Читать книгу Dynamic Consultations with Psychiatrists - Jason Maratos - Страница 48

Bob was born in the city. His father was a shop assistant, described to be hot‐tempered, and often scolded and hit with bare hands, a bamboo cane, with hangers, or keys. His mother was a housewife, described to be even‐tempered, but also used corporal punishment.

Bob was described to have normal development milestones but had poor social interaction with his classmates. He was reported to have poor eye contact, often felt scared to see people, and refused to talk to others. He had interest in memorizing bus and train lines. He enjoyed watching TV advertisements with jingles and often sang these jingles in the wrong social context. He reported that he had been speaking only English since 2001 because he believed that he was an English teacher and that he “should not” speak the local language. He recalled watching the news in English and tried to imitate a British accent. Since then, he had been speaking in English obsessively, even when it was socially inappropriate for him to do so. For example, he insisted on speaking English to his students' parents even though they could not understand. He was told by his school principal and his colleagues that he shouldn't be rigid, but he ignored the advice. At school, he was described as socially awkward and weird. He had no friends. Growing up, he was bullied throughout primary and secondary school for being “weird.” He had no confiding relationships. He reported various episodes of intense anxiety during his school years prior to school examinations or being asked to do public speaking. He described his baseline anxiety to be high, and trivial events were enough to cause a surge of intense anxiety.

Other than corporal punishment and physical abuse by his parents, he reported an episode of sexual abuse/harassment when he was 12. He was at home watching cartoons with his two brothers and the phone rang. A man claiming to be a policeman asked him how many people were at home and then asked him to do as he was told or else the police would come and arrest him. He was asked to take out his penis and to measure the size. He was then asked to masturbate and then measure the size again. He was then asked to do the same to his two brothers. He was then asked to stimulate his elder brother's penis with his mouth, but he found it disgusting so he sucked his own fingers instead. His mother then came home and asked what had happened. She told them to hang the phone up. Since this occurrence, Bob believed that some adult men were dirty, especially those who smoked and spoke foul language.

Bob met his wife at university. It was his first relationship. The couple started dating while they were still at university. His wife found Bob to be socially awkward at times but admired his ability to speak in fluent English. His wife was also a primary school teacher. The couple married in August 2016. However, they found it difficult to have sexual intercourse because Bob did not know what position he should be at. When he tried to penetrate her, he claimed his wife would experience pain, and he would stop to avoid hurting her. As a result, Bob and his wife developed a fear of sexual intercourse. As the couple wanted children, they downloaded pornography online to watch together and hoped that by imitating the actors, they would be able to have successful sexual intercourse. They tried for 2 years already without making any progress.