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DSM-V (they made five dick sucking manuals?)

Summary:

Dean has no strong opinions on his new therapist. Really. Doesn't think about his hands, or his eyes, and definitely doesn't google "can therapists fuck their patients" before he goes to sleep.
He'd like to go on record saying he was against therapy in the first fucking place.

Notes:

please heed the tags!!! due to the nature of therapy, there will be in depth discussions of mental health.
this fic is a direct result of the therapy scene in fleabag and my inability to be honest with my therapist. cheers!

(See the end of the work for more notes.)

Chapter Text

Dean Winchester does not need a fucking shrink.

So his dad died. Great. They tend to do that after a certain age. And he's fucking fine with it. Really.

What he's not fine with is his brother Sam skipping out on the funeral (that Dean arranged himself, by the way). Apparently being some hotshot lawyer in California gives you an excuse to pretend like your fucking family doesn't exist.

Sure, their dad was a dick. But he did his best. Him and Sam might not have gotten along all the time, but that doesn't stop him from being Sam’s fucking dad. You don't just ignore that shit.

What he’s doubly not fine with is when a month later, on his 29th birthday, he receives a card in the mail in Sam’s loopy handwriting. And instead of a shitty card, he gets a voucher for therapy a week from his birthday, along with a note reading Happy birthday. Sorry I couldn’t make it. Hope this can be helpful. 

Dean would’ve preferred no fucking mail at all.

See, Dean’s perfectly stable. Lives in an apartment, works at his surrogate uncle Bobby’s salvage yard. Drinks and watches movies most nights, gets together with his uncle every so often. Texts his brother on holidays and usually doesn't get a response. Gets a little neurotic about electrical wiring and fire safety. Has pictures hanging up of his parents before they had him or little Sammy.

He does not need fucking therapy.

Bobby, on the other hand, disagrees.

When Dean shows up at Bobby’s house that night, waving the voucher in the air and scoffing about Sam’s fucking audacity, Bobby doesn't have the outrage Dean expected.

“Hell, Dean, this is just Sam’s way of showing he still cares,” he says, passing Dean a beer and sitting down at his shitty little kitchen table. “Yeah, the kid don’t visit enough, I get it. I miss him just as much as you do. But that don’t take away from the fact that this could be good for you.”

Good for me?”

“Can’t hurt.” Bobby shrugs and takes a sip of beer. “Lord knows your daddy weren’t exactly easy on ya, Dean. Just give it a shot.”

Dean grumbles and looks away, cuts off that conversation once and for all. When he gets home that night, the voucher sits on his kitchen table and mocks him. Dean scowls and shoves it in his junk drawer, content never to think about it again.

A week goes by, and he’s still thinking about it.

If this is Sam’s way of saying he cares, then he’s got a funny way of doing it. Dean’s well adjusted. Sure, he was a troubled kid. Sure, he didn’t exactly have a "stable household" growing up. Sure, he has dreams where he wakes up yelling and thrashing in his bed. Sure, he doesn’t really get close to people that aren’t family.

But Sam can fuck off. He’s probably still got the same mindset he did when he was a kid, that he was gonna run off to college and have a normal life and never speak to Dean or Dad ever again. That Stanford was gonna fix him right up and he’d never fucking look back. That Dean and Dad had issues and how he wanted a normal family.

The idea of a normal family burned right along with their mom.

Did Dean like moving all over the continental U.S. as a kid? Did he like never staying more than six months in one place, ‘cause his dad couldn’t keep a single stable job? No. But he fucking dealt, alright? Raised Sam well, anyhow. Then the kid went off to college, and Dad fucked off, and Dean fucking dealt with it.

He’s probably dealing with it even better than Sam, seeing as he’s the one who’s still fucking here. Still picking up the pieces of their dad’s death, paying his fucking debts, sorting through his shit.

He finds himself at the kitchen table on Sunday night, whiskey glass in hand, staring at the voucher. Wondering how much Sam must’ve paid for this shit.

