As a therapist im having trouble with a client

As a therapist im having trouble with a client

>meet young man (19)
>he refused to see a therapist for many years and take any medication because he thinks therapy and medication is for crazy people
>has anger issues, major anxiety, depression
>compulsive habits but not necessarily OCD
>many symptoms of ADHD but is incredibly smart, even socially
>hes 5'6 but has several dates and past girlfriends
>hes seen a lot as a leader in his workplace and union
So hes not socially dumb and hes an extrovert

Hes extremely troubled
>has gotten in many fights
>pushed his girlfriend
>theft of 1000's of dollars
>very defensive
>distrusts others
I can tell hes afraid of love and things of that matter. Hes not a psycho/sociopath because he has a great love for animals and all types of people and has slowed down the violence because he doesnt want to hurt his gf ever again and blamed himself for most of his actions

Hes also incredibly smart. He was redirected to me by another psychologist who was afraid he couldn't help him. Hes incredibly gifted
>meet him in waiting room, he points of my fake speaker mimicking the sound if an AC, we laugh about it but it showed he pays attention to detail
>asks about his vivid dreams
>he remembers them very clearly
>asks about his earliest childhood memory
>explains very early memories from age of 2 and 3 in great detail
>he knew floor patterns, and sometimes what he was wearing in the dreams
>asks if he has photographic memory and he denies because he feels like he cant remember whole pages of text but he has such a remarkable memory

He has a lot of symptoms of a little bit of everything and i cant put my finger on anything he might have. I want to say ADHD since he has the same brain functions (he describes his brain works like a motor). I have no clue what to do, i meet him for the second time Monday but i know all of this because he signed a release and his previous therapist met with him twice and wrote many notes down.

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I agree with your analysis. It sounds like it's time to prescribe some adderall and see if it makes him more functional. Sell it to him as a performance enhancer rather than a psyche med though. Adderall has a different reputation than other drugs with young people. Tell him a lot of successful people, CEOs and entrepreneurs take it to feel superhuman and get a lot done. I recommend also prescribing something to help him sleep at night, as a lot of doctors forget about the way adderall can mess with your sleep cycle.

>pushed his girlfriend
like that matters

>can tell hes afraid of love
show us your tits

>I want to say ADHD
Thank you for clarifying you guys don't know wtf you're doing most of the time

The least you could do is step down from your pedestal and tell the dude you have no fucking idea what's going on, to the point that you even had to ask in an underwater basket weaving message board. Then refer him to an actual psychiatrist that can at least give him some pills to ride out the anxiety while he certifies what he really has.

should you really have a clue as to what you should do after a single meeting and some notes?
if someone met you once and had some general notes about your history/behavior, could they honestly reliably understand the causes of your problems?
don't know the situation, but it sounds like many of the described problems won't just be gone by diagnosing adhd (anxiety, anger, "antisocial" tendencies, social problems)
many adults have adhd but are highly functional and may even consider it an aspect of their personality: are his problems created by the adhd symptoms?
he sounds like he has a lot of expectations he has to meet (refused therapy, seen as leader, seen as talented) but the information given here is quite minimal.

Assuming this isn't bait: I am 27yrold femnon with ADHD and was diagnosed when I was 5. I would definitely do tests to rule if it is or isn't ADHD.

Let's assume he does have ADHD. One thing I had to learn to regulate wad impressive behavior or reactions. I found growing up with I went with the first thought in my head to situations I ended up being a fool or getting into trouble. So I learned if I took the few extra seconds to fully process a situation I got into trouble less.

The theft and agression sounds like bad regulation of impulses. I would try to get him to work on taking a few seconds in situations to think before he acts or to disengage to calm down. Defensive and distrust tells me that he clearly has been hurt in the past and is emotionally guarded.

Why is adderall the defacto drug for ADHD anymore? I was on ritalin when I was younger than switched to concerta mid way through elementary. From my light readings adderall has a much stronger affect on the brain, has two acting ingredients and worse negative side effects/ withdrawal compared to ritalin/ concerta. I remember people complaining how they felt messed up on adderall when they were prescribed it.

Here’s my advice; hopefully he browses 4channel, sees your post talking about him, beats you to a pulp when he sees you, and then rapes your corpse.

Honestly, nobody will believe you're a therapist. Asking for advice on your patient on Jow Forums? Come on dude, you may think you are smarter than everyone, but you're not. Just admit you're talking about yourself, for fuck's sake

I'm confused as to why you though LARP'ing as a therapist was a nifty idea. 1/10.


Congrats you’re autistic and a narcissist.

You are just discovering that psychology is complete BS. You won't find any answer in your diagnosis you have to find out what kind of person he really is not worry about some bullshit diagnosis from the BSM.

Nice LARP, OP.

bruh if your a therapist coming to Jow Forums for help, you really need to leave your job.

