Report on Patient: HOLDEN CAULFIELD. After having twenty-six therapeutic sessions with patient Holden Caulfield, I have seen

Transcription

1 Supernaugh 1 Report: Month 1 Patient: Holden Caulfield Analysis by: Dr. Jessica Supernaugh Overview: Report on Patient: HOLDEN CAULFIELD After having twenty-six therapeutic sessions with patient Holden Caulfield, I have seen serious signs that he is suffering from Clinical Depression. Holden is currently seventeen years old, tall and thin, and comes from a wealthy family living in New York. When Holden was thirteen years old, he lost a major importance in his life when his little brother, Allie, died from Leukemia. This loss has greatly impacted Holden to this day, causing him to not be able to move past the traumatic event. Since the death, Holden has lost motivation for his education, his relationships, and his life purposes. As a result, he has dropped out of four different boarding schools for his lack of effort in his classes, and disagrees with the way his professors teach. Holden has learned to hate life and society, and often thinks about taking the easy way out and escaping his problems. Furthermore, the patient experiences feelings of loneliness, unworthiness, and exhibits re-occurring thoughts of suicide. Education: During our sessions, Holden has demonstrated his knowledge concerning his lack of motivation for school, and admits he has completely given up. In our second session, he told me about a discussion he had with his previous professor, Mr. Spencer. The two discussed an essay on Egyptians, when Holden proclaimed to Mr. Spencer, I can t seem to get very interested in them although your lectures are very interesting. It is all right with me if you flunk me (12). Holden indirectly admits that he has given up on applying himself in school, when he gives his teacher permission to flunk him. He is interested in learning about the Egyptians, but unwilling

2 Supernaugh 2 to play his part in his education growth process. The patient no longer wants to put in the effort to succeed in school because he is suffering from his brother s loss and depression. Further, as I have found no indication in our sessions that the patient is unintelligent, I believe that the problem lies is in the growing bitterness from his depression and his lack of effort caused by deeper issues. These issues include his resentment towards the school s promoting of conformity, as well as his negativity towards classmates. Holden views school as another object of society that forces its students to conform to the superior s views. He expressed his dislikes about school in our twenty-fourth session, when he explained why he failed his Oral Expression class. He abruptly stated, that digression business got on my nerves...i like when somebody digresses. It s more interesting and all...the boys that got the best marks in Oral Expression were the ones that stuck to the point all the time I admit ( ). The patient is a non-conformist, and does not like how society and people pick on the weak. He does not realize that in order to succeed in school, or in life, a level of conformity is required. In addition, Holden is an outcast in school and views his classmates as phonies. Holden told me that, one of biggest reasons he left his previous high school, Elkton Hills, was because he was surrounded by phonies claiming, it drives me crazy (14). The patient can not stand being around people he refers to as phonies, so he jumps from school to school, even though every place he goes he will continue to find phonies. Furthermore, the patient displays his negativity towards his classmates when he purposely separates himself from social activities. In our first session, Holden immediately mentions that at a school football game, he separated himself by standing up top on a hill next to a cannon, and shot insults at his fellow students (3). After several sessions with the patient, I believe that this social separation comes from his growing depression, and is a defense mechanism to protect his feelings from further lowering of his self-esteem.

3 Supernaugh 3 Relationships: Due to his depression, the patient seeks for companionship, but has weak relationships with females because of his superficial interests and his sexual immaturity. In several of our sessions, Holden has mentioned that he dates a girl named Sally only because she is goodlooking and fun to mess around with, even though he is very annoyed by her and thinks she is a phony (134). Holden continues to date her because he is depressed and longs to have companionship with someone who is interested in him. In session thirteen, Holden discussed his sexual relationships and admitted that he is a virgin (92). He then ventured into saying that he wants to have sex, and that he is a sex maniac, but that he respects women and listens to their requests when they tell him to stop pressuring them for sex. The patient gave the impression that he was ashamed of his respect for a woman s boundaries, when he said you take a girl when she gets really passionate, she just hasn t any brains...they tell me to stop, so I stop. I always wish I hadn t...but I keep doing it anyway (92). Holden s desires combined with the public s view on sex has lead him to feel ashamed, when in reality, he needs to realize that his actions are good. Furthermore, Holden wants to keep people and girls innocent, and believes that by forcing women to act sexually with him, they are loosing their innocence. This happened when he hired a prostitute at the pit of his depression, but canceled on her when he saw that she looked too young and innocent to be a prostitute. The patient told me that he gave her the excuse: I don t feel like myself tonight...i ll pay you and all, but do you mind very much if we don t do it? (96). After watching her interact and viewing the nervousness she was feeling, Holden knew it would feel wrong to have sex with her, and destroy her innocence. Holden turns to sexual relations when he feels lonely as a solution to feel wanted, even though most of the time they leave him even more depressed.

