JAMES
To me, there is nothing worse than watching a child or young person suffer from mental illness and being unable to assist them due to factors that are out of my control.
There are some children, particularly the younger ones who have faced serious neglect and abuse that are far too terrified of the world around them to allow some strange new person into their personal space, even if their psychologist is the friendliest person on the planet.
Then there are some of the older children and teenagers who are forced to attend counselling sessions against their wishes who resent their treating psychologists. They may need the help that is being offered to them, but the negative stigma surrounding mental health often deters them from seeking the assistance they need.
As infuriating as it can be trying to help someone who doesn't want to be helped, there is nothing we can do but keep moving forward and hope that the person in need will finally come to their senses.
It's not my job to judge them or make them feel as if their problems aren't real. It's my job to find a way to help those young people cope with their stressors and make the overwhelming weight of their emotions, or in some cases lack thereof, seem less daunting.
Working with children and young people also has its up sides. The resilience and strength of some of my patients is astounding and to be brave enough to seek help from a professional even with the stigma and fear of being vilified by their peers hanging over their head is one of the most courageous things I can think of.
That's why when Kenzie agreed to consult with a psychologist during our breakfast together last Sunday I was reminded once again why the profession I chose is the right one for me. I had expected her to refuse my suggestion or even get defensive as a lot of other people her age do when they are faced with the type of proposal I had offered her, but she didn't do any of that.
She was mature enough to acknowledge that she needs help and is brave enough to face one of her biggest fears in order to give herself the best chance at recovery. I don't think there is anything more courageous that a teenager could do than that.
Now, looking down at the unconscious girl in front of me it is difficult to believe that there is anything majorly wrong with her. She seems healthy enough in her physical appearance, the only visible sign that something is off are the four distinct crescent shaped cuts on top of her wrist and surrounding bruises where her fingers have pinched the skin too roughly.
"She looks so peaceful like this." Murmurs, tenderly caressing her uninjured hand with the back of his fingers in a slow swirling pattern. I have no doubt in my mind that if Kenzie was awake right now she would be cowering away from his touch in both fear and repulsion.
Nobody knows the true extent of the horrors Kenzie faced in her childhood, but from the limited time I have spent observing her mannerisms and behaviours I can tell that whatever abuse she had been subjected to, both before and after being taken into state custody, was far more disturbing than what anybody has been lead to believe.
No child should be so afraid of physical contact that even the mere thought of being touched, even as a gesture of affection, is traumatic enough for them to spiral into a panic attack.
"I agree, she looks like an angel." And she does. Her usually pale skin is flushed, tinting her cheeks a soft shade of pink and her dark brown hair falls in loose waves around her face before spilling out onto the comforter beneath her. Perhaps the most endearing aspect of her appearance is her small, childlike stature which makes her look much younger than that of other girls her age. Those features, coupled with her shy personality give off an air of innocence and the sight of her laying there so tranquilly sends a wave of protectiveness rushing through my body.
"She's too young to be so damaged. It's not fair." Chris says somberly, removing his hand from Kenzie's arm and moving away from the side of the bed so that I have better access.
I know how he feels considering I work with vulnerable and emotionally damaged children every day, and he is right, it is absolutely unfair that Kenzie is suffering from the condition that she is. She could have had the whole world if she had just been given the chance at a normal life, but instead she had faced years of abuse and a constant lack of stability with her living arrangements, all of which she had no control over.
Nothing about Kenzie's life up until this point has been fair, but there isn't anything that can be done to change what has happened in the past. All we can do is try to give her a better future.
"Anyway, how bad is the injury?" Chris enquires, pulling himself out of his miserable state by changing the topic.
"It looks like her nails only broke the first layer or two of skin, so the lacerations themselves aren't a major concern." I answer with a sigh "It's what's going on in that head of hers that I am most worried about."
Patching up a couple of scratches is easy, but trying to patch up fifteen years worth of suppressed emotions and hidden trauma is a whole new ball game. I can only attempt to fix the issues that I am made aware of, so in cases like Kenzie's where she is reluctant to share her demons it makes it extremely difficult to find the correct strategies to start the healing process.
In a way, trying to help Kenzie recover from her psychological injuries is like trying to navigate a minefield while blindfolded. One wrong move could have catastrophic consequences for both her emotional wellbeing and any progress she has already made in the past or could potentially make in the future.
