![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
The Silent Tower: The Windrose Chronicles (Book One)
; The Silicon Mage: The Windrose Chronicles (Book Two)
For the purposes of this exercise, I'm assuming that I know all about magic, other worlds, etc, and take that into consideration when assessing my clients.
Presenting Problem: Antryg Windrose is a slightly disheveled and eccentrically (but not bizarrely) dressed man with somewhat but not markedly tangential speech, and somewhat labile affect. When asked what brought him here today, he states that he is sad and frustrated over his inability to work magic in Los Angeles.
Client denies suicidal ideation, but says he has moderate anxiety over realistic fears of being returned to his home country for execution. Client still takes pleasure in daily life and current relationship, and is employed.
Personal History: Childhood abuse, torture and imprisonment by government, refugee. Client discusses this with insight and appropriate emotion.
Family Background: Client was raised by unrelated abusive man; has no contact with biological family.
Psychiatric/Treatment History: Previous diagnosis of paranoia proved to be incorrect: the client’s seemingly paranoid beliefs were objectively true. Client states cheerfully that “everyone knows he’s mad.” When asked if he believes that he’s mad, he is evasive, then states that he understands why others think he is. Exploration of this point produces several statements of “odd” beliefs regarding magic theory and the likely truth of superstitions. Client has no hallucinations, and possible “delusions” are within the realm of eccentricity.
Differential Diagnosis: Evaluated for depression. Client states that he has no history of mania, major medical condition, substance use, somatic symptoms, symptoms of major depression, or dysthymia. Client agrees that depression and anxiety developed in response to stress.
Consider adjustment disorder with mixed anxious and depressed mood. Rule out on basis of lack of sufficient impairment of social and occupational functioning.
Rule out PTSD (due to trauma history): client states that he has no symptoms of PTSD. Rule out schizophrenia: no symptoms. Rule out paranoid personality disorder: no symptoms. Rule out schizotypal PD: Client is indeed “odd.” But he lacks a pervasive pattern of social and interpersonal deficits due to oddness, is comfortable with close relationships, and is not distressed by being “odd.”
Client appears to be quite well-adjusted and emotionally healthy, especially given his background and circumstances.
Treatment Plan: Therapy for grief over loss of magic. Refer to orthopedist for consultation on injuries to client’s hands.
Axis I (clinical disorders): No diagnosis.
Axis II (personality disorders and mental retardation (note: yes, that is the term for diagnosis)): No diagnosis.
Axis III (general medical conditions): Injuries to hands from torture.
Axis IV (psychosocial and environmental problems): Loss of former career. Exposure to torture and imprisonment. Threat of execution. Refugee.
Axis V (GAF: Global Assessment of Functioning): 80. (Transient and expected reactions to psychosocial stressors.)
(GAF explanation: 100: Buddha. 50: Seriously affected by mental illness. 0: Catatonic or currently randomly shooting passersby.)
ETA: I'm going strictly by the book here. In real life, he probably would have gotten an "adjustment disorder" diagnosis so his treatment would qualify for insurance.
; The Silicon Mage: The Windrose Chronicles (Book Two)For the purposes of this exercise, I'm assuming that I know all about magic, other worlds, etc, and take that into consideration when assessing my clients.
Presenting Problem: Antryg Windrose is a slightly disheveled and eccentrically (but not bizarrely) dressed man with somewhat but not markedly tangential speech, and somewhat labile affect. When asked what brought him here today, he states that he is sad and frustrated over his inability to work magic in Los Angeles.
Client denies suicidal ideation, but says he has moderate anxiety over realistic fears of being returned to his home country for execution. Client still takes pleasure in daily life and current relationship, and is employed.
Personal History: Childhood abuse, torture and imprisonment by government, refugee. Client discusses this with insight and appropriate emotion.
Family Background: Client was raised by unrelated abusive man; has no contact with biological family.
