By Tim Stevens
Sharon Carter, formerly Agent 13, is an adult female in excellent physical shape. She appears for sessions on time, appropriately dressed, and appears to have no difficulties maintaining her Activities of Daily Living (ADLs). However, she also appears to be significantly more tentative and withdrawn than one would expect given her background. She is more than capable of maintaining conversation with the writer, but often "shuts down" by either zoning out, refusing to answer questions, or claiming, honestly or not, to not remember what the writer is referring to.
At this time, due to her kidnapping by the Red Skull and his associates and the subsequent outing of her role in the death of Steve Rogers (Captain America), Carter has been placed on suspended duty until it can be determined what her mental status is.
After several sessions, this writer feels comfortable at this time with offering a preliminary diagnosis of Acute Posttraumatic Stress Disorder stemming from her manipulation by Doctor Faustus and the events that occurred while she was held captive. Particular symptoms of note include flashbacks, specifically to the moment when she shot Rogers at close range, dreams involving the same incident as well as events from her captivity and her pregnancy, her inability to recall being pregnant during her waking hours, hyper-vigilance, insomnia, and disinterest in activities she previously enjoyed or in interacting with those she considered friends.
Treating the client is a difficult process that has been compounded by both her sense that she remains in captivity (due to the constant presence of agents watching her, regardless of their honorable motivations) and the fact that trusting and speaking to a mental health professional, in this case a disguised Doctor Faustus, is what led her to this moment in the first place. As such, developing a therapeutic rapport has
proven a protracted complicated affair that is still moving slowly towards that goal. As such, the writer has experimented with a variety of nontraditional approaches to our sessions, including rarely meeting in the office, often incorporating some sort of light physical activity like walking, and working on cooperative projects, like puzzle completion, together. Things are better than they were, but this writer feels that it will take some time longer to truly win over the client.
With the development of some rapport, the writer has begun to move towards specifically treating the client's PTSD. At the moment that includes a Cognitive Behavioral approach to talk therapy and the use of Eye Movement Desensitization and Reprocessing (EMDR). While EMDR has not yet been demonstrated to definitively aid those coping with PTSD, it has shown some success in limiting symptoms and is useful for some like Carter who thrives on feeling in control and finds it hard to, as she puts it, "talk to someone and wait for them to make me feel better." By giving her tasks to practice and master, it empowers her to see her PTSD as a temporary condition she is capable of overcoming.
Going forward, the writer would also like to see the client attending a PTSD Therapy Group that is offered for government officers who have been taken hostage or kept in captivity by enemy forces. Also, Carter has expressed interest in a family therapy-like approach involving James Barnes, the current Captain America, and Sam Wilson, Falcon, so she can thank them for her rescue and discuss her role in Steve Rogers' death. While she understands that her actions were not her own that day, she still feels incredible guilt for it and has expressed some belief that if she can talk to them about it in the formal setting it may help her emotionally accept her rational beliefs.
Tim Stevens is a Mental Health Supervisor currently pursuing his Psy D who has experience in working with people who are coping with PTSD.
Sharon Carter's next appointment will be conducted by Doctors Ed Brubaker and Luke Ross on April 15. All information about this session can be found in file CAPTAIN AMERICA #49.
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