That is why I have spent the past week searching endlessly for a psychologist or psychiatrist who not only has the experience and expertise to properly identify Kenzie's condition, but also the patience it will require to address her triggers and the gentleness to provide the appropriate treatment. It has been more difficult than I would have liked, but finding the right doctor to consult with Kenzie is the most crucial step in starting her healing process and if I can't find a doctor that she is comfortable with then the chances of her making any improvement are very slim.
I have a few of my colleagues in mind who may be able to assist, but ultimately the final decision will come down to Kenzie. If she is unable to connect with one of them then I won't force her to keep seeing them. It is about time she got to have some input on decisions relating to her own health and treatment regardless of the fact that she is still a minor.
"Why don't we go downstairs and discuss this with the others. I'm sure that Nathan could use some reassurance right about now, I can hear him pacing from here." Chris rolls his eyes at his own statement but the friendly smile that graces his face shows that he I only being playful. Even I have to admit that sometimes Nathan can be a little intense when it comes to his protectiveness over the people he cares about, but ultimately it just proves that he is a good man.
"Sure, I don't see her waking up for a while so I suppose we should go and put Nate out of his misery." I shrug, placing Kenzie's arm back down on the mattress, watching as she unconsciously draws it closer to her body in search of some warmth.
Taking my jacket off, I place it over the top half of her body, making sure that the collar is tucked beneath her chin and her arms are completely concealed beneath the fabric. I don't know what it is about my jumpers that she finds so comforting, but within a few seconds her body shifts so that her legs are curled closer to her body and her face is pressed gently into the collar of the jacket.
With one final glance at her sleeping figure, I follow Chris out of her bedroom, closing the door gently behind us so that nothing will disturb her. We all have a tendency to speak louder when we are all together and I don't want our conversation to be the thing that wakes her up from her peaceful state.
"Is she alright?" Nathan's anxiety ridden voice is the first thing I hear as we reach the top of the stairs. He is standing at the bottom, his hair a tousled mess and a worried frown adorning his face.
"She's asleep." I answer with a nod, watching as the tension in Nathan's body suddenly deflates at my answer. "Let's go into the kitchen and I will fill everyone in on her condition."
And that's exactly what we do. Mitchell must have come downstairs after all the commotion and the five of us as well as Lachlan discussed what had happened only ten minutes earlier. I told them that Kenzie's physical injuries were only minor, but also that we would still need to keep an eye on her wrist to make sure it doesn't get infected.
We remain talking for a while even after we have finished discussing our problems with Kenzie's health and after we have all stomached some of Chris's take on beef stir fry which held more bitter notes than anything else, Lachlan decides to head out and the rest of us disperse throughout the house to do our own thing for a while.
Heading up to my room, I decide to check in on Kenzie one more time before retiring for the evening. Peeking through the door, I can tell that she is still sound asleep, curled into a ball with my jumper wrapped tightly around her body. My gaze lingers on her for a few seconds longer, just to make sure that her sleep is still peaceful and once I am satisfied that there are no signs of distress, I retreat to my own room, closing her bedroom door behind me once more.
***
I wake up in the morning to the muffed sound of animated voices echoing through the door. My phone indicates that it is only 6:00am in the morning and I know that the only person in the house that wakes up this early is Will and he is usually always careful not to make too much noise.
Climbing out bed, I pull a hoodie over my long-sleeved sleep shirt and venture out of my room to investigate the source of the voices. The moment I walk into the hallway, the muffled voices grow more distinct and I am able to determine that the noise is coming from downstairs.
Looking to the right side of the hallway, my eyes land on Kenzie's room and I am slightly taken aback when I notice her door wide open. The bathroom door is also open and no lights have been switched on, leading me to believe that she must have wandered downstairs.
Following the sounds downstairs, it becomes clear that the voices are in fact coming from the TV and once I have made my way to the living room I am stunned by the sight that awaits me.
Kenzie sits curled up in one of the single recliners, the comforter from her bed wrapped tightly around her body acting as a shield against the cool morning air. Her eyes are glued to the TV screen which is currently displaying an episode of Scooby-Doo, but the thing that really shocks me is the way she leans forward, her pointer finger rested in her mouth as she stares intently at the animated pictures in awe.
Stepping further into the room, Kenzie still hasn't spotted me, but the second I pick up the remote and lower the volume by a couple of levels her head snaps towards me in an instant. The once calm look on her face has disappeared and the finger that had been propped between her lips falls down to her lap where her fingers clutch onto the fabric of the comforter.
