Psych Ward: Bullseye

Before providing the progress note below, this writer must lodge a complaint regarding the therapeutic environment. While I have no complaint with the institution making my safety their primary concern, the lengths they are going to do so seem best characterized as “excessive.” Not only is the therapist barred from seeing the client “Bullseye” (real name unknown) in the same room, the therapist is unable to see the client at all. All communication is done via vocal communication only and due to the nature of the speaker system, it is makes the client’s speaking voice difficult to “read” accurately.

From the file provided, the therapist is aware the client experienced significant bodily injury recently that evidently necessitated the use of an iron lung like instrument to keep him alive and healthy. While the therapist feels comfortable guessing this is no longer the case, I have no definitive answers on the matter and the institution refuses to disclose such information. Without body language, a means of hearing the client clearly, and/or an update health record, this therapist will be greatly limited in helping the client.

Of course, the second question is how much can be done to help the client in the first place and this is not at all clear. Given both his history and statements issued in our initial sessions, the client clearly seems to fit criteria for Antisocial Personality Disorder. Additionally, given the client’s repeated attempts to be famous and appreciated for his skills—initially in baseball and then, later, as an assassin and what seems fair to refer to as a “super villain”—this therapist feels comfortable with a diagnosis of Narcissistic Personality Disorder.

(It is worth noting that the client also suffered a tumor-induced Delusional Disorder for a time, but, after surgery, no longer appears symptomatic)

Those two diagnoses together are incredibly difficult to treat. Even under the best of circumstances, some therapists have speculated that treatment really only helps the client become a more interpersonally effective sociopath and these are hardly the best of circumstances. The client being forced to comply with a therapeutic regime in a prison setting combined with the aforementioned issues above does not create a pro-therapy environment, typically. Additionally, “Bullseye” has made it very clear he has no regrets about his violent activities and has no interest in changing them or his nihilistic worldview.

Bullseye by Dave Johnson

In presentation, the client is often charismatic but provocative and quick to anger at the mere mention of the street vigilante Daredevil. “Bullseye” is casual with stories of his violent crimes and seems to be sharing them to intimidate the therapist. At times, the client abandons subtlety and straight up threatens the therapist.

Given present circumstances, this therapist does not feel he can be successful with this client. Therefore I would suggest the doctors listed below as possible better options for the client. If the changes the therapist have requested regarding the therapeutic environment are made, however, the therapist would consider at least attempting to build therapeutic rapport and establish an ongoing treatment plan.

If not, I recommend Doctors Charles Soule and Goran Sudzuka. Their writings on “Bullseye” are available in the pamphlet DAREDEVIL #16, available for review on January 25. Alternately Doctors Ed Brisson and Guillermo Sanna are experts in the assassin and will have an academic report available on him on February 1 called BULLSEYE #1.

Psy D. Candidate Tim Stevens is a Staff Therapist who was always pretty good at archery. Not to brag or anything.