Name: Violet Esperanza
DOB: 10/14/1993
Sex: F
Race: Hispanic
Marital Status: Single
Employment: Unemployed
Education: BA in Political Science
Violet arrived 10 minutes late and was seated in the corner of the lobby, isolated in a sea of wooden chairs. She was slouched over, legs shaking with anxiety as she stared at her phone. An untidy, thick mass of purple hair shielded her eyes from the gaze of onlookers, thus she did not see me as I stepped towards her. She was dressed in jeans (holes from top to bottom, somewhat fashionable, but a little extreme), faded black Nirvana hoodie, purple Converse sneakers. Her clothing gave the appearance of a non-conforming conformist.
“Violet Esperanza? Hi! It’s nice to meet you.” She peered up from her phone, barely glancing at me before standing and shaking my hand, stuffing the phone in her pocket. “Come on up.”
She didn’t say a word until after we were safe in my office. She sat in the chair across from mine, back straight, maintaining confident eye contact. She was a bit on edge, biting on her lower lip. Purple bangs covered her brown eyes, and she didn’t bother pushing them away, opting instead to hide. Her elbows rested on the arms of the chair.
“What brings you here today?”
Her body trembled slightly and she began shaking her leg with restless anxiety. “I guess I have anger issues.” She said it matter-of-fact, then just stared at me, unwilling to continue without prompting.
“You guess?”
She shrugged. “To be honest, I was expecting a dude.”
“Oh?”
“Yeah, I don’t like for chicks to tell me what to do. No offense.”
“None taken. I mean, it’s not my job to tell you what to do, but my guess is that there was no availability with the guys so you’re stuck with me… for now at least.”
“You don’t look annoyed.”
“Should I be?”
She shrugged again and looked around the room a little, still shaking her leg. “I dunno. I’d be annoyed if I was tryin’ to do my job and some kid was hatin’ just cuz I’m a bitch.”
Now I shrugged. “I had a male therapist back in the day and also know that women can be annoying. So it’s fair if you prefer a guy. And I can’t help that I have a vagina so…”
She allowed herself to laugh and I noticed a little smudge of pink lipstick on her teeth. “And white chicks are the worst.”
“We really are though…. Well sometimes white dudes are the worst.”
She nodded in agreement, still laughing. “You’re funny.”
I just smiled and maintained eye contact in comfortable silence, waiting for her to take the lead.
“I went to see a shrink before… a few different ones actually… when I was in high school… my family made me. They were all assholes.”
“Who?”
“All my shrinks…. Well, an’ my family, too, to be honest. Fuck ‘em all.”
“So what made you decide to come back to therapy?”
She took a deep breath in, nostrils flaring, then exhaled slowly, allowing her eyes to close as she braced herself to speak. “It’s a long story.”
I gave an exaggerated glance up at the clock and said, “we have 33 minutes.”
We made eye contact again and it appeared that she was considering how much to tell me. Her gaze was fierce, I could see why she claimed to have anger issues — it seemed she was on the verge of attacking, so used to hiding her hurt with anger that it was almost uncontrollable.
“I don’t know where to start.”
She sat in silence for a moment looking around the room, eyes darting from the bookshelf to the window to the floor before finally settling back on me. “What was the thing that happened that made you decide to call and make an appointment?”
Her shoulders tensed and she looked out the window. “My friend made me… because I started using again and I’ve been in a bad place lately… cuz me and my boyfriend broke up and I lost my job and kinda went crazy.” She glanced back in my direction.
I nodded, prompting her to continue.
“My friend… his name is Gabe… hasn’t talked to me for like 7 years.” I couldn’t hide my surprise. “Yeah, I know. 7 fucking years and he tells me to go to therapy and I just jump and do it like a fucking puppy. Sometimes I dunno what the fuck is wrong with me.” She sighed and now leaned her head back, body softening as she finally started relaxing. “You probably want to know why we stopped talking. It was my fault actually.” She shook her head, undoubtedly remembering the details. “I was 17, he was like 30… we had a Dom/sub-type thing going on.” She glanced up at me to see my reaction and must have been satisfied because she continued. “It was right after I got kicked out of my crib. Molly introduced us. Molly’s my girl — she’s legit been with me through some shit, yo. The night that Jason broke up with me she was there an’ took me in and stuff. And she’s hooked me up with so much.” She paused suddenly and made eye contact again. “I’m probably not making any sense, I’m all over the place.”
I gave her a weak smile and understanding nod. “Why don’t you come sit over here?” I said in my most therapist-y voice, pointing to the chair next to my desk. She hesitated but obeyed and I grabbed a container from behind the box of tissues. I unscrewed the lid and turned it over, shaking it ever so slightly until the purple kinetic sand made its way slowly onto the desk.
“What’s this?”
I waited until the container was empty to push the sand towards her a little before motioning for her to touch.
