Therapy

Therapy

"What brings you here today?"

"Well, I have a feeling you may be able to help."

"Have a seat and relax." The Therapist points at the comfortable couch.

The patient sits.

"What is it that you need help with?"

"I think talking would help me get a better understanding of my situation."

"Okay then," the therapist pensively utters. "What would you like to talk about?"

"Oh, yeah, I know where we can start."

"Go ahead."

"Truth be told, if I had no health insurance policy to pay for the visit, I wouldn't be here."

"I agree. Health insurance is always a good subject of conversation," the therapist says.

"It's kind of a delicious appetizer for a good dialogue."

"Yes, it is. And I do understand your concern about the cost. I know how expensive it is to get the proper health insurance to cover your medical bills. I see here in your paperwork that your plan pays 100% of charges for this therapy. As a matter of fact, it pays for 25 sessions per calendar year."

"I came here to talk to you because it doesn't cost me anything."

"I'm sure you didn't come here just because your insurance pays for the cost. But let's say it is the reason you came to see me; now you have the rest of the hour, and I'm listening. What else would you like to talk about? Tell me what's on your mind."

"It's a recurring dream that bothers me."

"What is this dream about?"

"Well, I see that I'm lost and confused in a strange environment."

"What do you mean by strange environment?"

"Well, in this dream, I find myself in a different country, and I don't speak the language of the people in the street. I see myself late at night, lost in a strange city of a foreign land, and I have lost my way back to the hotel. It's a terrible feeling of being lost and confused about how I ended up there and what to do. Then I wake up, realizing that it was all a nightmare."

"How often do you have this dream?"

"This particular dream, I would say maybe once a month on average."

"What do you mean by this particular version?"

"Well, I have other recurring dreams that I feel somehow are related to this dream."

"Tell me about the other dreams you have."

"I see myself as a university student. One morning when I'm on campus, I see students rushing to class to take the final exam. It is for a course I was registered for, but I had no clue that it was time for the final exam. I didn't know anything at all about the subject, and I was so confused about why I had missed the entire semester. Why was I so preoccupied with other courses to forget all about such an important final exam? In this dream, I'm so baffled about why and how I ended up in such a disturbing situation."

"How often do you have this dream?"

"About the same frequency as the other episodes."

"Have you ever attended college?"

"Yes."

"Did you quit?"

"No."

"Do you have any goal in life that you feel has not been fulfilled to your satisfaction?" The therapist asks while taking notes with her right thumb in a splint.

The patient notices the therapist's difficulties taking notes.

"Oh, don't worry, you don't have to write any notes in this session. I'm not saying anything important anyway."

"It's part of my job; it helps me get a better grasp of your mindset and the context of your situation."

"Do you read your notes after the session?"

"Sure I do; that's how I learn more about my patients to enable me to help them, and how I improve my knowledge and advance in my field."

"I've read 'The Interpretation of Dreams' by Sigmund Freud. He actually interpreted his own dreams more than others."

"That's true," the therapist is still jotting down notes with difficulty.

"What happened to your thumb?"

"Life happened. My condition is called osteoarthritis."

"Does the splint help?"

"Yeah, it helps reduce pain when I use my hand, but it's not a solution, just a bandage of sorts to alleviate pain, and it limits my hand's movement drastically."

"So what's the solution?"

"Well, it's age-related, you know."

"There are no other options?"

"Yes, there are if you can afford them," she chuckles.

"But insurance covers something like that, doesn't it? You do have health insurance, don't you?"

"Technically, yes, I do have health insurance, but in reality, after counting the out-of-pocket costs for something like this, I'm better off not considering other options."

"When I wake up after having these dreams, I cannot go to sleep anymore; I suffer from insomnia. The racing thoughts snatch away the serenity of my night. My mind goes through so many experiences of my life, thinking about what I have failed to do in life to deserve such nightmares."

"I can get a series of cortisone shots. I was told the cost could be as high as thousands of dollars, and even then, the underlying issue is not addressed. The cartilage separating my bones is worn out, and bones are grinding like teeth; that's where the pain comes from."

"I always thought I was an accomplished individual. I've never failed to fulfill my dreams, but why these tormenting thoughts?"

"The shots are costly and painful. They're a short-term solution without resolving the issue permanently."

"Something is in the back of my mind that I cannot bring to light..."

"The doctor told me that cortisone temporarily suppresses the local immune response, which is beneficial in autoimmune conditions where the immune system attacks healthy tissues."

"I'm always lost in a dark maze, a bleak milieu I cannot comprehend. Every direction I turn, I find myself alone in a long and dark endless alley, none of which leads to my hotel; a peculiar sense of perplexity."

"Dreams are in the realm of psyche, but they may be triggered by physical stimuli."

"You can't live in constant pain."

"I can see a common thread in your dreams that we should delve into and explore in depth."

"The shots only take away the pain?"

"They basically help the nerves not to send the pain signal to the brain, so I don't feel the pain. It's a trick of sorts."

"Have you ever thought of surgery?"

"With the benefits I have with my current health insurance plan, my out-of-pocket cost would be enormous if I choose surgery; I just can't afford it. Remember, I'm self-employed and in a higher age bracket. Insurance companies don't like people like me." She chuckles.

"I haven't told you about my other recurring dreams."

"Why is that?"

"I didn't think this recurring dream was related to the other two."

"Tell me about it."

"In this dream, I see myself driving a car in reverse. The car has no brake, and I have no control to steer the wheel. When you drive in reverse, you don't have full control of the wheel, so the car can easily spiral out of control. That's exactly what happens in this recurring dream; the car is not driving at high speed forward, but uncontrollably in reverse. I cannot properly see the road in the rearview mirror; I turn my head back trying to avoid an accident. The car is constantly swerving to the left and right, and I know sooner or later it would crash."

"If I decide to do the surgery, my premium would skyrocket the next year. Then what do I do?"

"In the heart of darkness, I'm lost in a strange city. I try different routes and walk in different streets, desperately hoping to find my way back to serenity, but the more I wander in the maze, the more agonized I am. Disoriented, I struggle to find my way out of this abyss; I ask a few passersby for directions to my hotel, but no one understands my language. None of the roads I take leads me to my hotel. And I'm going to fail on this exam for sure; I don't even know the subject of the course I had enrolled in. How could I take a final exam for a course for which I've never been to class?"

"The wise approach is to use my health benefits when I need them most; I cannot be sloppy and make rash decisions. I need insurance coverage for more serious health issues bound to happen soon."

"The car is veering off the road, and there is nothing I can do, it’s destined to crash."

The patient details the horror he’s going through and as he expresses his agony the therapist takes notes in pain.