Case Formulation Report - Abnormal Psych

For just twenty minutes a year, the world seems like the empty moon. It feels lighter with 1/6th the gravity, like on the moon. I wish the world would freeze like this. So life could be 1/6th lighter. ~ Jung-yeon

Based on the girl main character from the 2009 South Korean movie "Castaway on the Moon."

Contents:
I. Identifying Information and Referral Problem
II. Psychosocial History
III. Medical and Psychiatric History
IV. DSM-IV-TR Multiaxial Axis and DSM-V Diagnostic Criteria and Codes
V. Rationale of Diagnosis
VI. Case Formulation
VII. Recommendation
Citations

Note: The only thing that my professor disagreed on was my diagnosis of Persistent Depressive Disorder (Dysthymia), that the symptoms can be explained by the MC's first two diagnosis - Social Anxiety Disorder (Social Phobia) and Anorexia Nervosa, including her Avoidant Personality Disorder. Avoid over-diagnosis was the advise given to me. I still stand on my diagnosis though. Maybe it just needs better formulation/presentation. Or just ignore that part if you agree with my prof.

Frame/d Angst

          I think there are two kinds of people: those who fit well inside frames, and those who don’t. Frames? You might ask. I mean, family, nationality, sex, things like that . . . they’re all frames, aren’t they? They exist outside the body known as “I,” don’t they? I used to live my life inside a gilded frame, but I realized one day that the picture inside the frame was terribly poor. In order to redraw a picture, one has to remove it from its frame. - Double House 

          So when I got rid all of my hair on the so-called doomsday last December 21, 2012 according to the Mayan calendar, everyone around me were dumbstruck and kept asking “What are you?” Oh my. What a deep question, I thought, considering their state of inebriation. But how should I answer it? Hmm. I don’t really want to answer a question about biology. 

San Francisco Flower

    I am not a flower lover. It just so happened that I was entrusted the key to our room. Thus starts the beginning of my everyday responsibilities of waking up five in the morning and doing lots of odd jobs every now and then. One major part of my routine was finding three fern leaves, or as we commonly call it – pakô. At first I have no idea what the hell is pakô so the “ayun oh, sa gilid, ayan ayan, hindi iyan, nasa harap mo na turuan portion” lasted around five minutes in our school garden. 

   Over time, I have developed my personal preference whenever I set out my journey of picking up pakô: lusciously green and of the same sizes. The next thing that I did was to fill the translucent and longitudinal vase with tap water. Now, where is this now vase-with-three-ferns displayed? It was placed at the center of our teacher’s table, surrounded by a calendar, pen holder and table trays. But it did not end there. 

Chewed Longing

          I envy my grade five self-made papier-mâché project. I can’t believe that it will still be ‘alive’ up to this day considering my age at that time and that it was my first time making it. I remember that we were just generally told of what to do. And so I gathered pieces of used bond and manila papers and a piece of tin can. Firstly cooking gawgaw (cornstarch) so I can have plenty of paste, then cutting the papers into small pieces and finally pasting as many as I can so that eventually it becomes so thick, I foolishly paved my way towards the first part. After it completely dried up, I laboriously cut it into halves, removed the tin can, pasted additional layers of paper again and voila, my very cheap paper mache pen holder was done. And for beauty’s sake, I managed to add designs into it by painting it royal blue and pasting bits of egg shells shaped into flowers. 

Leadership, eh?

(This is my essay on my perception of leadership. A requirement somewhere, somewhen)    

            Sa ilang oras na pagbaling-baling ko sa higaan, sa bawat gabing hindi makatulog sa panunood ng anime sa pag-asang makahanap ng mga kasagutan, sa ilang araw na pagkausap sa sarili at pagmumuni-muni ng mga naging karanasan, wala pa ring katiyakan kung aking mabibigyang katarungan ang isang payak subalit mahiwagang katanungan – na hindi ko na kailangan pang isa-isahin sa kadahilanang lubha itong mahaba, nasa wikang Ingles at nasa Facebook naman. Naman! Hindi ba’t pormal dapat ang aking pagsusulat? Subalit ipagpaumanhin mo at ‘di ko na mapigilan ang paggapang ng aking mga kamay sa aking ulunan at mangamot, sapagkat  ako’y labis na nagugulumihanan, oo, ako’y sadya pa ring nag-aalinlangan.  .  .

