Carrie swung in the swivel chair for the millionth time that day. With being pulled from school for the week, it led to Carrie spending many hours sitting at the Bureau office. Sometimes JJ invited Carrie to sit in her office with her while they were working not in meetings, but other times with Carries state, Emily had requested for Carrie to stay in the pen at her desk. Carrie had sat uneven today with the promise of therapy laying head in the upcoming hours. She pondered on her homework assignments that she had to get done for the week. Emily and JJ knowing the teen was anxious would walk by and squeeze her shoulder or rub her back trying to calm the teen down for any moments they could. Rossi stopped by on a break looking through Carrie's work and trying to comment on the important things to remember and trying to find a way to get the teen to laugh. At this point Carrie had just packed up her stuff and was spinning in the chair anticipating Emily walking in at any point to get her to go with it being close to four thirty.
"Ready?" Emily asked, walking up to Carrie from behind.
"Yeah, I guess," Carrie sighed.
"Okay let's get going," Emily smiled.
Carrie stood up and threw her bag over her shoulder and followed Emily. Emily paused waiting for Carrie to catch up before draping her arm around the teens shoulder; protectively guiding her out, instinctually. Carrie felt her anxiety subside and moved in to be closer to Emily as the elevator lowered them down tot the parking garage under the building. The two walked to the car and got in.
"So," Emily started, "Dr. Shaffer called to talk to me this morning about everything with you from my end."
"Oh," Carrie said, feeling her anxiety spike.
"It's routine," Emily nodded reaching out to hold Carrie's hand, "But I explained everything that had happened with your family and to here so she is aware and you won't have to go into full detail."
Carrie felt a sense of relief wash over her, "Thanks, Emily. What happens if I talk about it though and just end up panicking?"
"Carrie," Emily said softly, "Remember I'll be outside in the waiting room the whole time. Therapy is also a safe place to go through any of those. Dr. Shaffer is trained to talk and work through panic attacks with people. I've seen her in the past and she is a really lovely person who I entirely trust and she won't also push you to a point where you are uncomfortable."
"Okay," Carrie nodded with a gulp.
"You've got this," Emily reassured Carrie. "I promise. I know it seems scary. You can ask the whole team too about me, because I always fight them on going, but then I never regret it."
Carrie nodded and grew silent thinking again about how Emily could work cases and see things like she had seen once, but on a regular basis, and just go on with life. Maybe it would help. Eventually they pulled into a parking lot lining an old brick building and Emily squeezed Carrie's hand one more time before getting out of the car. Carrie followed Emily inside and up a flight of stairs and into a small waiting room. Carrie took a seat next to Emily and noting the ocean sound machine running and refreshments stood with water and tea sitting across from her. Within a few minutes the inner door from the office opened and a woman in her fifties with graying blonde hair emerged.
"Hello Emily," Dr. Shaffer said smiling.
"Hi," Emily smiled. "Nice to see you."
"And you must be Carrie," Dr. Shaffer spoke.
"Yes," Carrie replied softly.
"Well it's nice to meet you," Dr. Shaffer said with a smile.
"Nice to meet you too," Carrie smiled.
"I was thinking," Dr. Shaffer paused looking between Emily and Carrie, "That I would talk to Carrie alone for the first bit, since Emily and I talked on the phone. Then Emily, maybe you could join us and we could all talk for a bit. How does that sound?"
Emily looked down to Carrie who was trying to stay positive, "I think that should work."
"Okay then," Dr. Shaffer smiled, "Carrie, how about you come with me."
Carrie looked to Emily who squeezed her knee once more before Carrie got up and followed Dr. Shaffer into the office.
Dr. Shaffer closed the door, "Feel free to sit anywhere. Oh, and would you like any water or tea right now?"
"I'm fine," Carrie shrugged, looking around the room and taking a seat on a crème double.
"So it's nice to officially meet you," Dr. Shaffer started. "I wanted to start off with making sure you knew Emily and I talked earlier about everything that has happened in the past bit."
Carrie nodded, "Yeah she told me. It's just a lot to go over."
"Yeah it is a lot," Dr. Shaffer nodded reassuringly. "I want you to know, I will never push you to talk about anything that happened if its too much at the moment, and whenever you are ready to talk about any of it we can. In therapy it is important to talk about that, but also important to talk about today and yesterday, and tomorrow. Talk about how to cope in the moment with feelings and issues and so we can work towards having those conversations that will be needed to be have at some point."
"Okay," Carrie nodded feeling relieved to here that. She felt her legs stop shaking. "I guess I can talk about it, but it's also distant in a way."
