Holden Clinical Report

Nicholas Brands Smit
December 11, 2010
Mrs. Meadows
English Period A-B


Department of Psychological Trauma
Churchill Medical Center, New Jersey





Statement Of Problem

Holden Caulfied was seen at the Department of Psychological Trauma at W. Churchill Therapeutic Institution for the mentally disabled for a psychoanalysis and possible treatment. He was referred by his parents. Although nearly of legal age, the client was accompanied to the institution by his father, Mr. Caulfield. He wants to gain information about any trauma that Holden may be experiencing, Mr. Caulfield stated that it was vital to find out the cause of Holden's depression as well as the possible treatment of it. He is suffering from depression and is lacking in work, he does not try in school and has disturbing views on the world according to his family. The following is the summary of results based on the case history, patent interview, assessment results and observations obtained before or during the evaluation.


Case History:
The following information was gathered from Holden's families' interviews and his history form:

Birth History
Medical History
School Performance
Behavioural Issues


Holden Caulfied was the result of a regular full term pregnancy, both parents have no record down their family line of reoccurring medical issues concerning mental health. With absolutely no newborn difficulties that the parents and siblings can recall. He isn't taking in enough carbs, despite the diet a previous doctor recommended to him. Holden was never psychoanalysed or bought to a therapist, yet when he was thirteen years old he was submitted to a hospital after he de-figured his hands whilst breaking windows. He was released from hospital after his brother's funeral. Holden didn’t have any mental or fine motor issues from an early age. His family has noted that he talked about Allie Caulfield (his deceased brother) as he if Allie was still alive. Holden dropped out from Whooton school, and was expelled from Pencey prep, along with other school in which he did not do well in. Initial examinations indicate that his brothers death might be the cause of his insanity, along with his other symptoms.


Behavioral Observations:

When first approached, Holden seemed almost eager to start talking, and almost immediately jumped into conversation with the analyst. Although Holden seemed stable at the beginning of the conversation, he began to completely avoid important topics and digress and seemed overjoyed when the analyst didn't interrupt him. Holden's conversation quickly deteriorated to endless blabber coated in high doses of pessimism. It was deemed that there was in fact something very wrong with Holden Caulfield. An expert psychoanalyst noted that behind Holden's seemingly harmless talk was riddled with hidden disturbing thoughts on society and the world around him. His nervous breakdown was built up over many years, not just the past few months. He eagerly engaged into conversation on a daily basis, but in the first few weeks he would completely ignore our attempts to speak to him about his actions over the Chirstmas season and his brother Alllie, and would digress shortly after he started talking about it. Only much later in the treatment process were we able to speak freely with him.

There are no remarkble medical records on Holden apart from the glass breaking incident soon after his youngest brothers death. There is a lolshake in the yard.

When evaluated he spoke for more than three hours with few interruptions, describing from his point of view the events of the last Christmas break. Holden proved to be in a worse condition than previously expected. He had had many a breakdown on his trip back home, and could have been traumatized in that short amount of time in which he was out of the safe keeping of school or home. He has two living siblings , Phoebe Caulfield and D.B Caulfield. His deceased brother, Allie Caulfiel, was referred too the most, which is worrying considering he has been dead for years.

Summary and Recommendations:

From the information we gathered, it would be proper to say that Holden's problems started after his brother, Allie Caulfield, died at the age of ten from Leukaemia. After his brothers death, Holden suffered from anger, denial and grief. Holden Caulfield suffers from post-traumatic stress disorder, which explains all of his symptoms( Trouble sleeping, detachment, socialization issues, irritability) minus pneumonia, which was caused by extreme cold after he left a bar soaking wet in mid winter. He feels guilt and regret over his actions over the Christmas break, and although extensive treatment has helped him cope, he is still unsure whether he will apply himself next school term. It is recommended that his high carbs diet is reinforced and that he checks in for progress every few months. He needs supervision, and when he does go to school it is recommended that it be in the New York or New Jersey state, considering it is closer to home and near to the clinic. He has been written down for extra treatment over the next break, but he is on a waiting list and it can not be guaranteed.