"It's ok Kenzie, you can keep watching. We just had to the turn the volume down a little bit." I explain, placing the remote control back onto the coffee table where I had collected it from.
The complete shock that had been written on Kenzie's face is quickly replaced by fear as she draws the comforter up to cover her eyes, probably embarrassed by the circumstances I found her in. Deciding not to overwhelm her, I sit down on the short section of the corner lounge where Kenzie usually sits and turn my attention towards the TV.
From the corner of my eye I can see Kenzie's face pop out from behind the comforter, however the second she notices me watching her, the comforter is pulled up once again. This happens several times over the next few minutes before her attention is suddenly drawn back to the TV when the Pokémon theme song begins to play.
We continue to watch cartoons together until Will walks into the room, declaring that it is breakfast time and Kenzie needed to get ready for school. I had expected Kenzie to head to the kitchen straight away, however my assumption had been incorrect when her eyes pool with moisture and her lower lip begins to tremble, a sure sign that she is about to start crying.
Alarm bells ring in my brain as I observe the teenager in front of me. It is clear that she is experiencing some type of distress but I haven't noticed anything that could have triggered this emotional outburst.
Eventually after a few minutes of gentle coaxing on mine and Nathan's part, Kenzie finally follows us to the dining room where Will and Chris are casually sitting at the table, their breakfast already half eaten. Sitting down in her usual spot, Kenzie looks around the room in wonder as if the kitchen and dining room are the most amazing thing she has ever seen, before Nathan pours a stream of Milo cereal into a bowl and places it in front of her.
The confused look on her face as she looks down at the chocolate flavoured shells sets me on edge and for the second time within ten minutes my internal alarm bells signal once again. This time, I can't push my concern to the side.
"Hey can I talk to you three over there for a second?" I ask, pointing towards Nathan, Chris and Will before jerking my head towards the kitchen area. They all agree, somewhat confused by my sudden request but do as I ask anyway.
"Somethings wrong with Kenzie." I half whisper, making sure that only the four of us can hear.
"Is she sick, or do you think it has something to do with yesterday?" Will asks, glancing over at Kenzie with a worried expression.
"I can't be sure, but I don't think it would be a good idea for her to go to school today." Not while she is acting so out of character. My gut instinct is telling me that sending her to school in this state is a bad idea.
"James, she's already so far behind in her classes, if she misses any more it could seriously mess with her ability to keep up with her peers." Nathan protests, unaware of how serious Kenzie's condition is this morning.
"I know, but right now she is in a very fragile state of mind and if we send her to school I am almost certain there will be a repeat of last Friday's events."
Will and Nathan look like they are about to start arguing with me but I cut them off before they can get a single word out.
"Do you trust me as a professional mental health practitioner?" I ask them seriously, needing them to understand how grave this situation is.
"Of course."
"Then I need you to trust me when I say that something is seriously wrong with this situation and sending Kenzie to school in the mindset that she is in could have a serious impact on her mental health." I state each word confidently, leaving no room for argument.
"Alright. If this is as serious as you believe it is then you have my consent to keep her home from school today." Chris is the first one to agree, however it doesn't take long for the other two to jump on board as well.
"Are you able to help her?" Nathan asks in a hushed voice, looking up to ensure that Kenzie is still distracted by her breakfast, which she is.
"This issue might be out of my area of expertise, but I do know a doctor who might be able to give us some answers. With your consent, I would like to take Kenzie to see him for an assessment sometime today." I have no appointments at work and I had already advised my boss yesterday that I would be working from home today.
"Absolutely. Her health and safety are our main priority so if she needs to see a doctor, I have no issues with that." This time Will agrees instantly.
"I'm on night shift for the next few days so i'll tag along to the appointment if that works for you?" Chris asks, seeking confirmation from me.
"Sure, that's not a problem at all. I would actually prefer it if one of you is present so that I'm not the only one who is being made aware of her diagnosis."
"Ok guys, just give me a call after you have spoken with the doctor so that I don't lose my mind." Nathan
"I'm pretty sure you already lost that ages ago, but sure. We'll give you a call." Chris shoots Nathan a cheeky grin which earns his a slap across the back of the head in return, but the retaliation doesn't seem to bother him in the slightest.
With that, we all return to the table where one of us has to try and break the news to Kenzie.
