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Melvin Udall
Approximate Age: 59
The client Melvin Udall, is a 59 year old single, author. He has previously seen
his other Psychologist for a few sessions. The other psychologist had prescribed him
medication to combat and lessen the effects of his OCD. He was also diagnosed by his
other physician as having OCD and for being a misanthrope. OCD or Obsessive
thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel
dislikes humankind and avoids human society. (Obsessive Compulsive Disorder." Psychology
Today. Sussex Publishers, n.d. Web. 24 Feb. 2017) (Misanthrope. Merriam-Webster. Merriam-Webster,
The client, Mr.Udall had referred himself to his previous psychologist to try and
get a hold on his disorders and take back control of his life.
Presenting Complaint
Because of Mr. Udalls OCD, he has several things that he has to do and some
that he cant do,they are almost nervous ticks that if he doesn't comply with his OCD
then he begins to get emotional and wont calm down until the things that he has to do
are done. Some of these things that he has to do include, locking/unlocking doors five
times before closing them, and turning on/off the lights 5 times before leaving them
either on or off. He also cant step on cracks and will even avoid going into certain rooms
washes his hands and it is always with scalding hot water. He also needs to sit at the
same restaurant in the same booth and have the exact same waitress every time as well
as getting the exact same meal. Will also use his own utensils for the food. This is
challenged when his waitress, Carol, cant come into work because of her sick son. Mr.
Udall had actually payed for a stay at home doctor to look after her son just so that she
With his Misanthropy, he also has a few complaints as well. He cant be touched
and will become extremely uncomfortable when he is. He doesn't like to hear about
peoples past and will become irritable when he is told about such things, for instance
when his neighbor, Simon, starts talking about about his past, he tells him to shut up
and that he doesn't want to hear this. He is impatient, rude, and doesn't have much of
a filter, actually saying get away from me you elephant to a waitress who isn't Carol
tries to take his order. He also finds it difficult to give compliments to others.
a) Melvin said that his OCD began to affect his daily life when he was about 2 or 3
years old and about the same time is when this began to manifest to those that
b) The clients highest level of adaptive functioning in the past year would be almost
some of his OCD stresses and there being no reactions from him at all, however
these are always only temporary as they never truly go away and will surely come
c) Besides the OCD and Misanthropy, he has no other pre existing conditions, or
Inhibitor. or SSRI. This drug, eases symptoms of depressed mode and anxiety.
(Obsessive-Compulsive Disorder (OCD) - Medications." WebMD. WebMD, n.d. Web. 24 Feb. 2017.)
Medical History
His OCD may be genetic and he may have inherited it. There is also of a history
of abuse in his family. He says, my father spent 11 years of his life in his room and
whenever I made a mistake on the piano, he would hit my knuckles with a yard stick He
doesn't say much else about his father but this little bit of information could be a cause
Personal History
a) There are not any outstanding events in his birth or in infancy such as frequent
b) He does not say much about his childhood, except for the fact that there may
have been a history of abuse. This also may be where his misanthropy may have
c) In his adolescence, this may have been where his father stayed in his room for
those 11 years. Also this is where his misanthropy and OCD would have been in full
form and where he is just starting to learn how to deal with them. This is also where he
might have gotten prescribed the medication that he is taking to help relieve the stresses
of his OCD.
d) After his adolescence up until now, he has become an author and has also
learned how to masterfully play the piano. It is very unlikely that he has ever been
dating, nor does he have any sexual history or experiences. He has never been married.
His living arrangement at the moment is that he lives by himself but has invited Simon,
his neighbor who was attacked in his home and is close to filing for bankruptcy due to
Family Constellation
Melvin has not said much about his family, although he has mentioned a father
who had a tendency to abuse Melvin, as well as staying in his room for 11 years. Even
though it isn't a part of his actual family, Simons dog Verdell, whom Melvin watches
while Simon is in the hospital, is a huge part of Melvins life, Verdell may actually be the
one who makes Melvin come around to accepting other people in his life.
Other big people in his life would be Carol, the waitress, and Simon his neighbor.
Both of these people, however unlikely at first, become close friends of Melvin.
Probably the first that he has ever have. And he may actually have found something
would be that he starts to need the people that are in his life and that as he becomes
closer to those people in his life, he realizes that his compulsions aren't as important as
Because of the people in his life, he actually starts to take his medication again
because he says to Carol, you make me want to be a better man and that he would do
Melvin's level of function has ranged anywhere from not being able to walk into
rooms because of his OCD, to not even realizing he is disobeying his compulsions. His
strengths in this area would be that once he gets over the fact that his compulsions are
actually just feelings that he has he can function almost completely normally, allowing
him to have normal relationships with other people, have normal hobbies and be able to
be a productive member of society. His weakness is that his compulsions will never
actually go away and that eventually he will always revert back to those strong
compulsions. Basically rendering him unable to hold conversation with people, even the
simplest tasks could become very difficult for him. He wont actually be at any actual risk
of harming himself or even committing suicide. Nor is it likely that he will act in any
homicidal way.
Tentative Diagnosis
disorder that causes him to act on feelings and compulsions that he has. He has
unwanted and intrusive thoughts or distressing images that are causing him to do
certain things over and over again. These are usually accompanied by compulsive
directed and for him to also schedule an appointment for regular evaluation every 2
weeks and if there is progress then reduce the amount of visits down to once a month. If
he starts to improve from there then we may do away with appointments all together.
The treatment goals for Melvin would be to get him to a place where he can
Initial Prognosis
If Melvin stays on his medication, and continues to meet with a psychologist the