“Observing me,” I said carefully.
“Observing, yes. But also working with you.” She took a sip of wine. “I’m not here to judge or evaluate whether you’re ‘doing it right.’ I’m here to help you build better coping strategies for the situations that challenge you in the real world, not theoretical ones we discuss over video.”
“What does that look like practically?” Alex asked.
“Individual sessions with Finn, probably every other day or so. We’ll talk through what’s been happening, process any difficult moments, work on specific skills.” Elena looked between us. “But I’ll also want to observe Finn in different contexts. Family dinners, ranch work, things like that.”
My stomach tightened slightly at the thought of being watched while trying to live my life, but I nodded anyway.
“And Alex,” Elena turned her attention to my girlfriend, “you’ll be part of some of our conversations. Not as a patient, but as Finn’s partner. There will be things that affect both of you, strategies that work better when you’re both aware of them.”
“Like what?” I asked.
“Grounding techniques when you feel a panic response starting. Ways to communicate when you’re hitting your limit before it becomes a crisis. How to recognize the difference between actual danger and your nervous system remembering danger.” Elena’s voice stayed matter-of-fact, professional but not cold. “Some of this Alex already does instinctively, like yesterday morning when you were processing everything that happened. But having a shared language for what’s happening in the moment makes it easier for both of you.”
Alex nodded slowly, her hand still in mine.
“I also want to spend some time specifically observing you doing things you’re good at,” Elena continued, looking at me. “You mentioned teaching Alex to fly. I’d like to watch one of those lessons if you’re comfortable with it. See you in instructor mode, how you handle the responsibility, how you manage the technical and safety aspects.”
Hated that.Being watched while teaching was different than just teaching. “Why?”
“Because right now, your identity is wrapped up in what you’ve lost. What you can’t do anymore,” she cut another piece of short rib, casual about dropping truth bombs. “I want you to see what you still have. What you’re still capable of. Sometimes we need external validation to believe our own competence.”
I huffed in response.
“The flying lessons aren’t about getting you cleared to fly again,” Elena added. “They’re about reminding you that your knowledge, your skills, your ability to teach… none of that went away. Your body has limitations now, yes. But your expertise? That’s still intact.”
I swallowed hard.
“What about the PTSD episodes?” Alex asked quietly. “Like what happened two days ago?”
“We’ll work on identifying triggers and early warning signs. Build better coping strategies for when you feel one coming.”Elena looked between us. “The goal isn’t to make them never happen, that’s not realistic. The goal is to make them less frequent, less intense, and give you both tools to manage them when they do occur.”
“What kind of tools?” Alex asked.
“Grounding techniques, breathing exercises, ways to interrupt the panic spiral before it takes over.” Elena’s fork moved through her short ribs as she talked. “But also environmental strategies. Things that help regulate your nervous system before you hit crisis mode.”
I nodded, following along.
“Actually,” Elena looked at Alex, then back at me, “I noticed something interesting when you mentioned Maggie earlier. How she’s decided Alex belongs to her for now, but she switched to both of you. I assume that was after your episode?”
“It was,” I confirmed. Where was this going?
“Have you ever considered a service dog? Not just an emotional support animal, but a dog specifically trained to help manage PTSD symptoms.”
The question caught me off guard. “I… no. Haven’t really thought about it.”
“Service dogs can be trained to interrupt panic responses, provide tactile grounding during flashbacks, create physical barriers in crowded spaces, even wake you from nightmares.” She paused. “The way you both responded to Maggie’s presence is exactly the kind of benefit a properly trained service dog could provide consistently.”
Alex’s hand tightened slightly in mine. “Would that help?”
“For many veterans with PTSD, absolutely. The dog becomes an early warning system for emotional distress, which means you don’t have to maintain that constant hypervigilance,” Elena looked at me directly. “They’re trained to sense when you’re heading toward a panic response and intervene before it escalates. Give you something concrete to focus on, redirect your attention outward instead of spiraling inward.”
“So the dog handles the monitoring I’m doing constantly anyway,” I swallowed at the idea of relief—of not having to constantly monitor.
“Exactly. And for TBI specifically,” Elena continued, “service dogs can help with balance issues, remind you to take medications, even alert you when you’re showing signs of fatigue or overstimulation before you recognize it yourself.”
“How would we go about doing something like that?” Alex leaned forward, resting her chin in her palm, her elbow on the table.
