Blood trickled from the man’s mouth. He sat on a hard, concrete floor, back against a black basement post, naked, blindfolded, hands bound with zip ties, mouth gagged. Down below, blood spurted from an empty space in the middle of his body. The swift swipe of a large, sharp object had separated him from his private parts. He could not see the blow coming, nor observe the result, but the excruciating pain told him all he needed to know. He could feel blood oozing down both legs, trickling to his feet, onto the cement floor. He understood that if his blood continued to gush at its current level, he would soon be dead. He was terrified, mumbling pleas for his life—silently begging for compassion, mercy, or, if neither was forthcoming, a quick death. Was she seeking only to torture him or was she a sadistic killer?

Yes, his captor was a woman. The captive tried to calm down without success, to make sense of the past few hours. He attempted to recognize his captor, the location of his captivity—anything he could recall in case a miracle occurred, and he survived this torturous event. The room was secluded; the door was shut. The tightly bound gag over his mouth prevented him from calling for help. The frantic man couldn’t know this, but the door was bolted shut. 

What is this place? A basement? Where? Have I been here before? Who is this woman?

“Is this how you like it?”

She’d spoken in a whisper, raped him to understand the attraction, poured vodka down his throat to soften him up for the kill, and finally, sadistically, sliced off his manhood.

The scene was akin to the worst horror movie he could imagine, only this time, hewas the star of the show. In a movie or on television, he might have survived this horrible ordeal, lived to tell his story to the authorities. People loved horror stories, didn’t they? Perhaps he’d seek revenge in the sequel. Alas, this was not an imagined scene from a television show or a movie. It was real, and the tortured victim was about to take his last breath. His thoughts turned to the love of his life.

The worst part of this, my love, is being forced to leave you, to never fulfill the dreams we had or the plans we made. We will never have a child together, but you still can have a child. Move on with your life, my darling. Mourn me—don’t forget me; but find someone who makes you as happy as I have been with you by my side. I will always love you and watch over you. I’m so sorry for my momentary lapse in judgment . . . my indiscretion.

He was in and out of consciousness, becoming somewhat impervious to the horror. Fear, anger, pain, and torment slowly gave way to a silent acknowledgment of his soon-to-come death. He had fought courageously, struggled mightily to survive—there was solace in the fact that he had done all he could.

Brad Crawford was a two-term congressman from Southfield, Michigan. His Fourteenth District encompassed much of the larger cities and suburbs northeast and northwest of Detroit. He wondered if his abduction and torture had political implications. Did his enemies hate him that much? What could he have done to enrage this woman, or the people she worked for, to earn this horrific fate? 

Try as he might, he could not think of any issue he supported or opposed that might be that consequential. In his second term, he was a rising star in the Democratic Party, a liberal supporter of the new president, and sponsor of a highly popular twenty-first century infrastructure bill that would create high-paying jobs and improve the quality of life in his district. Could his support of President Belding’s progressive-leaning policies be a reason to torture and kill him? He was a popular, even beloved, congressman to most of his constituents. This tormented him in his last moments—he was dying to know why he was bound, gagged, and bleeding to death.

Feelings of confusion and sleepiness set in. A door opened; he sensed a light come on beneath his mask. Someone spoke to him—he thought he recognized her disguised voice but could not comprehend her words. He felt beads of sweat trickle from his temples and armpits, much like the blood that trickled from his empty groin. 

Someone fumbled with his restraints. His hands were freed but he was too weak to fight back or resist in any way. His gag was removed but he was too feeble to scream, protest his fate, or plead for a last second reprieve. His blindfold was removed. His vision was blurry—he could not focus. He searched the room for his captor and made out the shape of a woman. But the image appeared and disappeared in a flash. She touched his crotch, admired her handiwork, but he no longer felt pain or humiliation. It was as if the trauma disabled him, gotten bored, and transported into someone else’s body. 

He calmed, spoke to his version of God, cursed Him for his fate, and thanked Him for the good things in life—his terrific family, a wonderful woman, and a rewarding career devoted to public service. His tormentor continued to speak to him. Her voice sounded like multiple voices speaking simultaneously, unintelligible. Freed from his bonds and gag, he tried mightily to move and speak, but all he could muster was a soft moan. 

He felt someone tugging at both his legs, his body straighten, and his head bang against the hard floor. He tried to cry out in pain but could only emit another fragile moan. He felt a sudden rush, a pulsating movement, vibration, or sense of exhilaration. His vision suddenly focused and he saw a stern, muscular, short-haired woman pulling him forward. He again tried to mount a defense, to call out or resist, but sounds were muffled, his vision blurred. 

