Kevin Kirley

Melvin Udall

Approximate Age: 59

Identifying Information And Referral Statement

The client Melvin Udall, is a 59 year old single, author. He has previously seen

his other Psychologist for a few sessions. The other psychologist had prescribed him

medication to combat and lessen the effects of his OCD. He was also diagnosed by his

other physician as having OCD and for being a misanthrope. OCD or Obsessive

Compulsive Disorder is an anxiety in which people have unwanted and repeated

thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel

driven to do something (compulsions). And being a misanthrope means, a person who

dislikes humankind and avoids human society. (Obsessive Compulsive Disorder." Psychology

Today. Sussex Publishers, n.d. Web. 24 Feb. 2017) (Misanthrope. Merriam-Webster. Merriam-Webster,

n.d. Web. 24 Feb. 2017.)

The client, Mr.Udall had referred himself to his previous psychologist to try and

get a hold on his disorders and take back control of his life.

Presenting Complaint
 Because of Mr. Udalls OCD, he has several things that he has to do and some

that he cant do,they are almost nervous ticks that if he doesn't comply with his OCD

then he begins to get emotional and wont calm down until the things that he has to do

are done. Some of these things that he has to do include, locking/unlocking doors five

times before closing them, and turning on/off the lights 5 times before leaving them

either on or off. He also cant step on cracks and will even avoid going into certain rooms

if stepping on cracks would be inevitable. He uses a new bar of soap overtime he

washes his hands and it is always with scalding hot water. He also needs to sit at the

same restaurant in the same booth and have the exact same waitress every time as well

as getting the exact same meal. Will also use his own utensils for the food. This is

challenged when his waitress, Carol, cant come into work because of her sick son. Mr.

Udall had actually payed for a stay at home doctor to look after her son just so that she

could come into work and be his waitress.

With his Misanthropy, he also has a few complaints as well. He cant be touched

and will become extremely uncomfortable when he is. He doesn't like to hear about

peoples past and will become irritable when he is told about such things, for instance

when his neighbor, Simon, starts talking about about his past, he tells him to shut up

and that he doesn't want to hear this. He is impatient, rude, and doesn't have much of
a filter, actually saying get away from me you elephant to a waitress who isn't Carol

tries to take his order. He also finds it difficult to give compliments to others.

History Of Presenting Complaint

a) Melvin said that his OCD began to affect his daily life when he was about 2 or 3

years old and about the same time is when this began to manifest to those that

around him, parents, other family members.

b) The clients highest level of adaptive functioning in the past year would be almost

completely functioning normally. He has at times been able to go without completing

some of his OCD stresses and there being no reactions from him at all, however

these are always only temporary as they never truly go away and will surely come

back almost if not as strong as before.

c) Besides the OCD and Misanthropy, he has no other pre existing conditions, or

psychiatric hospitalizations. However he does take medication to help combat his

OCD. this drug could be or be closely related to Selective Serotonin Reuptake

Inhibitor. or SSRI. This drug, eases symptoms of depressed mode and anxiety.

(Obsessive-Compulsive Disorder (OCD) - Medications." WebMD. WebMD, n.d. Web. 24 Feb. 2017.)

Medical History
 His OCD may be genetic and he may have inherited it. There is also of a history

of abuse in his family. He says, my father spent 11 years of his life in his room and

whenever I made a mistake on the piano, he would hit my knuckles with a yard stick He

doesn't say much else about his father but this little bit of information could be a cause

to why Melvin is the way he is.

Personal History

a) There are not any outstanding events in his birth or in infancy such as frequent

moves, birth complications, medical problems, also he was not adopted

b) He does not say much about his childhood, except for the fact that there may

have been a history of abuse. This also may be where his misanthropy may have

started to form. By now he has also realized that he has OCD.

c) In his adolescence, this may have been where his father stayed in his room for

those 11 years. Also this is where his misanthropy and OCD would have been in full

form and where he is just starting to learn how to deal with them. This is also where he

might have gotten prescribed the medication that he is taking to help relieve the stresses

of his OCD.

d) After his adolescence up until now, he has become an author and has also

learned how to masterfully play the piano. It is very unlikely that he has ever been
dating, nor does he have any sexual history or experiences. He has never been married.

His living arrangement at the moment is that he lives by himself but has invited Simon,

his neighbor who was attacked in his home and is close to filing for bankruptcy due to

his medical bills, to live with him.

Family Constellation

Melvin has not said much about his family, although he has mentioned a father

who had a tendency to abuse Melvin, as well as staying in his room for 11 years. Even

though it isn't a part of his actual family, Simons dog Verdell, whom Melvin watches

while Simon is in the hospital, is a huge part of Melvins life, Verdell may actually be the

one who makes Melvin come around to accepting other people in his life.

Other big people in his life would be Carol, the waitress, and Simon his neighbor.

Both of these people, however unlikely at first, become close friends of Melvin.

Probably the first that he has ever have. And he may actually have found something

deeper than just friends with Carol.

Clinical Descriptions, Impressions, And Observations

Some of the dynamic factors in the development of the presenting complaint

would be that he starts to need the people that are in his life and that as he becomes
closer to those people in his life, he realizes that his compulsions aren't as important as

the people he holds closest.

Because of the people in his life, he actually starts to take his medication again

because he says to Carol, you make me want to be a better man and that he would do

whatever he can to keep her in his life.

Melvin's level of function has ranged anywhere from not being able to walk into

rooms because of his OCD, to not even realizing he is disobeying his compulsions. His

strengths in this area would be that once he gets over the fact that his compulsions are

actually just feelings that he has he can function almost completely normally, allowing

him to have normal relationships with other people, have normal hobbies and be able to

be a productive member of society. His weakness is that his compulsions will never

actually go away and that eventually he will always revert back to those strong

compulsions. Basically rendering him unable to hold conversation with people, even the

simplest tasks could become very difficult for him. He wont actually be at any actual risk

of harming himself or even committing suicide. Nor is it likely that he will act in any

homicidal way.
Tentative Diagnosis

My tentative diagnosis is that Melvin has Obsessive Compulsive Disorder. A

disorder that causes him to act on feelings and compulsions that he has. He has

unwanted and intrusive thoughts or distressing images that are causing him to do

certain things over and over again. These are usually accompanied by compulsive

behaviors performed to undo any obsessive thoughts or images. (Butcher, James N.

Abnormal Psychology. 16th ed. Boston: Pearson, 2014. Print.)

Initial Treatment Recommendation

My recommendation would be to have him stay on his medication and to use it as

directed and for him to also schedule an appointment for regular evaluation every 2

weeks and if there is progress then reduce the amount of visits down to once a month. If

he starts to improve from there then we may do away with appointments all together.

Will be seen by undersigned.

The treatment goals for Melvin would be to get him to a place where he can

function as closely to normal as possible.

Initial Prognosis
 If Melvin stays on his medication, and continues to meet with a psychologist the

recommended number of times, then his prognosis will be good.