But fuck Sam. He’s gonna cash this thing out.

 

. . .

 

Monday morning, he calls and tells Bobby he’s taking a sick day- something he hasn’t done in over a year, so despite Bobby’s grumbling, he lets it slide.

Dean plugs the address of the therapy office into his GPS and his hands certainly do not shake as he drives there. He’s got nothing to be nervous about, anyway. He’s just fucking cashing it out.

The building is daunting. Dean scowls when he realizes that Sam must’ve researched this place, made sure it was local, and scheduled the fucking appointment for him. He forces himself to take the stairs one at a time, shoves his hands into his pockets to keep them steady as he makes his way into the waiting room. Shuffles forward when the receptionist tells him she can take him next.

“Hey,” he says. “I, uh, I got this voucher for a therapy session, ‘nd I’m just hoping to cash it in. Return it, I mean. For the money.”

The receptionist raises her eyebrow at him, and Dean straightens his shoulders. He’s not gonna be fucking judged for not getting his head shrunk. That’s ridiculous.

“Name?” she asks, turning back to the computer.

“Dean. Winchester. Dean Winchester.”

“Date of birth?”

Jesus Christ, just give me the fucking money. “January 24th, 1979.” I turned 29 last week, you know. All I got was this fucking voucher and a stiff drink. Staring down the barrel at 30 and this is what my life looks like. 

Receptionist lady turns to pick papers out of a filing cabinet as she speaks. “I’m sorry, but you’ll need to speak to Dr. Novak if you wish to exchange your appointment. If you take a seat in the waiting area, he’ll be out in a few minutes.” She clips the papers to a clipboard, then holds it out with a pen. 

“I can’t just get the money?”

“No,” she says slowly, like Dean’s the one being ridiculous right now. She shakes the clipboard, and Dean reluctantly takes it. “As I said, you’ll need to speak to Dr. Novak first. Please take a seat.”

Dean frowns, takes a deep breath, and turns around. This whole thing is turning out to be a lot more complicated than he’d hoped, but whatever. He’ll meet this fucking doctor, explain that his brother is a holier-than-thou piece of shit , and get the cash. No big deal. He sits in the corner, where he can see both doors. Just in case. Just in case.

He’s just about ready to bail when a man with ruffled dark hair and an unassuming brown sweater walks into the waiting room and calls out, “Dean?”

“Yeah,” Dean says, pushing himself out of his chair and advancing towards the hall. “That’s me.”

The guy- Dr. Novak, Dean guesses- gives him a warm smile. “Pleasure to meet you,” he says. “Please, follow me to my office.”

Dean does not have a doctor fetish- he doesn’t, and this guy isn’t even a real fucking doctor anyway- but oh god his voice. How does anyone pay attention to therapy with this guy as their therapist? Guy must get a lot of chicks with daddy issues.

Nope. Not going there.

Dr. Novak closes the door to his office and gestures for Dean to sit on the couch. It’s a small room with a couch on one end, a desk on the other, and artwork and "inspiring quotes" littering the walls. The guy has his diploma above his desk, and Dean wonders what kind of shitty therapist has to assure his patients that he definitely does know what he’s doing.

“So, what brings you here, Dean?” He sits at the rolling chair, takes a clipboard and pencil off his desk, and crosses his legs. “I see you have neglected your intake forms.”

“Uh. Yeah. Kinda what I wanted to talk to you about.” He eyes the clipboard in Dr. Novak’s hands. “Won’t need all that, Doc. Uh, my brother scheduled this for me. Just hoping to exchange the whole shrink thing for the cash instead.”

“Ah, yes. Sam, correct? I spoke to him on the phone.”

Dean snorts. He can just picture that conversation. Hello, Doctor, I would like to schedule an appointment for my brother, which I think will be a better birthday present than actually fucking talking to him. Yes, he’s the one who needs help, not me. I’m absolutely perfectly adjusted with my perfect job and perfect hair and perfect fucking life, which is of course why I’m scheduling him for a fucking shrink instead of talking to him on his birthday. “Yeah, real delight, ain’t he?”

