Short Report, Diagnosis and Recommendations
Reason for Referral:
I have been approached by the courts to conduct an independent evaluation of Mr. White Rabbit, following his apprehension for the alleged kidnapping of a young girl who he was said to have lured into his hole which led her to an alternate realm called Wonderland. While there, it was further alleged he provided her with drugs that may have caused her to hallucinate, believing herself to shrunk to the size of a mouse then to have grown to giant size. The underage girl also reported believing she had come into contact with a number of unusual creatures including a cat who appeared and disappeared at random, a pipe smoking caterpillar with whom she had a conversation, a Duchess who had her baby sit her infant who turned out to be a pig, and the Queen of Hearts with whom Alice plays croquet using flamingos as mallets and hedgehogs as balls.
While the kidnapping charge was dismissed due to Alice?s own testimony that she had followed Mr. Rabbit voluntarily and he hadn?t done or said anything to force her to do so, the drugging charge still stood. I was asked to evaluate Mr. Rabbit due to concerns as to his mental state as well as complaints made by residents of Wonderland regarding his tendency to make them and their children feel anxious to the point they hesitate in going out so as not to run into him. They reported that he is constantly seen hopping ?madly? around Wonderland looking at a large pocket watch and replying to any general pleasantries with the comment, ?I?m late, I?m late, for a very important date.?
When asked about his apparent rush, Mr. Rabbit stated that yes, this was the case, and added that in fact he was late at that moment, attempting to rush off. As he was being held in custody due to the fear he would jump bail, literally, his inability to leave the room where the evaluation was taking place seemed to exacerbate his symptoms and he became increasingly agitated over the course of the interview. Asked what he was late for, he stated he didn?t know exactly, but knew that if he didn?t get there on time it would be ?disastrous.? He was also unable to say precisely what he believed would happened if he was late. Mr. Rabbit reported being anxious ?most of the time? but couldn?t really give specifics of what triggered his anxiety. Other that ?when the Queen of Hearts wants to behead me.? He also couldn?t point to anything that made the anxiety worse or lessened it.
Mr. Rabbit continued to hop about the room in a frenzied manner, frequently consulting his pocket watch and stating he must be released as he was late. When queried as to why it was so important to him he replied that something terrible would happen if he didn?t arrive on time. He was offered a cup of (caffeine free) tea, in an effort to calm him, he refused, saying tea was only for tea parties and the evaluation was far from a party as he was being held prisoner although he had done nothing wrong.
When asked about the substance he had given to the young girl, Alice, to drink, which apparently made her believe she had grown to an enormous size ?like that of a giant?, Mr. Rabbit became short tempered. He replied in a clipped tone, that she had found the substance in his home and had decided to drink it on her own. Afterwards, Mr. Rabbit alleged, she grew to a ?huge size? and attempted to grab him in one of her ?monstrous paws?.
When asked how she had gotten into his house, Mr. Rabbit stated that he had ?mistook her? for a servant and had her washing his ?unmentionables.? Though he was not home at the time, he left the door locked to ensure the girl could not escape. He showed no remorse for wrongly making her work for him, nor for wrongly imprisoning her, saying that where he came from, ?Servants know their place and understand that their class is meant to make life easier for those of us who are above them.? He merely shrugged when reminded that the girl was, in fact, not his servant, but an underage girl who did not belong in the realm in which he lived.
Mr. Rabbit added that ?the girl? had already shrunk and grown several times prior to the episode in his home due to drinking and eating substances she likewise found that didn?t belong to her. He pointed out that these other instances had nothing to do with him. He said this just went to prove that Alice?s experience growing and shrinking was her own fault. He stated he couldn?t be held accountable for a girl who clearly had a problem with ?stealing and excessive risk taking.?
When queried further about this it was evident that Mr. Rabbit also believed it was possible to grow and shrink based on ingesting certain substances found in Wonderland, including different parts of some sort of mushroom. He denied that the mushroom constituted a ?drug,? further denying using any kind of ?mind altering substance.? He did acknowledge drinking a large amount of tea during the day, attributing this to attending numerous tea parties each day. He reported drinking 3?5 cups of the beverage at each party, adding, ?Well, you can?t just go and not eat or drink anything can you? They?re called tea parties for a reason, you know.?
Mr. Rabbit wasn?t able or willing to describe the actual mushroom, becoming more agitated and replying, ?Don?t you understand? I?m late and talking about mushrooms is just wasting more time and making matters worse!? Attempting to further clarify additional points and areas led to aggressive posturing and Mr. Rabbit began to yell, physically threatening the psychologist and psychometrician who was also present. Ultimately, a sedative was ordered and it took two orderlies holding him down to enable the nurse to inject him with the anxiolytic. Mr. Rabbit quickly became calm then sleepy, unable to remain awake and the interview was terminated.
Conclusions:
It is unclear at this time whether drugs could be a cause of or contributing factor to Mr. Rabbit?s anxiety, though he states he does not use any type of substances. Due to the premature termination of the interview it was unclear whether Mr. Rabbit?s reality testing is intact or if his claims were due to a psychotic process. Additionally, the causes of Mr. Rabbit?s behavior and anxiety could not be determined. Furthermore, conclusions regarding Mr. Rabbit?s potential for contributing to the delinquency of a minor cannot be made at this time. As such, regarding diagnoses, only Rule Outs can be assigned without competing the evaluation.
Preliminary Diagnoses:
- Rule Out Psychotic Disorder, NOS
- Rule Out Antisocial Personality Disorder
- Rule Out Generalized Anxiety Disorder
- Rule Out Hallucinogen Use Disorder
- Rule Out Drug Use Disorder, NOS
- Rule Out Narcissistic Personality Disorder
Recommendations:
1) It is recommended that drug testing be undertaken to determine if any substances are in his system that may be contributing to his difficulties. However, it is understood that due to the length of time that has occurred since he was first detained, no indications of substance may show up on his toxicology screen. As such he should be observed carefully for physical symptoms or behavioral indicators or changes that might indicate drug withdrawal.
2) It is recommended that Mr. Rabbit avoid drinking tea due to the caffeine content. This includes decaffeinated tea as this still has some caffeine included in the product.
3) Further evaluation of Mr. Rabbit?s background and history would be useful in determining whether there are other logical sources of Mr. Rabbit?s extreme anxiety.
4) Follow-up interview with Alice should be conducted to clarify her perceptions as they related to Mr. Rabbit?s legal and other difficulties.
Natalie C. Frank has a Ph.D. in Clinical Psychology and specializes in Pediatric Psychology and Behavioral Medicine.
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