JAN. 20, 2006
SESSION NOTES: CURED

Today, the patient insisted he was on the brink of being cured of his obsessive-compulsive disorder.

When I asked him what he based this on, he explained how he tallied the number of sessions we've had and compared it with the national average for patients who have ceased therapy.

According to his figures, he should be totally cured in 4 1/2 more sessions, but seeing as he is above average, he is confident that this could be our final session.

I queried him about the therapeutic process, and specifically my methods, to determine if he was reverting back to his initial resistance to treatment.

He responded that although there were many occasions where he found me tedious or felt that my office was not as tidy as he preferred, he rather enjoyed our sessions. I asked him if he was feeling unusually exasperated by his obsessive-compulsive condition and, therefore, had a stronger than ever desire to be rid of it once and for all.

He remarked that last weekend he spent close to 45 minutes eradicating a credit card receipt to make it impossible for anyone to steal his identity. He detailed how he first crossed out his name and card number repeatedly with a ballpoint pen, then tore up the receipt into 10 separate pieces, which he then distributed into 10 separate garbage cans in San Francisco.

He explained how doing this made him so late for an appointment with his superior that he asked his assistant to drive 2 mph above the speed limit. But he emphasized that this was all a minor flurry and caused him only minor stress.

I proposed that his concern about identity theft could be a component of his resistance to therapy, as he could be worrying unconsciously that by trying to cure him I might be wishing to steal his identity.

He answered that he recently read an article about identity thieves and was merely taking extra precautions.

I decided to create a simple test to determine if he had truly achieved a new plateau or if he still had more work to do with me here.

I got up from my chair, went across the room and opened the middle drawer of my cabinet. I then went back to my seat and proceeded with our conversation.

The patient made a concerted effort to continue with the session as if nothing had happened. But looking closely at his left temple, I could see several beads of perspiration forming. In less than 10 seconds, he bolted from his chair, dashed across the room and closed the drawer.

"So, what were you saying about being cured?" I asked.

"I see that our time is up for this session," he replied.

I told him that while I was flattered to hear myself quoted with a phrase I often use, there was plenty of time remaining. He then spent the remainder of the session talking about how hard it is to kill dust mites.