Behavioral Modification Unit
Patient: N. Gingrich
Insurance Number: Blue Cross/College Health A7YXX Group: 107
Nov. 11, 2011
Patient arrives on time — this is starting to be a habit with him. When questioned, he insists that he has made such progress on his egocentric issues — grandiosity, messianic complex, automatic talking, Baron Munchausen — that he has come to realize that showing up late so consistently was an ego-driven power choice. Doctor compliments Patient on his insight. Patient requests more Ziprasidone. He feels that he’s on the brink of making “a big move” into the top tier of the Republican primary candidates, but when he says this, he smiles sheepishly. This suggests great progress on the part of Patient. For the first time in over a decade of treatment, he shows signs of self-awareness. Will consider upping the Ziprasidone and perhaps supplementing with another anti-psychotic without weight-gain side effects.
Nov. 18, 2011
Patient again arrives on time. Is ebullient and upbeat. Accompanying him is his wife, Callista, which is of course a violation of the therapeutic frame. When Doctor mentions this break from convention, Patient and wife both insist that “as a team” they need to be in total sync with Patient’s treatment. Both seem to feel that great progress has been made. Patient is able to speak extemporaneously for less than eleven minutes, and has modeled normal human behavior so effectively that he is now within a few percentage points of the current Republican frontrunner. They credit Doctor, which is gratifying, though Doctor is aware that this could also be flattery strategically delivered in order to obtain a more powerful prescription for Ziprasidone or even Quetiapine. Patient has negotiated serious social challenges with great skill and grace. Doctor has observed his behavior in many debate settings, and can report that he is currently displaying immense and impressive self-control for a person suffering his level of mental illness. Answering questions, acknowledging the physical presence of others, making wry and self-aware comments, all suggest that the current dosage is correct.
On the other hand, Patient is displaying hostility toward all members of the press corps, which suggests chemical imbalance in the behavior-modulating functions. Patient is fixated on the false solution of increasing the anti-psychotic medications and does not respond well to Doctor’s suggestion that the meds will be more effective with increased exercise, meditation, and light therapy.