She was 14 years old, and very angry.
She had come to see me for a suspected eating disorder. She was not interested in any therapeutic alliance. Her crossed arms and schoolbag planted firmly on her lap made her displeasure clear.
Her mother was quiet, pleasant and polite. She tried to make up for her daughter’s reticence. I spoke to her alone behind closed doors.
“She hits me.” She began to cry. The mother, not the daughter.
Hers was a heart-wrenching story of domestic violence. Of divorce and all its painful aftermath. Now the daughter was following in her father’s footsteps.

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I listened, and consoled. I offered several suggestions and avenues for help. But mainly I just listened.
“Thank you so much.” Some of the tension had left her face. Now I can go on.
The rest of the consult was methodical, aimed at excluding organic causes of vomiting. For the first time in a long while, I left the clinic feeling that I had genuinely helped someone.
Footnotes
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The authors confirm that all the characters in this work are fictitious.