Thursday, February 10, 2011

Profiling the Tin Man

02 Summer 1935

Dr T.M. Chambers

PATIENT: Kain Delacroix

Following the incident in the control room I found it necessary to consider Delacroix’s state of mind. Firstly, I felt there was a substantive difference between that incident and previous acts of violence used to obtain information.

My baseline for comparison is regretfully quite expansive. We have engaged in a number of acts of enhanced interrogation, a number of which have ended with extreme prejudice. These rare acts have usually been prefaced with an acknowledgement of the need for such extreme measures and as such resulted in what is described as a bauer-shift (a conscious and temporary decision to suspend moral-norm reactions in order to perform necessary and often horrible acts - a form of cognitive compartmentalisation).

What happened in the control room was mitigated by two factors, a large number of potential civilian casualties and a limited time-frame. However, the troubling issue was that Delacroix did not display the somatic elements of a bauer-shift, there was no pause, no inner or outer deliberation or so-called putting on of a “game face”. In fact, in stark contradiction to an extreme interrogation that took place only moments before, Delacroix acted autonomously, without group consensus or forewarning. His act came suddenly, spontaneously and reflexively.

The subject was calm, collected and fully aware of his actions while displaying no empathic reaction regarding his act, even afterward. The subject was logical, rational and un-remorseful when later confronted about the incident.

The primary symptomatic vectors for analysis were therefore violence without remorse, emotional detachment, perfect cognitive functions throughout and a lack of awareness of the effect on others of his actions.

Differential Diagnosis
My initial impression was that of a chronic form of Posttraumatic Stress Disorder, although several of the symptoms are consistent: intrusive recollections, impairment of social functions and anhedonia to name a few; there are important contradictory elements in the diagnosis. Primarily, Delacroix has not displayed any anxious or panic related symptoms which characterise all PTSD victims. Emotional outbursts have been entirely absent. There has been no avoidance which is critical to the diagnosis - patients go to extreme measures to avoid stimuli associated with the traumatic event. In Delacroix’s case, he has displayed the near reverse.

In the absence of a clear diagnosis of the first axis, he met the criteria for a secondary axis disorder: Deviation from cultural norms, the enduring pattern is inflexible and pervasive, the pattern is stable and of long duration starting in early adulthood. Though there are some elements of antisocial personality disorder, I must discount it as Delacroix’s intentions and nominal rational for his acts are not narcissistic. Also, there is no indication he performed violent and antisocial acts in adolescence. His symptoms of distrust, devotion to a cause, self sacrifice and so forth are more closely related with paranoid personality disorder. There is probably a dual-cluster type A-B composite disorder with elements from both antisocial (sociopathic) and paranoid disorder which inhibit his ability to empathise, form close bonds or learn to trust implicitly.

He has entered a closed loop of revenge fueled by internalised guilt and externalise empathic dissociation. Apart from breaks in what is considered acceptable behaviour which he is unable to process on an instinctive level, his cognitive capabilities allow him to simulate normal social processes. However I fear that Delacroix’s baseline has changed in the course of his 15 cycles alone on his “mission”. Whereas I am capable of atrocious acts within the confines of a bauer-shift and returning to a social norm afterwards, Delacroix may have blurred that line or even crossed it, where he must now simulate normal social behaviour.

He is not a threat to us nor himself, he is unlikely to suffer any break, psychotic or otherwise, as long as his perceived “mission” is ongoing. As long as he has an “enemy” to fight, the “war” will never be over and so his condition is stable and self perpetuating. He is, oddly enough, a near-perfectly functional psychiatrically-dysfunctional subject.

Without addressing his second axis disorder, he could be reconditioned to work in a group. The fact that he retains his ability to simulate social paradigms and maintains high cognitive capabilities means he can be made aware that others are rendered uncomfortable by his actions, even if he cannot intuit that on an empathic level.

However, in order to break the cycle and return to a higher functional level of interpersonal relationships he would need to break from his “mission” and externalise his feelings of failure, remorse and doubt accrued since the death of his wife and his self-confessed “murder” of innocents. This would be a lengthy process and require a multi faceted therapy including: pharmacological, psychological and family-social approaches. This would inevitably significantly reduce his functional abilities for an undetermined period and might in all likelihood completely deconstruct any psychological capacity to perform cognitive compartmentalisation in the future. This would severely mortgage his ambitions regarding the NEC and his “mission”. In effect, Kain would no longer be Kain.



Julie said...

Incidentally, where do you get all this terminology? Is it through your work, or do you research it, or are you channelling aliens, or what? *grin*

Certain Betrayal said...

I read psychiatric reports daily, so a lot of this is of the top of my head. But to be as accurate as possible I did reference the DSM-IV heavily. In fact there is only one serious non-clinical reference in there. Anyone care to guess?

Game Thug said...

I know what it is, but it would be cheating if I said. I'll wait a day and no longer though before responding. ;)

Game Thug said...

A composed of X hours....

Hermes 72 - Heavy Gear RPG - Most artwork Copyright 2002 Dream Pod 9, Inc.