Had first session with new patient. Always difficult to start a new series of treatments, this time slightly more difficult due to the presence of Secret Service personnel in session room. Very hard to get patient to focus on his current delusional self-image and do the hard work of seeing himself as real and human and flawed when he’s surrounded and protected by armed guards.
When asked to wait outside, the Secret Service detail complied, which allowed patient and doctor precious moments to connect. When queried as to the key issues that the patient feels need attention, he just shrugged. …