Progress Note

by Joseph Reich

Client informed clinician today

that he sleeps with those fangs to

replace bite plate the orthodontist

gave him. Clinician was curious about

role of mother and if she had had any

concerns about nightmares, night terrors.

It is also important to note that this was

the same mother when we provided family

stabilization services at domicile disclosed

while having a manic episode hx of domestic

violence and trauma while still wearing a hockey

mask and youngest child taking slapshots at her.

Family was originally brought to our attention

based on a charge that daughter had been fondled

by a foster child of next door neighbor and son’s profound

feelings of guilt at not being there to protect her; mother’s

poor coping mechanisms, confrontational behavior, and

possible Munchausen Syndrome, emotionally subjugat-

ing her son by constantly reminding him of that traumatic

episode, which apparently was a mask for her own symptoms

of possible drug use, Borderline, Bipolar…Clinician was concerned

about her lack of orientation, disassociative presentation, and restless

body language, which he felt may not have only been symptomatic of

a personality d/o, yet might possibly point to a substance abuse problem.

The husband who was d.v. perpetrator and who had recently been

laid off simply sat in corner in a submissive manner and clinician

was able to feel a genuine amount of empathy for everyone in home

except for her. DSS was contacted for precautionary measures

and 51A was filed for possible addiction to pain killers.

Note too, that clinician felt close connection to client

picturing the image of him sleeping with his fangs on.

______

Joseph Reich is a social worker who lives and works out in the state of Massachusetts…

He has been published in a wide variety of eclectic literary journals both here and abroad, been nominated twice for the Pushcart Prize, and his books include, A Different Sort Of Distance (Skive Magazine Press), “If I Told You To Jump Off The Brooklyn Bridge (Flutter Press), Obscure Aphorisms Written On A Fine Overcast Day (Lummox Press), Pain Diary: Working Methadone & The Life & Times Of The Man Sawed In Half (Brick Road Poetry Press), Escaping Shangrila (Punkin House Press), Drugstore Sushi (Thunderclap Press) and A Whole Childhood Put Together By Model Glue & Other Works (Alternative Current Co-Op.