"Yeah," Dr. Shaffer's eyebrows arched, "And what do you mean by that?"
"Well when everything happened," Carrie started taking a deep breath, "The murders, everything, its all I was living and seeing. Like I closed my eyes and it was right there and then when I was awake it was just playing over and over and I felt like I was right there. Then all of a sudden it switched. I was obsessed with trying to help and do whatever I could to solve the case. And I feel like I just became so distant from everything I was feeling except for certain times and now that's just disappearing and I'm seeing it all again fully and feeling everything I was feeling when it happened."
"I think that is more of a normal response to such events," Dr. Shaffer nodded. "You've been dissociating in a sense. Your mind and body does this to try to protect you and distant you from something extreme. It's one of your body's coping mechanisms and it can be helpful, but can also be harmful."
"I just also have been going through things like try to forget in a way," Carrie shrugged, "Like starting school full force. And then the team and Emily just keep trying to do so many things for me and I become so happy that it's like conflicting with what I think I might be feeling."
"Carrie," Dr. Shaffer started, "You've had a lot of quick change. There are going to be good times and bad times and you don't have to feel one over the other. Sometimes allowing yourself to have happy times is a good thing, and having the sad times are also important. Having both are expected. You aren't expected to just be in one or the other the whole time. Do you have any guilt around being happy?"
Hearing that question asked, Carrie felt a tear roll down her cheek. Dr. Shaffer reached over and handed Carrie a tissue. Carrie took a moment and wiped her eyes and took a deep breath.
"Yeah," Carrie sniffed. "The guys who killed my family had seen us at a restaurant with me arguing with my parents. That's how they chose my family. I should have been quiet. Because now they are dead and I'm alive because the men couldn't kill me because I reminded him too much of his sister who he lost. I found that out while holding one of my families murderers hands and now I'm here and Emily just…is wonderful, so I don't know."
"And you can have that guilt," Dr. Shaffer said. "That;'s expected, but also working to make boundaries over it and grieving, but to also keep on living is so important. But everything with Emily is good?"
"Yeah, I guess," Carrie nodded with a smile. "She is the one person who I have ever actually felt safe and fine around. I don't know why. But she just talks and understands everything with me usually to where I don't have to try to be someone, I'm just myself. And that scares me."
"Why does that scare you?" Dr. Shaffer asked.
"Because," Carrie began feeling her breathing become uneven. "I always had to try with my parents and we always were arguing and with Emily it's all just natural. I know I've only known her for like five weeks, but she's just already like…like…a parent, I guess. And so I don't want to scare her with all the messed up feelings I have inside so that's when I become distant and do stupid things because I think she wont be there for me if I go to her, even tho I know she will."
"Emily wants to be there for you," Dr. Shaffer replied with a smile, "I can tell how much she cares for you."
Carrie blushed hearing that, "I know. I just…my parents."
"Emily doesn't have to replace a parent," Dr. Shaffer noted, "You can always think of it as adding in another one."
Carrie nodded liking the way that sounded.
"Do you think trying to think of it as that or another guardian would help?" Dr. Shaffer asked.
"Yeah," Carrie agreed.
"There is a lot we can work on with all of that," Dr. Shaffer continued. "I think having therapy even two times a week right now would be really helpful."
Carrie nodded in agreement.
"Have you been having any nightmares or things?" Dr. Shaffer asked.
"Yeah," Carrie nodded, "Like every night or other night. Sometimes I just have flashbacks at night and can't sleep then."
"Do you have them ever during the day?" Dr. Shaffer asked.
"Yeah," Carrie nodded. "Those are the worst and then I get panic attacks usually after the nightmares and such and they just get really bad."
"Have you hurt yourself in any way?" Dr. Shaffer asked.
"Yeah," Carrie whispered. "That's why Emily wanted me to start coming in. I didn't do anything too serious, but she said we would also need a safety plan."
"I agree with that and was going to suggest we talk about that tonight and then revise it as we continue," Dr. Shaffer continued. "I do think we might want discuss having those conversations about grief with Emily."
"I know," Carrie nodded, "And she knows I have them, but yeah, I haven't ever fully expressed some of it to her."
"How do you feel if I come get her and we can all talk?" Dr. Shaffer asked.
Carrie nodded, "Yeah."
Dr. Shaffer stood up and walked over to the door and called Emily in. Emily walked in and Carrie briefly looked up and made direct eye contact with her. In that moment all Carrie wanted to do was run into Emily's arms, cry, and tell her everything, but she sat there frozen.
Emily walked over, "Can I sit next to you?"
"Yeah," Carrie said softly.
