Catcher in the Rye: Mental assessment
!.?. !? Psychological Examination Princendale Psychiatric Hospital Name: Holden Caulfield Examination Date: December 16th, 2012 Case No: 1124 3553 Admission Date: December 10th, 2012 Function for Examination: The patient is a 16 years of age, single, white, male. He is presently a junior in high school and was recently expelled from his boarding school Pencey Prep in Agerstown Pennsylvania, where he was the manager of the fencing group. Family confessed this client after suffering a nervous breakdown. The function for the present evaluation is to determine whether the client struggles with any mental illnesses.
Evaluation Procedures: · Clinical Interview · Psychological Status Examination · Physical exam · Beck Depression Inventory (BDI) · Blood Test · Case History Evaluation · Physical tests as well as lab test are carried out to dismiss the possibilities of the client having a major health concern, which could cause indications of a mental disorder. Background Information:
Based upon the medical interview of the patient I had the ability to figure out that the patient has a difficult time interacting with his peers. He seems really discontent with society and tends to separate himself from those around him. The patient has a really tough time getting in touch with his peers and is unable to correctly socialize with others. The client speak about not liking humankind however then will typically ask previous good friends to join him for a beverage. He can usually only hold a discussion with an adult figure or a person of authority such as his former English teacher, Mr Antolini and his former history instructor Mr.
Spencer. The client was also able to communicate with Ms. Morrow. The client voluntarily isolates himself from society and thinks that all those around him are “fake”. He mentions that he wishes to become the catcher in the rye and conserve children from growing up. The patient is convinced that growing up immediately makes you an individual who is very bogus. The patient’s usage of the term phony is superficial; it provides the sign that his use of the term bogus makes the clients own understanding of individuals aside from himself superficial.
The patient highly slams individuals who are what he would describe as “uninteresting, insecure, and fake “. Holden feels victimized by the world around him and he feels as if he does not belong. He believes that no one has the ability to relate to him, since of this the client is a very lonesome person and chooses to not interact with his peers or those around him and regularly alienates himself from society. This client does not fulfill the scholastic requirement and does not actively participate in school. Although he handles the fencing group his academic grades are rather low.
He previously attended four different boarding schools. 3 of which are Elkton Hills, Whooton School, and Pencey Preparation. The client was expelled from all of the schools he previously attended due to the fact that of his bad grades. He refers to the previous learning institutions that he attended as phony. He thinks that these institutions were filled with burglars. This client have a minimal amount of buddies at the schools he formerly went to, he did not try to interact with others. This patient has no genuine ambitions or objectives he wants to accomplish in his life time.
He seems very intelligent but does not have the inspiration to put forth effort in his studies. This patient is really capable of academic success if the effort was put forth. The moms and dads of the client were unaware that the patient had actually been expelled from his most recent school. The patient is the kid of a rich business lawyer and a society female mother. His family is very conservative and seems rich. He is the second of four children. The patient’s earliest brother or sister D. B Caulfield is utilized as a writer for Hollywood films.
The patient considers his brother very bogus and does not appreciate the reality that he selected to compose films for Hollywood and transition out of composing narratives, which the patient utilized to delight in. The patients younger bro Allie Caulfield died of leukemia three years prior to the patients admittance. The patient was really near to his brother and was distressed by his death. This caused many emotional issues for the client. The patient is really close to his younger sister Phoebe Caulfield who is ten years old. He believes she is the only one who is able to understand and connect to him.
The client shows that his sister is really intelligent and is able to understand how the client feels and has the ability to listen to him. The innocence of the patient’s sibling is one of his only sources of happiness. The patient points out that his family background is a concern on him. He is saddened by the occasions that have taken place in his life. He feels that he is not very near his family due to the fact that they are still experiencing the death of his younger sibling Allie. The client is unable to hold a proper relationship. He has a hard time initiating a discussion particularly with a person of the opposite sex.
This patient does not have correct communication abilities and appears to be immature when it concerns holding a conversation, which results in him not having many buddies. It appears that a lot of the client’s peers would like to befriend him however because of his improper behaviour they rapidly grow remote from the patient. The patients roommate Ackley attempts to befriend the client and the patient treats his with disrespect and only picks to relate to Ackley if he is struggling with monotony or is in need of some attention.
He has actually not attempted to contact Ackley since the patient was expelled from Pencey. The client recently reunited with a previous girlfriend Sally Hayes, after going out one night the client started to argue with Sally causing him to openly yell at her, forcing her to leave. Another female good friend of the clients Jane Gallagher appears to be very essential to the patient. He frequently discusses her however throughout him current time in New York the patient never called her. The patient explained that he tried to call her but was too scared to call her and would always postpone the act.
Although the client never ever in fact contacts Jane, she is one of the only females the client truly appreciates and discovers attractive. The patient in general does not have many friends and tends to spend most of his time alone. The client appears to resort to alcohol and tobacco as a source of comfort. Throughout his visit to New York the client spent lots of nights at regional bars and clubs drinking alcohol. Although the patient is under age it seems very simple for him to be able to have access to alcohol. He client invested lots of nights drinking and smoking cigarettes. The client frivolously invests cash, the majority of it being invested in alcohol.
