“Hello, Jessica. How have you been this week?”
“Fine,” she groans, sitting in the chair opposite.
As talkative as ever.
“Good. Have you been sleeping?”
“Good. Good.” Even after all these years, it’s still difficult to get a fifteen-year-old talking. Every week is the same, we begin with single-worded answers until she feels comfortable again. But I understand. It can’t be easy spilling your darkest secrets to a stranger. “So, let’s get straight to it, shall we? Have you had anymore hallucinations recently?”
“It’s not a hallucination. But yes, it’s still there, like always.”
“Hmm, I see.” An unusual case. Jess seems to display symptoms of schizophrenia as she suffers from hallucinations of a shadow-like figure. She is adamant that it’s real. However, her behaviour seems otherwise normal. No disorganised speech, no thought disorder or delusions. A little shy or unmotivated perhaps, but she’s only fifteen. Too young for medication obviously, so her parents sent her to me. The only option she has left is to talk it out. “Does it look the same? Has anything changed?”
“No, it’s the same. It’s crouched in the corner, watching us.” Jess looks down and trembles slightly. I’ll be honest, this unsettles me. I peak at the corner quickly for reassurance. But of course, nothing but darkness covers the wall. How stupid of me.
“Perhaps we should start from the beginning. This is our third session and you haven’t explained how it started. Do you think you could tell me where this ‘figure’ came from?”
“I guess so. If you think it’d help.”
“I do. It would be good for you to re-imagine the birth of the hallucination. Perhaps we could find the reason why it originated.”
“It’s not a hallucination, but… okay, maybe.” Breathing deeply, Jess gathers herself and looks down at the floor before continuing. “Did you ever have an imaginary friend? I know I wasn’t the only one, most children have them, right? I’ve heard other people’s versions, how they watched them following during car journeys or played hide-and-seek with them in the house. Some had animals, some had things they made up. It was fun, I guess.”
“Yes, of course I remember having an imaginary friend. I think her name was Alice. Definitely helped with the boredom. It’s healthy for children to have these types of friends, it develops their creativity. You definitely weren’t alone.” Jess looks at the corner, uncertain. “Go on.”
“Mine was a unicorn, at first. My mother says that I always wanted a horse when I was little. It seems silly now, but I loved playing with her. She was so beautiful. She had a white coat and a baby-pink mane. But then…” Suddenly, she went quiet. I can see she’s struggling, but she’s doing so well. This is the most she’s talked to me about it so far. I smile to encourage her but she avoids my gaze. This must be uncomfortable to discuss if she thinks it’s watching us. I need to be careful not to push too hard. There’s a chance of hallucinations becoming aggressive if the patient is provoked.
“It’s okay, take your time.”
She took a deep breath before continuing. “Well, something changed. I can’t explain it. When I was about seven, the unicorn sort of…died. I don’t know what happened. I was staring at her when her skin started to flake off. The mane rotted away and revealed something dark underneath. A black shadow-like figure that devoured her body. It peeled away the unicorn until it was free. Dark hands clawed its way out, ripping her apart. I was so scared.” She pauses as she glances from me to the creature. “Ever since, it’s always been there. It never disappeared. I thought you were supposed to grow out of imaginary friends, but this never left.”
“I see. Well, some children take longer to mature than others, it’s perfectly normal.” Such a violent scene for a young child to imagine. Incredibly disturbing. “Does it ever leave you alone? What does it look like? I know you said it was a black figure, but can you describe anything else?”
“It follows me everywhere. I hate it.” Her eyes dart towards the corner as a whimper escapes her. “There’s no face, just sharp, red eyes. It’s tall and has these enormous claws. If it gets angry, it’ll grow until it scrapes the ceiling. It likes scaring me.” A shiver runs down my spine. I don’t know why, but I search the corner again. I feel like I’m being watched. I could never understand the horror of seeing these sort of things every day, especially at such a young age. “It doesn’t like you.”
“Excuse me?” I sit up, bewildered, my blood running cold.
“It doesn’t like you. It thinks you want to get rid of it.”
“Well, perhaps not ‘get rid of’, but ensure that you’re not scared of it. You may never actually ‘get rid’ of it, so I’m here to help you make peace. I’m no threat.” The hairs on my arms rise as my eyes pick up movement from the corner. What’s wrong with me? I’ve heard worse stories than this, why is it affecting me so much? I collect myself before asking, “Perhaps it isn’t the one who doesn’t like me? I thought we were getting along fine? Did I push you too hard, Jess?”
“No. I like you. I want it gone.”
“Okay, good. Let’s move on. Is there anything else you could tell me about this figure?”
“It doesn’t like it when I have friends. I have to stay quiet and walk around school on my own. If I don’t, it clings to me and hurts me. I think it likes hurting me.” Interesting. It’s not unusual for hallucinations to feel like they’re physically harming the sufferers. But again, Jess doesn’t display any other signs of schizophrenia. There was no progression, it just appeared during childhood.