Let me guess. You're the young man, right? Why are you pretending so hard? Why don't you just ask people straight up what you have?
>meet him in waiting room, he points of my fake speaker mimicking the sound if an AC, we laugh about it but it showed he pays attention to detail
Is this supposed to be something special?
>asks about his vivid dreams
Lmao okay? I can literally astral project at will, but I don't brag about fucking dreams?
>he remembers them very clearly
I'm pretty sure everyone members a few dreams clearly.
>explains very early memories from age of 2 and 3 in great detail
>he knew floor patterns, and sometimes what he was wearing in the dreams
>asks if he has photographic memory and he denies because he feels like he cant remember whole pages of text but he has such a remarkable memory
You don't have a remarkable memory. I can remember early days as well. I can remember certain floor patterns as well. And I bet you almost everyone else in this world who isn't an absolute retard can as well. You are in no way special, nor do you have some sort of mental disorder. I hope this post can help you overcome your narcissism.

He legit sounds exactly like me except I don't care much about relationships/friendships.

The main issue with the guy are anger issues with mean he has the wrong structure because he simply cannot come in peace with his reality.
"Understand what keeps you down and what moves you forward" and "God, grant me the serenity to accept the things I cannot change. "Courage to change the things I can, And wisdom to know the difference".

One quote is from buddism IIRC and the other from protestanism, what this guy can, an wants to change, explain the merit of changing, what he cannot change, and what he must give up. What patterns make him react to things like he does?

If you are a psychologist sue your university and start reading more.

Clearly, he's a manifestation of your own self image

This is like a long, drawn out, excruciatingly cringy version of "asking for a friend." No one believes you're a therapist because therapists are fucking smarter than you and have basic approaches they take to every client before getting them on a customized path (towards anger management for example), also literally no therapist fucking dotes on a 19 year old of average intelligence like they're some fucking enigmatic puzzle and the second coming of Einstein. I bet you a dollar you're not seen as a leader in your McJob, you're a stupid bitch (gotten in many fights, thefts of 1000's of dollars, guarantee these are exaggerations), therapists literally don't give a fuck about dreams, please get the fuck off the internet before you embarrass yourself any further. I'm begging you.
P.s. your girlfriend is going to break up with you and you'll be a stupid bitch about that too but by the time you're fucking 24 you'll look back and see the cringe factory we all see. Maybe 22 if you're lucky. Go fishing with your dad and get off Jow Forums, you'll both be so much happier.




This advice here. you can't help him if you aren't confident in your own diagnostic abilities. Refer him to a psychiatrist.

So you came to Jow Forums. Makes sense

A therapist going on4chan for mental health advice. Checks out

Isnt there laws, from info like this being in the public?
Paitent cofidentiality?
Look i have ton of exp with dr, nurses, therapy and crazy people.
But i'm not sure i want to say anything here for now.

Talk to him like you are his friend. I currently have a good therapist that I can open up too. To be honest I open up to all of my therapists but my therapist right now seems like she opens up back to me.
I am guessing your patient is also ashamed about a lot of things in his past, help him understand that shame better so he can get out of it. Make sure he understands therapy isnt a quick fix and time is needed to heal.

I had most of those when I was at his age and no therapist could help me. They kept resorting to DSM diagnoses: OCD/ADHD/anxiety/depression/whatever.
After many years I've concluded that the DSM is a big fat joke, and that serious issues are more systemic and can be better described as personality disorders. Only long term psychoanalysis may help

> I have no clue what to do i meet him for the second time Monday
We're not helping you talk your way out of court mandated therapy user.

My Girlfriend is amazing, until she gets angry. When she gets angry she sucks me into the tenth level of Hell with false allegations (calling me abusive, calling me a liar, claiming I did things I literally never did), insults, attempts to physically shove her way past me (I'm usually standing facing her in conversations, if I stand my ground and refuse to be shoved when shoved, she will say I shoved her (a lie) just because I didn't budge) threats to call the police (with threats to lie about me), threats to leave me, threats to find some else to date, etc.
I realize she was in a car crash and has literal brain damage. I realize it isn't her fault. ...but just how much should I tolerate? I love her, and most of the time she's amazing, but she never apologizes for any of this or acknowledges her behaviour. If I even try to bring it up, she accuses me of lying and playing mindgames. It's like she's two completely different people in the same body and she never acts this way in front of other people. Oh...and her favorite insult is narcissist. She uses it when describing anyone who has ever made her angry. How do I get her to knock off her shit or at least acknowledge she's doing this so she can find a way to constructively correct her behaviour.

First things that come to mind are highly functioning sociopath, some form of resentment and insecurity that makes him act the way he does (violent, aggressive) and possibly neglect (stealing = looking for attention) and loose morality based on their upbringing which possibly allowed too much when they were a child. Based on the age I would also say being immature is the problem, with time a guy like him (especially if intelligent) will regulate his behavior towards his mid 20's, before that a lot of destructive behavior is to be expected but could be severe in consequences so I'd watch out for that, and not having an outlet for all the deviant behavior just fuels that behavior because a clever person needs to let it all out somehow, otherwise they think too much on it.