She looks just like her. I know the girl’s face from the black and white photos better than the memories from that school. She’s one of the ones who killed herself.

I take a deep breath, my notebook shifting on my lap and I steady myself. Now is not the time to be sifting through old memories of that place. Now is the time to focus on my patient.

To focus on Kelly.

We’re forty minutes into the session, and she is curled into an overstuffed chair across the office from me. Her posture is defensive and hurt.

In my experience, there are two ways people can go when they look like that. Kelly might be on the edge of a breakthrough, or she might be on the edge of getting up and walking out.

I would understand if she did. I’ve done my fair share of walking out of appointments when it seemed like the therapist I was working with would never understand.

Now I know that it’s impossible for people who weren’t in that situation at the school with us to understand, and I don’t blame them.

Kelly sniffles. Tears run down her face, but she clears her throat, her expression determined.

“Take your time,” I reassure her and she heaves in a breath, her fingers running through her hair and then resting on her forehead.

I’m glad for all the work I put into my office at times like this. I wanted it to look safe and welcoming. I wanted it to be safe and welcoming, of course. Some therapists think the environment isn’t the most important thing when it comes to working with patients, but I don’t know where they got that idea. Kelly’s shoulders relaxed the first time she stepped into my office. She’s never said what the furniture and the soft lighting—light from the window during the day—and the throw blanket on the arm of the overstuffed chair reminds her of. She might not even know on a conscious level.

But I’m glad that the space around her is comfortable, because she’s clearly experiencing some uncomfortable feelings.

“I’m here to listen,” I remind her. “I’m interested to know how you’re feeling and what you’re thinking about right now.”

“Ugh,” she says. “I’m frustrated. I’m so frustrated, and I don’t know what⁠—”

Kelly breaks off and whips another tissue from the box on the side table. She blows her nose, then crumples the tissue into a tiny ball in her fist.