Bette nodded. “I’ve never liked to talk about how I feel.”

Dr. Burrows just nodded.

“I came here because the other doctor said I should,” she said.

“Is that the only reason?” asked Dr. Burrows.

Bette shook her head. “Well, no. I also came because I feel…I feel broken inside.”

“And why do you feel broken inside?”

Bette looked away, focusing on a pink, blooming flower on the wall. “I have been feeling off balance. My wife is in rehab right now. Things are not great with us. We are getting divorced.”

“And the divorce makes you feel broken?”

“Hmm. Not exactly,” said Bette.

“So what does?”

“I feel like I can’t trust myself,” said Bette.

“In what way?”

“Sometimes, when I feel stressed or overwhelmed, I want to drink or do drugs. I had….have… a problem with it.”

Dr. Burrows replied, “What do you mean by problem?”

Bette cleared her throat. “I mean, I have used them to escape from things in the past. And right now, even though I don’t want to use them to escape, I sometimes feel compelled to drink or use.”

“Let me ask you a few questions, okay?”

“Okay.”

“Do you ever feel like you should cut down on your drinking?”

“Yes.”

“Do you ever annoy or anger anyone when you drink or get high?”

Bette thought about this question. “I – – -I don’t think so.”

“Do you ever feel guilty about your drinking or drug use?”

“Well, yes. I feel guilty all the time. I should never have even started.”

“Last question. Do you ever need a drink or a hit early in the morning when you wake up? As a way of getting over a hangover or starting the day?”

Bette had vague memories of doing these things in the past. Those memories weren’t strong. All of her memories tied to her substance abuse were fuzzy.

“I think so,” she replied.

Dr. Burrows smiled. “Thank you for your honesty. Bette, I do think that what you describe as a problem does have some clinical significance.”

“What does that mean?”