March 22nd, 2002

The patient, Mr. J, appears to be stupid. After our first session, he claimed that he was primarily here to discuss his “depression,” which he describes as manifesting itself in various poor habits, among which are slovenliness, slothfulness, and a general disregard for maintaining relationships. He described having difficulty finding interest in any subject and when asked about previous subjects that he previously found interest in, he described several peculiar studies that mostly took the form of a large amount of reading. In my view, he somewhat deflected my question by listing titles in an attempt to impress me with the “depth” of his interests, rather than make any attempt to synthesize the works in question. He likely lacks the intellectual skills necessary to generate such a coherent synthesis. The subject matters were eccentric, to say the least, mostly dealing with matters of pseudoscience. More on this fact later.

I believe his symptoms primarily arise from a sense of ennui that would be difficult for him to elucidate due to his clear lack of vocabulary. I would guess he reads at an eighth grade level. What might appear to him as a lack of drive to increase his knowledge likely has more to do with basic limits to his capacity to think. And while he may ascribe other behaviors such as “being very messy” and “not cleaning the bathroom often” and “not ever making the bed” to depression, I would not jump to such a conclusion since he is so clearly a slob. I should note at this point that patient J wore a t-shirt with mustard stains and jeans with holes in them to the session. He also did not sit up straight. When I inquired about his preference for wearing a beard, he replied that his father had worn a beard and that perhaps there was something in that. While I would generally prefer to avoid basic Jungian archetypes in my therapeutic practices, thus ignoring this patient’s observations on matters psychological, on this point he is likely right; he is used to men with beards. Big deal.