I noted that my heart, which had previously been sluggish from depression, was pattering in my chest and that somehow another emotion had made its way through my mud, that feeling of fear, or anxiety: however would I master all these forms? As it turned out, I didn’t have much time to think about that because, as I was sat in my cramped office, my telephone rang, with the receptionist telling me my first patient was ready to be seen. I put the sheaf down and went to get him.

He was just a tad over six feet, with visible biceps. His shirt was unbuttoned to the tattoos that raced over his chest: roses on vines and serpents writhing upward, and strange symbols I had never seen before. He had been incarcerated for the murder of his wife and was, after 25 years, on pre-release, which meant wearing the ankle monitor, p**sing daily into a cup for toxicology screens and seeing not only me, but his parole officer every day. He told me a story that fascinated me.

He told me, in a rusty gruff voice, why he had held a gun to the temple of a woman he supposedly loved and pulled the trigger. “Voices,” he said. “My voices told me to do it.” He described the voices that had instructed him so badly and said he heard them still, muffled by medication but nevertheless very much there, and they terrified him. Inside me something uncoiled and reached towards this massive man, a feeling that was almost fondness, or admiration, or empathy. I was warmed by my own responses and by the burgeoning of a relationship on which every therapeutic encounter is based.

“How holding down a job helps me manage my depression”