“Well maybe it needs to understand that it doesn’t control you. It should-” A terrifying wail pierces my ears. “Jess? Jess! It’s okay, what’s wrong?” Jess is suddenly out of her chair, screaming. Her eyes are wide with horror as she stares at me. No, not at me, through me. She’s looking behind me. My head darts around. There’s nothing there. Of course there isn’t. I feel a light breeze brush past as I turn back to the terrified girl.
“No!” Jess closes her eyes abruptly and collapses into the chair. Panting, she lays her head back and starts to cry. “It… I think it was going to hurt you.”
“It’s okay. I’m fine, there’s nothing here to hurt me. Or you. We’re fine, see?” I lean across the table separating us and hand her a tissue. “It’s fine, calm down. I’ll get you some water.” I’ve never seen a patient so scared. This is more than just a hallucination. “I’ll be two minutes.”
I head towards the office bathroom and retrieve a glass from the cupboard. I turn to check on Jess, she seems to be calming down slowly. Poor thing, she looks petrified. I fill her a glass but I’m suddenly startled as something violently pushes me into the sink. Gasping, I swing around but there’s no one there. Perhaps her story is affecting me more than I thought. Jess suffers from hallucinations, that’s all this is. I’m a psychologist, this shouldn’t be getting to me! She’s just a scared girl who needs help.
I look across the room to see her sitting in the seat, still crying. Get yourself together! Jess needs you. You’re supposed to help her, not encourage this behaviour.
“Here. It’s okay, drink this.” I hand her the water and she begins to breathe normally. “Are you okay? Do you feel any better?”
“It scared me. I’ve never seen it grow so big before. It stood over you and raised its hands. I think I startled it by screaming. But… it’s gone now. I can’t see it anymore.”
Something isn’t right. This doesn’t sound like something that would just suddenly disappear. This creature shouldn’t be scared of its host; a young girl who created it.
“Good. But I don’t think it’ll be gone forever. It’s a start though. You’re improving already, see?” I stare at her as she collects herself. She tries to raise a slight smile as she nervously scans the room with darting eyes. “I hope you’re feeling better. What happened?”
“I…I don’t know. It kept watching you when we were talking. Its eyes wouldn’t leave yours.” Regaining her strength, she dabs at her eyes with the tissue. “I didn’t notice at first, but it started to crawl out from the corner. I think you made it angry.”
Why is it so intrigued by my behaviour?
“When you said that it doesn’t control me. That’s when it stood up. I tried ignoring it but then it just randomly leapt towards you. It moved so fast that I couldn’t help but scream. I thought it wanted to kill you.”
“I’m fine, it’s just a hallucination. Thank you for frightening it though. Maybe you’re more in control than you think?”
“Maybe. I don’t think it’s gone but I can’t see it anywhere. I’m scared.”
I look at her confused, “Why are you scared? If it’s gone, it can’t harm you.”
Jess looks at the ground with a worried expression. “No. But it can hurt others. If I can’t see it, I can’t stop it from harming other people.”
I watch her in silence. She really does baffle me. Most patients are too preoccupied by the hallucinations to be concerned about the safety of others. But Jess believes the figure isn’t here and is obviously still concerned. Shouldn’t she be happy it’s gone? Shouldn’t she feel better to be free of it? Even if it is only temporarily? Before probing further, I look up to see Jess stifling a yawn. Her pale complexion highlights the black under her eyes. She’s exhausted. These will have to be questions for next session.
“That’s enough for today. Your mother should be outside waiting for you, she’s always early. You’ve been really brave, well done, Jess. I’ll see you next week.”
“Thank you.” Slowly, she rises from the chair and walks towards the door. “See you next week, I guess.” Confusion has flooded her face as she continues to search the room.
“Good-bye”, I call as the door quietly shuts, leaving me in complete silence. How unusual. I’ve never witnessed a hallucination act so strongly, then just disappear. If they act out, it’s usually for a reason. It shouldn’t have left just because Jess screamed. I’ve heard of situations where they vanish suddenly, but never so soon after an act of extreme aggression.
A heavy thud emanates from the door.
I spin around expecting to see Jess or my receptionist. I freeze in terror. There, standing in front of the office door is…what is it? No. It can’t be? It slowly continues to knock on the door. The sound echoes around the room, demanding my full attention. Suddenly, the room feels cold, I can feel myself shaking with fear. What is it? This can’t be real, can it? Sharp talons scratch at the wood; its blood-red eyes penetrate mine like a vulture circling its prey. Its eyes feel like they’re feasting on my soul, I feel helpless to its stare. Scarlet holes are set in a deathly, black head. A long, slender figure slithers behind the door, out into the corridor. Before it vanishes, a crack appears from nowhere under its eyes as it hangs its head around the door frame. As the figure leaves, it grins, smiling right at me.