***
"Woah, man. Some of these disorders are scary." Chris mutters, closing one of the several information brochures he had plucked from the information stand beside us. Unbeknownst to him, the brochures he had collected are nowhere near close to the category of disorders Kenzie could fall under, but it seems to be keeping him entertained while we wait for Dr Miller to summon us back into his office.
This particular doctor had been my mentor while I was studying for my degree at university. I had been placed with him on my second practical experience unit and it became known to the both of us quite quickly that we shared the same thirst for knowledge and passion for helping others. In the six short weeks that I worked with him, I had managed to impress him enough with my skills that he had offered to remain my mentor even after the placement had finished, an offer that I had taken up on many occasions throughout my degree and still to this day.
If there was any psychologist who could give an accurate diagnosis of Kenzie's condition, it would be Dr Miller.
Initially, he had requested to speak with Kenzie alone, and considering the fact that she hadn't exhibited any signs of fear or distress around him, both Chris and I had agreed. It has now been over twenty minutes and the more time that passes the more nervous I begin to feel about the outcome.
"If you find it scary just reading an information brochure, imagine how scary it must be for a child who actually has the disorder." I reply, not bothering to look his direction as I speak, instead my eyes are trained on the door that leads to the consultation rooms.
"You don't think Kenzie has a disorder of some type do you?" The worry in Chris's voice is enough for me to turn myself towards him so that I can try to console him, even though the evidence of a disorder being present in Kenzie's behaviour is overwhelming.
"Young people such as Kenzie who experience severe trauma, abuse or neglect throughout their childhood are generally more prone to developing psychological disorders." I respond, purposely refraining from directly confirming his fears in order to avoid inciting further stress. I have my own theories as to what conditions Kenzie may be suffering from, but until Dr Miller hands down his opinion I don't want to give Chris or anybody else any reason to panic.
"Yeah, I know, but what does that mean for Kenzie, and for us, if she does?" He asks, honestly bothered by the very real possibility we are faced with.
"Even if she does have a disorder of some description, it doesn't change the fact that she is still the same Kenzie we have grown to care for over the past there weeks. It just means that she will have a proper diagnosis and the opportunity to be provided with the correct type of treatment to achieve a higher quality of life in the future." I try to explain it in a way that will make him see the positive side of the situation.
"As for us, we just keep doing what we have been doing and trust that whatever Kenzie's psychologist recommends is the best course of action to follow." Kenzie has always been the one who is required to adapt to her ever-changing living situations, this time, if the doctor gives us a difficult diagnosis, we will be the ones who will need to do the adapting.
"You're right. I think these brochures just spooked me a little bit." Chris nods, rising the stack of pamphlets so that I can see them.
"Dr Tilley, Christopher, would you please accompany me in my office for a moment?" Dr Miller's voice cuts through the waiting room, effectively cutting our conversation short.
Immediately, both Chris and I follow the doctor through the building until we are back in the spacious room we had left Kenzie in about a half hour earlier. He waits for us to take a seat on one of the couches before diving straight into the thick of the problem.
"Look, I don't see the point in beating around the bush here. When you first told me about this girl's background and the characteristics you have observed, I initially believed that she was suffering from a mixture of Post Traumatic Stress Disorder, Reactive Attachment Disorder and some form of stress induced amnesia, however after observing her in my office just now, I am beginning to think that the diagnosis of stress induced amnesia may not be as precise as I originally thought."
My heart drops slightly as Dr Miller confirms my worst suspicions. The amnesia was a little unexpected, however now that he has mentioned it I can start to see how the condition applies to Kenzie's behaviour.
"I want to get this diagnosis right, not only for Mackenzie, but also for you and the other people you live with. That is why I would like to observe her in her normal day to day environment to see if my own theories and initial diagnosis are correct." He adds, adjusting his dark framed rectangular glasses so that they balance higher up his nose.
Looking over at Chris, he appears to be slightly startled by the severity of the news, but he quickly recovers from the initial shock of the diagnosis and after quickly rubbing the stress from his eyes with the tips of his fingers, he is able to provide an answer to the doctor's request.
"I seriously doubt that Nathan or Will are going to have a problem with that, we all just want what's best for her and if that means having you observe her in our home environment then that is what we will do." Chris nods before turning slightly in his seat so that he can see Kenzie, who is happily sitting on the carpet next to the coffee table, focussing intently on the drawing in front of her.
"Wonderful. How does tomorrow sound? I have a rare weekend off and I don't feel comfortable leaving this diagnosis unconfirmed for an extended period of time, especially considering the seriousness of the situation." Dr Miller gives us both a friendly smile which has the effect of automatically eases some of the tension I had been holding back.
