Looking back at her love affair with heroin now, she knows it wasn’t love at all, but a very human need for escape. And little wonder, Elisabeth had a lot to wish to escape from. She still does, it is heavy stuff she carries, and it is all the heavier for having to carry it alone. And yet, it has helped to be here and to express herself by returning to painting and being encouraged and supported to do so. Still, she is tired. Elisabeth often thinks of herself as a much older woman, someone who has lived a long life and doesn’t yearn for more. Other times, she thinks of herself as an animal, a wild little thing who has exhausted itself just trying to stay alive, and who craves the long, dark months of hibernation, tucking herself away in a tiny cave, giving in to a dreamless, peaceful sleep. Elisabeth leaves the window wide open and returns to bed, tucking herself in tight with the light summer duvet. When the usual images insist themselves upon her and want to keep her up all night in terror, she holds on tight to the image of herself as a wild animal, exhausted but safe in its snug winter den, and it works, she’s lulled into a heavy, dreamless sleep.

*

‘Nightmare disorder,’ the new therapist says, an attractive woman named Olivia with a faint American accent. Dr Olivia Hudson reads the diploma hung on the wall above her desk. Formal and impressive, thinks Elisabeth, and knows that must be exactly the intention. She studies the other woman’s face carefully, trying to decide whether she instinctively likes her or not, if this is someone she could envision speaking to several times a week. Olivia sits opposite her on a blue sofa, casually dressed in jeans and a plain black T-shirt, her face clean of make-up except for a deep red shade of lipstick. Elisabeth is tired: though she fell into an initial, deep sleep, she woke up after less than three hours and the night was short and broken. She didn’t want to come here today, running through her therapy notes from her previous shrink with the new one. Getting to know each other, Olivia had called it when she entered the room.

‘What do you mean?’ asks Elisabeth. ‘I have bad dreams, so do a lot of addicts. I’ve read about it. Heroin changes the pathways of the brain and makes them more alive. Comes out at night.’

‘Yes, but nightmare disorder, one form of parasomnia, is more than just having bad dreams; it’s a disturbed sleeping pattern, being too afraid to fall asleep, to such an extent that it affects you during the day. How does it present itself for you? Are you restless during the night? Do you find that you’ve kicked the duvet off? Do you sweat? These can all be signs.’