CASE STUDY:

“THE LAWYER”

The patient is a 45-year-old lawyer who seeks treatment at hiswife’s insistence. She is fed up with their marriage; she can nolonger tolerate his emotional coldness, rigid demands, bullyingbehavior, sexual disinterest, long work hours, and frequentbusiness trips. The patient feels no particular distress in hismarriage, and has agreed to the consultation only to humor hiswife.

It soon develops, however, that the patient is troubled byproblems at work. He is known as the hardest-driving member of ahard-driving law firm. He was the youngest full partner in thefirm’s history, and is famous for being able to handle many casesat the same time. Lately, he finds himself increasingly unable tokeep up. He is too proud to turn down a new case, and too much of aperfectionist to be satisfied with the quality of work performed byhis assistants. Displeased by their writing style and sentencestructure, he finds himself constantly correcting their briefs andtherefore unable to stay abreast of his schedule. People at workcomplain that his attention to details and inability to delegateresponsibility are reducing his efficiency. He has had two or threesecretaries a year for 15 years. No one can tolerate working forhim for very long because he is so critical of any mistakes made byothers. When making schedules for himself and his staff, but thenis unable to meet them and works 15 hours a day. He finds itdifficult to be decisive now that his work has expanded beyond hisown direct control.

The patient discusses his children as if they were mechanicaldolls, but also with a clear underlying affection. He describes hiswife as a “suitable mate” and has trouble understanding why she isdissatisfied. He is meticulous in his manners and dress and slowand ponderous in his speech, dry and humorless, with a stubborndetermination to get his point across.

The patient is the son of two upwardly mobile, extremelyhard-working parents. He grew up feeling that he was never workinghard enough, that he had much to achieve and very little time. Hewas a superior student, a “bookworm,” awkward and unpopular inadolescent social pursuits. He has always been competitive and ahigh achiever. He has trouble relaxing on vacation, developselaborate activities schedules for every family member, and becomesimpatient and furious if they refuse to follow his plans. He likessports, but has little time for them and refuses to play if hecan’t be at the top of his form. He is a ferocious competitor onthe tennis courts and a poor loser.

List what you would diagnose for each of the 5 axes and a briefexplanation of why:

AXIS I: _________________________________

Explain your reason for this specific choice:

AXIS II: _________________________________

Explain your reason for this specific choice:

AXIS III: _________________________________

Explain your reason for this specific choice:

AXIS IV: _________________________________

Explain your reason for this specific choice:

AXIS V: _________________________________

DSM-5 Diagnosis (write diagnosis in format of DSM-5 aswell):