“Oooo… that’s cool!” She scooped up a big pile in her hands then let it ooze downward, then repeated a few times before remembering I was there. “When my tia kicked me out, my aunt I mean, I ended up at Molly’s. And she took me to Gabe’s. And Gabe let me stay with him until I could get a new place. But…” she hung her head, picking at the sand again. “He didn’t know I was underage and found out in a bad way and then literally didn’t talk to me for 7 fucking years.”
She was silent for a few seconds, deep in thought as she played with the sand, so I spoke. “How did he get back in the picture?”
“Molly of course.”
“And she’s your… friend?”
“More like family to be honest. But yeah, she’s a friend… close friend. She lives with my brother Vic. When Jason broke up with me, I went to Molly and Vic was out of town so I crashed in his room. And I was in a bad place, just fucked up on all sorts of shit and playing video games and Molly tried everything, and even got Toby and he was useless but then she somehow got Gabe to come over and that’s what got me back on my feet again. Sorry, I confused you again.”
I was wide-eyed and, “Yes, I’m a bit confused — that’s so many names! Let me get everyone straight.” I pulled out a piece of paper and pen and began writing as she re-explained her close social circle.
Violet (me)
-Vic (my brother)
-Molly (my BFF)
-Jason (my ex)
-Gabe (my Dom)
-Toby (my ex-Dom)
“So you and Jason broke up, you went to Molly and Vic’s place, Molly tried to help and couldn’t, brought your ex-Dom Toby to help and he couldn’t, so brought another Dom named Gabe who somehow miraculously got you to stop using drugs and come back to therapy?”
“Exactly.”
“And I’m almost afraid to ask, but how did Gabe convince you? Do I want to know?”
She gave a smirk. “He beat my ass.” She really did like saying things to get a reaction.
“Can you be more specific?”
Without even a slight blush or any indication of modesty, “He came over with Molly and Toby… who are both shrinks too, by the way. They’re such softies with me. Molly is just like begging like ‘Viiiiiii c’monnnnn’ and Toby tries to be all dominant like ‘Violet get your ass up now!’ but he’s so pussy that I call his bluff every time. But then Gabe comes in and he just radiates authority. He was in a suit, looked all fancy compared to my brother’s apartment.” She let out a slight chuckle. “I was a fucking mess. I hadn’t showered in days, all I did was smoke weed and sleep. And I’d been fiending for blow so had the brilliant idea to snort an Adderall which fucked up my nose so the sofa was littered with tissues and ashes and the room reeked of weed and my hair was greasy as fuck and there was Gabe in his fancy-ass suit looking down at me and he could’ve easily given me that smug I’m-better-than-you look or even a look of pity but you know what? When I looked at him he was pissed! He was mad!” She started laughing. “Who the fuck gets mad at some useless addict that they supposedly hate?” She didn’t wait for me to answer. “He was like growling: ‘Violet Esperanza! You have ten minutes to get your ass in and out of the shower and front and center prepared for the whipping of your life!’ Are you fucking kidding me, Gabe?” She laughed again, then shook her head and sobered up.
“Me and him ain’t nothing alike. He’s all fancy pants and corporate white guy bullshit and I’m just this Mexican immigrant fea who dropped out of high school. But what we share is… we’ll be cold as fuck when we’re mad… and mean as fuck when you’re forgiven.” Her eyes watered and she focused back on the sand, clearing her throat. “So you don’t know me like that yet, but anyone who knows me knows that I don’t put up with people talking shit. I gotta get the last word in or yell the loudest. That’s another reason maybe that me ‘n Gabe didn’t work out. We were always at each other’s throats. But fuck. I was in a depression, I didn’t even care that he yelled at me. Not a ‘fuck off!’ or death glare or nothin’. I always wanna provoke… that’s what everyone always tells me… that I’m such a provoker or whatever. But that day I just wanted him to leave me alone and I didn’t care and I figured he’d just go. But then he literally picked me up and carried me to the bathroom, told Molly to get me freshened up and then when I was clean and more sober I had to stand there in a towel in front of all 3 of them. And I like being the center of attention an’ all but fuck… not like that. Gabe was pacing and rolling up his sleeves, clearly planning to do something. Toby had his arms folded and kept shaking his head at me. Molly was just squeezing my arm every so often and looking at me all pathetic like I was an abandoned puppy or somethin’. And I think that’s what legit motivated me most to change. The 3 of them fussin’ over me and so disappointed and worried and actually caring. I was so embarrassed. That was the worst part of the punishment.”
“There was more?”
She smiled again and licked her lips. “Yeah, of course. Gabe is a Dom, remember? I told you, he beat my ass. He took off his thick leather belt and whipped me black and blue….. Not literally…. Not in an abuse kinda way, don’t go callin’ the cops or somethin’.”
“I won’t… but be careful.”
“Ha! You don’t know me at all.”
“What’s that supposed to mean?”
“I can’t be careful. It’s boring as fuck.”
