Chapter Nine

John's fingers found Sherlock's neck, checking his pulse, which had slowed back to a normal rhythm. "Let's get him into bed."

Mycroft shook his head. "No, John. We can't let him avoid this."

The doctor exploded. "Mycroft, he didn't collapse as a way of escaping you. He's fainted before like this- the PTSD is just overwhelming him." He remembered his own reaction to the diagnosis- how he had denied it, argued against such a ridiculous view. He wasn't traumatised by being shot- he worked with blood, death and pain every day of his professional life. He'd been deeply mortified at the very idea. But no one had ever tried to provoke a flashback or a panic attack. They just waited until he had one and then recorded it. When it was played back to him the doctors asked him to diagnose the symptoms and the underlying cause. He'd been caught by his own knowledge. If they were to do the same with Sherlock, they had to use logic. "What you are doing is cruel, Mycroft, and indefensible."

"And that's exactly why fainting is his mind's way out of this. Subconsciously, he knows it's a get out of jail card, and he will keep playing it so long as we reinforce the behaviour."

Mycroft was now sitting on the floor, oblivious to the oddity of a three piece suited man cradling the head of a pyjama-clad Sherlock. "When he wakes up, we will be treated to a re-run of the conversation you've just had, John- he will have deleted memory of the collapse, and deny all knowledge of what he is trying so desperately to avoid remembering."

Esther looked away from the scene, digesting what the elder Holmes was saying.

John was outraged. "You cannot be serious. First you provoke an anxiety reaction, then you cause him pain by grabbing his wrist and backing him into the wall. That probably led to allodynia and now you claim he is responsible for collapsing as just… an avoidance strategy?" John's disbelief made his voice rise along with his eyebrows.

"John." Esther's quiet voice tried to interject.

"What are you going to do, Mycroft? Just keep poking the memories in his face until you provoke a complete breakdown? This is NOT the way to treat PTSD. Tell him, Esther. He needs to rest, recover slowly. You can't force this on him."

"John." Esther repeated her quiet appeal.

"What?!" The doctor tore his angry eyes away from Mycroft to look at the grey haired psychiatrist.

"Mycroft may be right." She held up her hands in a calming gesture when her statement started to provoke another outburst from John. "Just hear me out."

She looked down at the unconscious younger man lying in his brother's arms. "You haven't known Sherlock as long as I have, and neither of us as long as Mycroft has. And most of the time you've known him, he's been in a reasonable healthy state of mind. It's not always been the case. I don't agree with provoking him to re-live the trauma. I agree with you on that, so let's create a safe environment. You were starting on that and I agree it's the way to proceed."

"But don't underestimate his ability to manipulate us by using symptoms to avoid dealing with the fact that he has repressed memory. That takes priority over the PTSD. He won't accept the idea that he is even suffering from its effects if we let him dictate too much. Remember, Sherlock is a genius at avoidance strategies. At ten he chose elective mutism for seven months, simply because he wouldn't engage with a therapist. If we are to get him to admit that he needs help, to actually engage with it, then we can't let him avoid the conversation. I don't agree that provoking a panic attack is sensible, but you were starting down the right path before he just shut you off. If he thinks he can escape and repress the memory every time it comes out of the closet, then he won't get to the stage of accepting it."

John crossed his arms across his chest, the physical defensiveness telegraphed in his posture. "So, what are you suggesting?"

"We put him back on the sofa and get him awake. I don't suppose you've got smelling salts? They work a treat on that hypersensitive nose. If not, I'll just soak a sponge or handkerchief in something from under the kitchen sink. That will do it. Once he's awake, we start over again. If he runs down the corridor and shuts the bedroom door, then we open it and sit around the bed until he deals with us. If he knows he is going to be faced by the same questions every time, then the flight urge may be overcome by his own sense of logic- if he can't avoid it, then he will just get it over with. It's worked before. In fact, it's the only tactic that has ever worked. He thinks in transactional terms, John, so we have to get him to see the benefits of engaging."

She looked down at Mycroft. "We need to know how much he does remember, where the areas of his suppression are deepest. If you will agree to play by my rules, and not force him to go places he doesn't want to go, then we might make some progress. Are you willing to trust me on that Mycroft?"

