Sharon, a 27 year-old female who had been physically and sexually abused by her father throughout her childhood and adolescence, has been receiving intensive therapy sessions for the past three years. Throughout her adulthood, Sharon has exhibited at least four personalities. Each personality was of a different age, representing the phases of the woman's experience - a fearful child, a rebellious teenager, a protective adult, and the woman's primary personality. Only one of the personalities, the protective adult, was consciously aware of the others, and during therapy sessions was realized to have been developed to protect the woman during the abusive experiences. When one of the secondary personalities took over, Sharon would often act out according to the nature of the dominating personality. Terrance O'Reilly, a single 39-year old transit authority clerk, was brought to the hospital by the police after his increasingly hyperactive and bizarre behavior and nonstop talking alarmed his family. He loudly proclaimed that he was not in need of treatment, and threatened legal action against the hospital and police. The family reported that a month prior to admission Mr. O'Reilly took a leave of absence from his civil service job, purchased a large number of cuckoo clocks and then an expensive car which he planned to use as a mobile showroom for his wares, anticipating that he would make a great deal of money. He proceeded to "tear around town" buying and selling the clocks and other merchandise, and when he was not out, he was continuously on the phone making "deals." He rarely slept, and, uncharacteristically, spent every evening in neighborhood bars drinking heavily and according to him, "wheeling and dealing." Two weeks before admission, his mother died suddenly of a heart attack. He cried for two days, but then his mood then began to soar again. At the time of admission, he was $3000 in debt and had driven his family to exhaustion with his excessive activity and over talkativeness. He said, however, that he felt "on top of the world". A man, aged 32, was admitted to a psychiatric hospital. Two months before commitment the patient began to talk about how he had failed, had "spoiled" his whole life, that it was now "too late." He spoke of hearing someone say, "You must submit." One night his wife was awakened by his talking. He told her of having several visions but refused to describe them. He stated that someone was after him and trying to blame him for the death of a certain man. He had been poisoned, he said. In the admission office of the hospital he showed many mannerisms, lay down on the floor, pulled at his foot, made undirected violent striking movements, again struck attendants, grimaced, assumed rigid postures, refused to speak, and appeared to be having auditory hallucinations. He was at once placed in a continuous bath where, when seen later in the day, he was found to be in an unresponsive state. His face was without expression, he was mute and rigid, and paid no attention to those around him or to their questions. His eyes were closed and the lids could be separated only with effort by a doctor. There was no response to pinpricks or other painful stimuli. For five days he remained mute, negativistic, and inaccessible, at times staring vacantly into space, at times with his eyes closed. Prior to being admitted to the hospital, Archie, a forty-year-old male, provided the following description of how he had been feeling over the last several months. "There is a particular a kind of pain, elation, loneliness, and terror involved in this kind of madness. When you're high, it's tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the ability to captivate others a felt certainty. There are interests found in uninteresting people. Feeling of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one's marrow. But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption upon friends' faces are replaced by fear and concerns. Everything previously moving with the grain is not against -you are irritably, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end for madness carves its own reality."
Diagnostic Label:
Recommended Treatment(s): It takes the greatest effort to get out of bed in the morning. I am tired all day, yet when night comes, sleep evades me. I stare at the ceiling, wondering what has happened to my life, and what will become of me. Nothing is getting done at work. I have projects to complete, but I can't think. I try to focus on my work, and I get lost. I keep wondering when the boss will discover how little I have accomplished. My wife does not understand. She keeps telling me to "snap out of it." I'm irritable all the time. I often yell at the kids, and then I feel terrible later. Nothing is fun anymore. I can't read, and the music I used to enjoy so much does nothing for me. I am bored, but I feel like doing nothing. There are times that I think that life is hopeless and meaningless, and I can't go on much longer.
Diagnostic Label:
Recommended Treatment(s): Melanie Johnson is a 35-year-old accountant who moved to Green Bay, Wisconsin, two years ago from her hometown of Sarasota, Florida. Beginning this past November, for the first time in her life, Melanie began experiencing periods of depression, lethargy, and excessive sleeping. In addition, she noticed that she was eating more than she had previously, and as a result, had gained 10 pounds. Melanie's condition remained unchanged for several months until she began to notice an improvement in her mood the following March.
Diagnostic Label:
Recommended Treatment(s): Joe saw a good deal of active combat during his service in the military. Some incidents in particular had never left his mind - like the horrifying sight of Gary, a close comrade and friend, being blown-up by a land-mine. Even when he returned to civilian life, these images haunted him. Scenes from battle would run repeatedly through his mind and disrupt his focus on work. Filing up at the gas station, for example, the smell of diesel immediately rekindled certain horrific memories. At other times, he had difficulty remembering the past — as if some events were too painful to allow back in his mind. He found himself avoiding socializing with old military buddies, as this would inevitably trigger a new round of memories. His girlfriend complained that he was always pent-up and irritable - as if he were on guard, and Joe noticed that at night he had difficulty relaxing and falling asleep. When he heard loud noises, such as a truck back-firing he literally jumped, as if he were readying himself for combat. He began to drink heavily.
Diagnostic Label:
Recommended Treatment(s): "They are following me. Quick, hide behind the stacks." Beth, a nineteen year-old college freshman, dragged her startled classmate by the sleeve as she peered between some books on the library shelves. "What are you talking about?" asked her friend. Beth cupped a hand over her friend's ear and whispered, "They watch me all the time. They don't think I recognize them just because they disguise themselves as teachers or students. But I can tell. I see right through their tricks." The other girl backed off and tried to gauge Beth's seriousness. Beth stepped close to her and said in an insistent whisper, "It's the Soviet KGB and the radical terrorists who are out to get me. They shoot electronic waves into my house to try to brainwash me. They douse us all with impulses to soften our brains and our resistance, and then they pipe preprogrammed thoughts into our heads. It's all part of their conspiracy to gain worldwide mind control." The other girl was backed into the far corner of the stacks by now, and, a little frightened by Beth's vehement accusations, she avoided her penetrating gaze. "You," muttered Beth, pointing a finger. "They already own you. I see it in your eyes." "Beth, I have to get to class," said the girl as she tried to squeeze past. "I knew it all along," said Beth, fleeing from the girl. "They've got you in their power just like they have seventy-five percent of the kids in this school."
Diagnostic Label:
Recommended Treatment(s): 10th Edition•ISBN: 9781305498204 (3 more)Wayne Weiten180 solutions
13th Edition•ISBN: 9781337594486Lori Watson, Patrick J. Hurley1,967 solutions
3rd Edition•ISBN: 9781506330693 (1 more)Joyce Munsch, Laura E. Levine465 solutions
3rd Edition•ISBN: 9780495914976E Bruce Goldstein, Robert Hershberger150 solutions