Jess is due to have her contraception injection today. She has them every three months to prevent pregnancy and ensuring she has them is always a strain.

After much discussion I have established that she is seeing the nurse at 3pm. But then she calls me to say that the nurse could not get to work because of the rain. This is unlikely. It has rained, heavily, but people are getting to work. They usually do in the rain.

As Jess, my eldest daughter, is 20, I cannot just ring up and ask what is going on. But the GP and the nurses know Jess well, and they also know that when she was put on the pill – an experiment cooked up between Jess and the nurse – she got pregnant within weeks.

So when I ring and ask to talk to the nurse, and say it is because I am worried that she has not had her injection, I get taken seriously. But we have to go through a charade. I cannot be given direct information about whether or not she has had it.

"Has rain stopped anyone getting into work today?", I ask instead.

"No." This tells me all I need to know.

"Can I make an appointment for Jess to have her contraception injection as I understand she missed one."

"Of course."

I arrange a 9am appointment. I pick Jess up from her boyfriend's and I take her in. The boyfriend, Paul, also comes. I am rather mortified as he comes to the surgery. He is my age and, incidentally, already has three kids (we think). As I get to know him I realise he is a good and kind person, who truly loves my daughter, but I feel awkward at times. We make an odd little trio in the waiting room, and I see people looking at us, trying to work out the relationship between us.

The only thing I do not do is go into the room with Jess and actually check the needle goes into her backside. I just have to trust the nurse on this one.

When Jess got pregnant last year she miscarried within weeks. What struck me at the time was that both she and her then boyfriend (someone her age, who already has one son) were insistent they did not want the baby. The miscarriage was sad, but Jess was obviously relieved as was her boyfriend and his family. Jess has a tattoo commemorating the dead baby. Truth is, it is a conduit for all her historical and deeper sense of loss to flow through.

Still, she tells everyone she is pregnant. She has been doing this intermittently since she was 15. This coincided with her coming off Ritalin and putting on weight, a considerable amount of weight. But the constant lies have caused huge stress and strain. They have mortified her younger sister and her friends, all of whom have found them puzzling and alarming. Pictures of babies have appeared on her Facebook page, and people have always reacted badly when they have found out that the twins – or the little boy, the little girl, the whatever – just never existed. Such stories have not helped her friendships, educational chances or job prospects.

I understand her need for fantasy, and work so hard to give her more meaningful narratives about herself, ones that show her in a truer light – a little girl who survived the unbearable to become a loving and good daughter. But the pull of the phantom child still drags her down.

And the story of how we have tried to get mental health support for her, involving our MP and endless appointments, is a depressing saga for another day. Too little is understood about the behavioural impact the abuse she suffered as a young child has had on her. There is no diagnosis, no meaningful support.