Eight people, taken seriously

29, she/her, veterinary nurse, lives with her partner

Panic attacks with increasing avoidance of driving, supermarkets and the underground.

A textbook maintenance cycle — and a patient whose "safety" strategies are the reason it persists.

41, he/him, structural engineer, married, two children

Longstanding low mood, exhaustion and loss of interest, framed by him as "burnout".

The presentation is depression; the formulation is about what he was taught success costs.

34, she/her, primary school teacher, lives alone

Persistent grief nineteen months after her mother’s death, with insomnia and withdrawal.

A case that asks whether this is mourning that needs company, or mourning that has become stuck.

24, he/him, part-time barista, recently returned to his parents’ home

Recurrent self-harm, intense mood swings, and a pattern of relationships that begin intensely and end catastrophically.

The case that tests whether a therapist can hold a frame under pressure without becoming cold.

37, she/her, pharmacist, married, one child

PTSD following an assault at work fourteen months ago.

A case where the evidence base is clear and the sequencing question is everything.

52, he/him, self-employed builder, separated, sees his son alternate weekends

Alcohol use, referred after a drink-driving conviction; he does not think he has a problem.

The case that punishes any therapist who argues.

31, they/them, graphic designer, lives with two housemates

Social anxiety and low mood, worse since starting a new job eight months ago.

Where does the anxiety end and an accurate reading of a hostile environment begin?

Nadia (46), Ross (49), Kit (16), Iris (12)

Referred over Kit’s school refusal; six weeks of near-total non-attendance.

The identified patient is sixteen. The problem is not sixteen.