“Are you harming yourself?” he asked. “Cutting? Burning?”

I tried to speak but I couldn’t.

He jotted something down on his pad of paper. I could no longer see what he was writing. I just stared at him.

It was chilly in his office, and my nose had started to drip. As I reached for a tissue, I noticed my fists were clenched so tightly that when I released them, my fingernails left half-circle indents on my palms. I pulled a Kleenex from the box on the table beside me and wiped my nose.

“How long have you been cutting?”

“A couple of months,” I finally stammered. “I guess.”

He turned the pad face down in his lap and placed his hands on top. “It’s okay,” he reassured me. “I only want to help you. But I need you to be honest with me.”

I nodded, crumpled the dirty tissue into a ball and clutched it.

“When was the last time you cut yourself?”

At that point, I wasn’t familiar with the way the mental health–care system worked. I didn’t know then that you learn to lie or embellish to avoid getting what you need.

“Last night,” I whispered.

“Where do you usually cut yourself?”

With my head down, I followed the ecru rug’s circular pattern with my eyes. “My wrists.”

“Have you ever had to go to the emergency room?”

When I wasn’t looking at Dr. Brace, I became more aware of his voice. He used very little inflection, a performative tone that was meant to soothe. It made me uncomfortable. I shifted in the chair, uncrossing and recrossing my legs at the knee.

“Grace?”

I shook my head.

“Can I see your wrists, please?”

No one had seen my wrists in months. I was careful to wear only long-sleeved shirts. Since it was winter, this didn’t appear unusual. I was cognizant to never roll them up while washing my hands, letting the fabric dampen and gradually dry against my skin.

Slowly, I pulled back the sleeve to reveal my left wrist. I was naïve; I thought I had to do whatever he said.

Thirteen ridged slashes, one after the other, like lines of cocaine. It was always thirteen. Lucky number thirteen. The cuts were horizontal, starting at the base of my palm and ending just below the crease of my elbow. The whitest and most delicate part of my skin.

I studied his face, hoping for a reaction.

Nothing. He was good.

“Thank you.” He regarded the notes in his lap, jotting something down.

My cheeks reddened as the anger surged and the shame built. I yanked my sleeve back to cover my wrist.

“Why do you cut yourself?” he asked, searching my eyes for some sort of tell.

I needed to see my blood to make sure I was real. I liked the way it felt as it trickled down my arm. It was punishment. It was a way to feel something. It was an outlet for my fucked up thoughts. A level of control was required. Never too deep, otherwise you might have to go to the hospital, but just deep enough to feel that release. The warmth of blood soothing the sting of the freshly exposed wound. I would use anything I could get my hands on. A razor blade, a pen, a nail, a needle. I preferred something that made a clean cut. Precision was key. I was always surprised how little it hurt. I hardly felt it.