By Tim Stevens
Phil Sheldon is a middle aged adult male. Physically, he appears to have recently be in average shape, but due to his cancer this is no longer the case. The client's other noteworthy Axis III information is that he has lost sight in one eye. However, despite making his living based on his ability to "capture" what he sees as a photographer, this loss of vision has not impacted his career at all.
Sheldon presents as tired and frustrated much of the time. He can occasionally lose himself in a memory or thought and will, in essence, "disappear" from session for a bit. At these times, his speech often trails to a mumble or simply stops. However, given other observations, it is the feeling of this writer that this is not a sign of dissociation or any mental difficulty but rather the way Sheldon has processed his thoughts for
some time. Given the often solo nature of his job and his already reticent constitution, it is likely he spends long periods of time by himself and is therefore given to such presentations. Following each of these episodes in session, he is able to return quickly, to recall what was being discussed, to indicate what he was thinking about, and to explain why that distraction occurred to him in that moment. Thus, while frustrating, the writer detects nothing clinically wrong with this presentation.
His seemingly perpetual exhaustion and consistent frustration, however, are causes for concern. Some tiredness, given the nature of his medical condition, is to be expected. However, it is the assessment of the writer that the client's fatigue goes beyond this level. The client also acknowledges this as possible and says that others have indicated it as well. Specifically, it was the comments from co-workers at the Daily Bugle and his oncologist on the matter that convinced Sheldon to seek out psychological help.
The client's thoughts, as of late, have been dominated by two large subjects. The first encompasses his disease, the reality that he will probably die from it, and his fear of both his mortality and the awful pain of the treatment that might not even save his life.
The second is his book project which he says will focus on exonerating and restoring hope in the super hero community. He admits that because he is often consumed by these thoughts and feelings, he finds it hard to engage socially in ways that were once easy, has been putting off treatment, has been dodging his wife, and generally has been detached from his own life.
Based on these factors, the writer is diagnosing Sheldon as being in the midst of a depressive episode, as many would when placed in his situation. He feels betrayed by his own body and betrayed by the world around him that refuses to see the goodness of those he labels "Marvels," instead choosing to hate and fear them. It is understandable, but it is still problematic. Depression will make his illness more difficult to fight and his book more difficult to complete.
Therefore it is the recommendation of the writer that the client continues weekly therapy and begins to attend group therapy for cancer sufferers and survivors. Additionally, Sheldon is being referred to a psychiatrist for an assessment and possible prescription for a low-level antidepressant to be used temporarily until he can better manage his mood.
Phil Sheldon's next appointment is set for February 25 and will be conducted by Doctors Kurt Busiek, Roger Stern, and Jay Anacleto. Their report can be found in MARVELS: EYE OF THE CAMERA #4.
Tim Stevens is a Mental Health Supervisor currently pursuing his Psy D who has experience in dealing with individuals with depression.
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