She regarded him for a while, her expression aloof and uninvolved. She must have spent hours in front of mirrors during graduate school, Step thought, practicing that detached, I'mabove- emotional-engagement-with-mere-humans-and-their-pettyproblems look.
"All right, Mr. Fletcher," she said, "I will tell you what possibilities I am currently considering as diagnoses for your son's condition. First, we may be seeing a simple factitious disorder. Second, we may-
"Factitious disorder?" asked Step.
"Factitious means the opposite of what it sounds like, Mr. Fletcher-"
"I'm aware of the meaning of factitious," said Step. "It's the meaning of the phrase factitious disorder that I'd like you to explain."
"In layman's terms, it means that Stevie might be lying about these imaginary friends because he knows it upsets you and he's hungry for the attention that ensues."
Step stifled his desire to say Stevie doesn't lie, he has never lied, he tells the truth even when it causes him to be embarrassed, even when he's sure that he'll be punished for it. If Stevie says that he's playing with imaginary friends, then that's because he really thinks he's playing with these friends, and it's not some damned cockamamy factitious disorder. Instead, he merely said, "And your second hypothesis?"
"It is possible that this is a mere adjustment disorder with depressed mood and withdrawal."
"And what would that mean?" asked Step.
"That he was seriously disturbed by your move to North Carolina. That he felt dislocated from his friends, from a familiar and safe setting, and instead found himself plunged against his will into a terrifying environment where he is incapable of making sense of what is going on and feels himself unable to protect himself from others. In that case, these imaginary friends would be a hallucinatory effort on the part of his unconscious to re-create the safe environment of the past, while his depression would be a sign that in fact the hallucinations are not successful in masking his unhappiness. He does not quite believe the falsely happy reality that his unconscious mind has created for him."
Step kept himself from saying, That's precisely what DeAnne and I thought before we ever brought him to you. "What do we do about it?" he asked.
"That was a hypothesis," she answered, "not a diagnosis, and therefore we will do nothing about it."
"But if it turned out to be the true diagnosis, what would be the right course of action?"
"We are getting into dangerous territory, here," said Dr. Weeks. "Highly speculative."
"I understand that, and I'm not proposing that you do anything improper. I just want to have some idea of what the treatment might consist of if this turns out to be the diagnosis."
"Well," she said, "we might begin by having you contact the parents of some of his former friends back in Indiana, to get them to write to him or telephone. However, that may not be effective because at his age children are not very adept at making meaningful emotional contact through indirect media like the telephone or letters."
"And?" asked Step.
He meant for her to propose other possible treatments that might be used if Stevie's condition really was adjustment disorder with depressed mood and withdrawal. But she took it as a request for the third hypothesis.
"The third possible diagnosis, and the one that I think is most likely, is also the one that will be most difficult for you to hear impartially, and therefore I ask you to keep an open mind as best you can."
Step nodded, even though it was clear that she didn't think him capable of it.
"I think we can best account for Stevie's behavior if we view it, not as a new condition brought on by the move to North Carolina, but rather as an exacerbation of a preexisting condition of some severity, one which remained unobserved because it had gone on so long that you thought it a part of Stevie's underlying character."
"So why would we only have noticed it since-'
"Please," said Dr. Weeks. "An open mind. The stress of the move changed his pattern, you see, and it was the change you noticed, not the actual onset of his condition."
"And the condition would be..."
"Atypical dissociative disorder," she said. "This has been primarily documented in people who have undergone int ense brainwashing experiences, but it is my belief that it shows up far more commonly and merely remains undiagnosed."
Step was baffled. What experience could Stevie have undergone that would produce the same effects as brainwashing?
"Actually, most children in America are subjected to a particular form of indoctrination from their earliest years, in which they are repeatedly reinforced in their belief in a powerful figure who does not actually exist.
However, evidence is given to them to sup port that belief, accompanied by stories to make the child believe that the whole world believes in this particular mythic figure."
"You're saying Stevie's problems are because we taught him to believe in Santa Claus?" asked Step, incredulous.
"On the contrary. I think Santa Claus is, by and large, quite beneficial, for when the child is finally allowed-or forced-to recognize the nonexistence of Santa Claus, then the child is able to go through the vital intellectual process of reconstructing reality in light of new evidence, complete with back-forming new stories to account for past events. This prepares the child for many other disillusionments and gives her vital and well-supported experience in maintaining her grip on reality independent of the stories told to her at any given time."
"So Santa Claus is good," said Step.
"Santa Claus is usually not maladaptive," said Dr. Weeks, "and can be turned to a good end. I doubt many parents actually have that outcome in mind when they tell their children the ludicrous chimney story."
"No, I imagine not," said Step.
"Santa Claus is certainly not at the root of Stevie's problem. He has a healthy skepticism toward that story already."
We paid you ninety bucks an hour to find out whether Stevie believed in Santa Claus?
"Stevie has been subjected to another nonconsonant belief system whose implications are far more all-pervasive in his interpretation of events in his life. He feels an enormous weight of pressure to demonstrate his loyalty to this belief system, and therefore has for a long time been forced to come up with sup porting personal experiences to tell you and your wife about. However, Stevie also has been taught to have an absolute commitment to truth, and cannot do as many children do and simply lie, claiming to have experiences that they do not have. Nor, being a child of a rather placid temperament, has he been able to work himself up to a level of emotion in which hysterical phenomena appear, which is the most common means of satisfying these expectations."
"You're talking about religion, aren't you?" asked Step.
"And the Mormon religion in particular, since yours is, as I understand, a somewhat, though not extremely, charismatic sect. As I have learned from Lee, there is considerable emotional dis play at your testimony meetings once each month, at which many people stand up and weep while they speak. This is clearly a hysterical phenomenon, and is not unhealthy- many churches throughout the South have long had a similar tradition and it has served them well as an emotional release. However, Stevie is one of those unfortunate enough not to be able to produce the appropriate hysteria, and he is also unwilling or unable to lie or pretend. Therefore, he produces hallucinations."
"Dr. Weeks, the only hallucinations Stevie has had are his imaginary friends, dating from our arrival in Steuben."
"On the contrary," said Dr. Weeks. "Stevie has told me that he had several experiences in early childhood in which he sensed a very evil presence, threatening to destroy him. I immediately recognized this as the father- fear that is not unusual in boys of that age and which they usually outgrow. However, he says that he told you and your wife about these 'frightenings' and 'bad feelings,' as he called them, and you both informed him that these feelings were from the devil."