Chameleon's Shadow

DR ROBERT WILLIS

MD, PSYCH

Extracts from notes on Lt Charles Acland January/February 2007

. . . Charles is suspicious of me. He wants to return to active service, and his reluctance to talk about his anxieties is clearly associated with this ambition. He thinks I’m acting for the army as a ‘mental health monitor’. [Query: How worried is he about his state of mind?]

...He places too much weight on his mental health assessment and not enough on his physical handicaps. I wonder if the reason for this is that he’s adapted well to the loss of his eye but hasn’t come to terms with the psychological impacts of sudden inactivity . . . the death of his men . . . feelings of inadequacy . . . guilt, etc....

. . . Personality change It’s hard to form an opinion after the event, but his current demeanour – cold restraint broken by occasional bursts of temper – seems to be new. His CO describes him as a ‘popular, outgoing officer with excellent leadership ability and good social skills’ . . . his parents as ‘loving and dependable’, a ‘nice person with numerous friends’. Both suggest a confident extrovert personality who conformed well to the conventions of the middle class. [Query: Why am I seeing an angry, introspective ‘rebel’?]

. . . I’m struck by Charles’s intelligence, which appears to be well above average. He is alert and observant – viz. his ability to reattach his own drips correctly – and has learned to compensate for his blind side in record speed. He’s also highly motivated and has developed his own fitness regime since being allowed out of bed.

. . . He’s reticent about his relationships, blocking questions about his parents by saying he gets on well with them. [NB This is clearly untrue, particularly re his mother.] However, he did describe them on one occasion as ‘mutually absorbed’ and ‘complacent’. When I asked if this meant he felt excluded, he said, ‘Not at all. I’ve always been my own person.’

...He claims he had no problems being sent away to boarding school at eight. ‘It gave me independence.’ [NB Independence seems to matter to him. He refers to the family farm as ‘the ball and chain’. ‘I’m an only child. I’m expected to marry and have children and inherit the damn thing.’]

. . . His indifference towards his fiance´e appears to be genuine, although mention of her irritates him. He says she’s ‘history’, therefore talking about her is pointless. He shows a similar indifference to the people who’ve sent cards. He doesn’t write letters or make phone calls, and he’s requested no visitors.

. . . Self-imposed isolation He spends hours alone in thought or watching the news channels on television. He avoids, or cuts short, any attempts at communication, often through rudeness. He distrusts and/or is contemptuous of the medical staff and other patients, has difficulty containing his frustration at what he perceives as stupidity or slowness, and transfers his anger and aggression into physical activity, such as pumping his palms together or clenching his fists.

...He rejects any idea that disfigurement is a contributory factor, claiming he doesn’t care what people think. [NB This is almost certainly untrue. He shows typical symptoms of a patient with facial deformity . . . refers to himself as a ‘freak show’ . . . dislikes being stared at . . . has difficulty judging other people’s reactions . . . distrusts shows of friendship . . . talks regularly about being in ‘a zoo’ . . . turns his chair so that his uninjured side is towards the door.]

. . . Attitudes to sex Despite describing Jen as ‘a damn good fuck’, he blocks every question on the subject and presents as a sexually repressed individual. He’s highly protective of himself, particularly his genitals. He objects to female nurses and has accused one of the men of being gay. [Query: Is this repression or obsession? Query: Sexual orientation? Not clear.]

. . . Traumatic brain injury/subsequent antisocial behaviour I asked Henry Watson to take another look at the CAT scan for frontal lobe damage. He remains of the opinion that there is none but suggested a second scan, using MRI. He confirmed my assessment that Charles’s current symptoms are not typical of an antisocial disorder but refused to offer a view on whether a changed personality occurred suddenly or evolved over time.

...He expressed some concern about Charles’s contempt for others, which implies arrogance, lack of empathy and an inability to connect emotionally, but was less troubled by the shows of aggression – attack on mother, clenched fists, etc. – which he described as ‘hot-blooded’. [NB Typically, sociopaths show no emotional discharge when they’re angry but plan their violent reprisals in dispassionate ‘cold-blooded’ ways.]

. . . Reprisal Watson suggested I contact the ex-fiance´e to find out if Charles has made any attempts to communicate with her...