Date: May 25, 2023
Subject:
Sudden Increase in PTSD Episodes possibly stemming from Patient's recent engagement with his former employer the Hardcore Wrestling Alliance, and realistic nightmares involving alternate realities, and now new Nightmares Involving a Demonic Force.
Background:
Talon W, a 44-year-old male diagnosed with post-traumatic stress disorder (PTSD), has been under therapy for several years. Talon's PTSD was triggered by a traumatic event involving the Hardcore Wrestling Alliance (HWA) sixteen years ago. Talon’s brother, Daniel, was murdered while in college and Talon believes that the owner of the HWA, Semester, was responsible for the murder; later in 2010, Talon was forced to watch Daniel’s decomposing corps be desecrated inside of a wrestling ring resulting in sever psychological trauma. Over the course of therapy, Talon has made significant progress in managing his symptoms, reducing the frequency and intensity of intrusive thoughts, nightmares, and flashbacks associated with the trauma. However, after March of 2020 Talon disengaged from therapy until a recent development has caused a sudden influx of episodes, raising concerns about his current involvement with the HWA. Talon is also reporting hyper-realistic nightmares involving a demonic force called a/the Malphas. This was our first session since 2020.
Presenting Issues:
During our recent therapy session, Talon disclosed an increase in the frequency and intensity of his PTSD symptoms. He reported experiencing more intrusive thoughts, nightmares, and flashbacks related to the traumatic events from his past. Talon shared that the return of the HWA, the very source of his trauma, has rekindled distressing memories and emotions. However, what is particularly concerning is Talon's growing interest and involvement in the revived HWA. Additionally, Talon has been experiencing hyper-realistic nightmares involving a demonic force called a Malphas which he claims has been taunting him about various issues in his life. Talon feels this Malphas is unlike his other dreams, sharing concerns that it could be something completely different from his PTSD, something more supernatural.
Assessment:
The sudden increase in Talon's PTSD symptoms coincides directly with the reemergence of the HWA. It appears that the reintroduction of this wrestling organization has triggered a resurgence of trauma-related emotions and memories. Talon's conflicted emotions regarding the HWA are notable. While the organization represents the source of his trauma, it also holds a significant place in his identity and past. The presence of the demonic force in Talon's nightmares suggests that the trauma associated with the HWA may be more deeply rooted than previously thought.
Treatment Considerations:
Psychoeducation: Revisit the comprehensive information about PTSD and the neurobiology of trauma to reinforce Talon's understanding of his condition. Emphasize the potential triggers associated with the HWA and discuss strategies to manage them. Additionally, provide information on sleep hygiene and the potential link between PTSD and nightmares.
Coping Mechanisms: Collaboratively develop and strengthen Talon's coping skills toolbox to help him effectively manage the increased anxiety and stress related to the HWA's return and the nightmares involving the Malphas. Implement relaxation exercises and explore new techniques to promote emotional regulation.
Trauma Processing: Revisit and process the initial trauma associated with the HWA using evidence-based techniques such as cognitive restructuring, exposure therapy, and eye movement desensitization and reprocessing (EMDR). These interventions aim to address Talon's unresolved trauma and its connection to the HWA and the demonic force, ultimately reducing its impact on his daily life.
Safety Planning: Develop a comprehensive safety plan that outlines strategies to ensure Talon's well-being during potential triggers and emotional distress related to the HWA and the nightmares. Encourage the use of support networks and crisis hotlines.
Ethical Dilemma: Recognize the ethical dilemma surrounding Talon's growing involvement with the HWA. Engage in a non-judgmental exploration of Talon's motivations and feelings, while gently highlighting the potential risks and consequences of reengaging with the organization.
Intervention:
In our recent therapy session, I have focused on validating Talon's emotions and experiences related to the HWA's return and the nightmares involving the Malphas. We have discussed the potential impact of the HWA and the demonic force on his PTSD symptoms and identified triggers specific to these experiences. Through cognitive restructuring, we are working on challenging Talon's conflicting beliefs and emotions regarding his involvement with the HWA and his experiences with the demonic force.
Regarding the hyper-realistic nightmares involving the Malphas, we have explored the potential symbolic meaning behind this manifestation. I have provided psychoeducation on the possible connection between trauma, nightmares, and the subconscious mind's attempt to process unresolved emotions and fears. Together, we have begun to explore the underlying emotions and themes present in the nightmares to gain a deeper understanding of Talon's trauma and its impact on his subconscious.
Moving forward, it is crucial to address the interplay between Talon's involvement with the HWA, the resurgence of PTSD symptoms, and the nightmares involving the Malphas. We will continue trauma processing techniques, including exposure therapy and EMDR, to target the core trauma associated with the HWA and the associated demonic force. Additionally, we will integrate strategies specifically tailored to managing the nightmares, such as imagery rehearsal therapy and grounding techniques to reduce the distressing impact of these dreams.
Considering the ethical concerns surrounding Talon's involvement with the HWA, it is essential to maintain a non-judgmental stance and foster an open dialogue to explore the motivations behind his attraction to the organization. By understanding the complex emotions and conflicts Talon experiences, we can work collaboratively to address the underlying needs and desires that may be driving his engagement. Concurrently, we will continuously assess the potential risks and consequences of his involvement, aiming to ensure his well-being and emotional stability throughout the therapeutic process.
In summary, Talon's sudden increase in PTSD episodes, his growing interest and involvement with the HWA, and the hyper-realistic nightmares involving the Malphas present complex challenges in his therapy. By addressing these interconnected issues through trauma processing, coping skills development, psychoeducation, and ongoing exploration of ethical dilemmas, we strive to support Talon in managing his symptoms, reducing distress, and fostering healing and growth.
Next Session: June 1, 2023
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