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Psychosocial Report:
Axis I:
305.00 Alcohol Abuse
291.5 Alcohol Induced Psychotic Disorder with Delusions
302.89 Frotteurism
Axis II:
301.7 Antisocial Personality Disorder
301.81 Narcissistic Personality Disorder
Axis III: None
Axis IV:
- Problems related to the social environment- difficulty with acculturation; discrimination; adjustment to life-cycle transition.
- Occupational problems - threat of job loss; job dissatisfaction; job change; discord with boss.
- Housing problems - unsafe neighborhood; discord with neighbors.
- Financial problems - inadequate finances for family after hanging.
- Problems related to interaction with the legal system/crime – arrest and hanging.
Axis V: GAF =30. Behavior is considerably influenced by delusions or hallucinations or serious impairment, in communication or judgment (e.g., acts grossly inappropriately or inability to function in almost all areas (e.g. no job, home, or friends)
Haman presents with bright, cheerful affect, a bit shifty eyed, talkative. He is dressed appropriately with a slightly wobbly gait, sometimes losing his balance. Haman has come to therapy to find out why no one likes him any longer and why people are threatening to hang him on a tree he prepared himself for that Jewish rogue, Mordechai, who didn’t have the decency to bow down to him (Tanach, Esther, 7:10).
Haman was given the Mental Status Exam and was found to have a fondness for drinking a lot of wine at dangerous parties where people are killed when they don’t obey the commands of the King Ahasuerus (Tanach, Esther, 1:19). After several of these parties Haman, while obviously intoxicated had delusions of grandeur, possibly caused by his excessive alcohol consumption, expecting Mordechai to bow down to him and thinking the Jewish people were a threat to him (Tanach, Esther, 3:3). In session, Haman related the story of King Ahasuerus (Tanach, Esther, 6:7) asking him, “What should be done for the man whom the king desires to honor.” Naturally, Haman stated, who could the king be thinking about besides me? His narcissistic response is consistent with other times in his story where he becomes enranged when Mordechai does not bow down to him and his aggressive stance toward the Jewish people, who he plans on destroying (Tanach, Esther, 3:8-12). One instance is when he returns home and recounts to his friends and wife the glory of the wealth and of his many sons, and all the ways in which the king had promoted him and elevated him above the other officers and royal servants. He reports that he said, “None of this is important to me as long as I see Mordechai, the Jew sitting at the King’s gate”(Tanach, Esther, 5:13).
According to the DSM-IV, people with antisocial personality disorder have a pattern of a disregard for other people’s rights, often crossing the line and violating those rights. Antisocial personality disorder is often referred to as psychopathy or sociopathy in medieval culture. Individuals with Antisocial Personality Disorder frequently lack empathy and tend to be callous, cynical, and contemptuous of the feelings, rights, and sufferings of others. They may have an inflated and arrogant self and may be excessively opinionated, self-assured, or cocky. Haman displays these symptoms by his aggressive stance against the Jewish people. This diagnosis is also consistent with narcissistic personality disorder as mentioned above.
Haman’s behavior in the Queen’s bedroom, where he falls upon her couch, shows a growing sign of possible frotteurism. The king, upon seeing him on the couch with Queen Esther says, “Would he actually assault the Queen while I’m in the house?”(Tanach, Esther, 7:8).
Haman presents with problems around his social environment, the loss of employment after his ruse is discovered and his legal problems centered around his upcoming hanging for not respecting the Queen and King. Once he is dead, his family will be left with no income and he will be the disgrace of his neighbors and friends.
DSM IV-TR, American Psychiatric Association, 2000.
G-D, Tanach (1996), The Stone Edition, Mesorah Publications, Ltd, Brooklyn, NY. (Original edition delivered by Moses on Mt. Sinai in the form of tablets, as well as orally).