Psychiatric/Treatment History: Previous diagnosis of paranoia proved to be incorrect: the client’s seemingly paranoid beliefs were objectively true. Client states cheerfully that “everyone knows he’s mad.” When asked if he believes that he’s mad, he is evasive, then states that he understands why others think he is. Exploration of this point produces several statements of “odd” beliefs regarding magic theory and the likely truth of superstitions. Client has no hallucinations, and possible “delusions” are within the realm of eccentricity.
Differential Diagnosis: Evaluated for depression. Client states that he has no history of mania, major medical condition, substance use, somatic symptoms, symptoms of major depression, or dysthymia. Client agrees that depression and anxiety developed in response to stress.
Consider adjustment disorder with mixed anxious and depressed mood. Rule out on basis of lack of sufficient impairment of social and occupational functioning.
Rule out PTSD (due to trauma history): client states that he has no symptoms of PTSD. Rule out schizophrenia: no symptoms. Rule out paranoid personality disorder: no symptoms. Rule out schizotypal PD: Client is indeed “odd.” But he lacks a pervasive pattern of social and interpersonal deficits due to oddness, is comfortable with close relationships, and is not distressed by being “odd.”
Client appears to be quite well-adjusted and emotionally healthy, especially given his background and circumstances.
Treatment Plan: Therapy for grief over loss of magic. Refer to orthopedist for consultation on injuries to client’s hands.
Axis I (clinical disorders): No diagnosis.
Axis II (personality disorders and mental retardation (note: yes, that is the term for diagnosis)): No diagnosis.
Axis III (general medical conditions): Injuries to hands from torture.
Axis IV (psychosocial and environmental problems): Loss of former career. Exposure to torture and imprisonment. Threat of execution. Refugee.
Axis V (GAF: Global Assessment of Functioning): 80. (Transient and expected reactions to psychosocial stressors.)
(GAF explanation: 100: Buddha. 50: Seriously affected by mental illness. 0: Catatonic or currently randomly shooting passersby.)
ETA: I'm going strictly by the book here. In real life, he probably would have gotten an "adjustment disorder" diagnosis so his treatment would qualify for insurance.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
From:
no subject
From:
no subject
From:
no subject
This is probably not the intended effect of these posts, but now I'm really curious about these books.
From:
no subject
From:
no subject
To the library!
From:
no subject
From:
no subject
From:
no subject
"Adjustment Disorder" is a way for people who are stressed out and need help but not mentally ill to qualify as mentally ill so they can get treated.
From:
no subject
From:
no subject
I don't know if you've ever read Norman Rush's Mating, but how would I adore a diagnosis of Denoon ;)
(Also, not really in the parameters of the project, but I'd be really curious to know if there is some medical term for the extreme over-identifying and projection that goes on among the *fans* of some fandoms--looking at SPN, at the moment.)
From:
no subject
extreme over-identifying and projection: Good question, and I don't know the answer. It's probably more addressed by a psychoanalytic perspective than a medical one. (Except for the Snapewives and such, depending on how serious they really are.)
From:
no subject
So how's that for a rec! But, like I said, it's strange and the subject matter is not exactly uncontroversial, so ymmv.
From:
no subject
From:
no subject
From:
no subject
From:
no subject
From:
no subject
From:
no subject
From:
no subject
(Could you add me to the DW filter as well, please, so I can read comments there? Same username.)
From:
no subject
Would you consider R/O Reactive Attachment Disorder? There are some oddnesses in his social responses to people, though not following the classic withdrawn-or-uninhibited models, and he has had very strange relationships with his primary caregivers - presumably including early childhood, since he attempted suicide at nine.
...It has been so long since I reread those books, and I still remember all of this without any need to think twice. I could even place exactly when in the continuum you timed this evaluation. The first time I read them, I finished Silent Tower on a weekend night and had to wait TWO DAYS before I could get Silicon Mage. Agony.
From:
no subject
From:
Antryg!