Henry’s Exposure Therapy – Part 2 of The Three Lessons in Psychology Series

Users have asked for details about my therapy sessions with my old clients from the internship. I was hesitant to release details of my patients and their treatments but the therapists I console have shown a great deal of interest in my treatment methods. They only asked that I use different names for clients and not to reveal anything that will make them easily identifiable to avoid lawsuits and maintain professionalism. Otherwise, these writings can be considered case studies.

In the comment section of my first post, I described an experience with a veteran returning from an overseas conflict. If you have already read this comment, you know how the story ends but I have included more details in this entry and gotten some help from fellow therapist with information the case to shine a light on what really happened, if that still interests you. Otherwise, I shall begin with “Henry”, my first client.

Henry phoned into Dr. J’s office where I interned doing administrative work and scheduling appointments. Unfortunately, Dr. J was booked for the next two weeks and Henry’s request was for an appointment as soon as possible. The closest appointment I had was in a month’s time after Dr. J returned from a conference in Arizona. There was something in his voice that told me that he wasn’t being impatient but desperately needed help. My instincts are rarely ever wrong when it comes to matters of psychology so I invited him to the office after hours so that we could have a session.

After getting ourselves settled into Dr. J’s office, I asked Henry the purpose of his visit. As I reached for my pen, Henry jumped across the table and grabbed my arm. The look in his eyes told me that was in panic. It was a result of being afraid of something. I asked him to release me as I was only going to grab a pen. He held on for a few moments before releasing his hand from mine and sitting back on his side of the couch.

He seemed embarrassed but asked that I not write anything down of our sessions. He didn’t want to leave a paper trail behind of his visit to the therapist. That’s when he revealed to me that he was in the armed forces. He didn’t want to use his insurance plan because it would be reported and noted on his permanent record. He’d never be considered for advancement again. I respected his wishes and told him we would discuss payment later. Always remember rule number three: Always discuss your salary before starting a job.

I was feeling hesitant before about scheduling the appointment but all that disappeared the moment Henry told me he was in the armed forces. Deep in my heart, I knew that I was doing my duty as a citizen of these United States and a psychologist to assist this young man in his time of need. We must always support our troops!

The session lasted three hours before we finished. Getting Henry to speak about his problems was as difficult as pulling teeth on a patient with no anesthetic. Henry was guarded to the idea of discussing his service time overseas in combat. Most veterans of war do not like to speak about their experiences. It is understandable so instead we talked about his symptoms. He had extreme difficulty sleeping as he experienced flashbacks of his time in war during the night. The anxiety of awaiting an attack did not allow his mind to rest. Along with lack of sleep, this was causing a hypersensitivity disorder making him prone to emotional outbursts and bouts of rage. He was self-medicating with narcotics and alcohol to put himself to sleep.

As Henry spoke about his symptoms, I could see it in his face that he would be haunted for the rest of his life. Wartime calls for men and women to perform unspeakable acts of violence and horror to each other. It was a clear cut case of post-traumatic stress disorder, depression, and drug addiction. What worried me the most was Henry’s admission of contemplating suicide then lifting his shirt to show me that he was currently armed. He slept with the gun under his pillow and felt unsafe if he didn’t have a weapon in arms reach at all times. It was shocking but I am not there to judge the man. I didn’t feel threatened by him. He wanted my assistance, unlike the others I tried to help before.

As my treatment options were limited, I believed that the best option of treatment was exposure therapy. Henry was a young man haunted by the demons of the past and he needed to confront them without facing any real danger. How do you send a man to war without putting him into danger? In a flash of brilliance, I prescribed Henry a form of exposure therapy that would be exactly what he needed. The young man did everything as I prescribed him, except for only one part that he did not follow.

To confront his demons, I had him watch the opening scene of the Allies soldiers storming Omaha Beach in “Saving Private Ryan”. To stimulate the parts of his mind still hurting from combat, he would need to turn it up as loudly as possible. The simulation of actual combat would allow him to relive those moments of war so he can come to terms with his fear. He would realize that he was safe and that his time on the front lines was finished. Henry would also need to have his gun nearby as it would serve as an anchor of safety to reality. It would serve as the protection his mind needed against the demons of war.

In my original comment, I guessed about what happened after the point of where Henry began to watch the film. With some corroboration from the therapists at my facility, they have informed me that my guess was almost correct. Henry suffered a flashback or re-experience scenario where his reality became storming Omaha Beach in World War Two. I was wrong that he discharged his weapon at the television screen in his delusional state. Instead, the neighbors called the police about a noise complaint because Henry was using a surround sound system with the volume extremely high.

In the middle of the movie, the police pounded on the door in an attempt to get Henry’s attention and unfortunately, they did. In his delusional state, Henry must have believed that German combatants were attempting to break down his door. He surprised them when he opened the door and fired his weapon into their heads at point blank range. The officers never had a chance to react. More police were called to the scene as a result of the gun fire and there was a stand-off between Henry and the police. Henry took cover inside of his home and began to fire out the window. With no other options, the police fired back at Henry and he was killed in action.

Finding out that this was the reason Henry did not return for our next session was heart-breaking but getting back to lesson number two that I’ve learned: You cannot blame yourself for client failures. And as to the one thing Henry did wrong, I don’t remember if I exactly mentioned it to him but I’m pretty sure that I told him to unload the bullets from his gun before he started the movie.

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