Treatment course)
The summary of A’s treatment course was as follows.
February, 2nd, 20XX
A visited my clinic for the second time. I further asked her about her past experiences. She stated that she has never been really understood by any psychiatrists that she ever met, and she no longer wanted to visit psychiatric clinic any more, unless she was urged to do so by her mother. She also said that she was recently officially fired by her current workplace. When she was told that she should quit, she could not really understand what was happening. She then became “another me” and could not come back for a while. This was her first statement suggesting the presence of another identity. When I clarified with A about it, she stated that until this time, she tried to hide that she has another part inside of herself. She said that she calls this identity “the negative of myself”, and said that she tends to switch into this identity when she has sudden disappointments, such as being stood up by her boyfriend or having any mistakes in her job pointed out by her boss, etc. In these occasions, she feels that she is not wanted by anyone, and then suddenly her memories get fuzzy.
I began to gradually grasp the global picture of A’s life. She likes to interact with people and loves to help others. The problem arises when she expects others to return in kind and gets deeply disappointed if she cannot get it. A then often switches into childish identity while A herself shuts herself up in her internal den and would not come out for a while.
A stated that initially she just wanted get some antidepressant prescribed, but she then changed her mind and now wants to have more chance to discuss with me, such as on weekly visits. I explained to her that my work schedule allows only half an hour session biweekly at best and I would love to refer her to a therapist. I then asked Dr. B (middle aged female psychologist) to meet with her for weekly sessions besides her bi-weekly visit with me, and A agreed with this arrangement.
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