DR ALEX MARTIN
22 November 2010 (15 Years Old)
"I didn't think you would come back again," I said softly, my voice intentionally calm, grounding us both as I observed the young woman seated across from me.
She wore a plain black shirt and white pants, seated cross-legged on the yellow couch as if reclaiming a familiar space. Her posture was composed, guarded even, and her eyes met mine with a studied neutrality that suggested practised emotional suppression—a clear sign of self-protection and emotional detachment.
"I didn't think the nightmares would haunt me again."
I glanced down at the file in my lap—aged paper, faint pencil notations. It had been two years since she last sat in this room. My notes read: 'Nightmares triggered by specific words and smells—possible triggers: friend's names (Avantika and Sameera), blood, burning wood.'
As she scanned the room—the beige walls, the mahogany desk, the carefully tended plants—I noted her distant expression, a familiar indication of dissociation. She was physically present but emotionally remote.
"Well, I was going to ask you about your life until now, but we can jump right in. Do you remember us discussing the things that trigger these nightmares?" I began gently.
She didn't turn to look at me or even acknowledge my question for a moment. Then, she gave me a sharp nod.
"Can you recall what they were?"
She inhaled deeply. "Blood, physical contact—particularly from men—friendly gestures from anyone, and romantic or sexual overtures. Those were the triggers then."
When I had first received her appointment, I was a bit surprised, to say the least. She had pretended to be fine and mentally healed so well that she had fooled her family into believing that she was ready to go back to school and be around others. And then, she stopped coming.
The pattern was indicative of avoidant coping and a premature return to baseline functioning, often seen in complex PTSD.
I had a feeling that she would come back. But not this late.
I looked down at my notes again.
'Panic Attacks - Blood, Physical contact by men, friendly and platonic advances, and sexual and romantic relationship advances.'
"Those triggers previously caused panic attacks, but not nightmares," I said. "The nightmares were precipitated by specific words. Do you remember?"
She opened her mouth and closed it again. "No, not clearly."
"That's because when we started working on those triggers, you had stopped coming."
She nodded. "We can start now."
I took a deep breath and looked at her. "Alright then. Let's begin. Run me through the events of the day. Something that stood out? Something you had a reaction to, other than neutral? Something that you kept thinking about?"
She shifted, drawing her arms in slightly—a classic self-soothing gesture. "Well, I have become the debate team captain. That day, I was interviewing the possible candidates to join the debate team. It was Mahi, my baby cousin's, birthday in two days, so we had a birthday eve party at our place, and after school, I had dressed up and oversaw the final touches of the party."
"Anything else?"
She shook her head. "Nothing that comes to my mind."
"Alright. Let's discuss the nightmare," I said. "Are you comfortable discussing that?"
She nodded. "Yes, yes, I am. I need to figure it out, soon and leave."
I made a note of her urgency—an avoidance strategy dressed as efficiency. The desire for rapid resolution often masks a fear of vulnerability. She was still in a hurry to leave. Her reluctance to face her issues had been the problem in our process to help her heal. She needed to overcome the trauma that had made her miserable for three months, and by the time she got used to living with her trauma and had become her normal, she left.
"When did you have the nightmare?" I asked.
"I had it first a week ago, but I thought that it was one incident," she said, and rubbed her hands down her pants. "Then I had it again the next day, and now, it has been a week and I have been having it every night."
I tilt my head. "The same nightmare? It's recurring?"
She nodded.
"What was the nightmare about?"
She began picking at her nails—a subtle manifestation of anxiety. "In the dream, I am with a guy. He has me backed up against a wall in our school, and he is looking at me. He leans down to kiss me, and I reciprocate, when there is a shift in my vision, and now, I am a spectator. I am now looking at the same boy, and he has me pinned against the wall, kissing me. But when I look closely, I am not the girl he is kissing, but someone else. A girl I didn't know. A tear falls down my face, as my heart aches, and that's when I feel something behind me."
She pauses and then sighs. "I turn around, my eyes filled with tears, I see a man raping a little girl. The man looks at me, and I know I am next. I turn to look at the boy, but now, he is getting married to her, and that's when I feel the man grab me and throw me to the ground. I am frozen in shock, and I turn to look at the boy, hoping he would save me, but he was looking at me with disgust all over his face. A voice rang out, saying, "It's all because of you." That's when I woke up."
I looked down at my notes again and looked at the triggers.
Back when she was taking therapy regularly, she had never given me the details of her trauma. She did give me the basic information that was needed to start somewhere. She and her three friends had been kidnapped and had been missing for seven days when she was found. Two were dead, one was in a coma, but she was unharmed.
She had been crying nonstop after she was found. Then she was brought to me, and after three months, she left.
We had made absolutely zero progress.
I reviewed my notes swiftly, processing the intensity of the dream. "Do you recognise the people in the dream?"
"Yes."
"Would you like to talk about it?"
"Yes."
