Week 6: Sunil

Paul puts a tray with two cups on the table. There is a knock and Julia is there. She says Sunil is outside smoking so she asks to come in. Paul asks about the bruise on her arm. She says Sunil pushed her in an argument that got out of hand -- she needed stitches in her arm. Julia says they are ending treatment today and gives him a check for that session and the last. Julia says if what has happened is what comes of building an alliance in therapy, she feels for the families of his patients. She says Sunil has been getting stranger every day since he began with Paul. She is afraid of him and finds the way he looks at her disturbing. She says she thought of calling the police. Paul tells her he cannot discuss the details of the work with Sunil with her. She expresses resentment at paying for this treatment while Sunil gets worse. She says she feels for Sunil -- he is an attractive middle aged man and could have a better life. She says she is having trouble sleeping and working and asks what he would do in her situation. He says he would keep Sunil in treatment and if she wants someone to talk with, he can recommend someone. He wants to talk with Sunil -- she says fine, he obviously sides with Sunil. Sunil appears at the door as Julia leaves and says he suspects Julia told him the therapy is over.

Paul apologizes for not having had time to make tea because Julia’s visit was unexpected. Sunil says he is sorry they will not being continuing because he looks forward to their discussion. Paul says he understands there was an incident this weekend. Sunil ignores what Paul asks. He says he has been thinking about the dream with the dark haired woman. The dream has been in his thoughts and he has thought about Malini all week. Paul ask what emotions come when he thinks about Malini -- he wonders if there is more to the story. She was a threatening figure in the dream and now there has been a threatening incident at home. Sunil says this is pointless because it is the final session, Paul says he is evading. Sunil says it is too late because Julia gave him final payment. Paul asks why the decision and is it about the bandage on Julia’s arm? 

Sunil says he walked into the tv room and their kids were watching their favorite dvd. He wanted to spend time with them so he switched it off and tried to teach them a Bengali folk song. Julia came in and was furious. Paul says Julia had said she didn’t want him teaching them Bengali, hadn’t she? Sunil says it was just a song and he sings it. Sunil asks if Paul finds the song terrible. 

He says Julia raised her voice. The kids started crying and Julia asked him to stop singing but he wouldn’t and she yelled and then his son came in and took Julia’s side. He tried to leave the room and she would not move. So he pushed her out of the way and she hit the bookcase. Arun told him he was disrupting their marriage so he must move into the basement. Sunil says the song is one he and Kamala sang to him as a child and he used to beg for it. Paul asked if he pushed Julia. Sunil says he pushed by her. Paul asks what is the difference? Where were the children? Sam was crying and the daughter was hanging on to her leg. 

He says when he woke up this morning, there was a note on the table saying it would be his last appointment with Paul that morning. Paul asks if their work has made him worse. He says he thinks ending now would be a mistake. Sunil says it would be pointless for Paul to talk with Julia and Arun. Sunil says he refuses to beg. Paul asks about continuing pro-bono. Sunil asks what he gets out of it -- the pleasure of his madness? He says he refuses to become his charity case. Paul says he does have another session because Julia paid him for next week. 

Sunil asks for a favor. He asks Paul to keep something for him. He says he went into the park after the fight. He says he did not know why he walked toward the field but he found a cricket bat there. He wondered why they had left it behind because it still has some purpose. Sunil says Paul could keep it as a reminder of him. And also because Sunil should not keep it. He says Arun will be gone for the weekend. Paul asks if he is worried he would do something with the bat, Sunil repeats his request that Paul keep it. Paul asks what he was thinking of doing with the bat. He says when Julia is in her study she sits with her back to the door that if your are quiet you can enter without her knowing. Paul asks if he has done this. Sunil says even a broken bat is useful. And he played cricket for several years. He asks why he is having these terrible thoughts. 

Paul says he is concerned. He says they must speak clearly. Sunil, he says, asked him to keep a cricket bat because he is afraid of using it. Paul says he is putting him in a very difficult position.  Paul says he is very unclear about whether Sunil might act out his anger or not. He says he does not know what really happen with Malini, that he is unclear. Sunil asks if he thinks he harmed Malini. Paul says he does not know what to think. Sunil says he feels very sad that Paul thinks he is a bad person. Paul says he doesn’t think about that but it is important to sort through all these conflicted thoughts and feelings. Sunil lights a cigarette. 

Paul says he feels Sunil wants a particular response from him, that Sunil is asking him for help. Paul asks what if he charges a small fee that Sunil can pay? Paul says he wouldn’t do this with any other patient. He tells Sunil he wants him to promise to come back next week. Sunil says he wants to go, that he needs some rest. The window in Julia’s office, he says, is the nicest window in the house. He says sometimes he goes and stares at it. Paul tells him not to go in that room again. If he has the impulse, even a fleeting thought of harming Julia, to call him. Paul gives him his home number and tells him he will be there all weekend. Paul says he will see him nest week. Sunil says Paul will have one final chance to help him, he assures him.

There is but one week remaining in the season, so all the cases will move rapidly this week and next. This would not happen in this way were there not the constraints of a television season like this. So in this instance, we see Sunil’s behavior accelerating in a disturbing way and Paul quite rightly feels alarmed.

This week there really is a possible Tarasoff situation. Sunil does not make a clear threat against her, not in words. But his asking Paul to keep the cricket bat and the things he said about it constitute enough of a threat that if Paul acted believing he has a duty to warn, he would not be challenged. However, were he to do that, there would be no possibility that he would see Sunil again as it seems very clear that Julia would not allow that and likely would report the threat to the police. This is almost always a very tricky element in such cases and finally the therapist must do what he believes is in the best interests of the patient and himself. This is also a place where it is clear that the privilege under which attorneys and priests operate does not extend to therapists. It is commonly assumed that communication with a therapist is privileged but it is not; it is confidential but it can be subpoenaed and can be breached in special circumstances like those outlined in the Tarasoff Ruling and in mandated reporter laws concerning abuse. It is, as Paul says, not clear where the line between fantasy and reality are with Sunil and how much of what he says is actually likely to lead to action. This kind of situation is a therapist’s nightmare.

Paul made one error that jumped out at me. He said, when offering Sunil other payment options, that he would not do this for other patients. This puts Sunil in the position of seeing himself as an exception and that is most often not desirable. I am surprised that Paul would not make arrangements to adjust his fee, perhaps considerably, to support a therapy that is in progress. And certainly if he believes there is real risk if Sunil leaves treatment there is danger, he should do what he can to persuade him to stay, but without the sense of a special favor. 

I should also say that I do not see how Sunil and Julia can continue to inhabit the same house. The level of mistrust and animosity between them is simply too great for it to work out and for him to remain is dangerous for them both. Because Sunil is an adult and competent, Paul cannot simply talk with Julia and/or Arun about this without breaching confidentiality. The only way he could do that would be in service of warning her and then we would be back to the probability of legal involvement. 

Oh, and again the cigarette when emotions ran high.

We see in the preview that Paul is unable to reach Sunil next week. What do you guess happens?

© Cheryl Fuller, 2018. All  rights reserved.