Reference no: EM133572417

Case Study: A 42-year-old male professional in public office, Edgar, was forced to resign after being arrested when visiting a brothel. In the aftermath, he suffered from depression, considerable alcohol consumption, and was admitted for a three-month treatment. He stopped drinking, but his depression remained unresponsive to anti-depressant medication. Still, without meaningful activities, he felt empty, restless, and was eventually referred to psychotherapy.

Developmental history indicates that at age five, Edgar's father left the family and they did not meet again until he was in law school. He was always ahead of his age and went through school without difficulty. In law school, he got high marks without hard work. He had many acquaintances, but no close friendships, and always felt like an outsider. He got married and had two children. Reaching his mid-thirties, Edgar felt bored. He had everything: house, career, and family. He was respected and accomplished but felt he didn't belong. He started drinking heavily and visiting brothels.

The psychotherapist found him self-assured, easily irritated, and quick to make devaluing remarks. Interactions during weekly appointments were extremely difficult. Unwilling to explore his situation or his feelings, he blamed the therapist for the impasse and told the therapist that he would not change and that the therapist could not help. The therapist dreaded the appointments, while the patient, despite finding the sessions unhelpful, always showed up. When the therapist announced a three-week break, Edgar suggested the treatment end and did not return. Nine months later, Edgar informed the therapist that he moved to another city, had a leading position working with international trade, and was greeted as a king. He said nothing about his wife and children. Nor did he indicate how he felt about the treatment.

Questions:

1. What are your diagnostic considerations for this patient. What symptoms are consistent and not consistent with your diagnostic options.

2. What is your final diagnosis of the patient and why?