The elder Holmes looked up at her. He was thinking it through. To help him make the decision, she decided to take a risk. "Look. You and I share a need here to find someone to blame for this. But it isn't Sherlock, that's for sure. So, let's try to lead the horse to water, before we ask him to drink, OK?"

Finally, Mycroft nodded. She turned her calm brown eyes onto the smaller man. "I know your instinct is to protect him, John. And I know that PTSD resonates a little too close to home for it to be comfortable for you. But, you have to accept that what might work for you won't necessarily work for him, and vice versa."

John wasn't happy. Not at all happy with what they proposed. But, he wasn't sure that his solution would be any better at getting Sherlock to realise the problem and be willing to do something about it.

oOo

That aristocratic nose twitched, wrinkled, and then the two furrows appeared over his brow. Esther pulled away the sponge that she had sprayed window cleaner onto- it had a high proportion of ammonia in the mix. Only seconds later, a huge sneeze erupted out of the man lying on the sofa. The violence of the sneeze moved his left arm, so his second sneeze was followed by a groan of pain.

"I'm sorry, Sherlock. But you need to wake up now." Esther's calm brown eyes greeted his grey green gaze, which looked decidedly annoyed.

"You did that…on purpose?"

"Yes."

The eyes closed again.

"And I will keep waving my sponge around until you pay attention."

That earned her a filthy look, as soon as his eyes re-opened. "Why?" It was snarled, rather.

"Because you need to pay attention."

"That's not a reason….you saying that I need to pay attention is definitely not a reason that warrants…chemical warfare. Go away." He closed his eyes again.

By now, John was trying to stifle a smirk. He was sitting in his usual chair; across from him, in Sherlock's leather and chrome seat, was Mycroft, looking impatient. Esther waved the sponge again in the general vicinity of that nose. Sherlock growled. "Get that thing away from me. What's so important?"

"Don't you remember what John said fifteen minutes ago? If not, then this is far worse than I thought." There was a slightly teasing tone to her question, but John caught the worry, too.

"John says a lot of things. What in particular caught your attention?"

"You asked him what was so important, and he said 'You are. Stop trying to ignore me.' I agree with him. You are the reason why we are here, and we are going to stay here, in your face, annoying you until you pay attention. Each of us has a question that we need you to answer."

There was a dramatic sigh from the couch, and then he struggled to sit up. "What questions?"

"Before we ask them, you are going to drink some tea." She thrust a mug into his right hand, and almost instinctively, his fingers wrapped around it. He looked at it suspiciously. "Why?"

"I'll show you why, but don't get upset when I touch you." She reached over and took a gentle pinch of skin from the top of his right hand between her two fingers. She ignored the slight flinch but they both watched the tented skin take a long time to sink back. "You're dehydrated. So drink the tea, and listen for a while."

He looked at his hand as if it had betrayed him, but then thrust the cup back at her. "You drink first. If you're willing to resort to chemical warfare, then who knows what's in the tea?"

She shook her head sadly, but took the tea and had a big sip. "Don't be paranoid. I'm not trying to drug you."

He took the cup back and started to drink, raising his eyes to look suspiciously at the two men sitting on either side of the empty fireplace.

"John?" Esther sat back down in the chair by the table. The three of them had discussed a plan, but like all plans involving Sherlock, there would need to be some improvisation, when he didn't react according to plan. So far, he was being more co-operative than they had expected. Mycroft was watching with his usual forensic eye- deducing his brother. Sherlock was studiously avoiding looking at him.

John cleared his throat a bit nervously. "You've always said that you can delete things you don't want to remember. You've just done it, I think. Do you remember me asking you about what happened in the car when we were on the way to Gloucester to get your wrist seen to at the hospital?"

Sherlock didn't say anything; he just took another sip of tea.

"Your short term memory is being…selective. Can you remember which of us took a hold of your right wrist ten minutes ago when you were on the way out of the room?"

Sherlock didn't answer.

"So, I'll ask it again, Sherlock. Doesn't the fact that you can't remember those things, doesn't that bother you? At the very least, this sort of lapse is going to mess up your ability to solve cases."

