Even when he is engaged in a one-on-one conversation and making direct eye contact, he appears to be off somewhere else and thinking about other things besides the immediate conversation. His family and friends report that in addition to being emotionally distant and unavailable, the subject is also unavailable more literally because he refuses to answer their calls on his cell phone even after being informed how much this frustrates them. Evaluation, Prognosis, and Recommendations

In some respects, this subject appears to have failed to successfully transition into and negotiate Erikson's Young Adulthood (i.e. Intimacy vs. isolation) Stage (Gerrig & Zimbardo, 2009). Instead of learning how to form intimate loving interpersonal relationships, he appears to have remained focused on the earlier (i.e. Identity vs. Role Confusion) Stage in which his dedication to his career provides the only identity he holds (Gerrig & Zimbardo, 2009). His irresponsibility is incongruous with his energetic professional ambition but much of his inability to focus on tasks and responsibilities is likely attributable to his refusal to take his prescribed medication for ADD and ADHD. The appropriate recommendation from a biophysiological perspective would be for him to resume taking his medication with instructions to document any specific instances of lack of mental clarity that he experiences for the purpose of discussing them in therapy. It would also be appropriate from an interpersonal or social perspective to counsel this subject to understand the fundamental importance of...

Generativity vs. Stagnation) Stage by contributing something positive and more meaningful than tangible possessions or financial assets to loved ones (Goodman, Schlossberg & Anderson, 2006). It would be appropriate to help the subject understand that his passive-aggressive unavailability (such as refusing to answer his cell phone) conflicts with his beliefs that he is demonstrating love for his family by working hard. Ultimately, the main goal of therapy would be to help this subject understand that he cannot be a complete person without allowing himself to experience and react genuinely to his emotions and that he cannot provide meaningfully for his loved ones without becoming more available to them in intimate communications and interaction and that no matter how hard he works or how much he provides for them materially, it cannot compensate for his emotional unavailability (Goodman, Schlossberg & Anderson, 2006).
References

Gerrig, R. And Zimbardo, P. (2009). Psychology and Life. New York, NY: Allyn & Bacon.

Goodman, J., Schlossberg, N.K. And Anderson, M.L. (2006). Counseling Adults in Transition: Linking Practice with Theory. New York: Spring.

Schlossberg, N.K. "A model for analyzing human adaptation to transition." Counseling

Psychologist Vol. 9, No. 2; (1981): 2-18.