Emily sat down next to Carrie and quickly rubbed the teens back.
"So Carrie and I have been talking," Dr. Shaffer started, "And I think we both decided therapy will be helpful right now. There are many things I think we all should talk about right now as we are working through this time."
Emily nodded looking to Carrie who was growing a little distant.
Dr. Shaffer, seeing that also continued, "We talked a bit about dissociation with traumatic events as something our body does to try to protect us, but also how it can enable us to process the event. We also talked about how guilt then plays into the emotions surrounding everything and how we can learn to balance them together eventually to still live. Carrie to you say that about accurately?"
"Yeah," Carrie nodded.
"I think maybe Emily if we start with some of the things we talked about," Dr. Shaffer started, "I think that might be a good place to start."
Emily and Carrie nodded.
"So Emily had talked earlier as you know," Dr. Shaffer started. "The biggest thing we were talking about is you processing and adjusting to life after the events. So that's a common goal we all have. Emily was saying you sometimes seem fine and then you end up having shutdowns which are worrisome. Emily would you like to say anything?"
"I guess my biggest fear," Emily sighed, "Is just you shutting down and shutting me out with no other safe outlets and that you spiral worse. I know everything is a lot and I am so proud of you Carrie and everything you have done so far. I just don't want you to feel like you've ever gone too far to where you can't come back or talk and rely on me for anything. I had that happen with too many people and I just don't want that to happen to you."
Carrie could see that Emily had tears in her eyes swelling up.
"Carrie," Emily continued, "I just love you so much and I know everything is such a change and overwhelming, but that developing a set of coping mechanisms and skills will help make everything manageable. I just think that is so important. I want you to be able to come to me at any time too, and I know it's scary too, I just also get scared when you don't."
"I know," Carrie said, lifting her head up for the first time since Emily had started talking.
"Carrie and I were discussing how grief is sometimes stepping in," Dr. Shaffer said guiding the conversation, sensing that Carrie was stuck on where to continue. "It's oftentimes conflicting for children and teens when there are new guardians. Carrie?"
"I…I…," Carrie started, "Sometimes it's like things feel too good and perfect and then I remember everything that happened, and remember they are all dead and their last hours were so painful and I'm just still here."
Carrie stopped as her throat grew a bit tighter and saw tears also forming in Emily's eyes still.
"And I feel guilty and shut down," Carrie continued as her voice cracked, "because sometimes, Emily, I just wish you'd been in my life longer because everything just clicks and you are the only person I feel safe around to be me. I…I…want to tell you everything, but this like fear stops me because I don't want the thoughts and dreams that happen to make you think I'm a freak and you will give up on me or push me away." Carrie paused again. "Because I really just need you because you are like my mom, and I can't lose you like I lost them. But I'm just too confused and conflicted to know what to do so I just shut down and push you away. I'm sorry, I'm so sorry. I can't lose you either."
Carrie realized she had tears running down her cheeks and looked up to see Emily looking at her also with tears. Emily reached out and pulled Carrie against her, just holding her tightly.
"I'm never going anywhere, Carrie," Emily whispered, rubbing Carrie's back. "Never, my love."
"Okay," Carrie nodded, gathering herself and pulling back and looking at Emily.
Dr. Shaffer reached out and handed Emily some tissues. Emily passed on to Carrie who dried her eyes and took a deep breath.
"We talked about a new way to think about it though," Carrie started, "You aren't replacing any of my parents or guardians, but just becoming another one."
"Yes," Dr. Shaffer said, jumping it. "To help divert some of the grief of feeling like Carrie is betraying her parents or you in any way. That way there is more room for not closing off as fast and working to find a way to live with the past and stay in the present."
"Okay," EMiliy nodded, still trying to take in how much Carrie was thinking of her as a parent.
"I think that should bring us to discussing a safety plan as a start," Dr. Shaffer continued looking between the pair. "Carrie is experiencing many dissociative episodes, panic attacks, and nightmares as a result of the trauma. I do think she has some PTSD which we can do an evaluation for, but I can suggest ways we can work in therapy to build coping skills. During panic attacks and dissociative episodes, you can become unaware of what you are doing and your surroundings which can lead to destructive and harmful behaviors. In those cases it is important to have someone around you or on the phone, facetime, and preferably in person; especially right now, to work through these and help prevent some of the harmful side effects. I know with those episodes you can sometimes feel them coming on and other times, not. Therefore, I think it will be important to start looking for tells and triggers so you can find someone like Emily, and work through them. We can work on building some skills that will help with them, and Emily I know you know some of them, but you too, so we can all work to help Carrie. Do you think that is reasonable?"
