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By Tim Stevens
Doctor Bruce Banner is an underweight adult male. He presents as quiet and withdrawn, especially initially. With time, however, the client can be quite engaging in conversation with a skill for listening and moments of understated humor. Regardless of how involved Banner is in conversation, however, he speaks in a hushed tone and struggles with making eye contact. He is hygienic, but seems largely unconcerned about his personal appearance. This attitude extends to his clothes as well as he favors utilitarian items over any sort of fashion.
It is evident that the client possesses an extremely gifted mind, but he is quite humble in accepting compliments or discussing his intellect. Due to Banner's areas of expertise he often discusses things that are significantly too complex for the writer. In these instances, the client shows great patience in explaining the information in layman's terms.
Currently, the doctor is under the care of
S.H.I.E.L.D. at an undisclosed location. At this time, no plan has been determined on when and where the client will be transported away from this temporary location. Grounds for discharge have also not been set at this time.
The client's most prominent diagnosis is Dissociative Identity Disorder. This illness was most likely brought on by the severe abuse that Banner received as a child at the hands of his father. It was further acerbated by patterns that this forced Banner into following his childhood. While never outright abused, he was repeatedly bullied and taken advantage of by those in power. Due to his childhood abuse, the client had, in essence, found that his anger (and other emotions) were ineffectual in protecting him and that simply yielding to his aggressor seemed to provide him the most protection. Thus, in his later relationships, he was unable and unwilling to be assertive because he had "learned" that such tactics would ultimately fail.
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However, ignoring or denying emotions does not make them go away and the client's mind reacted to the undue stress by developing "personalities" that could deal with and express anger. This process was made manifest when Banner was exposed to gamma radiation and his alter ego, the Hulk, was created. (For further information on the Hulk please see my
case notes
Since then, much of the client's life has been dominated by either denial or attempts to destroy his other side, coupled with ever-growing guilt about failing to do so. Eventually, Doctor Leonard Sampson was able to use hypnosis to create a dominant personality that was able to effectively regulate the client's various identities. The price was, however, the loss of Banner's body, both literally and psychologically. The "integrated" Banner was, in fact, a Hulk known colloquially as the "Professor Hulk."
This status has since reverted and Banner is once more capable of taking either form. Either due to choice or the conditions S.H.I.E.L.D. is currently keeping him in, Banner has remained the dominant form since coming into custody.
Recent events, specifically "World War Hulk," have further complicated the client's psychological state. While the injustices that occurred concerning his banishment and the death of his alter ego's wife were primarily Hulk-related, Banner feels them. Thus, he feels betrayed by peers he had trusted for some time and grief stricken at being a widower once again. There are also feelings of guilt churned up by this as both his first wife Betty and his second wife
Caiera arguably died because they were a part of his life.
Therefore, the first recommendation of this writer for the client's treatment plan is monitored mediation sessions between himself and those he blames for his time in space and his wife's demise. Initially, the sessions should be conducted as a group before progressing to one-on-one meeting as a baseline level of dialogue is established.
The second recommendation concerns Banner's emotion regulation. It is unlikely that the client will ever be free of this alter ego. Therefore, the client's hope of
psychological equilibrium lies with his ability to control his emotions and, thus, control his "other." To this end, it is the writer's opinion that the mindfulness and distress tolerance skills taught by Dialectical Behavior Therapy would be invaluable. Additionally, the doctor should begin to develop a crisis survival kit made up of items and activities that can soothe him in moments of duress. Finally, the client should be enrolled in assertiveness training to help develop the skills to express his "negative" emotions (fear, anger, etc) in healthy ways that achieve results beneficial to him.
Lastly, it is the opinion of this writer that Banner cannot be treated like a prisoner for his therapy to truly work. With this in mind, the writer strongly urges S.H.I.E.L.D. to release the client to a mental health facility following the first round of peer mediations.
Tim Stevens is a Mental Health Supervisor currently pursuing his Psy D. who has experience counseling those with poor emotional regulation.
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