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CASE REPORT: PATIENT Y (anonymized)
The patient is a 27-year old male, presenting with a complex of symptoms, including obsessive compulsive disorder (OCD), repression, chronic delusions, and occasional absence of functional mental capacity. The patient is seeking treatment after the break-up of his year-long marriage that was never consummated.
OCD in this patient manifests in the desire for extreme order and cleanliness, which is linked to a desire to impose control and which causes anxiety and distress, to the patient himself, but also to others. The patient's family history does show that these traits are also shared by his paternal grandmother, who, while affectionate towards him, displays symptoms of narcissistic personality disorder and abusive tendencies, some of which have been imbibed by the patient.
The patient's father passed away when he was in his formative years, and his mother is chronically unwell and lacks the courage to confront her abusive mother-in-law. She is, however, due to her positive attributes, an opposing influence on the patient. However, she has unfortunately also passed on her weak-willed acquiescence to the dominating martriach of the family unit, resulting in the patient being stuck in adolescent ambiguity and obsequiousness in his approach to his grandmother. The patient is therefore split between displaying arrogance and showing affection, between self-grandiosity and common sense, and between rigid discipline and a latent desire for fun and frolic. The patient is also given to extreme and cruel expressions of anger deflected from hurt, and seems to lose his discerning ability during such episodes.
The patient also reports that he was disappointed in his first experience of alleged love, which turned out to be deceitful and reptilianly repulsive and led him to clamp down on his emotions when he found himself drawn to his wife, whom he had to marry under duress; he had great dislike for her on the basis of his erroneous perception of her contribution to the enforced marriage (though he later learnt she was not party to said deception) and because he found her physically subpar and therefore negative, raised as he was to a standard of beauty he equated with positive characteristics. However, the patient started feeling progressively positive towards his wife and was, in essence, divided against himself by having feelings and desires he could not acknowledge.
The patient displays inconsistency and duality in matters related to 'dirt'. On one hand it appears that mud 'turns him on', as revealed by photos of his muddy wife on his phone; on the other, he claims that mud, dirt, dust, mess, and unclean things arouse him to great anger. The use of the word 'arouse' was especially noted.
The patient is severely repressed and frustrated due to denying his physical urges towards his wife, and tends to therefore attack her verbally to relieve his built-up anger as well as to initiate some interaction with her, as he finds himself craving her attention. He admits to an abhorrence for her attire and therapy revealed that it is due a subconscious desire that she be rid of it altogether. This too is notable in what unconscious desires it reveals.
The patient indicates that he practices a form of self-flagellation if he gets at all physical with his wife, it taking the form of showering to wash away the guilt. More disturbingly, the patient seems to believe that kissing on the cheek is intimacy inviting said self-flagellation, thus displaying a alarming innocence.
While it is patently apparent that this patient requires years of therapy to undo the conflicting influences and false beliefs, he is on the verge of a breakthrough now and may progress rapidly if he admits his neurotic behaviour and commits to unravelling truths hidden within himself.
The patient is a 27-year old male, presenting with a complex of symptoms, including obsessive compulsive disorder (OCD), repression, chronic delusions, and occasional absence of functional mental capacity. The patient is seeking treatment after the break-up of his year-long marriage that was never consummated.
OCD in this patient manifests in the desire for extreme order and cleanliness, which is linked to a desire to impose control and which causes anxiety and distress, to the patient himself, but also to others. The patient's family history does show that these traits are also shared by his paternal grandmother, who, while affectionate towards him, displays symptoms of narcissistic personality disorder and abusive tendencies, some of which have been imbibed by the patient.
The patient's father passed away when he was in his formative years, and his mother is chronically unwell and lacks the courage to confront her abusive mother-in-law. She is, however, due to her positive attributes, an opposing influence on the patient. However, she has unfortunately also passed on her weak-willed acquiescence to the dominating martriach of the family unit, resulting in the patient being stuck in adolescent ambiguity and obsequiousness in his approach to his grandmother. The patient is therefore split between displaying arrogance and showing affection, between self-grandiosity and common sense, and between rigid discipline and a latent desire for fun and frolic. The patient is also given to extreme and cruel expressions of anger deflected from hurt, and seems to lose his discerning ability during such episodes.
The patient also reports that he was disappointed in his first experience of alleged love, which turned out to be deceitful and reptilianly repulsive and led him to clamp down on his emotions when he found himself drawn to his wife, whom he had to marry under duress; he had great dislike for her on the basis of his erroneous perception of her contribution to the enforced marriage (though he later learnt she was not party to said deception) and because he found her physically subpar and therefore negative, raised as he was to a standard of beauty he equated with positive characteristics. However, the patient started feeling progressively positive towards his wife and was, in essence, divided against himself by having feelings and desires he could not acknowledge.
The patient displays inconsistency and duality in matters related to 'dirt'. On one hand it appears that mud 'turns him on', as revealed by photos of his muddy wife on his phone; on the other, he claims that mud, dirt, dust, mess, and unclean things arouse him to great anger. The use of the word 'arouse' was especially noted.
The patient is severely repressed and frustrated due to denying his physical urges towards his wife, and tends to therefore attack her verbally to relieve his built-up anger as well as to initiate some interaction with her, as he finds himself craving her attention. He admits to an abhorrence for her attire and therapy revealed that it is due a subconscious desire that she be rid of it altogether. This too is notable in what unconscious desires it reveals.
The patient indicates that he practices a form of self-flagellation if he gets at all physical with his wife, it taking the form of showering to wash away the guilt. More disturbingly, the patient seems to believe that kissing on the cheek is intimacy inviting said self-flagellation, thus displaying a alarming innocence.
While it is patently apparent that this patient requires years of therapy to undo the conflicting influences and false beliefs, he is on the verge of a breakthrough now and may progress rapidly if he admits his neurotic behaviour and commits to unravelling truths hidden within himself.
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