At that appointment, I half-lied about the voices. I heard voices, but they were all versions of my own voice or echoes of voices from my past. Those voices were not, I decided, the ones she was asking about. And I lied when I did not tell her about wanting to burn myself and the cook. I lied when I did not tell her about the door that had opened: The only solution is a permanent solution. My psychiatrist did not ask if there was a seismometer in my midbrain that warned of fissures that would widen into deep chasms and, eventually, into an all-consuming abyss. If she had asked about that, I might have answered honestly. It’s difficult to say.

The mention of Kuan Yin was spontaneous; I did not know whether Jack was familiar with her, and, when he was not, I needed to explain her to him. This took some time and threatened to overwhelm the session, taking him away from his feelings and into his intellect. But I wanted to turn around Jack’s long-standing sentiments of never having been enough. If he could imagine himself, even for a moment, as the healer, I hoped this would begin to offset his unquestioning identity as someone who needed to be healed. His slightly off-balance reaction to our interchange suggested some degree of success. Instability is sometimes a sign of new possibilities.

Rather than clearly seeing what was wrong, and laying the responsibility on her parents, she had remained vague, telegraphing her pain to those around her while simultaneously taking the burden upon herself. “You had to shut yourself off,” I tell her. “To protect yourself, but also to protect your parents. You loved your father,” I reminded her. “His behavior didn’t make sense. You took it on yourself instead.

Jean is criticizing herself for doing something harmless while at the same time rebelling against doing the one thing she has to do to keep her medical license. She is proclaiming her innocence in regard to the opioid prescription but pleading guilty to watching too much TV. Things are all twisted, and I do my best to straighten them out. “There’s a big difference between turning off the TV because you are tired and turning it off because you are supposed to,” I say. Jean has every right to watch as much TV as she wants; it is her only pleasure these days, the only relief from the surveillance she is under. I continue to talk with her about changing the story she is telling herself, about treating this time as a retreat (with TV!) into which she can surrender. Surrender becomes a theme we can explore. Jean is a conscientious and experienced clinician. She is devoted to her patients, and she knows that clinical work is much more important, and meaningful, than the electronic medical records being demanded of her. But right now, for the next year and a half, the medical records have to have priority. Can she submit to that with patience? Can TV be her reward? Or will her sense of the injustice perpetrated upon her paralyze her even further?

Violette had a wonderful feeling for the joy of connection and the benefits of generosity. She was a selfless person in many regards. But her upbringing had not made enough room for healthy aggression, and this had made it difficult for her to balance the inevitable give-and-take of separation and connection. Beneath her compliant exterior lay an aggression that made her feel guilty and removed from the people she loved. Surrender was not going to be Violette’s rhinoceros. She knew about surrender already. Her rhinoceros was much more likely to look like a rhinoceros.