“Do you think so?”

“Sure,” Dean says, leaning back in the couch and crossing his arms. His leg bounces of its own accord, and he’s long since reconciled with the fact that he can’t be still. “To other people, maybe.”

The doctor writes. Dean frowns. “I told you, you don’t need to take notes. I just want the money.”

“Yes,” Dr. Novak says with a small smile. “Your brother told me you would say that.”

“And?”

“And he told me not to accept.”

“Fuck,” Dean groans, scrubbing a hand down his face. “C’mon, man. He pay you extra, is that it? Look, you keep that little tip. I just want a goddamn decent birthday present.”

Dr. Novak’s little smirk slips a bit. Serves him right. “Happy birthday,” he says. He turns to set his clipboard down neatly on his desk, then turns back around to face Dean. “And, to answer your question, no, he did not pay me extra, and no, I will not accept an exchange. I want to help you, Dean.”

“You don’t even know me.”

“Then tell me about yourself.”

Dean scoffs a laugh and turns his head away.

“Why is that funny?” Dr. Novak asks.

“Ain’t much to tell.”

“More specific questions, then. Do you keep in regular contact with your family?”

My dad died a little more than a month ago and I’m shoving the grief down deep. I haven’t talked to my brother in over a year. My mom died when I was four and sometimes I think I died right along with her. “Nah. Not really. Just my uncle.”

“Do you have friends?”

What? “What?”

“Do you have friends?” Dr. Novak repeats.

Haven’t had a friend since I was sixteen in a fucking children’s home. Never stayed in one place long enough to make one. My brother was my best friend ‘till I was 22. He ran off seven years ago. Sometimes the loneliness feels like it’s drowning me. Like it’s filling up my lungs and I’m gonna choke on it. “Sure.”

Dr. Novak writes something. Dean wishes he would stop, or that he could read it, at least. “Significant other?”

Dean snorts. “Nah.”

“Why is that funny?”

Dean frowns, scratches the back of his neck. “I dunno, man. Sorry, I guess.”

“Please, don't apologize. I am not passing judgment- simply trying to understand.” He waits for Dean to nod before he continues. “What do you do for work?”

“Mechanic,” Dean says. Finally something he can fucking talk about. He shouldn’t feel like he’s getting tested over here. “I work at my uncle’s place. Damn good at it, too.”

“I’m sure you are,” Dr. Novak says. “And you enjoy it?”

Dean smiles. “‘Bout the only job I’ve ever had that I do, yeah.”

“What jobs have disagreed with you in the past?”

Wasn’t really a job. Just nameless bodies and a wad of cash tucked in my pocket as I got to my knees when poker and pool didn’t go as well. Dean’s mouth feels dry. His hands are shaking- he smoothes them down the thighs of his jeans. “Burger flipping. Minimum wage. You know how it is.”

Dr. Novak raises a brow at him, but he doesn’t call out Dean’s shit. Just writes. It’s really starting to get on Dean’s nerves, the fucking writing. “Listen, Dr. Novak-”

“Please, call me Castiel.”

Dean tries not to make a face, but what kind of fucking name does this guy have? “Sounds Biblical.”

Castiel smiles. “Yes.”

“Okay, Castiel ,” Dean amends, “I don’t need my head shrunk. I don’t, alright? My brother might think I do, but I don’t. He’s on a high fucking horse thinking he’s the well-adjusted one, but truth is, we haven’t talked in a year, so he doesn’t know what the fuck he’s talking about.”

Castiel schools his impression into one of neutrality. The poker face is sorta starting to piss Dean off. “It is my firm belief that everyone could benefit from therapy,” he says. “There is nothing wrong with talking to someone. There is nothing wrong with getting the help that you need.”

“I don’t need it.”

