The Diagnostic Profile: IV. A Terminal Profile (Gerry)

This terminal profile was written some eight years ago. Its aim was twofold: (1) to check the formulations of the original diagnostic profile against the subsequently unfolded treatment material, and (2) To reassess the patient's pathology and functioning at the end of treatment. Of especial interest was the pinpointing of areas of the personality in which changes had occurred and of those areas in which there had been little or no change.

The diagnostic profile was written by the diagnostician who initially saw the child and his parents; the terminal profile was compiled by myself, the child's therapist.

The form of the two profiles is the same. The terminal profile, however, was based on treatment material and on two post-analytic interviews, in addition to the diagnostic data. Its headings are those in use at the Clinic at that time.

Each section of the diagnostic profile is summarised and followed by formulations derived from the material of the analysis.

Gerry was 14 years old when treatment started and 15.9 when he prematurely stopped it. He was meant to attend five times per week but his attendance was very irregular and he mostly had only three or four sessions per week.

Description of Symptoms

As Seen in the Diagnostic Profile

Gerry was referred to the Hampstead Clinic by a psychiatrist who knew of the Clinic's interest in blind and partially-sighted children. He had been suffering for two years from a rare and severe eye condition which threatened blindness. Its specific aetiology was unknown.

Although highly intelligent, Gerry has always achieved far below his potential academically. The parents, especially mother, complained about his laziness. They had always tended to ‘push’ him. Mother felt guilty that his eye condition might be associated with intolerable stress due to excessive pushing. Gerry worried his parents by his apparent lack of ambition; they complained that he was exploiting his eye disease to avoid schoolwo