The patient seems to react to arguments with excessive anger. He initiated a battle with a previous roommate at Pencey Preparation called Stradlater. The client continued to attempt to fight his roommate since he presumed Stradlater maltreated Jane Gallagher when they headed out one evening. The patient did not have any considerable proof that Jane was maltreated. Another dormitory mate of Holden who’s name is James Castle committed suicide after being bullied by other students. The client saw his suicide and this considerably impacted Holden. The client was offered a woman of the street one night while in New york city.
He decided he did not want to become intimate with her and when she left the client did not pay her the appropriate amount resulting in the patient being hit by the man who offered him the woman of the street. The client mentioned that the hit made him feel as if he were shot and the client believed that there was a possibility that he would undoubtedly pass away. The patient’s mom ended up being very unsteady after the death of Allie and constantly worries; this has ended up being a burden on the patient. Psychological Status Examination: Depression: After conducting numerous tests on Holden Caulfield and reviewing his signs, it is apparent that he struggles with depression.
Common signs of anxiety are; unhappiness, difficulty making decisions, possible ideas of death of suicide, tiredness, and problem sleeping. In my opinion the trigger for the clients anxiety is the death of his more youthful brother Allie. It is apparent that the client has actually not been able to correctly cope with his brothers death and this could be due to the fact that he was not able to attend his brother’s funeral service. Due to the fact that of the death of Allie, Holden wishes to protect the innocence of youth since his bro lost his so young due to his fight with cancer. Holden’s failure to keep kids from growing up problems him.
The client likewise is distressed by the fact that he is extremely lonely and does not have a female companion. The client displays other typical signs of anxiety such as difficulty making decisions. Holden is unable to chosen what he wishes to carry out in life. The clients shows indications of being unable to chosen whether or not he is capable to handle the role of a grownup. He is not able to make simple decisions and typically alters his mind as the eleventh hour such as when he wanted to end up being intimate with the prostitute at the Edmont Hotel in New York City, but then rapidly decides he no longer wants to.
The patient is not able to decided whether he wishes to get in touch with Jane Gallagher and spends many hours contemplating this act and never does goes through with it. The patient also shows thoughts of death or suicide. After the woman of the street left his hotel space Holden pondered jumping out the window. Holden also mentioned that he is happy that the atomic bomb was created which if there was another war he would volunteer himself to sit straight on top of the bomb. The client discusses trouble sleeping and enormous fatigue. He explains that while in New york city he was not able to sleep.
Holden likewise discusses that the movies make him depressed and while in New York anything he experienced that would advise him of a film would make him feel upset and “depressed”. Judging by the patients signs and medical examination it is extremely clear that he suffers from serious anxiety clearly triggered by his distress which the world around him. It is apparent that he is saddened by the world around him and his impression on society provokes his feelings. Anxiety Condition: Based upon the information gotten from the Scientific Interview is it apparent that Holden Caulfield struggles with anxiety.
Common signs of anxiety are, stressing, belief that bad things will happen, trouble focusing and being easily overwhelmed. Holden displays all of the signs listed. The client has mentioned to me several times that he does not particularly like society. He thinks that all human who have actually maturated and as Holden words it “lost innocence”, are phonies. Holden thinks that by children connecting with adults they will loose their innocence and also become a “counterfeit”. It is also evident that Holden has problem focusing and can become extremely irritable.
While conducting the interview Holden had difficulty addressing simple concerns and was unable to focus on a particular topic that we were speaking about. Holden likewise mentioned that when he speaks he can never ever stay with one topic or end up a story. The patient appears to be easily overwhelmed. He points out that while in New york city he was walking down Fifth Avenue and witnessed some children playing. Holden said that this made him very overwhelmed thinking of children loosing their innocence. Holden easily become overwhelmed at the thought of kids.
The patient easily ends up being worried and this was activated specifically when his roommate Stradlater when out one evening with Jane Gallagher. Holden constantly stressed over the possibilities of Stradlater not treating her right. There are likewise physical signs displayed by Holden that lead me to think he experiences stress and anxiety. Someone with anxiety will experience queasiness caused by the consistent worrying. Holden discusses that he frequently feels sick and gets sick. After his day at the zoo with his sis Phoebe he mentions going home and getting ill.
Holden also discusses dizziness and fainting while going to the Museum of Natural History which are also physical symptoms of stress and anxiety. It is my expert viewpoint that Holden struggles with a small case of anxiety disorder. It is apparent that daily life is overwhelming for Holden and he is constantly worrying about society. Bipolar Disorder: The client shows lots of symptoms associated with bipolar disorder. Common symptoms of bipolar illness are outbursts, separating yourself from society, misconceptions and hallucinations, problem sleeping in addition to physical symptoms such as weakening of the body and loss of appetite.
