Here are theories about possible backstory. I also took the liberty to use informations & a very bit of dialogues in past episodes: "Ugly" 1st and then "Son of Coma Guy" It helps me to give substance to the arguments. I guess if your a House/Cuddy hater you will resent me for this but, in my mind, shipping isn't relevant. Hope you'll enjoy! :-)

House in Therapy

Fourth Session

Int. Psychiatrist office. Day

House enters the office, limping. Psy greets him then sits in his armchair. He observes House taking his jacket off and putting his cane down. ThenHouse sits, rubbing his right thigh.

Psy: More pain?

House: Yeah, lately it's worse. And no offense, but you're not helping.

Psy: Well I don't treat physical pain.

House: Oh no? You finally came to the conclusion that the whole "physical pain is related to emotional pain" thing is crap?

Psy: No. I do believe that it is related and I believe your leg pain worsened when your emotional pain worsened too. I just meant that my job requires time.

House: Yeah, see, I have a problem with that. It shouldn't take that long.

Psy: Maybe not but it does.

House: It sucks.

Psy: True. (beat) The pain got worse after she broke up with you, didn't it?

House doesn't respond. He doesn't seem to like the way things start here.

Psy: You know it's a simple logic that in therapy, the more you talk the less time it takes.

House: You're also gonna tell me it's in my head?

Psy: No but I do believe that the way you feel influences your already existing physical pain.

House: (sighs) I manage. Work is a good distraction. I can focus on something else, you know. But lately it's been more difficult. Of course the fact that I can't do my job properly doesn't help either.

House: Well, you kind of put yourself in this situation on your own. Did you discuss this with Dr. Cuddy?

House: (bitter) She won't protect me from the Board if I don't do this. She never talked about therapy before, certainly not when we were together but now I have to do this to keep my job.

Psy: She won't protect you or she can't protect you?

House: Both I guess. What difference does it make?

Psy: Are you angry with her? She took your happiness by breaking up with you and now she takes your job unless you do therapy. Is that it?

House: Vicodin or no Vicodin I'm still the best doctor. No therapy will change that. And she knows it. I shouldn't be here. I should be doing my job. The Board never understood that.

Psy: But Dr Cuddy does. Perhaps that's why she recommended therapy in addition of you quitting Vicodin. The Board didn't fire you yet because of it.

House: Doesn't matter, I still can't really do my job. Might as well be fired.

Psy: Your team still consults you a lot as I understand it. You seem to still be involved in your job.

House: It's not the same. And anyway, it gave her and Wilson an excuse to make me go to therapy.

Psy: That's what they did? I thought at least Dr. Cuddy never mentioned therapy to you before, that's what you said.

House: Yeah but since I went back on Vicodin they've been on my neck. Wilson convinced her I needed a shrink. He does that.

The Psychiatrist looks as if he wanted to answer this but stops quickly to remain silent. He is thinking.

Psy: So you blame them for your current situation?

House: No, I'm just saying that's what happened.

Psy: When I listen to you all I hear is you saying that Dr. Cuddy is responsible for your current misery and relapse because she broke up with you, Dr. Wilson is responsible because he apparently dragged Dr. Cuddy into a conspiracy to make you do a therapy you don't want to do. What is your responsibility in all of this?

House: I know I shouldn't have taken the pill. I know I'm responsible but that's who I am.

Psy: So it's their fault for not taking you as you are? That's how you sound like. It is their fault if you're in a very dark place right now?

House: (a bit vehement) No! That's not what I mean. I screwed up. I just thought we could get past it. I could do better.

Psy: And you can't anymore? Perhaps they want you to do this therapy because they care about you and that knowing you as they do, they think you still can do better.

House sighs, unconvinced.

Psy: You said earlier that Dr. Cuddy never mentioned therapy while you were together. Did you wish she had? Would you have wanted it?

House: (beat) I don't know. I just think it's odd she's pushing me in that direction all of a sudden. I mean, I know she negotiated that with the Board but still, it won't necessarily save my job so…

Psy: You didn't think she cared anymore?

House: I don't know. She didn't think I needed a shrink before that.

Psy: I ask again, did you want her to ask you if you wanted therapy?

House: I don't know. No, I don't want therapy, I just... What difference would it has made?

Psy: I don't know. Perhaps a part of you thinks that it could have saved your relationship.

House: This is ridiculous.

Psy: Really? You really sure you can tell me with absolute certainty that you didn't wish she proposed therapy for you as an alternative to the breakup?

House doesn't answer.

House: What makes you think we would still be together?

Psy: Nothing. I'm just pointing out that you wish you two could still be together, no matter what.

House: Yeah well, you can't always get what you want, right? (more for himself) Maybe it was just too late.

Psy: (intrigued) I'm sorry? Why do you say that? Why was it too late?

