The Freedom Broker (Thea Paris #1)(45)
She pulled them out and started reading.
Dr. Alexander Goldberg
July 4, 9:00 a.m.
INSTRUCTIONS
All clinical notes and records related to the patient Nikos Paris, including diagnosis and treatment, are to be released ONLY to the patient’s father, Christos Paris. Hard copy only, no electronic release or mailed communications.
SUBJECTIVE
Christos Paris indicates that he had “always spoiled” his only son, Nikos, fulfilling his every wish and desire, up until the time of the boy’s kidnapping. Nikos had grown to expect that he would be given everything he wanted and was accustomed to immediate gratification. Of particular note is the death of his mother in a sailing accident when Nikos was ten.
Nikos was kidnapped from his home in Kanzi, Africa, at age twelve. When he was returned after nine months in captivity, the father indicates that his son was moody, alternating between periods when he became withdrawn and uncommunicative and periods of uncontrolled temper outbursts, having little ability to enjoy many activities that would be normal for a boy his age. Nikos still had the expectation that his father and others should cater to his needs and desires with no exceptions. His moods are unstable, so Mr. Paris has a nanny watching over the children at all times. A new family dog seems to be helping Nikos adjust.
OBJECTIVE
Nikos is a well-groomed, intelligent boy who appears older than his stated age, in part due to his above-average height. He has no significant medical or health issues and no reported symptoms of pain, discomfort, or physical distress.
The patient’s father was present for the entire intake interview. The father was also interviewed separately. The initial therapeutic contact occurred approximately two weeks after Nikos returned home from captivity and continued for several months. At first the patient did not disclose any pertinent details of his time in captivity, having a difficult time voicing his experience. It was only after additional sessions, the establishment of rapport, and with encouragement to write his story in his own words that he shared an account of those nine months of captivity. Nikos presented the usual, predictable resistance of a trauma victim to relive the ordeal, but after training in relaxation skills, he started the process of recording his experiences.
He generally demonstrated a flat affect and was for the most part fairly uncommunicative, allowing his father to provide much of the information regarding the history. On a few occasions, when being directly questioned about his captivity, he demonstrated some fairly extreme outbursts of anger, with both verbal (swearing, shouting, berating the interviewer) and physical (kicking the coffee table, punching himself on the leg) manifestations of emotion. These outbursts were followed by brief periods of complete silence, during which he made no eye contact.
ASSESSMENT
This almost thirteen-year-old, physically healthy boy presents as generally uncommunicative, with periodic outbursts of verbal and physical anger, making only infrequent eye contact. The provisional diagnosis is that of narcissistic personality disorder with antisocial tendencies, along with strong resentment toward authority figures. A contributing factor to his narcissistic features, including a strong sense of entitlement, may well have been instigated through extreme parental spoiling, whereas some symptomatology likely also emerged as a result of his kidnapping and the events of his nine-month period of captivity. Follow-up sessions will further explore these issues and diagnostic details.
PLAN
A trial of psychotropic medications and ongoing long-term psychotherapy are recommended. Individuals of Nikos’s age, with his history, including that of trauma and captivity, and with his presenting symptomatology, generally require and may benefit from such long-term psychiatric interventions. However, it is noteworthy that individuals with a diagnosis that includes a personality disorder may have a guarded prognosis.
The story in the boy’s own words:
TAKEN
My name is Nikos. This is the story of my kidnap. I’ll warn you now, it ain’t pretty. A lot of people died. Some deserved it, some didn’t. I learned stuff, things some adults will never know. Like what a man looks like and smells like when he is dead. What it feels like when your mind is numb with drugs. What to do when no one gives a shit if you live or die. You want to hear my story? Be careful what you ask for. I really don’t want to tell it, but my psychiatrist says I should, and Papa is pushing hard for me to finish. But I don’t think he’ll like what he reads. Maybe he just wants to see if my private education made me a good writer.
Well, here goes. . . .
THE GRAB
I couldn’t breathe. My body tensed. I opened my eyes, confused. Looked around. Where am I? Thea’s favorite teddy bear lay beside me on the bed. Then I remembered—I slept in her room because she’d had a nightmare about Mama dying. I tried to breathe again, but someone held a strange-smelling cloth tightly against my mouth and nose. I kicked, punched. Didn’t matter. I wasn’t strong enough. No choice. I sucked in air through the cloth. It made me feel weird. I looked over at Thea hidden in the fort I’d made her. She was awake, her eyes big and scared. I screamed to her in my head: “Help! Go get help!” Her mouth opened, but no sound came out. She didn’t move. I felt dizzy. The room was spinning. Then it all went black.
The next time I woke up, it was still black. I had a hood on my head, rope around my hands, and a stinky rag in my mouth. Oil. Yuck. Puke came up my throat, but I swallowed it back down. My body banged against something hard. Felt like I was in the back of a truck. It hurt a lot. I tried to get free, but the rope was tied too tight. I was thirsty. My back was sore. My heart was beating fast, and I was wet and sweaty. Don’t know how long I was riding, maybe hours.