Ben, aged 52, was born and raised in Siloam Springs, Arkansas. At the urging of his supervisor at work, Ben has voluntarily sought help from his employer's human resources department. They have referred Ben to you. Personal and Family History Ben was an only child, and he explains that he got a lot of attention. He says that that he loved his parents very much, "but they were kinda weird.
" He adds that "They were like me. Just different, ya know? " Ben said that his aunt, his father's sister, has been institutionalized on several occasions.His father, who died when Ben was 18, was a janitor at a local department store. His mother was a homemaker. Neither of his parents finished high school, and Ben was born when they were only 17 years old. Ben is 52 years old and has been working as a driver for a postal company for the past 22 years.
He reports that he likes his job and enjoys interacting with people. Ben has been unmarried his entire life. He reports "I liked the girls OK and all that" but he never developed permanent relationships.Ben reports that he has always been "nervous with the girls and such" and he avoids making any significant social overtures with women. He meets his sexual needs matter of factly by visiting a prostitute on a regular basis. He reports that their sexual encounters are highly regimented.
He refuses to elaborate on this point, stating that his mother taught him to "never talk about dirty things". Ben reports that he also directed a lot of his energy into long walks. Every evening, he would go for a walk, sometimes lasting up to 5 hours.His neighbors were often concerned seeing him walking alone late at night and the police have been called on several occasions. Recently, however, Ben has lost interest in the walks, explaining that the streets are too dangerous.
Ben has attended church on a regular basis throughout his life. He has been involved in a number of community activities; people seem to appreciate his involvement, though they find him a bit odd. History of present illness During the past two years, coworkers have noticed a gradual change in Ben.While he always seemed a bit unusual, during the past few years, his social nteractions seem confused and inappropriate. He sometimes smiles when he is angry, and often seems distressed and agitated when everyone else is laughing. A coworker who befriended him reports that Ben may be using hallucinogenic drugs.
Ben denies this, however. Although coworkers have described a gradual decline, one dramatic event seems to have exacerbated his condition. Ben was scheduled to make a routine delivery, but instead of taking the box into the store, he handed it to a pedestrian who happened to be on the street.As he handed it to her, he explained "This is a gift from Jesus -- please keep it with you always.
" The puzzled pedestrian reported the incident to Ben's supervisor. The following day, Ben was unable to clearly recall the incident, and had no explanation for it. Although his actions were highly unusual, it was an isolated incident and his supervisors let him off with a warning. Unfortunately, the error became known around the station, and coworkers teased him for several weeks.
Ben explains that this error weakened his low self image, and undercut his confidence in his ability to perform his job.Ever since this event, Ben has become very careful to avoid making mistakes. He routinely double-checks all of his deliveries, sometimes running back into stores to confirm that he has delivered the correct box. He admitted that he sometimes hears celebrity voices telling him that he is making an error. Ben spends his spare time in solitary behaviors including watching television (he watches a lot of Court TV and builds plastic military models).
During the past six months, Ben also admits to carefully checking all of the locks on his house at night.Although Ben lives in a comfortable neighborhood, he points out that all of the young people in the area dislike him and they may be planning to break into his house. He also disconnects his phone at night to avoid potential threatening phone calls. Finally, Ben has recently begun insisting that he is suffering from cirrhosis of the liver. Although medical tests have proven negative, he insists that he can feel the organ rotting inside of him.
This thought seems to have developed after he watched a television program on the side effects of alcoholism.