"Yes," Carrie nodded.
"Agreed," Emily nodded looking down at Carrie.
"I know it can be really scary starting therapy," Dr. Shaffer continued, "But overall it should be helpful to find ways to adjust to everything. I think maybe meeting twice a week Carrie, and one of the sessions Emily comes in for part of it, would be a good idea right now. Carrie, how comfortable do you feel getting Emily if you start feeling off?"
"Comfortable," Carrie nodded. "I just don't always do it, though. But, it might also be a little easier now."
"Okay," Dr. Shaffer nodded. "Do you have anyone else you could call or spend time with if Emily can't?"
"Yeah, I guess," Carrie nodded. "Some of the members on the team and one of my friends from school."
"Okay," Dr. Shaffer replied. "So we are going to make a chart of things to do when you are noticing you are off. Since we don't know the triggers yet or signs we can fill that out later, but for now since you don't have set coping skills, your first thing should be let someone know and try to be present with them. First person should be Emily. Second?"
"JJ," Carrie said as Emily quickly nodded in agreement. "And then after JJ, my friend Bianca. I know I could trust the other members of the team, but I don't know yet."
"Okay," Dr. Shaffer added, "Then fourth or if its sudden and really bad, you can always call or text my number."
"Okay," Carrie nodded.
"I would suggest trying to talk," Dr. Shaffer started, "Whether it be to distract or to work through, just keep talking. Another thing would be at this point working on some techniques to stay present and help breathing, which Emily knows some of the basic ones. One of them is called "7, 4, 8" breathing and you breathe in for seven counts, hold for four counts, and breathe out for eight counts. It helps slow down the breathing and even everything out to calm anxiety and heart rate too. Another one is a method of picking something like a color and counting and pointing out everything you see around you that is that color. Say you pick blue, I would in this room name the rug, the trim on the curtain, and such until I've named everything then maybe I could try another color. This helps keep you present in the space and to stop dissociating. Do you think you could try those?"
"Yes," Carrie nodded.
"Okay," Dr. Shaffer nodded, adding them to the chart. "Are there any other things you've noticed help so far bring you back in. Either of you?"
"Sometimes," Carrie shrugged, "Emily just hugging me really tight helps."
"Compression can help make you feel safe," Dr. Shaffer continued.
"Carrie we could also look into a weighted blanket in case I'm not around," Emily added.
"What's that?" Carrie asked.
"They are these blankets that have some sort of material added to make them heavy," Dr. Shaffer started, "They found a measurement that for your weight how much weight added onto you is therapeutic and comforting. So therefor you have these blankets with them that provide that compression that helps with comfort, safety, and anxiety."
"Yeah that might be helpful," Carrie nodded.
"Okay," Emily nodded, "I can find you one."
"Good," Dr. Shaffer smiled. "The last thing I would like to talk about for now, is the harmful behaviors."
Carrie looked down.
"We don't always know when it's going to happen," Dr. Shaffer discussed, "and we all have forms of our own destructive behaviors. However, there are some preventive measures right now I think are needed."
"Agreed," Emily nodded.
"Carrie?" Dr. Shaffer asked.
"Yeah," Carrie nodded.
"I think then an important rule is removing anything that is an immediate threat," Dr. Shaffer started. "Specialifically razors or any utility knives. Having them in a harder spot to get to or a space where you have to ask to use one is then making it so it's harder to find things to hurt yourself with at the ready. Does that seem fair?"
"Yeah," Carrie nodded. "I can do that."
Emily nodded, "Agreed."
"I think it would be good to see Carrie later this week," Dr. Shaffer nodded, "And also set up some times for the next week and following weeks that work for Emily to come in and talk to. I can call tomorrow to schedule those."
"Okay," Emily nodded.
"I think this is going to be a good change," Dr. Shaffer smiled. "There's many things that might help right now. I'm really proud of you Carrie for being open to coming in today and talking and I look forward to continuing this."
"Same," Carrie nodded feeling relieved to finish her first session successfully.
"Well then," Dr. Shaffer said standing up. "It was nice to see you Emily, and meet you Carrie. I'll be in touch. Here is the safety sheet. We can revise and revisit and we go."
"Thank you," Carrie said, taking the sheet.
"See you later this week, Carrie," Dr. Shaffer nodded, opening the door.
"Bye," Carrie nodded back.
"Bye," Emily smiled.
Emily and Carrie quietly headed out to the car and got in as rain sprinkled around them.
"Thank you," Carrie said quietly looking ahead.
"Thank you for going," Emily said back quietly as she drove.