Holden seems experiencing all of the noted symptoms. Holden appears to easily become overwhelmed leading to outbursts. After the death of his bro Allie, Holden points out that he ended up being so furious that he continued to type a glass window from his garage resulting in a damaged hand. Since of this Holden was hospitalized and was unable to attend his sibling’s funeral service which devastated his. As discussed prior to the patient attempted to fight his former roommate Stradlater after he returned from his date with Jane Gallagher. Holden assumed Stradlater maltreated Jane and tried to hit Stradlater.
Holden also mentions that he yelled at Sally Hayes in public after skating at Radio City resulting in her leaving. Holden tends to completely isolate himself from society due to the fact that of his viewpoints. Holden’s judgements about society are really harsh for that reason he has a hard time to form relationships with his peers. Holden mentions that if he is feeling extremely lonely he would ask him former dormitory mate Ackley to go out however otherwise he dealt with Ackley with disrespect and was not really nice to him. He likewise discussed that one night in New York he contacted an old buddies named Carl Luce and asked him to go out for a drink.
Generally Holden selects to be alone and separate himself from everybody including his household because he considers them all phonies. Nearing the end of Holden’s journey to New york city he discussed he began to experience hallucinations. While strolling down Fifth Avenue, Holden points out that each time he came to the end of the block he felt as if he would not be able to cross the street, he believed he would disappear if he marched into the street. In order to cross the street Holden started to talk to Allie and would ask him to make sure he did not disappear. Holden seems delusional.
He thinks everyone is fake and that the loss of innocence is dreadful and kids ought to no experience it. Holden is convinced that maturing makes you a bogus individual. Holden likewise thought while in New york city that he had Pneumonia and he was accepting the fact that he was going to die. He also mentioned checking out a post on how if you establish sores in your mouth there is an opportunity you have cancer, and Holden believed he had cancer. Holden starts to believe whatever he hears. Throughout Holden’s examination he points out sometimes that after leaving school to go to New york city he had numerous sleepless nights.
He would depend on all hours of the night and day because he was unable to sleep. Accompanied by numerous sleep deprived nights Holden mentions his loss of appetite. He mentions that if he did eat it would usually just be a cup of coffee and a swish cheese sandwich. The lack of food in Holden’s system makes his body end up being very week, Holden points out that his final day in New york city he felt really ill. This is the outcome of absence of food and correct nutrition along with absence of sleep. Anxiety absolutely plays a factor in the way Holden acts and feels.
Post Traumatic Tension Disorder: Post Traumatic Tension disorder otherwise referred to as PTSD is apparent in Holden Caulfield. Post Traumatic Stress Condition is generally caused by a painful memory or event that took place in someone’s life time that significantly affected them. Typical symptoms of PTSD are, continuously reliving the traumatic experience in your head, avoiding activities and social interaction and absence of sleep. Holden plainly shows all of these signs. As mentioned previously Holden lost his brother Allie to leukemia three years prior to his examination.
Holden was unable to participate in the funeral since of a broken hand. Although Holden’s sibling was much more youthful they were very close and Holden considered him really smart. Holden was ravaged by the death of his sibling and has actually been isolating himself and withdrawing himself from society because his death. Holden likewise experienced the suicide of a former dorm mate James Castle who dedicated suicide after being bullied. Holden witness James fall out of the window and saw his body lying on the ground. This significantly affected Holden and changed his thoughts on society and how people deal with one another.
Due to the fact that of these occasions Holden avoids everyday activities and does not participate in gatherings. He pointed out that before leaving Pencey there was a football game however he decided he wished to visit his old history teacher Mr. Spencer rather. Holden avoids going out with his peers unless he feels extremely depressed or lonesome. Generally Holden is extremely judgemental towards those around him, for that reason he does not have many good friends. Holden mentions that sometimes he will ask his former roomie Ackley to go out to consume. As mentioned in the previous paragraphs Holden likewise does not get much sleep.
It is apparent that the client is unable to move past these two terrible occasions in his life. He seems to include them into his daily life triggering him to withdrawal from society and be really harsh and judgemental towards others. Holden does not want other children to loose there innocence so early like his brother Allie did to cancer. He feels that he can maintain innocence and by not having the ability to do that Holden feels a sense of vulnerability. Holden points out that he feels very yellow and it shows when communicating with him. It appears that Holden is struggling with PTSD.
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Treatment: After over looking the patients mental illnesses and symptoms I have developed an assortment of medications that ought to help handle the symptoms of the diseases. The patient will be placed on Abilify for bipolar disorder, Symbyaz which is a combination of Prozac and Zyprexa. This will be used as an anti depressant. Cipralex will be given to the patient to handle his stress and anxiety and Trileptal will be given as a mood stabilizer to assist the client with his outbursts. I recommend the patient get weekly counselling or treatment to help eliminate his stress and anxiety.
This will likewise assist the client discover to handle his signs and it will teach him the fundamentals to be able to work through his issues. In addition this will assist Holden find out to control his emotions and help him believe more positively. In addition to medication and counselling I would like the patient to invest more time with his household. The presence of his household will help him understand that he has a strong support group that will be there for him in his time of requirement. A combination of these medication and therapy will help Holden live a better and more well balanced life.