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By Tim Stevens
Tony Stark is an adult male who appears to be of above average physical health. He generally presents as friendly, intelligent, and relaxed. It is clear from his speaking style and manner that he grew up in an upper class setting and has received a top notch education. As noted, the client is typically loose and inviting in conversation, but can quickly close off to the writer when
a subject is raised that the client does not feel as comfortable discussing. This is particularly the case when matters related to the so-called super hero Civil War or the ongoing struggles with registering super humans are mentioned.
Currently, Stark serves as head of both the multinational peacekeeping force S.H.I.E.L.D. and of his own company, Stark International. The client also continues to serve as the armored hero Iron Man and, in that capacity, serves on the officially sanctioned team of costumed heroes known as the Avengers.
Stark has had an Axis I diagnosis of alcohol dependence for some time. The disorder is currently in remission and the client continues to "work the program," utilizing the connections he has made through Alcoholics Anonymous, including a fellow super hero whom the client declined to name. As this is part of the AA creed, protecting the anonymity of others, the writer does not see this as being any cause for concern.
What has not been formerly diagnosed on Axis I, but in the opinion of the writer should be, is major depressive disorder. By the client's self reporting, he has experienced at least two episodes of it in recent history: when S.H.I.E.L.D. attempted to take over his company by buyout and when Obadiah Stane seized Stark International. While both episodes were fueled by alcohol it is the diagnosis of this writer that the depression led to the alcoholism, not vice versa.
Complicating Stark's mental health matters are the health issues found on Axis III. The client has experienced a history of cardiac and neurological difficulties. These difficulties have necessitated, in the past, the need for a rechargeable chest plate and the need to be placed in suspended animation. While it does not appear that either condition is an issue for the client any longer, this bears watching.
More troubling is Stark's recent infection with the experimental disease known as the Extremis process. While the client reports it has been a boon for him, the writer has found that several exposed to the disease prior to Stark died and there is little evidence available regarding its benefits.
As such, it is the recommendation of staff that the client be closely monitored, with weekly physical exams, until such time as conclusive data on the health benefits of Extremis can be generated.
The client has partially met personal goal #1 (maintaining sobriety). While he has not had a drink in some time, he also has not attended any meetings because, he claims, he's "too busy." The writer has informed the client that this is the claim of many who lose touch with the program and thus relapse and the client has said that he will consider this information.
The client is also struggling with personal goal #2 (being open and honest in communication). He continues to be prone to secrecy and manipulation, something the client acknowledges often leads to feelings of intense guilt. His current position at S.H.I.E.L.D. complicates matters as secrecy and manipulation are oft considered part and parcel of the job. Recommendations that he take a leave have not been accepted.
Going forward, as noted above, it is recommended that the client better utilize opportunities for group therapy and continue to attend biweekly individual therapy sessions.
Tim Stevens is a Mental Health Supervisor currently pursuing his Psy D who has experience in dealing with individuals with co-occurring disorders.
"Iron Man" DVD and Blu-ray on sale Tuesday, Sept. 30. Preorder the Iron Man DVD now in a two-disc special edition, a single-disc edition or an ultimate two-disc Blu-ray edition. And be sure to head over to the official Iron Man movie site.
Want to catch up on your Iron Man reading? Check out this list of essential comic collections. And don't forget to head over to Marvel Digital Comics Unlimited for all the Shellhead stories you can handle!