A shadow seemed to pass over Sherlock's face, then he broke eye contact with John. He put the mug of tea down on the coffee table. He dropped his head so that all Esther could see was the dark unruly mass of curls. His right hand was fisting in his hair, his elbow on his knee. His posture was defensive, curled around his injured left wrist. A quiet question emerged from the man. "How many times do you think this has happened?"

John thought about it, and started counting. "Five, I think. Could be more, ones I wasn't aware of. If you add today's two, that's seven in the past week."

There was a little huff of breath, then a tentative, "Do you think it could be physiological? An interaction of drugs maybe… at worst, a tumour or a TIA?"

John was stunned for a moment. He hadn't thought of that possibility. Every instinct of his was that this was psychological. But, Sherlock was being logical, using deductive reasoning to think his way through the problem. Eliminate the possibilities until what was left, so long as it was possible, could be the reason for the lapses. "I think it unlikely. But a blood test for the drugs idea, and a tumour could easily be disproven with a scan. With a TIA there'd be slurred speech, drooping facial muscles and I didn't see any of that."

The head came up and John looked into a face devoid of emotion. "So, if it's not physical, and your tone implies that you believe it isn't, then you think I am losing my mind." Dispassionate, cold, almost ruthless.

Esther stepped in before John could even attempt an answer.

"No, Sherlock. None of us here think that. You included. You are experiencing repressed memory. It can be fixed."

His retort was icy. "Dissociative amnesia has been discredited in many journals, Doctor Cohen. Looking to create some false memories? I have always believed you were not prone to faddism. Perhaps I was wrong."

The grey haired woman sat forward in John's chair. The baton had been passed from John to her, and it was up to her to keep Sherlock focused. "Not dissociative…rather, traumatic amnesia. That has a much stronger basis in recorded observation. Given what I've seen today and what John has told me happened last week, I have no doubt that we could right now trigger yet another dissociation- a panic attack at worst, but certainly a repressed memory."

"Why would you do that?"

"To prove to you that this is serious and needs to be taken seriously. To get your agreement to get it sorted."

"Therapy." He packed every one of the three syllables with utter distain. "Oh, like that's really going to work." He unleashed his sarcasm. "You mean the sort of conversation where you're expecting me to say x, which would mean y, but you really want me to say a, which would mean b and that would change my behaviour, make me normal.* What a joke! I played those games as a child. It's just a case of figuring out what you need to hear from me in order to get you to unlock the door. Been there, done that and the psychiatrists have the scars to prove it."

John intervened. "You're the one who says your brain is a hard disk. Sometimes you have to call in the IT department, Sherlock. Not everyone can fix this kind of problem on their own."

"Traumatic memory? You think I am suffering from post-traumatic stress?" He sounded incredulous. "What trauma? I'm not aware of any such thing."

Esther was calmness personified. "That's what we have to figure out. Unlike most PTSD that presents, we don't know the full facts about what is causing your dissociation. So, you need to recover the memory before you can deal with the symptoms. Then you'll stop having the current lapses."

"That's not what has happened in John's case. He remembers, and it still troubles him at times. Maybe repressing the memory is safer than remembering."

Sherlock had put his finger on exactly the point that was troubling John. He and Sherlock had never discussed his nightmares. He'd respected his privacy and left him to deal with it. John was aware of the memories that triggered them, but awareness had not stopped them from happening.

All eyes in the room fell on him. He sighed. "I'm not saying it's a 'cure'- my memories do surface in nightmares. But since I moved into the flat, nothing has triggered a flashback when I'm awake. And, at least I know when they are happening, which is more than can be said about you. Anyway, my situation is entirely different from yours. I've not had panic attacks or a melt-down and I am aware of what is happening to me."

Esther took over. "Sherlock, your experience means you suppress the memory of what you are going through now, to avoid remembering what it is that caused it in the first place. You can't keep running away, Sherlock. That's just not you. That's not the Sherlock I know. You've never accepted a weakness that can be overcome. Why would you be willing to do so now?"

The challenge hung in the air between them.

*Author's note: I am grateful to Kate221b for this line. The idea of Cognitive Behaviour Therapy ever working with Sherlock is just impossible. Read her wonderful stories, The Box, Madness and Redemption and Dependency. Her Sherlock faces different demons than mine, but her medical understanding far exceeds mine.