4 Supernaugh 4 In addition, the patient s depression from his brother s death causes him to struggle in practicing healthy friendships with males, such as his school mates Ackley and Stradlater. Holden refuses to have close relationships with guys because he thinks they are phonies. Also, Holden looks for the faults in people and continues to compare those he meets to Allie. This is very destructive to his relationships, since Holden views Allie as the perfect human and as a bench mark as to what qualities a person should posses, even though no one can live up to them. Moreover, Holden once mentioned, in relation to Stradlater and Ackley, I hated them once in a while I ll admit but it doesn t last too long, is what I mean. After a while, if I didn t see them...i sort of missed them (187). This confession shows that Holden really does long for relationships with male peers, but feels he needs to stand up for his cause of not befriending phonies. Life Purposes: After numerous sessions, it has become clear that Holden Caulfield suffers from survivor s guilt, and that his depression has caused him to overlook the value of his life. Since Allie s death, Holden suffers from survivor s guilt, and often wishes he were the one to have died and not Allie (38-40). This shows an utter lack of care for his future, with regret for his own life, and shows that the patient does not view his life as valuable. In several sessions, Holden compares himself to his brother and sister, claiming that he can not measure up to their perfection. In session ten, Holden told me, Allie, the one that died, that I told you about, was a wizard. I m the only real dumb one in the family (67). Again, in session 21, he talked about his sister Phoebe and said that She s very good in spelling. She s very good in all her subjects (160). In these two incidents, the patient can not see the use in trying to succeed in life because he feels he will never be able to measure up to his siblings.

5 Supernaugh 5 Ever since Allie s death, Holden s depression has spread to every area of his life and now causes Holden to feel as though his future is unimportant. In session five, Holden retold me the story of the night he got the news of Allie s death. The disturbing news caused Holden to act out of aggression and harm himself. The patient confessed to me: I broke all the goddam windows with my fist, just for the hell of it...i can t make a real fist anymore...but outside of that I don t much care. I mean I m not going to be a goddam surgeon or a violinist or anything anyway (39). This episode of aggression shows that Holden suffers from Clinical Depression. His statement about not being a doctor or violinist, two skilled and admired jobs, amplifies that he has no goals in life for himself, and believes he can not achieve greatness. Additionally, in our second session, Holden told me that he did not have much concern for his future, which makes me believe that he has no self-worth and is not looking into the future for where he will be five years from now (14). The patient s behavior indicates that he is suffering from depression, as most teenagers his age are concerned with their future. When asked what career Holden is interested in pursuing, he has a difficult time pushing past his depression and pessimistic view on life, in order to formulate up with an answer. The only thing he can think of is to become the Catcher in the Rye. He explains this thought in our twenty-second session together with, I keep picturing all these little kids playing some game...and I m standing on the edge of some crazy cliff. What I have to do, I have to catch everybody if they start running and they don t look where they re going I have to come out from somewhere and catch them...i d just be the catcher in the rye and all. I know it s crazy, but that s the only thing I d really like to be (173). Holden says that if he were to be something, he would essentially want to save children s innocence by being the catcher in the rye. The patient s thoughts are geared towards helping children, and he needs to realize that there are other ways of doing this, but he must apply himself in life first.

6 Supernaugh 6 Prescriptions: In my professional opinion, I am prescribing Holden the antidepressants medication, Adapin, which will increase the amount of serotonin and norepinephrine in the brain. Along with this medication that will help improve feels of anxiety and depression, I am suggesting continuation of psychotherapy to learn to cope with feeling towards Allie s death and its aftermath. In addition, I am requiring that the patient create a list of times when he feels depressed and what is causing the feelings. Furthermore, the patient will write down goals for his future and desires he wants to achieve. On another note, in order to release Holden Caulfield from his destructive behaviors affecting his relationships, I am prescribing group counseling. He needs to change his attitude towards his peers, stop comparing people he meets to Allie, and realize that humans are imperfect. The group counseling will also help Holden look for relationships with people that have similar opinions on life as he does. In order to do this, the patient needs to begin to pay attention to people around him and look for opportunities to start healthy relationships. If Holden begins to have a new outlook on life and people, which will be enhanced though group counseling, he can greatly turn his life and attitude around. Finally, Holden needs to place himself in positions, jobs, or volunteer services where he can assist children and protect them from the dangers of the world. Protecting a child s innocence brings joy to the patient s life, and makes him forget about his depression. If Holden Caulfield takes the medication, partakes in the group therapy, and finds a way to interact with children, he will be able to move past the depression from Allie s death, and live an enjoyable life.

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