I had my first session with my new patient this morning, so here’s an update. Thanks for your comments so far – sorry I haven’t been able to answer them all individually. I hope this internet exercise will lead to some interesting insights without having to reveal any confidential information. I will stick to what is commonly accepted in academic journals, which should be enough for you to help me research the patient’s condition. The patient wasn’t very forthcoming this session, but we have another session scheduled this week which hopefully will reveal more.

When the patient (hereafter referred to as a “he”) came in, he was reserved and treated his environment with suspicion. I began by asking him why he came to see me. He said that his friends told him to come, that it might help him “adjust.” His friends appear to be protesters he met while living on the streets of Boston’s North End. He found a flier advertising a protest with free food. One of the protesters noticed him and offered to take him to the co-op where she volunteered occasionally.

His accent seemed foreign, and when I asked him about it, he said only that he had “been around.” He refused to elaborate no matter how hard I pressed, withdrawing and presenting me with nothing but a stony silence in response to questions about his family, his birth, and his home. As one of you pointed out, there are many possible reasons for this, but he was surprisingly hostile rather than simply vague.

He was also reluctant to talk about the protests; protesters are usually eager to talk about their causes and passions, but the patient answered questions about his personal beliefs evasively with responses like “I believe in justice” and “people deserve what they get.” I asked if he’d ever known what it felt like to be mistreated by someone in charge. This seemed to trigger a memory he wasn’t sure how to talk about and caused him to grow even more distant.

After a few more minutes of questioning, he stood up to leave. As he opened the door, he turned and said that yes, he had been wronged once, by someone important. Once – “a very long time ago.”