Case Notes
Session 1:
New client intake. Louis P. is a Caucasian male of undisclosed age. Well dressed. No reported health problems, but physical condition appears poor. Face, gaunt. Gaze, dull. Skin, pale, like marble. Eyes, red, hyper-dilated. Client reports being unhappy about his current lifestyle. Practices “vile and morally repugnant” behaviors which cause him to “sleep all day and stalk the lonely streets all night, haunted by an insatiable thirst.” Client has no “living friends.” Ruinous existence has “estranged him from humanity.” Describes himself as “evil in a handsome human guise” and “damned in mind and soul.” Client seems persistently ambivalent and brooding. No insurance.
Session 2:
Client on time. Reports having normal amount of sleep, then game of chess, before going out, around midnight. Client is encouraged to practice evocative change talk. Client counters he can’t change, because he is “dead and therefore changeless.” Swearing he will “roam the earth as a lone predator, condemning legions of mortals to a fate worse than hell,” client is again encouraged to look ahead with optimism. Client agrees. Optimistically, then, says he will probably “spend the rest of eternity feeding on rats, stray dogs, and feral tomcats and eventually shrivel up “like a grotesque, half-starved mummy.” Client is dark, mordant, hopeless. May even be French. Time is up.
Session 3:
Client again on time. Reports a satisfying night in which he “drained the mortal coil of every unsuspecting innocent that stumbled across his path.” Client is informed that comments like “drained the mortal coil” and “goodness is eternally difficult” sound like a lot of negative self-talk. Client is persuaded to try positive affirmations. Client refuses. Points out that his female neighbor once “recoiled from him in horror.” States that he often “lurks in the shadows until people feel his breath against them, and suddenly know they aren’t actually alone.” Client denies these people are simply startled, or a little bit drunk. Rather, he says, they’re in a state of “sheer mortal panic,” and most are subsequently “gone, dead, dead, dead, without ever knowing who or what he is.” Client then laughs, wickedly. Client may be resistant.
Session 4:
Client arrives early holding a black candle, a self portrait, and several strands of human hair. Claims they belong “to an artist friend who has offered himself, undyingly, to the grim reaper.” Client agrees to leave these items in the waiting room, and try decisional balancing. Admits that his behavior makes him feel an “uncanny warmth,” the sense of being “intensely alive,” and some “pretty long, crazy dreams.” On balance, client says nothing can lure him away from this behavior. For one thing, he has a young daughter who is “not his own flesh and blood. Just his blood.” Client also has a partner, who goes by nickname “the master.” Client describes him as a “messenger of hatred, dressed in silk and lace, who always comes to put out the candles.” Client then leaves abruptly, to resume the “never ending search for something…. something.” Client possibly on verge of breakthrough. Revisit the master!
Session 5:
Client late. Seems ready to discuss powerful emotional obstacles. Asked if he had a “difficult” evening with his family, client answers “yes, if difficult means the carnival of terror that descends when monsters turn on each other.” Client states that his daughter is a “beautiful demon child” who “feels almost nothing.” Also says she is a “true fiend, who only experiences intimacy through killing.” Client is encouraged to say more about this. Says that when he finally summoned the courage to discuss her orphan past, his daughter cried tears tainted with blood, proclaimed that the sleep of sixty-five years had ended, then tricked the master into drinking absinthe-laced blood, burned his corpse with an oil torch, and buried his remains in a swamp. Before end of session, client flies out the door, terrified that the master may survive, reconstitute his undead form, and return to take his ultimate revenge. Client was possibly NOT ready to discuss emotional obstacles.
Session 6:
Client late again. Reports having engaged in a “late-night feeding frenzy that ended in the destruction of a holy cathedral, and the blackest of silences for its corrupted communion of saints.” Client is reassured that his fears of change are normal. Client is advised that typical symptoms of behavioral change include anxiety, weight gain, and disruptive mood swings. Client sits motionless, with piercing stare. Client dismisses normalization as a hollow inventory of mortal clichés. Client is asked to lower his voice, but insists there is “no human cure for his supreme isolation” and that he “has never belonged anywhere, with anyone, at any time.” Client is informed he may be having a disruptive mood swing right now. Client retorts that he would rather “claw his way through moist earth, pry open a buried coffin, and sleep on top of a decomposed corpse,” than spend one more minute doing “whatever this shit is.” Unexpected motivational downturn.
Session 7:
Client arrives for one-week progress assessment. Reports having some lingering cognitive contradictions. On a scale of 1 to 10, reports his readiness for change as “well below zero.” Client admits he was ambivalent, and wanted to interview, but this was “not the kind of interview he had in mind.” Prefers to find someone who will take notes, and “say nothing else.” Given this new information, client is released from motivational therapy. If he wishes to resume treatment in the future, he is advised to find a Freudian therapist. For deep psychoanalysis. Possibly for the remainder of eternity.
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Erin Clune is a freelance writer, living in Madison, Wisconsin. Her writing has appeared in Thought Catalog, The Rumpus, Gulf Stream, America Magazine, and on several public radio programs, including All Things Considered. Locally, she writes mostly about beer and cocktails, and that suits her just fine.