MANIFEST I

PSYCHOTHERAPY NOTES

Date: 2-15-2021

Professional: Malcolm White

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PATIENT #353587-839311 SIMON HALLORANN

Session 1

Visited patient at HCA Florida St. Petersburg Hospital. Patient’s primary care physician expresses concern at the lingering distress from a seizure episode in October 2020. MRI & EEG returned no abnormal results.


SUBJECTIVE

Patient demonstrated extreme distress on my arrival. I have included an abridged transcript of my first moments with the patient below.


Patient: Who are you? Who are you?

Me: I’m Doctor White. I’m just here to talk with you. I want to help.

Patient: Why did you close the door?

Me: So we can be alone, Simon.

Patient: Go away! I know what you are! Don’t get near me!

Me: (Indicating a potted miniature tree on his bedside table) That’s a nice plant. Who got that for you?

Patient: No one. It’s dead. They won’t let me get rid of it.


At this point, the patient’s distress at my presence appeared to transfer to the potted tree. The patient stared fixedly at the tree throughout my questioning, answered distractedly, and refused to meet my eyes.


Me: You said you know what I am. What did you mean?

Patient: Nothing. I want my mom.

Me: Don’t worry. I’ll get her for you. But first, we need to talk. Why don’t you tell me what you remember about your episode in October?


The patient reported no memory of the event, and again asked to speak to his mother. My understanding is that he has two “mothers” — his biological father is transsexual — so I pressed him for clarification. Which mother did he want?


The patient avoided this question rather adroitly and asked me, once again, who I was and what I wanted. I repeated that I was Dr. White, here to help him: specifically, that I was here to learn why he was still bedridden following a single seizure several months ago, despite having no measurable physical symptoms.


The first step with a difficult client, especially a child, is to acclimate them to my presence. I expect to spend the first few sessions alleviating their suspicion. My hope is that Simon will soon understand I am not going away.


OBJECTIVE

Patient is listless, distressed, and paranoid.

All medical tests have returned results within normal range.


ASSESSMENT

Notes on these sessions will have no attempts at any formal clinical diagnoses, of mental health conditions or otherwise: I am here to treat my patient, not to diagnose him.


However: it is my initial impression that the patient is being untruthful with me, particularly with regards to his memory of his seizure event. For a ten-year-old, Simon appears shrewd and calculated. While distressed and frightened, I do not believe he is disoriented or disconnected from reality. His paranoia is not pathological.


PLAN

As stated above. I will attempt no intervention until I am confident that Simon is comfortable with my presence. His trust in me is paramount.


In the next session, I will see if we cannot unearth the roots of his suspicions.