He felt the odd sensation once again. What was it? Just some last-gasp energy? Nothing made sense—he tried to suck in a deep breath, the kind that emits a gasp of relief, as if he just emerged from the depths of a swimming pool having stayed underwater for too long. But he could not breathe. He no longer had lung capacity—he was now a mere shadow of life. He felt himself break into a million pieces—ashes to ashes, dust to dust—his last conscious thought on this earth. The room became dark and quiet . . .

            CHAPTER ONE

            Mia Folger lay on the couch, reflecting on her surroundings. Some version of a couch was featured in many television and movie versions of a psychiatrist’s office. Do modern therapists typically use them for treatment?

When she initially consulted Dr. Harold Rothenberg, her session was conducted in a different room—no couch. Once doctor and patient began to feel more comfortable with each other, therapy moved to the current room—the one with the couch.

            The couch was a rather common prop for psychoanalysts, first introduced by none other than Sigmund Freud. Freud learned, and practitioners have uniformly agreed, that patient-doctor encounters benefit from being freed of the constraints and self-consciousness that comes from looking each other in the eye. A patient enjoys the freedom of being able to talk without critique. The therapist’s office should be one in which a patient cannot see the reaction his or her statement elicits in the analyst—a judgment-free zone, so to speak. The couch facilitates more honest, heartfelt responses.

            Mia Folger began psychotherapy with Harold Rothenberg because she loathed herself and began to disparage her husband, who, she insisted, she deeply loved. She sought treatment to understand and rid herself of these feelings. Several sessions into her treatment, Rothenberg switched her session location to the room with the couch. Mia now enjoyed her newfound freedom to speak her mind without witnessing Dr. Rothenberg’s judgment. 

            “I am very self-critical,” she opined in an early session. “I feel my mother’s negativity, her unrelenting judgment toward everything and anything I try to accomplish in life.”

            At first, Rothenberg thought she was typical of most patients who complain about their mothers. While most complain and imagine their mothers were constant critics, internal pictures of patients’ mothers are commonly darker than the reality. These men and women could usually be persuaded, in therapy, that the mothers of their imagination were far more fearful than their actual mother.  But this was not the case for Mia Folger. Her mother was unrelenting, evil, judgmental, impossible to please, and a consistent negative force in Mia’s life.

            Mia was married, wanted to have children someday, but would never be a stay-at-home wife and mother. She was a radio talk show host and political activist. She planned and attended many political events. Mia first met her husband at one such political event. 

            Rothenberg thought he would encounter trust issues with Mia, that it would take multiple sessions to enable her to feel comfortable confiding her deepest and darkest concerns. To his surprise, Mia took to therapy almost immediately. By her third session, she emerged more free, less self-critical, and responded willingly and forthrightly to his questions. Most importantly, she seemed to appreciate his insights. Today, however, she seemed distant, uncomfortable, aloof.

            “Do most patients lie on this couch?”

            Rothenberg was surprised by her sudden change in attitude. He pondered an answer to her ‘couch question’ then told her it was a psychotherapy tool, one that relieved a patient from the burden of face-to-face treatment.

            “Many patients prefer the couch for that reason.”

            He asked her whether she had any thoughts or memories that would be easier to talk about if she wasn’t forced to look him in the eye.

            Mia was conflicted. Although she appreciated Rothenberg’s concern, she was somewhat ambivalent about revealing her deep-rooted feelings when it came to motherhood, fatherhood, and marital relations. Rothenberg was anything but judgmental, as she was about these subjects, but there were aspects of life she felt were private, feelings that caused fear and profound shame. Would the couch free her to discuss these things too; help to rid her of these feelings?

            “Let me get this straight. On this couch, I can now reveal all matters I wouldn’t feel comfortable revealing to your face? I don’t like your shoes, or the way you always cross your legs when we talk. I would never say those things to your face.”

            “Not exactly what I had in mind, but you get the idea. What do you think? More comfortable, less comfortable, or no difference?”

            “I’m not sure. I told you how I feel, though. Maybe there’s something to this couch thing, after all.”

            “Whatever gets the job done and makes you feel more forthcoming. Therapy is about discussing what’s bothering you in an open and honest manner. My intent is to reduce your inhibitions toward talking about what you are thinking or feeling. Anything, specifically, on you mind today?”

            “I love my husband. I’d love to slice him open and then turn the knife on myself.”