            Labimpitong taon na pala akong humihinga sa bilog na mundong ito, pero ni minsan hindi ko man lang pinagka-abalahang tanungin ang aking sarili kung ano at hanggang saan na nga ba ang aking nalalaman sa aspeto ng pamumuno at ng isang pagiging pinuno. Ano na nga ba ang naging impakto este epekto nito sa lakad-takbo ng aking buhay. Siguro naiinis ka na, ‘no? Ang dami ko nang pag-aantalang ginawa, wala pa rin akong nalalagay na makabuluhan. Hiling ko lang ay iyong maunawaan na basahin ang hindi nababasa, ngunit ‘wag kang mag-alala, aalalayan kita, bibigyan kita ng implikasyon at patnubay. Haaay! Epal ko talaga. Epal na nga, barubal pa magsulat!

            Leadership. Leadership. Mmmm… Ipakita mo sa ‘kin ang iyong tunay na kaanyuan! Toinks! Ano daw? Epekto ‘ata ng anime ‘yan eh, tsk, tsk! Haiss! Seryoso na nga.

            Ako, si hulaan mo, isang bata. Ngunit bata pa bang dapat na tawagin? Sa edad kong ito, pakiramdam ko napag-iiwanan na ‘ko ng mga kasabayan ko . . . noon pero malamang ‘di na ngayon, ang layo na nila, wari’y ‘di ko na sila maaninag. Basta. Naniniwala akong ang mahalaga ay importante! Tama! Maniwala ka lang at gagawa ang kalawakan ng landas na para sa iyo lamang. Natutuwa talaga ako at nakilala ko si Naruto, dahil paano ako magkakaroon ng sarili kong depinisyon ng leadership kung walang tao na siyang uukit sa puso ko ng depinisyon nito. Hindi ba’t ang tatlong katanungan ay may iisang layunin lamang, at iyon ay ang makilala kaming mga hangal na nagnanais na maging susunod na mamumuno ng **tooot*** sa kabila ng kaalamang labis-labis na hirap at sakripisyo ang aming pagdadaanan ng nakayapak, walang saplot at walang sandata maliban sa aming mga nag-aalab na pusong nagnanais maisakatuparan ang tila kahangalan at walang-kwentang pangarap na ito. Maaaring tama kayo sa iniisip niyo. Ano bang mapapala namin sa pagwawaldas ng oras at enerhiya sa mga training namin? Marami. Positibo. Negatibo. Tama lang. Wala lang. Depende sa ‘min.

OK Fine, You’re The Boss!

         Once my favorite teacher said, “Be humble.” And before I left she whispered “Stay humble.” Define humble. The dictionary defines humility as modesty, lacking pretense, not believing that you are superior to others. An additional definition contains: "Having a lowly opinion of oneself; meekness". Well, the word "humility" first struck me in the context of respect, humility in the lives of the students, of teachers, and how the word respect existed between the two. Let me share with you the series of things that has been swarming in the cerebrum of my brain and in the four chambers of my heart.

       Your four years of stay high school has taught you the two sides of humility in partnership with respect.  As a freshie student by that time, adaptation was the hardest thing you’ve to handle. You have had to listen well to the rules and regulations so you won’t be reprimanded. Now, there goes obedience, especially to your teachers who seemed to see you like sheep without a shepherd, and thought that they were good enough to accept the preordained task. Conform to everything they ask you to do and surely you’ll pass to be a sophie.

       Moving on, you’re on your second year in high school and of course you’ve gained profounder intellect and a teenager like you started somehow screeching for your rights, knowing that students have this thing called Magna Carta. Though you didn’t quite well understand the contents of that thing, for you even haven’t read a page of it, others say that it defends your being human and student, so you gradually learned how to furtively disobey some, yes,  some of those do’s and don’ts, thinking that it’s just for the meantime. 

        And as you became a junior student, all I could say was “what happened to you?” Complacently, you answered back - It wasn't until quite late in life that I discovered how easy it is to say "I don't know!" So that’s it, you’re acting dumb. Wow, isn’t that great? You’re proving that no one could ever stop you, could ever let you do things you do not somewhat like. Still, there’s that big difference between innocent and acting-innocent-turned-into-ignorant. You considered this year of your high school life as the most memorable one. The hell I care was the thing you repeatedly say.