First note: Patient arrived for session unshaven, unkempt and in clothes that looked slept in. Dare I say it doesn't look like he has showered in days? I'd already heard the news that he'd been suspended from the force, again, for erratic behavior. Last week, he ran into traffic, causing an accident, then left the scene, thus the suspension.
Patient offers this explanation: last week, he claimed he was "seeing" a man in both waking reality and dream state. This person would appear in both worlds, arriving without any particular reason that patient could identify. This man was not real and claimed to be a product of patient's imagination - he could not identify himself, nor his presence. At the time of the accident, this hallucinatory man drew patient's attention to his actual human doppelganger. Patient followed the hallucination's lead, running out into the street to chase the doppelganger, thus causing the accident. He left the scene of the accident in hopes of pursuing this man, but upon losing him, accosted the precinct sketch artist. The resultant drawing - of a man it may be important to note could be described as "little" - turned out to be another detective. A further surprise, this detective was the first PD on scene of patient's accident, five months ago.
So while last week it seemed that patient was finally on the brink of accepting the reality of his son's death, this week the pendulum has swung to its apex in the opposite direction. Patient is now convinced that this detective ran him off the road, thus causing the death of his son, and is deep in the grips of anxiety, caused by his newfound belief that some individual - or individuals - in the department are after him. Of course, he refuses to consider the more likely explanation that this is all a paranoid delusion, a ripple effect of last week's near acceptance of the truth of his reality.
Late note: Have just received LAPD alert - city-wide manhunt is underway for patient, who is wanted for the murder of his former partner.