Clinical Case Presentation

When Derek, Aged 30, Initially Telephoned me he said he had wanted to call me for several months but had been too terrified. He was cheating on his girlfriend Kim, with whom he began a romance shortly into his two-year marriage to Miriam. He feared really seeing how “messed up” he was, he said, and he feared his own harsh judgment as well as mine. But he felt overwhelmed emotionally (and logistically) by the situation he had created. He very much wanted to be with Kim, he said, and promised her he would leave his wife, but found he was unable to do anything that would hurt Miriam. He was confused and panicked about what he was doing. He felt he desperately needed help. This presentation covers the beginning phase of the treatment, conducted several years ago.

A very tall, muscular man arrived on time for the appointment. He was dressed in black leather pants and jacket, with blonde hair nearly to his waist in a pony tail, and with a mustache and goatee. When he removed his leather jacket I could see that from his wrists to his neck he was covered in tattoos. His face was pierced with metal in his nose and lip and discs in his earlobes. He was not your usual looking patient.

Over some time the story of his lonely, painful childhood emerged. He said he came from “white trash;” that is, poor, uneducated people who engage roughly with one another and, in his case, have guns and drugs at home. He remembered as a small boy a stream of people coming to buy drugs from his parents. He was aware of what was happening and was disturbed by the strangers and the atmosphere. He turned to a television character, Duane the Dude, on show similar to that of the World Wrestling Federation. After wrestling bouts Duane the Dude spoke to the children in “television land” and would say, “Drugs destroy, dudes” and “School is cool, kids!” Derek felt a caring presence in the trusted Duane and felt guided through his childhood by this father figure.