💗19 / Artist / Any pronouns /Illustration Major / Loves The Boys, The Walking Dead, Death Stranding, Dispatch/ Roleplayer 💕 Homelander Yume (Mirror/Selective)
A video compilation of Homelander crying and dissociating, set to the song "Hurt" by Johnny Cash. It's weird for me to relate so strongly to a fictional character but I honestly see all of my trauma reflected back at me in this sad baby man.
Also @sehtoast told me to submit this to @cozycornerevents for Kinktober because the prompt "crying" is on the list. It's not really kinky but this is for the one person out there who sees Homie sobbing and thinks "heh… nice 😏".
A collection of treatment notes for the first three sessions + diagnosis/treatment plan for homelander. I usually write my notes much more shorthand, but this is for fun not to get insurance benefits so whatever.
If y'all like this, I'll keep going! I'll likely do his NPD diagnostic work up just for funsies in the future anyway though.
Rated G for General Audiences.
Treatment History: The Homelander (John Gillman)
Vought International - Health and Wellness
Dr. Eleanor Connors, PhD
Session One - JG
Mental Status Exam:
JG presents as a put together man in his forties, with a clean cut appearance. His clothing is appropriate for his vocation, though may be perceived as bizarre without context. JG maintained intense eye contact for the majority of the session, appearing to be an attempt at exerting control over the situation. JG indicated that he finds attending therapy novel, hence his decision to “play along”. JG appears to be oriented in time and space, though seemed irritated by the routine questions. His self-perception appears grandiose, even when considering his objective skills and abilities.
Presenting Problem:
JG was referred to the clinician due to unpredictable behavior and emotional instability. Clinician was informed by relevant parties that JG responds negatively to fear from those around him. To foster a safe space, the chosen clinician must have experience with highly volatile individuals to avoid issues that could arise around JG’s sensitivity to other’s emotions. JG was also reported as being more cooperative with female authority, hence Dr. Connors was the best choice.
Psychotherapy Note:
In the first session with JG, building rapport was the main goal. The clinician asked open-ended questions about JG’s feelings about attending. JG seemed pleased by the clinician’s interest and participated by answering said questions. JG also appeared to feel positively about being informed that he did not have to stick to his “lines” and could share about actual experiences. JG informed the clinician of multiple violent acts he has partaken in, possibly to test boundaries and fear response. Boundary testing may be a common occurance with JG, as he appeared amused by doing so. JG informed the clinician that he would attend another session as it was “a hoot.” JG may benefit from having a place to explore his self-perception without judgement, especially as he shows very low insight into his own actions and behaviors. JG may also benefit from working on frustration tolerance and self-soothing skills to help reduce aggression towards others.
Personal Note:
Upon first meeting, JG already shows signs of arrested development. His boundary testing and egocentricism seem to stem from an underdeveloped view of the world and how he interacts with it. JG’s emotional and reasoning abilities appear significantly stunted, more in line with that of the preoperational stage (2-7). His intellectual abilities are above average, however due to his other deficits, he seems to engage in harmful behavior before thinking through the consequences. Working diagnosis is C-PTSD (F43.12), which has possibly developed into a disordered personality.
Vought International - Health and Wellness
Dr. Eleanor Connors, PhD
Session Two - JG
Psychotherapy Note:
JG appeared agitated when entering the session, as evidenced by his affect (set jaw, glaring/rolling eyes, closed body language). JG indicated that he did not want to share in session, spending the first 20 minutes ignoring the clinician and maintaining his closed posture. JG seems to view session as another career obligation, which is congruent with how he seems to conceptualize the world as a whole. When given space and time without pressure, JG eventually opened up about frustrations regarding coworkers and their perception of him. Clinician validated JG's emotions, as rapport building is the primary goal. JG appeared to relax after expressing himself, then proceeded to praise the clinician emphatically for “knowing who's right”. Once more trust has developed, JG may benefit from gentle push back instead of pure person-centered validation to promote him developing deeper insight.
Personal Note:
JG may be a good candidate for art based therapies to engage with trauma work. JG may find it difficult to express what he is feeling verbally due to lack of frame of reference, so a non verbal medium may open communication. This will likely be a hard sell, but may be worth bringing up if he continues to attend.
Vought International - Health and Wellness
Dr. Eleanor Connors, PhD
Session Three - JG
Psychotherapy Note:
JG entered the session appearing to be in an upbeat mood, as evidenced by his affect (smiling, cheery greeting, use of clinician's first name). JG shared that he would be spending time with his son, R, later in the day. He indicated that R is a major factor in him “tolerating this whole rigamarole” and that he was “sick of doing things wrong [with R].” This statement shows more insight than previous sessions, and the acknowledgement of struggle is a significant departure from JG's baseline. Clinician prompted JG to share more about his son. JG spoke at length about his love for his son, and indicated worry over his son's discomfort with “being a god.” JG mentioned that his childhood was very difficult, however became distressed at the idea of elaborating. JG may benefit from some take-home activities to complete with R. He may also require closer observation regarding his grandiosity due to how his disregard for others/seeing others as below him is a safety risk.
Personal Note:
I was contacted by Miss Barrett to inform me that she is shocked JG has continued to attend. JG seems to have reasoning to continue attending, though due to his fickleness he may lose interest. Further evidence implies that JG may meet criteria for Narcissistic Personality Disorder (F60.81), however I do not give out such heavily stigmatized diagnoses unless it is absolutely necessary. For now, he will be designated as C-PTSD (F43.12), especially considering what has been shared about how he was raised.
Treatment Plan (JG)
Presenting Problem Summary:
JG struggles to connect with those around him due to his emotional volatility.
Dx Code: Post Traumatic Stress Disorder, Chronic - F43.12
Symptom Qualifiers:
A. JG was subjected to recurring traumatic experiences from a very young age, including physical abuse, emotional abuse, and significant neglect.
B. JG experiences prolonged psychological stress when exposed to reminders of traumatic events.
C. JG engages in avoidant behavior surrounding reminders of traumatic events.
D. JG exhibits the following symptoms:
-Persistent negative emotional state
- Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world
- Feelings of detachment or estrangement from others.
E. JG exhibits the following symptoms:
- Persistent difficulty maintaining relationships
- Irritable behavior and angry outbursts (with very little provocation)
- Verbal or physical aggression toward people or objects.
- Reckless/self-destructive behavior
- Hypervigilance surrounding relationships/distrust of others
F. JG has engaged in the above behaviors for longer than 6 months.
G. JG's symptoms impair his functioning across all areas/settings.
H. The symptoms above are not related to substance use.
Currently unclear if JG's symptoms includes disassociative episodes. This will require further investigation when JG is more comfortable with the clincian.
Goal: To reduce the severity, duration, and frequency of JG's symptoms
Objective: Develop self-regulatory skills.
CBT - Grounding, emotional catharsis, and self-soothing coping skills
DBT - distress tolerance and emotion regulation skills
ACT - improve ability to accept and move forward from difficult situations/emotions
Objective: Create and maintain healthy relationships
Psychoeducation - healthy v. unhealthy relationships, how to set own and respect other's boundaries
Person Centered - unconditional positive regard, challenging beliefs in a safe space to model disagreement not meaning rejection.
Objective: Identify how past events impact current behaviors
CBT - address negative thought schemas and maladaptive coping skills
Psychodynamic - explore personal timeline and identify how it influenced areas of difficulty
IFS - identify internal dynamics to develop a deeper understanding of self
Objective: Live a values focused life
ACT - identify personal values and make choices in line with said values
ACT - Separate personal values from those influenced by trauma/abusive parties
Solution Focused - develop goals and actionable steps toward said goals
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