CONTRIBUTOR SPOTLIGHT:
Interview with Trae Stewart

Rappahannock Review Fiction Editors: The trilogy of short stories you submitted seems to reflect states—or perhaps stages—of mental illness. Would you consider them connected in more than just a common motif (for example, is there a chronological connection)?

Trae Stewart: They are absolutely connected, though I’d resist calling the connection strictly chronological, because mental illness rarely follows a clean timeline. What links them is a trajectory of proximity to the self. “Caption Mode” is the most internal; it lives entirely inside one person’s mind, narrating the war between intrusive thought and conscious will. “Discontinuation Plan” sits at the threshold between internal and relational; the protagonist is trying to metabolize another person out of their system, which is still a private act, but one shaped by someone else’s gravity. “Identification Band” pulls the lens outward entirely, into the institution, the system, the clinical gaze, where the self is compressed into a barcode and a set of screening questions. So the arc isn’t onset-to-recovery. It’s more like a zoom out: from the skull, to the heart, to the wristband. Each story asks the same question, who narrates your suffering?, and each answers it from a different distance.

RR: In your letter, you mentioned that you utilize a complex taxonomy “to explore intrusive thought, relational withdrawal, and institutional containment.” What inspired you to interrogate these topics?

TS: Clinically, I sit across from people every day who are living inside these exact taxonomies. I’m a psychiatric-mental health nurse practitioner: I prescribe the medications, I write the discontinuation plans, and I’ve been the clinician on the other side of the clipboard in “Identification Band.” And what I’ve learned is that the language we use in psychiatry, “intrusive thought,” “taper schedule,” “72-hour hold,” is precise but rarely honest about how these experiences actually feel. The DSM can tell you what OCD looks like. It can’t tell you what it’s like to stand in a pharmacy line while your brain screams at you to throw something. I wanted to close that gap, to take the clinical vocabulary I use professionally and run it through the emotional filter of the people I’ve worked with. These stories interrogate the taxonomy because the taxonomy, on its own, isn’t enough. It classifies suffering without translating it. Every piece in this trilogy grew from real clinical encounters, composites of clients whose experiences stayed with me long after the session ended. I wrote them not to disclose anyone’s story, but to honor the emotional truth that clinical documentation can never quite hold.

RR: Mental illness is a topic that’s become more and more lucid to popular communities. Is your intent to promote this sort of awareness, or were these stories written as a conduit for some more introspective thoughts and feelings?

TS:  Both, but if I’m honest, the introspective impulse came first. I didn’t sit down thinking, “I want to raise awareness.” I sat down because these images, the captions scrolling across a windshield, the taper schedule written at 2 a.m., the identification band narrating its own purpose, wouldn’t leave me alone. They came from years of sitting across from people in the worst moments of their lives and carrying fragments of those encounters home with me. Not their details, but their weight. I think clinicians absorb something over time that doesn’t fit neatly into case notes or supervision; it accumulates as imagery, as rhythm, as the feeling of a room when someone finally says the true thing. These stories are where that accumulation went. But I do think the best awareness work happens when the writing isn’t trying to educate, when it’s trying to be truthful, and the reader happens to recognize themselves in that truth. I’d rather someone read “Caption Mode” and say, “That’s exactly what it’s like,” than have them read a pamphlet about OCD. The awareness is a byproduct of emotional accuracy, not the other way around.

RR: As the protagonist, how might you reframe your thoughts and emotions to better stabilize the internal hardships through all three narratives?

TS: What’s interesting is that the protagonist in “Caption Mode” actually models the reframe in real time, and it isn’t a traditional cognitive restructuring. It’s defusion. The protagonist stops arguing with the captions and starts saying, “Okay.” Not agreeing with the content, but refusing to give it the adversarial energy it feeds on. That’s straight out of Acceptance and Commitment Therapy; the recognition that thoughts don’t require rebuttal to lose power, they require detachment from authority. In “Discontinuation Plan,” the reframe would be shifting from “I am failing at getting over this person” to “grief is not a compliance issue,” recognizing that the medicalized language the protagonist uses is both a coping mechanism and a trap. Treating heartbreak like a prescription taper gives structure, but it also pathologizes a normal human experience. The reframe is permission to grieve without a protocol. In “Identification Band,” the reframe is the hardest because it isn’t entirely in the protagonist’s hands; it’s institutional. But the moment of honest speech, “I don’t want to die,” which isn’t the clean answer the system prefers, is itself a stabilizing act. Authenticity, even when it doesn’t fit the screening tool, is its own form of regulation.

RR: If you were a friend of the protagonist, how would you help them? With a comfort meal? A day at the spa? A walk through the park? Give us a play-by-play.

TS: 

As a friend or family member:

Not a spa. Not yet. The protagonists in these stories are people whose nervous systems are on high alert; overstimulation would feel like punishment dressed as pampering. I’d show up without asking permission. Not with a plan, just with presence. I’d bring something warm and simple, soup maybe, or good bread and butter, because when someone is in the thick of it, elaborate meals feel like an obligation to perform gratitude, and they don’t need another performance. I’d sit with them. I wouldn’t open with, “How are you?” because that question, for someone in crisis, is an impossible assignment. I’d say something low-stakes: “I brought food. You don’t have to talk.” Then I’d just be there. If they wanted to walk, we’d walk, but somewhere flat and quiet, not a scenic trail that demands awe. A neighborhood loop. Sidewalks. Something that says, “The world is still ordinary, and you’re still part of it.” At some point, I’d say the thing no one says enough: “You don’t have to explain this to me. I’m not here because I understand. I’m here because you matter to me, and I don’t need you to perform okay.” And when I left, I’d text the next day. And the day after that. Not “let me know if you need anything,” because that puts the labor on them. Just: “Thinking of you. I’ll come by Thursday.” What people in these stories need isn’t rescue. It’s repetition. Someone showing up, again and again, until the showing up becomes its own kind of evidence that the captions are wrong.

As a psychiatric clinician:

From my seat, the play-by-play looks different because my role is to comfort, stabilize, assess, and build a framework the person can carry out the door. For the protagonist of “Caption Mode,” I’d name what’s happening in language that depathologizes the experience without minimizing it. I’d say something like, “Your brain is producing intrusive thoughts, and the fact that they disturb you is actually evidence that they don’t represent who you are.” I’d explore what therapeutic approaches might help, and I’d assess medication options, particularly an SSRI if we were looking at OCD-spectrum presentation, while being transparent about what medication can and cannot do. For the protagonist of “Discontinuation Plan,” I’d validate the grief without rushing toward resolution. Attachment disruption activates the same neural reward pathways as substance withdrawal; the protagonist’s instinct to medicalize the experience isn’t entirely metaphorical. I’d work with them on distress tolerance, explore relational patterns that preceded this attachment, and hold space for the reality that “moving on” is not a clinical milestone with a target date. For the protagonist of “Identification Band,” I’d focus on the moment the hold lifts. The discharge plan matters more than the admission. I’d ensure continuity of care, not just a list of phone numbers on a folded paper, but a warm handoff: a scheduled appointment, a safety plan built collaboratively rather than assigned, and an honest conversation about what the experience of being held felt like, because the therapeutic rupture of involuntary containment doesn’t heal itself. In all three cases, the clinician’s job isn’t to fix the story. It’s to help the protagonist become a more reliable narrator of their own life.