Free Essays - Holden Caulfield's Psychiatric Evaluation

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Holden Caulfield's Psychiatric Evaluation



This is the first psychiatric hospital admission for the patient, a 17 year-old male. The subject freely admitted himself to care at 13:00 hours on November 28, 1958. Mr. Holden Caulfield arrived at the hospital in the company of his parents--whose consent was necessary given Holden's legal status as a minor--and his younger sister Phoebe. His induction took place without any incident.


At the time of his arrival, Holden appeared very tired and run-down. He was wearing woolen slacks and a warm jacket but appeared to be suffering from an intense chill. His walk was slow and his gait guarded, as if he expected an attack at any moment. He appeared lucid but seemed unsure of his location. His tiredness and confusion, however, did not mask his above average intelligence. This became especially apparent to the nurses assigned to his care, one of whom reported that Holden's penetrating gaze made her feel as if he was judging her character. The patient has also displayed a penchant for sarcastic comments, especially regarding "phonies." At this time, we remain unsure of whom he is referring to when he uses this terminology.


Holden is the second eldest son of Mr. and Mrs. Caulfield. Mr. Caulfield works as a lawyer. His wife is a homemaker. He is one of four children born to the couple. His relationship with his parents and siblings appears to be normal. Preliminary interviews indicate that Holden had idolized his older brother, D.B., throughout his childhood. Recently, however, his opinion has reversed. D. B. Caulfield, a writer, has recently relocated to Hollywood. Holden regards this move as a misstep for his brother and has even gone so far as accusing him of prostituting himself by agreeing to work for the film industry. The patient also appears to have had a close relationship with Phoebe, his youngest sister. Holden's other brother, Allie, was two years his junior and died of leukemia on July 18, 1946 (page 38). Tragic as this loss was for the Caulfield family, it seems to have had a greater impact on Holden than on any of the others. He was thirteen at the time of his brother's death. Upon hearing the news, Holden broke all the windows in the garage with his bare fists. His parents report that Holden's personality underwent a radical change following Allie's death. Among the most notable changes, they list a decline in Holden's social skills and a loss of interest in academic pursuits. The loss of his younger brother appears to have upset Holden's mental state.


The events immediately precipitating Holden's hospitalization began with his expulsion from Pency, his boarding school. According to school officials, Holden was scheduled to leave for his parents' home on Wednesday but a fight with his roommate caused him to leave earlier. After leaving Pency, Holden traveled to his hometown of New York City but failed to go home. Instead, he stayed at several hotels and went out to clubs and bars. His forays into such inappropriate environments led to encounters with, among others, a prostitute and her pimp. Holden went so far as to solicit and pay the prostitute, though he claims to have never engaged in sexual intercourse. Following this encounter, Holden went on a disastrous date with Sally Hayes, an acquaintance. The date did not go well and, in very low spirits, Holden sought out his youngest sister at the family home but left before his parents returned. His next stop was at the home of one of his former teachers, Mr. Antolini. Holden reports that Mr. Antolini was inebriated and, in the course of the visit, made sexual advances toward him. After wondering through the streets of New York feeling lost, Holden reports that he decided to leave the city to go out and make a life for himself. Before leaving, however, he sought out Phoebe to say goodbye. Holden located Phoebe in Central Park but, rather than saying goodbye, he stayed after being overcome with a feeling of "true happiness" while watching his sister on the carousel. However, a few days after returning to the family home, Holden became depressed again. His parents suggested he visit a psychiatric hospital. He agreed stating, "might as well go since everyone around me is a phony."


In his entry interview, the patient stated that he is voluntarily here because he can no longer stand the phonies of the world. He defined a "phony" as an insincere and artificial person. Holden says he longs for a place where it is "sunny as hell all the time" (page 199) and where he may be free from the constant intervention of phonies whom he claims ruin the world with their insincerity. Holden seems to strongly dislike the world around him. He has expressed nostalgia for his childhood days when he could go fishing and had no problems. This longing is also reflected in several of his statements regarding how much he hates to watch Phoebe grow up and lose her innocence. However, Holden seems to realize that life is much like a carousel where one must reach for the gold ring and if "they fall off, they fall off" (page 211). The patient cried intermittently throughout the session. After each crying fit, Holden acted as if nothing had happened and referred to me alternatively as "a real prince" (page 47) and "a scholar kid" (page 48). After several of these somewhat hostile remarks, I decided to conclude our first session.


In my professional opinion, Holden Caulfield is suffering from an acute case of growaphobia. This condition is characterized by an irrational fear of growing up and losing one's childhood innocence. It is clear that Holden finds many of the changes he is encountering, as he grows older difficult. He shows a remarkable lack of maturity, as demonstrated by his reluctance and inability to engage, at the age of seventeen, in sexual intercourse. Holden's relationship with his siblings also reflects his growaphobia. While he enjoys a good relationship with his younger siblings, his relationship with his older sibling, D.B., is much more troubled. He seems to have displaced his fears about the effects of growing up onto his resentment of D.B. and his desire to protect Phoebe and preserve her childish innocence. Luckily, under treatment, Holden is beginning to accept the fact that Phoebe cannot remain a child forever.


I recommend that Holden remain under my care at Happy Loons Hospital for the time being. I believe that participation in regular psychotherapy sessions will greatly benefit him as he negotiates his fears about adulthood. I also suggest that Holden initiate a course of Zylonconoff to stimulate the chemical production of his maturity gland. I believe that this combination of therapy and medication will result in Holden's acceptance of adulthood. Should he be able to do this, I believe the patient shall be able to attend the public high school his parents have chosen for him, as well as be able to make more mature relationships. The future looks bright for this patient.



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