Probably for confidentiality reasons, Dr X took a fictional character as a sample rather than trying to camouflage a real patient. This is my idea of a real diagnostic impression of a patient without a major illness (eg dementia, schizophrenia, narcotic addiction, melancholia and major depression, bipolar disorder, etc.).
He briefly covers the defensive structure, the character structure, the basic conflicts as they relate to the person's life. Outside the major ailments, the DSM is useless in depicting a patient - a person with his flaws and weaknesses. In these times of the the low-rent superficial, check-list, cook-book Psychiatry, I find internists often more interested in the whole person than some Psychiatrists who just want to give you the right pill without delving into your psyche beyond the surface complaint. In my view, that is not serious medical practice. I do not approve of it, nor do I think it is cost-effective in the end. Some people are attempting to hyper-medicalize and simplify my field of work, but the human soul is too complex for that to work most of the time.
My field is deeply divided these days. It makes things interesting, controversial, and sort-of fun.
Unlike Dr. X, I never write these things down anymore. It takes too much time, can be subpoenaed and distorted in divorce court (some bad experiences with that before I quit writing things down), and otherwise nobody will ever read it before it is shredded. However, I store them in my brain. My brain has plenty of storage capacity.
I will re-post, for those who might be interested, my series on serious diagnosis over the next few days.
Character is destiny. Mostly, except for bad luck.