Castiel raises his eyebrows and sets his clipboard in his lap, folds his hands over top of it. “Okay.”

Okay?

“Your brother scheduled you ten sessions. That is ten weeks. If you do not wish to come, then you are not obligated to. I, personally, hope that you do come. I think that you have preconceived notions about what therapy is and who needs it. I think that talking would benefit you, whether or not you have a problem. But I cannot help you if you do not wish to be helped.”

Dean sits there for a minute. Works it over in his mind. Ten sessions. Sam paid for ten sessions. Wasted his money on me for ten sessions. He thought I would keep coming back. He thinks I need so much help that I’d come to ten hours worth of therapy. “Would Sam know? If I came or not?”

“No, he would not,” Castiel says.

Dean nods, avoiding the doctor’s gaze, who looks at him like he’s looking into his very soul. It wouldn’t hurt to talk, he guesses. He can tell Sam he didn’t come just to make the guy feel shitty for his dumbass idea of a birthday present, but truth be told, he doesn’t wanna just waste his money like that. Maybe it’s how he grew up, but he’s not gonna let someone pay for something just to waste it. 

Alright, then. Sam doesn’t have to know. Sam doesn't have to know, not that he'd even ask, but Dean can pretend that he's sticking it to Sam and making him think he's perfectly fine.

Because he is perfectly fine. But if a hot doctor wants to spend ten hours in a little room alone with him, then fine. Whatever .

“Okay,” Dean says. “Sure. Guess it couldn't hurt.”

Castiel smiles, and Dean’s heart beats a perfectly normal speed, thank you very much. “I’m glad, Dean. Now, seeing as this is our first session together, I’m going to ask you a few basic questions about your history with mental health, your background, and your goals. Okay?”

“Don't got a mental history, or whatever, but sure.”

“I’m sure,” Castiel says, and his eyes flick to Dean’s restless leg for a moment before back up. Smug bastard. “Have you attended therapy in the past?”

“Nope.”

“Does your family have a history of mental health issues?”

“Uh.” Dean frowns. He knows fuck all about either sides of his family when it comes to that. His mom, for obvious reasons, and his dad- well. According to him, Dean would be a pussy just for coming to this fucking appointment. “Dunno. My dad had,” past tense past tense past tense , “that, uh, thing from war, I think? Shellshock or whatever?”

“PTSD?”

“Yeah."

Castiel nods and makes a note. Dean tries not to wonder what it says. PTSD. He couldn’t even tell you what it stands for. Just that his dad kept a trunk full of guns, didn’t trust the government, always sat facing the door, and drove his sons away.

No. He drove Sam away, and he himself drove away from Dean.

“Do you have a history of suicidal ideation?”

Dean blinks. Swallows. Licks his dry lips. “Sorry?”

“Suicidal ideation,” Castiel repeats patiently. “This can be either active or passive. It could range anywhere from actively attempting to commit suicide, to risky behavior, to wondering if anyone would care if you died.” At Dean’s silence, Castiel smiles softly, reassuringly. “This stays between us, Dean. I am required to report if you are a danger to yourself or others, but otherwise, this is private information, and a judgment-free zone.”

“Yeah. Okay,” Dean says distractedly. He’s not- suicidal. Never tried to kill himself, that's for sure. Risky behavior is par for the fucking course, and who doesn’t wonder if their family would care if they died? Castiel is patient as he thinks, and Dean kinda wishes the guy would just move on with his questioning, but he doesn't. Just sits there like a statue, like he could wait forever. Big blue eyes. “Can you, um- what's passive?”

“Thoughts and feelings about wanting to die, without any planning or attempts. Active, of course, would be the opposite of that- making plans, writing notes, and attempting suicide.”

“Sure,” Dean says, his mouth dry. “Um. The other one, I guess. A little.”

Castiel nods. “Thank you, Dean. Admitting that, even to a therapist, can be difficult. I appreciate your honesty.” 

