Thanks to Roane for the beta help.


Confidential. For training purposes only. Do not circulate.

Date: 3.6.2002 11a.m.

Psychologist: Dr Carola Rivas, PhD

Patient: S.H., 25yo White male, cocaine and heroin user, mood disorder NOS. Session No. 4.


SH: Did Dr Franklin tell you that I had a visitor?

CR: Yes. Would you like to tell me about it?

SH: Obviously.

CR: …

SH: You're supposed to ask me who it was.

CR: But you know that I already know who it was.

SH: Yes, but this is what they teach in the social skills group. It's more polite to ask someone a question than to assume that you know the answer. Even though I know the answer.

CR: Now I'm confused. Are you saying that I should pretend that I don't know who came to see you? Even though we both know that I talk with other clinicians here? Weren't you going to tell me about your visitor? The detective?

SH: Ah-hah! You did know. Yes, Scotland Yard detective. Came to see me about a murder – not the one I was telling you about earlier, mind you, but I think he'll take care of that one too. See that it doesn't happen, I mean. No, he came to see me about a case that has been open for two or three months now. I thought I'd left a real trail for them to follow but apparently it wasn't enough to lead the horse to the water. Did you catch that, doctor? I used metaphorical language.

CR: And?

SH: It demonstrates that I understand metaphors. Symbolism. Imaginative variation. Something that autists aren't supposed to do.

CR: So now you're calling yourself an autist?

SH: I've never used that term to describe myself. It's what others have said. Derisively, I might add.

CR: …

SH: Detective Lestrade came. Acted like he'd never seen the inside of a loony bin before. The way he looked around before he took a seat. Told me you looked through his pockets, too. Not you, personally, Doctor Rivas. I for one liked the idea of the police getting the pat-down. Would you do the same to my brother, I wonder, if he were to pay a call? And could I watch? That would be a motivator. I'd have him in right away, in that case.

CR: Aren't you going to tell me about the murders? Or were those not important?

SH: Important? Hardly. Run-of-the-mill homicides. Nothing to write home about. If I were the type to write home, I mean. Strange, I've hardly seen a pencil around here. Or pens for that matter. Are you afraid that we're going to poke our eyes out? Like Oedipus? Now, that would make an impression on your little Freudian brains, now wouldn't it?

CR: I fail to see the relevance.

SH: Relevance? I'm telling you what comes into my head. You're supposed to make sense of it, doctor, not me.

CR: Do you imagine that I'm not 'making sense' of this?

SH: Your work is tedious. Boring for you, and even more so for me. I already know what you'll say.

CR: Which is?

SH: That I'm trying to compensate for a childhood spent under the shadow of an older, more competent brother. That I blame myself, wrongly (you suppose), for my mother's death. That I hated my father. That I believe that my mother's death was punishment for my hatred of my father.

CR: You have been reading Freud, I see.

SH: Dull, really. Formulaic. The Greek myths all over again. And told much less elegantly.

CR: I agree.

SH: Do you really, now? Now, there's an opinion from you, at last.

CR: It's lacking meaning when you parse it down like that. But – have you read his case studies on hysteria?

SH: What?

CR: Have you read Freud's Studies on Hysteria?

SH: No.

CR: You might find them amusing. I know for a fact that the patient library has a copy.

SH: Perhaps, if I'm feeling at a loss for something to do…

CR: Because you're obviously feeling so entertained around here.

SH: Sarcasm is the lowest form of humour.

CR: …

SH: I find things to do. Solving old murders, for one. Now, that is a productive pastime. Oh, there I go again! Productivity. Is that how you measure your worth? Mycroft would say so. Always a Calvinist, Mycroft was, like our father. I was the Roman one. Pagan, even. Must be why I like confession. And the Dionysian rites. He, on the other hand, is the more sanctimonious one. He practically drips with sanctimoniousness.

CR: How did he come to be the one to bring you in?

SH: Mycroft? I called him.

CR: You called him? Wait – I don't understand.

SH: It's very simple. I called him. Asked him to bring me.

CR: But – but – why?

SH: I know you are an idiot, but can you please refrain from making that expression with your mouth? It's most unflattering and gives you the appearance of a goldfish. Now, as I was saying, I called Mycroft to bring me in because I knew that it would annoy him.

CR: …

SH: That expression really isn't doing anything better to your face. Yes, I made him bring me in. I deliberately wanted to annoy him. Am I not supposed to admit to that? Is that a conclusion I'm supposed to come to only after years of analysis? Because I know my own motives. Which were—

CR: To annoy your brother. That's why you're here.

SH: No, that's not why I'm here. You didn't listen carefully. You must listen carefully in this profession or you'll be rubbish. I said he was the one to bring me in. But I would have come anyway. He was just the means.

CR: You would have come? By yourself?

SH: Yes. I would have come anyway. Does that surprise you?

CR: Frankly, yes.

SH: I'll give you another five seconds to get over your shock and close your mouth. Now, as I was saying, Mycroft brought me in, but that's only because I knew that he was meeting with the Russian ambassador that day, and I thought it would be a bit of a lark to make him have to come down to London to rescue me from myself. I just wish I could have heard what kind of excuse he made to the ambassador. But I wasn't supposed to know about that meeting, so I wasn't going to flat-out ask him how that went.

CR: Let me make sure I understand. You were going to come here anyway, but you asked Mycroft to bring you in because you wanted to make a nuisance of yourself?

SH: Now she understands. Yes, that's exactly why.

CR: Let me ask you another question. Why did you want to come here?

SH: Isn't that obvious?

CR: I can think of any number of reasons why you might want to be here, but I might be wrong. Perhaps you can tell me.

SH: To stop using. Isn't that why people get into rehab?

CR: I'm not interested in 'people,' Sherlock. I'm interested in you.

SH: Ah, I see. Individual data, not central tendencies. N of one, etc. Throw out everything you previously knew. Descartes? I'm a bit more Bayesian, to tell you the truth. I'd rather base my conclusions on all the previous evidence available, not to mention what I know about others in a similar situation. Revise as I go. Discard improbable solutions. Reformulate my hypothesis. Hypothesis, test, revise hypothesis, test again. So, tell me: what do you know about others in my situation?

CR: It's interesting to me that you seem to not want to talk about yourself. That you talk around yourself.

SH: I have no problem talking about myself. Isn't that what I'm doing here? Talking about me, me, me? All the livelong day. Sherlock in the morning, social skills group. Sherlock at midday, therapy. Sherlock in the afternoon, drama and music. Sherlock in the evening. Me, me, me. I get bored of it all.

CR: I'm not bored. Quite the contrary. I want to hear more about Sherlock Holmes. Which is why I'm sorry that we have to end soon.

SH: Always that sad old trick, eh? Just when things are heating up, you end the session.

CR: Or one might say that, just when the session is drawing to a close, you come up with the most interesting things to say. Almost as if you bring them up now so that we can't talk about them at length. Because you know we're ending soon.

SH: Harrumph. What was the interesting thing that I said just now?

CR: That you want to be here. That you want to quit using. That it was your choice to come.

SH: Yes. It was. Are you satisfied?

CR: Far from it. I want to hear more.

SH: …

CR: So we'll see each other on Wednesday?

SH: Not like I have anywhere else to be.

CR: Until then.

SH: Good-bye.