“... Okay…”
There was a moment of silence as Violet just played with the sand, molding it into different shapes. “It was high school when I realized that I’m a spanko or whatever. It was one day that I was out with my girls, we was gonna fight this gang and were all amped up ready to go, one girl throws hands then I jump in and before I know it I’m bein’ swooped up by this beefy Puerto Rican cop dude. Ho-ly-shit. He was so fucking hott. But I was bein’ all fiesty and he had to slap those cuffs on me and swat my ass to get my attention. Then he told me off… gave me the longest lecture going on and on. It was half-English half-Spanish. Said something about kids these days and how a good beating would do me good. And something inside of me knew he was right.”
“He was right? At some point you got a beating and it was good for you?”
“Uh yeah… like the one Gabe gave me to convince me to come here.”
“But you said that the most motivational part was them shaming you.”
“Hmm. Touche. Okay, fine… but yes, it’s def done me good. When I was livin’ with Gabe before he would spank me all the time… like… when I gambled… and that worked I didn’t gamble after that but I guess that’s not true cuz the night he found out I’d lied about my age I was gambling… hmmm… Okay well Toby, he definitely helped me out with a good beating.” She paused to think of an example, stuck in her thoughts for a moment. “Or Jason… I’m sure something…” She racked her brain again and again but still nothing. “Well, there’s definitely something. I just can’t think right now.”
“It’s probably more complicated than just the beating part.”
“Facts. Lots of stuff matters.”
“Can you tell me more about your anger?”
“What about it?”
“How long has it been a problem for you?”
“Since I was in like middle school. Girls at school were bitches and my family were bitches and the government were bitches. It’s when I first realized how much people are bitches.”
“And what makes you angry now?”
“Bitches haha… no I’m jk. But legit everything makes me mad.”
“Such as..?”
“Bitches trying to tell me what to do. Bitches makin’ me deal with their bullshit rules. Bitches who are bullies. Bitches who are unfair. When I’m running to the bus but driver bitches ignore me and drive off anyway. When bitches are rude or bump into you cuz they’re not watching where they’re going…”
“Okay so really everything.”
“Yup.”
“And what do you do when you’re angry?”
“Punch bitches in the face. No jk jk. I… count to 10… take a deep breath…”
“Sounds like you’re just saying what you think you’re supposed to say.”
“Okay, you caught me. I yell… I throw things… sometimes I get physical but usually I’m better with words. And revenge. I’m good at revenge.”
“Hmmmm…” I said and leaned back in my chair. “Did you ever get your diagnosis from therapy in the past?”
She shrugged. “Why? What are you thinking?”
“Oppositional Defiant Disorder.”
“I don’t know what the fuck that is but it def sounds like me.”
“Dislike of rules and authority. Need to win arguments. Angry outbursts. Substance abuse. Physical aggression. Seeking revenge. Getting arrested. Those are all symptoms.”
“Yup, sounds about right.”
“But the curious thing is, usually this is a disorder I see most often in kids, and the treatment is usually behavior therapy with the guardians involved. Like family therapy.”
“Why family therapy?”
“Because the authority figure must enforce rules in a certain way to promote behavior change. Of course, that’s easier said than done, even with kids. So we can start with anger management techniques.”
She made a sour face. “What would behavior therapy be like?”
“Well, we discuss which behaviors need to change, then set rules and consequences, as well as rewards. The rules must be realistic, consequences severe enough to deter bad behavior, rewards motivational enough to encourage new behavior.”
“Sounds like something we could do, too, right?”
I shrugged. “It’s possible. The challenge is figuring out the right behaviors to change. It’s often hard for me to see because I don’t see you out there in the world. And it’s often hard for people to see in themselves what of their own behavior should change.”
She stopped messing with the sand and shot me a glare. “You think I won’t be able to figure out what ‘behaviors’ should change?”
“Is that what I said?”
Her nostrils flared again and she looked towards the ceiling, seemingly to replay my words in her mind. “Ok, I guess you didn’t. But ok, I can talk to my friends to get their opinions about what behaviors gotta change. Then we can set the consequences or whatever. Gabe can enforce them. Sounds like what you’re talkin’ about.”
I wasn’t sure how to answer that. “What do you hope to get from therapy? What are your therapy goals?”
“I dunno. Just be a better person I guess. Stop fightin’ with everyone. Settle down long enough to get a real job and salary and my own place and maybe also figure out why I was such a dick to Jason.”
“That’s quite a bit… but okay… we will discuss that more in a couple of weeks. Next week we’ll continue with the intake and talk more about your family.”
“Cool. Hey, can I bring people sometimes? Like, you know, family therapy, but with my surrogate fam?”
“Sure, anytime.”
“Thanks. You’re not so bad.”
“See you next week, Violet.”
“Cya. Hasta luego.”
Intake for: Violet Esperanza
Presenting Problem: Patient presents with symptoms of Oppositional Defiant Disorder (F91.3) characterized by intense angry outbursts, extreme dislike of authority and rules, physical aggression, substance abuse, vindictiveness, and criminal record. Patient reported that symptoms have been present since middle school (~age 11-13).
Risk Factors:
-Substance abuse
-Criminal activity
-Financial instability
Strengths:
-Sense of humor
-Social support
-High verbal skills
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