            Mia’s husband was Bradley Crawford, a two-term congressman, son of Congressman Isaiah Crawford, the long-term congressman of the 13thcongressional district, which included the city of Detroit. The younger Crawford was recently re-elected, in a landslide, to serve the 14thcongressional district. He rode the coattails of a proverbial blue wave led by current president Louis Belding, made possible by the toxic, divisive presidencies of Ronald John and Stephen Golding. Rothenberg lived in the district and voted twice for the younger Crawford. He was impressed with the young man’s rhetoric, was aligned with his politics, and considered him future presidential material. Crawford had solid credentials, came from good stock, and, by all accounts, was a wonderful human being.

            Rothenberg was stunned by Mia’s sudden admission of suicidal and homicidal ideations, especially as it related to her husband. Is she telling the truth or just trying to get my attention? As an experienced therapist, Rothenberg knew that most people with such thoughts never acted upon them. Rothenberg also knew Mia was depressed and angry, but he had not considered her a danger to herself or others. Had he missed something? After all, clinically depressed people are sometimes pre-disposed to violence. Depression, when coupled with weak impulse control, frustration, irritability, and rage, can often lead to violent acts. While their sessions revealed many of these personality traits, Rothenberg did not consider Mia a person with weak impulse control—quite the contrary. He decided to explore this further.

            “How long have you felt this way?”

            “A long time.”

            “How long?”

            “Not sure. Couple of years, at least.”

            “How long have you been married?”

            “Four years.”

            “Happily?”       

            “Yes, for the most part.”

            “What causes you to qualify your ‘yes’ answer?”

            “I want to have a baby. Brad is more focused on his career.”

            “Is that a reason to kill him? After all, you can’t have a baby with him if he’s dead,” Rothenberg rationalized.

            “I agree. I didn’t say I had a logical explanation for my feelings, only that I felt them.”

            “But would you act on them? And do you actually loathe yourself enough to consider suicide?”

            “I didn’t say I could or would act upon them. I said I’d like to.”

            “That’s an important distinction.”

            Rothenberg also knew that a person with a history of past physical abuse or illicit drug use was far more likely to resort to acts of violence.

            “Is there anything about your past I should know? Have you ever been abused, physically or sexually? Have you ever taken or abused drugs of any kind? Anything you tell me, as you well know, will be kept in complete confidence.”

            “No, nothing like that.”

            Rothenberg was happy to hear Mia say this, assuming she was being truthful. He decided to focus on impulsivity. Impulsivity correlates favorably with aggressive behavior. The more he probed, the less concerned he became. She took no drugs of any kind. There were no recent events in her life that would trigger any type of violent outburst. She appeared to have good impulse control, almost no rage, and exhibited little aggressive behavior. All drug and clinical tests were negative. There were no physical components or impairments. Testing for serotonergic deficiency was negative, as her 5-HIAA levels (the primary serotonin metabolite) were within normal limits. Rothenberg was also able to rule out any impairment of the prefrontal cortex, which is involved in executive function.

            Mia had no history of aggressive behavior or serious childhood trauma (despite her mother’s judgmental behavior), no impulsiveness, and no alcohol abuse. Rothenberg decided to note her comments and monitor her for signs of increased aggressive behavior or serious escalation of threats to commit hostile or belligerent acts. At the end of the day, he remained relatively unconcerned about her admission.

            “How are you feeling right now?”

            “I’m fine, thank you. How about yourself?”

            “Funny, Mia. Are you trying to get a rise out of me?”

            “No, not at all.”

            “Good. So, tell me, if you were going to commit suicide or kill your husband, what’s the plan? How would you do it?” Rothenberg challenged. He knew that the absence of a plan was a sign his patient lacked the clinical intensity to commit the acts. 

            “I haven’t thought that far ahead. I just get angry every now and then.”

            This was the response he hoped for. Suicidal or homicidal thoughts, to be considered serious, needed imminent risk, a plan, some intrusiveness, or frequency. None of this was present in Mia’s responses.

            “Well Mia, I’m glad you disclosed these feelings. This is a very important step in your treatment. Let’s keep talking about them. Perhaps we can develop a safety plan together. I’d like to increase the frequency of your visits. Would that be okay?”

“Sure. I like talking to you.” 

“If you ever feel out of control, you’ll call me immediately?”

“I will.”

“Great. Let’s get together in two days. Make an appointment as you check out today.”

“Check out?” Mia laughed.

Rothenberg huffed and chuckled. “Right. Poor choice of words. How about, see you in two days?”

“See you in two days,” she repeated with a grin.