Volume 36 · Number 1
JANUARY 2006

A 38-year-old Man With Anxiety, Intrusive Violent Thoughts

Editor’s Note: This monthly presentation describes a case of a psychiatric disorder, discusses past treatment attempts, offers options for continuing treatment, and explains the reasons the solution was selected. Submissions of interesting psychiatric case reports are welcomed for this department. Please e-mail soconnor@slackinc.com for further information.

This case is presented by Stephen P. McDermott, MD, founding director, Cognitive Therapy Institute, Cognitive Therapy and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

PATIENT HISTORY
Mr. G is a 38-year-old married father of a 10-year-old girl and a 7-year-old boy. He works at home as a graphic designer and is married to a 37-year-old management consultant who often travels for business. He was the only child of a mother he describes as “loving and strong" and a father he describes as “basically a good person with a bad drinking problem". The patient’s father was never abusive toward his mother or Mr. G, but Mr. G describes him as “not much of a father figure". He says, “If it weren’t for my mother, we would have been out on the street many a time."