"The older man?"
"One of the kidnappers."
"And the boy?"
She paused.
I ran through my old notes. I remembered her vaguely mentioning a guy she had a crush on when she was kidnapped. She had mentioned him just once, but it was one of those sessions in which she had cried uncontrollably.
'There it is!'
"The boy was someone you had a crush on back then, wasn't he?"
She nodded. "Yes. Yes, he was."
I looked at my notes. "Aryan?"
She looked away. "Yes."
"Did something major happen with him that first day?"
"No," she said quickly. "I didn't even see him until the party. The nightmare started the night before."
"Okay, why do you think you got the nightmare?" I asked.
She rolled her eyes. "I hate that question."
I smile. "I remember."
"But, to answer your question. I think I had the nightmare because it was Avantika's birthday that day. And since then, it hasn't stopped because, once I was triggered, it's a little difficult to repress those emotions and the triggers, and that's why I am in this state," she replied.
I looked down at my notes. It made a lot of sense.
"I understand. That could be the reason for the nightmare." I took a deep breath and looked at her. "Did you remember it was Avantika's birthday that day?"
"No. It had been in my head that entire month. Every day, I woke up to the realisation that Avantika and Sameera would never grow old," she said. "That day, when I was conducting the interviews, Pakhi entered and she was discussing her new relationship with Aryan. She was talking about how it was her birthday, and instead of coming to her party, he was going to be at Mahi's birthday-eve party," She finished.
I took a deep breath and crossed my legs. "And how does Avantika fit in this, again?"
"Birthday? Pakhi and Maithili have birthdays on the same day, and Aryan was going to be celebrating it with Mahi and not her? Avantika had passed and wouldn't grow older than twelve years, ever? Her conversation about the birthday had triggered the nightmare?"
I licked my lips and thought of a way for her to see. "But her birthday had been in the back of your mind the entire month. But why did you get that nightmare that day?"
"That's where you come in."
"Alright. I think the trigger was Aryan's new relationship and not Avantiika's birthday."
She scoffed. "Why do you think so?"
"For starters, you were very specific when you mentioned Pakhi's new relationship and how she is dating Aryan. Then, the fact that you had the nightmare that night. And, because he was a part of it. The romantic undertones. "
She remained silent. "Alright, so what should I do?"
I frowned. "You accepted this far too easily than I had thought."
"I don't want to have these nightmares anymore." She shrugged. "So, if you say that, that's what triggered the nightmare, I will take it."
'Right, I should have expected that.'
She went quiet, then nodded. I watched her intellectualise the moment, bypassing the emotional core—a recurring defence mechanism. Her cognitive insight was intact, but emotional processing was compartmentalised.
She hadn't changed.
"Remember, we had discussed you working on your triggers, back then? By facing them?" I asked.
"Yeah. By having a physical relationship with a guy."
I shook my head. "No. I suggested you make a female friend first. That way, we would slowly be working on smaller problems and triggers and move my way up."
"Ah! That's right." She nodded. "Well, I didn't do either, so..."
There was one little thing I had planned to discuss with her two years ago, but she had stopped coming, and we couldn't do that.
"Kanak, there is something I wanted to talk to you about," I said.
"Remember when we were discussing how you thought that you would never be able to be involved with a man physically, because not only did you have the trauma, but also the fact that you had never been physically attracted to someone? That you lacked the desire that drives people into being intimate, but you had never felt that?" I asked.
She nodded.
"And you had asked, and I quote, "Doctor, am I asexual?" I asked her.
She nodded again.
"Do you still think so?"
She shrugged. "I mean, I still don't feel that desire for a man. I don't understand what people mean when they say sexual desire, because I don't have that for a man or a woman. So, I must be asexual."
"But you had also told me that once, before the kidnapping, there was a time in school when you wanted to kiss Aryan?"
She paused. "I did?"
I nodded. "Yes. It's here in my notes. I don't have all the details, but I have written down that once you two were alone in a room, when he was looking at you and you were looking at him and you just wanted to kiss him in that moment."
She was silent.
"Kanak, how did you know about Asexuality?" I asked.
"I googled it."
"Let me be honest with you," I said. "I don't think you are asexual."
"Then? How do you explain my lack of sexual desire?"
"Have you heard about demisexuality?" I asked. Then I went into details of what it meant and how I came to the conclusion. She listened quietly, unreadable. Her face was neutral, yet her stillness was telling.
Throughout the rest of the session, I tried my best to gauge her reactions. I knew better than to bring up her lack of responses again. It had triggered her, and she had run away mid-session.
So, we worked on her nightmare, and I gave her tips to deal with it. I transitioned us into grounding techniques and imagery rescripting—tools aimed at reducing the emotional impact of recurring nightmares. These would help regulate her nervous system, promote emotional safety, and reduce the intensity of trauma re-experiencing.
By the session's end, Aryan's name didn't come up again. And I chose not to revisit it
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