Session Notes, the Therapist and Not Amber Heard
Leaked session notes on a famous actress, and diagnosis of her psychological-disorder
The client arrived 10 min late today. She looked well presented and clean, but her breath smelt of alcohol again. Her front teeth appeared wine-stained. Could be lipstick smear? She was lucid and seemed sober throughout the session.
When asked to remove her sunglasses, the client sat in silence. Refusing to take them off, she wore them for the entire session. This made it impossible to evaluate eye contact with any certainty. The client has been told in previous sessions not to wear sunglasses.
Disregarding the session rules and the belief they do not apply to her is further evidence of her self-importance.
She’s more emotional today, displaying an anger I haven't seen in her before.
We revisited what triggered her anger in the last session and her possible need for control.
The client became deeply distressed when questioned about her anger over J.D. removing his own boots and pouring himself a glass of wine. The client reported the boot-removing and glass-pouring as a routine solely carried out by her. She claimed J.D. prevented her from carrying out her routine with the intention of antagonising her. It appears she has ritualised the act and uses it as a method of control.
When asked why it was unreasonable and upsetting to her when J.D. took his own boots off and poured himself a glass of wine, she furrowed her brow and told me J.D.only had to wait until she had finished her phone call. The client became visibly angry, so I decided to break from questioning her on the issue while she composed herself.
The ritual could be a strategy used by the client to make J.D. dependent on her, thus exhibiting deep insecurities by the client. Possible fear of abandonment? Need to explore this further in future sessions.
In our last session, the client stated she still loved J.D., and he is her “everything,” but when asked how she feels about J.D. in today’s session, she answers, “He’s a washed-up actor who is going to die a fat, lonely old man.”
Her sudden changes in extreme emotion over J.D. along with possible fear of abandonment, inner hostility & rage, and externalisation of blame, all point to borderline personality disorder. I hope to confirm the diagnosis over the next few sessions. It’s too early to say with any certainty at this stage.
On leaving today’s session, the client suggested we change the office lighting if we expect her to remove her sunglasses in future sessions. When asked if she has a medical condition involving light sensitivity, she told me the wearing of sunglasses is a preventative measure rather than a reactive one.
The office lighting is standard, and there have been no complaints from clients re lighting over the 8 years we have held our practice here. This could be another attempt by the client to exert control over the session?
I suggested we increase our sessions to three times a week.
When leaving the session, the client grabbed both my arms and pulled me in close to kiss my cheek goodbye. I moved backward, away from the client, and told her we refrain from physical contact with our clients, and I am her therapist and not her friend. She smiled at me, patted me on the head and left.
Need to make sure the client is aware of and understands the boundaries between the client and therapist.
Action: email the client before the next session, outlining boundaries and reinforcing the client-therapist relationship.
Disclaimer: the above piece is purely fictional and for entertainment purposes only.
