himself that he would never to lie or mislead a patient again.
Never would he say, “No matter what,” again.