House: I don't know, it's nothing, forget it.

Psy: No. Why did you say that? Is this a reference to what happened between you in college?

House: Oh for God's sake it was 25 years ago!

Psy: Yes and it is apparently still very vivid. What happened?

House: (vehemently) Nothing! We met, I tracked her down, actually she tracked me down too and we had a one-night stand. Nothing much to say.

Psy: You tracked her down. So you liked her. (beat) What did you mean exactly by "actually she tracked me down too?"

House: Just that. We noticed each other. Actually she noticed me first but you know what I mean.

Psy: You did it again. It's like you're not so sure of those things or that at least you weren't at that time. You didn't know she tracked you down? When did you realize it?

House: Well it turns out I have no recollection of our first meeting so…you know. (beat) She told me a year and a half ago how we met and that she tracked me down.

Psy: So before a year and a half ago you didn't know she liked you too back then?

House: No, well yes, I knew she liked me. She slept with me willingly. (beat) Anyway it doesn't matter, I had to leave college the next day so…. I mean, it wasn't as if we were in a relationship.

Psy: Why did you have to leave? Did you finish your studies?

House: (announcing, a bit like proud) I was expelled! Believe that?

Psy: (smiles) Actually yes.

House: Yep! Just like that. A minute I was in her room early in the morning, silently getting dressed to go buy breakfast and the next minute I was in the President of the University's office telling me to go pack my things. Crazy.

Psy: So it wasn't supposed to be a one-night stand. Not for you anyway.

House: I didn't say that.

Psy: Yes you did. You said you were getting dressed silently before going for breakfast. I believe that being careful to not wake-up your partner to surprise her with breakfast is hardly a thing you ever done for just a one-night stand.

House: Well it doesn't matter because I just left and never called her back. That's it.

Psy: So Cuddy never knew you meant more with this than a one-night-stand?

House: She does now. I told her a year and a half ago. Why are we talking about this? It's got nothing to do with Vicodin. It was way before.

Psy: Well you're the one who addressed this and yes it's not related to your Vicodin addiction but I think it is important. I think it is very revealing of your fears and relationship issues. I guess leaving her like that was just simpler. You just avoided the issue of your relationship status with you away, which means you were already avoiding being hurt.

House: Who cares? You can't change the past.

Psy: I think it says a lot about your current problems.

House: Maybe so but it won't change anything. You maybe think that people can change but I don't. What Cuddy and I have is way more complicated than you think. It's not something you can repair just like that.

Psy: I'll say.

House: I don't want to talk about it anymore; it's done. I lost her like I lost Stacy. I'm fatally screwed up that's why I'm better off alone. It's not new, it's the story of my life. There I said it, now you know everything. Can we change the subject now? How about you tell me when you will give me the prescription and write to the Board that I'm a good guy deep down and a good doctor so I can have my job back? That's a good subject.

Psy: We're not finished. Now we're back to your self-loathing and your childhood. I suppose you still don't want to talk about your father?

House: Leave him alone. He did what he thought was right. He's dead now.

Silence. Psy and House look at each other.

Psy: Why did you become a doctor?

House: Patch Adams.

Psy doesn't respond. He just looks at House pointedly and patiently.

House: I saw a Buraku practicing medicine once when I was in Japan. He was just a janitor so basically he was nothing but he knew that the other doctors needed him sometimes for lost causes so he couldn't care less about how he was treated. He knew who he was. The other doctors couldn't do anything to him because of that, of his gift in medicine.

Psy: And you decided you wanted to be this Buraku? To be the one not touched by the way he is treated thanks to a higher knowledge and a gift in a domain. You found your way to escape your father's strictness and judgement, the mockery of some of your friends perhaps and also the loneliness of always being the new guy at school due to the numerous moves. Suddenly you had the key to not care about any of those things. (beat) Do you think the Buraku created a personality to mask his real feelings and refusing to acknowledge them or is this just your version of being a Buraku? Do you think he was as miserable as you are now?

House: How should I know? What kind of question is that? I was fascinated by a Buraku at fourteen so suddenly the only reason I'm a doctor is to escape my father and feelings or whatever you've just said? I like the medicine and I like my job, you know. I wouldn't have chosen to do it otherwise.

Psy: I never pretended you would, but you said that you were fascinated by how he overcame the way he was treated by the other doctors. How he was sure of himself and of his gift. That's what fascinated you. I think that's part of why you became a doctor. You said it yourself actually: you don't care what other people think of you and you're still the best doctor of the hospital.

House: Well, yeah… Yeah.

Silence. House passes his right hand on his neck; he seems tired and in pain. His hand then goes directly to his right thigh.

House: Is our session over?

The Psy looks at the clock on the left wall.

Psy: Yes it is. I'll see you next week.

House then puts his jacket back on, takes his cane and leaves the office quietly.