Patient is fraught with despair and denial over the death of his son. In this state, he refuses to accept that his son died in a car accident. The patient is having an ongoing, realistic dream about an alternate reality in which his wife died in the accident and his son survived. Moreover, the patient not only doesn't see the inherent problem in carrying on this complicated dream fantasy, but he refuses to try to correct it. The therapy, to him, is merely a mandatory encumbrance forced upon him by the police department as a condition of his being able to return to work. He really believes that he is living two different realities. I believe this condition to be the result of a complicated coping mechanism, which allows him to avoid dealing with the death of his son. Furthermore, I believe he has developed this coping mechanism because, while he denies it, medical records from the night of the accident indicate that his blood alcohol level was elevated.
Awake Patient Files
PRIVILEGED and CONFIDENTIAL
Under normal circumstances, confidentiality is a prime condition in establishing an effective therapeutic relationship. Without confidentiality there can be no trust; without trust there can be no therapy. Nevertheless, in certain specific instances, statutes may require the production of records in an effort to report, warn or protect. Herewith are weekly session notes, created on behalf of the LAPD for the evaluation of Detective Michael Britten, as recorded by Dr. John Lee and Dr. Judith Evans.