It doesn't feel like a line he's feeding Dean- feels like the guy is actually earnest about it. Doesn't mean he's still not humiliated to be baring his goddamn soul here. Dean just nods as Castiel writes something down.

“Do you have a history of self harm?”

“Jesus Christ, no. I don’t cut myself,” Dean says, disbelieving. He’s not that kind of person. He thinks if his dad ever saw him doing that shit, he'd be dead, anyway, so it'd be pretty useless all around.

Fucking pansy.

“Cutting is not the only form of self harm, Dean. Self harm can include risky or reckless behavior, like excessive drinking, drug use, or unsafe sex.”

Fuck. Fuck. Fuck. Passing with flying colors. “Nah,” he says anyway. If his leg bounces a little faster, well, that's unrelated. Castiel looks at Dean like he can see right through him, but he just looks down and makes a little note. 

“Problems with substances? Do you drink?”

Deep breath in, deep breath out. “No problems, but yeah, I drink.” Clasps his hands on his knees to keep them from shaking. 15 drinks a week defines heavy drinking. Doesn't necessarily make it a problem. Nobody’s business if there’s a couple more than 15.

“What do you hope to get out of therapy?”

You. “Dunno.”

Castiel nods, gives him a little smile. “That's perfectly fine- this is a somewhat unique circumstance. We can navigate your goals together.”

“Hey, you're the expert, Doc.”

God, this guy’s smile might just fix him, after all. Fuck talking- if Castiel just smiles at him for an hour, he might be cured. “Would you be willing to complete those intake forms for me, now? If you have any questions, I will gladly help to the best of my ability.”

Dean nods and turns back to the papers he discarded on the couch. He didn’t think therapy was about goddamn homework, but whatever. Easy shit. He could do this in his sleep.

Two of the papers have lists, with shit like “I move so slowly that others notice; or I am so restless that others notice” and “I feel like a failure to my family” and “I am disinterested in hobbies, work, and relationships” with boxes next to them ranging from how much he agrees with each statement, then more boxes at the bottom asking how much they affect his life.

The third paper asks if he’s ever attempted suicide. He quickly checks no on each box without even reading the questions. Then, he hands it back to Castiel.

He looks through Dean’s papers with a perfectly neutral expression. Dean fidgets with his nails as he watches, wishing the guy would just break the damn poker face. Hell, he’d honestly prefer being told he’s a goddamn basket case than this. Makes him uneasy. Makes him flick his eyes to the door every so often, like he’s preparing to spring up and flee.

Finally- finally- Castiel turns back to him with a pleasant smile. “Thank you, Dean. I would like to warn you that you will be receiving similar papers each session to monitor progress.” Dean groans, and Castiel chuckles- and it’s nice. God, it’s nice. His eyes crinkle and he looks down, like he’s trying to hide his own smile. It’s fucking-

Guys aren’t adorable. Guys are not and can never be adorable. His guy therapist can never, ever, be adorable.

Fuck.

“As this is our first session, and you’re new to therapy, I will ask only one thing of you between now and next week.” I think you could ask me for anything. “I want you to make a list of ten positive things in your life.”

Oh.

Maybe not anything.

Castiel must catch the look in his eye, because he says, “Five can be sufficient, as well.”

“I can do it,” Dean says hurriedly, and fuck, he sounds like a goddamn child. “I mean- dude, I’m not depressed. Ten things, easy. Could list ‘em right now.”

“Then I await our next session. Please, make sure you stop by the receptionist before you leave to confirm your appointment date and time.” He stands, and oh God, he’s holding his hand out. Oh God. Dean stands in a rush, quickly wiping his hands on his jeans before he reaches out to shake Castiel’s. Big hands. Big hands. Big hands. Get it the fuck together big hands. “It’s been a pleasure to meet you, Dean.”

“Yeah, uh, you too,” Dean says, cursing himself for the fucking stutter, and he rushes out of the room before he melts into a puddle on the floor.

Dean Winchester is not gay.

And he is not attracted to his fucking shrink.