Phil Enter Therapy Case Study

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Phil entered therapy because he was given an ultimatum from his wife that he either receives therapy or she will file for divorce. This ultimatum was not surprising, as they had been suffering from marriage issues for some time. The final straw came after a fight they had, where he reportedly hit her and pushed her against a wall, after she threw a pot at him. Both of them had been drinking at the time of the event. The police were called during this incident, and both were held in jail for the night. This event is not unusual, as Phil reports that he has periods of time when he is so overwhelmed with angry energy that he cannot stop himself from engaging into fights and drinking binges. During these periods he will fight with almost anyone, …show more content…
In the vignette, he reports having “rage benders” where he becomes overwhelmed with anger and does not feel like himself. His angry moods are negatively impacting his work, as well as his marriage. He reports having trouble holding down a job, and when he can he often disregards safety policies, has “crazy talk” about moving to a bigger and better job, and is prone to getting into arguments with his fellow coworkers during his unstable moods. His marriage is affected additionally by his lack of communication as well as his actions of leaving his house for five to six days at a time to wander the town and drink, as well as engage in multiple fights. Phil also stated that he had previously been prescribed Trazadone and Risperdal by a counselor in prison. Trazadone is an anti-depressant that can be used for BPD, and Risperdal is an anti-psychotic medication that can be used as a mood stabilizer for BPD as well. That is why I chose to diagnose Phil with borderline personality disorder. He shows signs of having atypical behaviors, having impairment in his daily life and having a cognitive and emotional dysfunction. The DSM-5 Criteria for BPD is also meant. The criteria for borderline personality is to have five or more of the following symptoms including: frantic efforts to avoid real or imagined abandonment, a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes idealization and devaluation, identity disturbance: markedly and persistently unstable self-image or sense of self, impulsivity in at least two areas that are potentially self-damaging, recurrent suicidal behavior, gestures or threats or self-mutilating behavior, affective instability due to a marked reactivity of mood, chronic feelings of emptiness, inappropriate, intense anger or difficulty controlling anger, transient, stress-related paranoid ideation
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