Physical Aspects the Subject Is

Physical Aspects The subject is a 28-year-old male who is meticulously neat in his appearance and in maintaining his hygiene but is extremely disorganized and sloppy in other respects. He does not focus on people or maintain eye contact in conversations and is always fidgeting with his hands and with objects within reach. He suffers from chronic pulmonary and respiratory congestion as the long-term result of being a smoker although he would be considered a light smoker because he only smokes a few cigarettes per day.

He wore glasses from the time he was a child until last year when he underwent corrective laser surgery to augment the earlier eye surgery he had as a child that had improved his vision but not sufficiently to discard corrective lenses previously. Mental and Emotional Aspects The subject suffers from Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) and has been prescribed medication to mitigate the symptoms associated with those disorders.

However, he refuses to take the medication because he believes that it interferes with the clarity of his thought processes. The subject is intelligent and highly creative and has been quite successful professionally. On the other hand, he is somewhat irresponsible and avoidant about his responsibilities and typically does not follow through with plans after starting them with gusto and tremendous enthusiasm.

While he has managed to establish several successful business ventures, his contribution was mainly in their conception and initial launch but thereafter, he relied heavily on others to do the necessary work to achieve success for those enterprises. His principal contribution beyond initial conception was in assembling teams of others capable of following through on the tasks and responsibilities that he delegated to them.

Likewise, he is very lackadaisical about regular responsibilities and tends to foist those kinds of responsibilities onto subordinates in the workplace and onto his wife at home. He exhibits many more traits of a Type-B personality because of his excessively relaxed attitude in those respects and is somewhat unreliable. His style of reacting to personal challenges and difficulties is also Type-B-like because he is not particularly reactive in the moment and tends to keep his thoughts and feelings to himself as long as possible (Schlossberg, 1981).

He is not communicative at all with his family and loved close acquaintances. After failing to react to trying situations for a long time, he experiences periodic emotional collapses as the result of suppressing all of his natural responses during challenging situations. Social Aspects The subject is excessively focused on business and tends to direct all of his energies in that direction, at the substantial expense of his family and social relationships. He lacks any ability and apparent willingness to balance his professional goals and personal and family responsibilities.

He seems to place a disproportionate value on success based on status and acquisitions and believes that he demonstrates his love for his family by working hard. Meanwhile he is emotionally unavailable and unresponsive in meaningful personal communications and in his interpersonal relationships. 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 being able to establish meaningful bonds through his communications with others, especially loved ones, and that genuine personal fulfillment in later adulthood depends very much on the ability to transcend.