"That should work out fine. I am currently rostered on to work night shifts for the next few days so I will most likely be asleep when you come over, but I am sure that James will be more than capable of explaining any further diagnosis that you may determine." Chris turns to me as if seeking confirmation, which I give to him in the form of a gentle nod and reassuring smile.
"That won't be an issue, I just need to observe her behaviour and mannerisms while she is in her usual state of mind. As you can see, right now Mackenzie seems to be in some form of dissociated head space which makes it difficult for me to properly ascertain whether she suffers from any other form of mental illness." Dr Miller tilts his head slightly, a thoughtful expression taking over his facial features as he watches Kenzie draw in the background.
"Is there anything else we should be aware of before we see you again tomorrow?" I ask, more for Chris's benefit than anything else.
"I don't think so. Just keep a close eye and make a record of any drastic behavioural changes that occur between now and tomorrow. I will do some research tonight and hopefully be able to give you a proper diagnosis and discuss treatment options." he responds instantly, his usual kind smile inching onto his face once more.
"No problems. What time do you think you will be around tomorrow?"
"How does ten sound?"
"Perfect. I'm sure everyone will be awake by then." I agree, standing up from the couch and adjusting my jeans from where they had fallen down my hips slightly. Chris follows my actions, but as I stay close to Dr Miller, he walks over to where Kenzie is sitting so that he can inform her that we are leaving.
"I'm glad you brought her here James. Mackenzie has some complex issues and I am almost certain that there is more to her story than what we are aware of."
"I feel the same way, but I don't want to throw my theories into the mix until I have some solid evidence of the condition being present." I respond earnestly, subconsciously running a hand through my combed back hair.
"Don't stress yourself out over this. We are going to get to the bottom of this case and when we do I can assure you that I will do everything possible to ensure that she receives the best treatment possible." Dr Miller promises, holding his hand out between us.
"Thank you for seeing her on such short notice." I thank him, giving his hand a firm shake in return.
"You're very welcome. My door will always be open for you and your family whenever you need me." He replies, walking across the room to open the door for us.
Kenzie gives Dr Miller a shy wave as she walks out the door which he returns with a friendly "goodbye", while Chris also settles for a brief, but grateful handshake. From there I lead the three of us back through the corridor towards the main exit.
Kenzie follows us out of the building, the drawing she had been working on clutched clumsily between her fingers. Chris remains silent, obviously deep in thought as he tries to process all the information Dr Miller had shared with us back in his office. I had made sure to collect the correct brochures from the waiting room as we were leaving in case Chris or any of our other housemates wanted further information.
It isn't until we are all in the car that the silence is finally broken when a middle creased sheet of paper is thrust between the two front sheets and dangled awkwardly between both Chris and I.
"What's this cupcake?" Chris asks gently, taking the paper from Kenzie and holding it evenly between us so that we can both see the drawing closer.
"It was a drawing that I was going to put in my room, but then I saw that you look sad so I want you to have it." She explains shyly, her fingers fidgeting in her lap as she waits for one of us to say something.
"That's really sweet of you, cupcake. I think we should put it on the fridge so that we can all enjoy it." Chris's voice is filled with emotion as he carefully passes the sheet of paper to me as if it is one of the most prized possessions he has ever encountered.
Who would have thought that a single piece of paper with a few scribbles on it could bring the giant policeman close to tears?
"You did a wonderful job on this, angel. Thank you." I say, flicking my eyes over the colourful figures that have been scribbled onto the page in different coloured crayons.
Kenzie's face lights up with a joyous smile at the praise and it is in this moment that my worst fears start to become evident, because no matter how heartwarming this moment is for both Chris and I, I am suddenly reminded that this isn't our normal Kenzie.
Turning my attention back to the paper, I try to swallow the lump that has formed in my throat. On close inspection of the colourful blobs I am able to determine that they are in fact Pokémon characters. Pikachu, Snorlax and what I believe is supposed to be Charmander, but looks more like a pudgy orange ball with a smiley face etched on in black crayon.
In the end it doesn't matter how poorly Charmander has been illustrated, because at the bottom right corner of the page is the most important part of the drawing and the one piece of evidence I have been searching for to prove my theory. There, beneath the ill fated Charmander is a single name, all written in wonky strokes and some letters even formed backwards:
Emily.