"Sara can you please come to my cabin?.........Yeah okay!" I put the office phone down and sort through the patient's case notes I have just taken once again before putting it in my file and locking them in the drawer.

"May I come in dear" I hear Sara knocking on the door and ask her to come in.

I hand her the list of therapies issued for all the client's and also the list of appointments she needs to make for their next sessions.

"Sara here are the lists and also make appointment for Mr. Sharma on next Wednesday. And Ms. Pandey can now shift to one session in two weeks. Her progress is coming quite well so we will shift her to a new schedule. Also how many more client's do I have today?"

"Let me check!....You have Mr. Raj today and later your talk session with a few patients and outer audience and that's it. You will be done by 5pm today Mam" Sara said checking her notepad and smiling at me.

"That's great! And how many times should I tell you to not call me Mam, Sara!" I admonish her stubbornly making her laugh.

"Okay okay! Shall I send Mr. Raj in then. He came early. I guess he is nervous since this is his first session today"

"Oh! That's fine send him in. I'll complete it and since you know the session ending time, could you prepare the room for the talk session?"

"Sure dear don't worry about it" Sara said smiling at me and went out to call my next client.

While waiting for the client I drop in a quick text telling Arjun when I'll be done at work.

It's been two weeks since we came back from our honeymoon and it has been very hectic. Arjun and I rejoined our respective jobs and we have been catching up on our works since then. Arjun is busy with this really big international deal and I have been busy with my back-to-back clients and also my research study with my colleague and friend on the long term effects of childhood trauma or the effect of childhood trauma on one's adult life. We have been working on the survey questionnaire since I came back and I am yet to get them edited and accepted by my chief.

Even though life has been hectic it's good too. Arjun and I share our entire day's events with each other everyday before going to bed. And sometimes we don't even get to talk as my husband shuts me up by doing other things which consists of a lot of physical activity (wink!). All in all in this hectic schedule we are trying and making time for each other and also for our family members.

My thoughts came to a halt when I heard a knock on my door.

"Come in" I said as I gathered myself and waited for my patient. A neatly dressed man came inside. He was tall and looked like he was dressed to perfection. His grooming is perfect and well-maintained. One of the habits of us psychologist's is that as soon as a person walks in, we observe everything about them to get a good knowledge about them. As he came inside I smiled warmly at him to ease the nervousness visible on his face and asked him to sit down.

"Good afternoon Mr. Raj. How are you doing?" I asked starting a conversation picking a safe and comfortable route to approach him.

When a client enters your session space the therapist is needed to bridge the gap between them and make the client comfortable enough to share their worries. It's different with each client. It takes a different approach with each client to get them to feel relaxed and to open up. One has to rely on their initial observations and instincts as to which approach to use.

"Hi Dr. Dixit. I am good" his answer was to the point showing that his guards are up in front of a new person.

His right hand shook finger was tapping continuosly on his leg. He was looking at me yet his mind looks like it's somewhere else.

"That's great! So your chart tells me that you wanted a session to talk to a therapist and find out what is your problem" I said looking at his chart which is taken as an application form to schedule a session by Sara.

"Yes I feel there is something wrong with me. It's causing problems in my marital life and also my professional life. I think I know what it is but I would like to confirm it by talking to you" I listened intently taking note of how his eyes dart over to my desk everytime and his fidgeting increase.

"Umm... You have crumpled papers on your desk over there" he said the words almost choking it out and his fidgeting stops as I put my attention on it.

While I was putting some papers away I took out an unwanted paper and crumpled it which I thought I threw away.

"Oh! I am so sorry I forgot to threw it away" I said throwing it in the dustbin and sitting back in my chair. I observed how he heaved a sigh of relief and stopped fidgeting. I pretty much got an idea of what his problem could be but I first had to speak to him before coming to any conclusion.

"So do you want to talk about what brought you here?" I dived into the topic because looking from his appearance he looked like a "get things done with" type. You get that when you counsel a lot of people.

"Yeah... Sure... So where do I start? ......I am a software engineer. I am married to my wife Sana since the last three years. We live in a nice apartment here. The problem arised six months before. I suddenly started acting so cleanly which I haven't before. I was a very clean person but not to the point where I get frustrated about it. I check everything again and again. It's like I am compelled to do it. And if something is out of order then I will get so irritated that I yell at my wife. I repeatedly get images of something not being right and I immediately drop work at hand and I go check it. I started being off at work because of this. I try and try not to think about hygeine or cleanliness and all and I fail to do so. I need everything in a specific order, if not I burst out and get aggressive. I .....even got pretty aggressive with my ...wife. She was very very supportive thinking this will pass but now even she got fed up of me and she said if I don't get my shit right she will leave me. My work and my personal life started getting very affected and I just want this to stop. I haven't kissed my wife in three months nor had.... I wasn't intimate with her in these three months as I was more interested in the fact whether she bathed before being intimate with me or if she brushed before we kissed and she is so upset at me that it is killing me. I just.... am so tired. I want this to stop. I want to be happy with my wife" he said in a rush. I was listening intently and I can see the tiredness on his face clearly. I can also see the pain in his eyes at the thought of losing his wife.

I poured some water and gave it to him. He gladly accepted and gulped it down in one go.

"I hear you Mr. Raj. I can imagine it must be really tough. And I am glad you decided to come here and seek help. So, I have an insight of what this could be and I want to ask a few questions regarding it. Can I ask them?" I asked taking his permission to make him feel comfortable at the prospect of questions. He nodded his head in affirmation and I asked him a few questions to rule out the symptoms and diagnosis and my initial guess was right. He has OCD.

"Well I could rule out that you have OCD. How do you feel about that?" When mentioning a diagnosis you have to make sure to know the patient's feelings as this is where we know how much insight the patient has and how much psychoéducation is needed to provide. This will also help with how you approach therapy options.

"I looked up the symptoms before and I did realise that this is it but I wanted to a professional help. So I think yeah I feel.... anxious even though I did figured this before but I want to change. I want to get better for myself and for my wife...... You know we wanted to start having kids but because of my problem not only kids are a far away topic but even my marriage is at the brink of collapsing." I empathised a lot with him. To love someone and to think they will leave us is a very torturous feeling and causes deep pain.

"Well you have a great insight Mr. Raj and you acknowledged your own problem and you want to change for the better. That means you have already taken a step towards recovering yourself." I said smiling gently at him.

It's true. Admitting that the tether exists is the first step towards recovery.

After reassuring him that I will as his doctor will help him completely towards being better I discussed treatment options for him and after filling him about having two sessions a week initially and making sure he is okay with that we ended the session.

I wrapped up the case notes and put them in my file and went to the bathroom in my cabin and freshened up getting ready for the talk session which is in a few minutes.

Agh!!! This is a hectic and tiring day and all I want to do is go home and snuggle with my husband and just sleep!