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Monday, October 25, 2004

Sixth consultation with Timothy Speedle.

Tim attended scheduled appointment in private consulting suites today. He looked physically well - clean shaven and left shoulder and states he has been sleeping better since he returned home. Tim states he has continued taking alprazolam prior to going to bed but is hoping to wean off in the near future. He states the initial side effects from when originally initiated on sertraline have abated and feeling 'OK'. States he has been 'thinking a lot' about the memories which were reawakened from our last session regarding Ben's accident and subsequent death. States has tried to combat these memories by attempting relaxation techniques however states he thinks it 'was easier to deal with when he could not remember'. Reinforced the overall goal to process these memories appropriately and to, therefore, be able to process the recent shooting events in order to function effectively in the future.

Tim has been discharged with home services and outpatient physical therapy. He states that he is also receiving and lot of support from his friends with regard to meals and company. According to Tim, Dr Alexx Woods has been staying overnight at his apartment since he was discharged and that his friend, Eric, had been 'rostered on for later in the week'. He states he is happy to accept this as 'doesn't feel up to being alone at the moment'.

On further questioning, Tim talks about feelings of vulnerability given his current physical limitations and describes feelings of being overwhelmed at times with an influx of 'bad memories'. He states he appreciates waking up and knowing he is not alone in the house. When asked how long it had been since he had shared a house with someone, Tim stated it had been 8 years and that he had lived with an ex-girlfriend for almost 6 months in St Petersburg. In the demise of the relationship, Tim had moved from St Petersburg to Miami and had not had such a serious relationship since. States, in lieu of a girlfriend at the moment, tends to confide mainly in Dr Alexx Woods and her husband with regard to personal issues although also states that he has not told them anything about recent information pertaining to Ben's accident. When questioned, he talked about being hesitant to 'drag [his] past life into his present one'. Tim went on to say he felt as if he had worked hard over the past 11 years to build a new life for himself which had enabled him to distance himself completely from his childhood and to reinvent himself with new friends and a 'new family' who knew nothing of his past other than very basic information.

Discussed the importance of being able to confide in trusted individuals and talked about the physical and psychological effects of carrying such a heavy mental burden through life without support.

Tim was challenged to list several people he would feel comfortable to confide in regarding the events surrounding Ben's accident and his subsequent departure from his life in New York. He identified Drs Alexx and Joe Woods as two people he felt comfortable talking about most things with but states he did not want to 'burden' them with his past as he felt it would result in them seeing him differently and would affect their close friendship. He states he did not feel he could discuss matters of such a personal nature with his best friend, Eric Delko, nor his colleague Calleigh Dusquene. He states he has two close friends outside of work, Matt Harkins and Rachel Bianco, but, again, feels as if it would risk affecting the status of their current friendship.

Given the lack of solid friendships throughout Tim's childhood, I believe he struggles to understand the concept of non judgmental friendships and loyalty - despite Tim clearly exhibiting these traits among his own friends. Reinforced to Tim that confiding in trusted friends adds depth to these relationships and asked if he had ever played the role of confidant to any of his friends. He was able to identify several examples when he had been the 'trusted friend' and confirmed that the experience had not adversely effected their friendship and he still saw them as the same person they had been prior to them confiding in him. Reinforced that confiding in his trusted friends, was an important step in his recovery from both his childhood and the recent shooting.

Talked about recent studies showing significant benefits of unburdening oneself of negative experiences and the impact of talking to others in overall healing and psychological progression through to wellness. Highlighted the reduction in depression rates and anxiety through sharing experiences and reinforced that, despite the difficulty in opening up to others, the benefits are often profound.

Asked Tim to nominate one person he trusted completely to share the experience of Ben's death with. He identified Lieutenant Caine and states that, although he expects it to be very difficult to tell him, he feels he is the one person who would listen and not pity him. When questioned about his friendship with Lt. Caine, Tim states he has been his boss on and off for his entire time in Miami and that he had been the one to hire him from St Petersburg. He talked about how he had always seen Lt. Caine as someone to look up to and how he admired him as a person as well as a boss and mentor. On further discussion, it is apparent that Tim has substituted Lt. Caine as his father figure in the absence of his biological father in his life. He is driven in his need for acceptance and to be respected by him. Based on my discussion with Lieutenant Caine, I believe that the feeling is reciprocated with him seeing Tim as a surrogate son and, as such, I have reinforced him as a good candidate as a confidant. Reinforced complete confidentiality of these sessions.

PLAN: I have received permission from Tim to contact Lieutenant Caine again and to set up a time of mutual convenience to help him talk through the events of Ben's accident and death.

Tim to continue relaxation techniques (breathing techniques prior to sleep and counting techniques in times of increased anxiety or when heavily burdened from previously repressed traumatic memories).

Scheduled next appointment for Friday, October 29 - to continue with normal appointment if unavailable to attend.

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