I need help with some thoughts to a diagnosis using the DSM5. I need primary, secondaries, and rationale for the diagnosis.
Here is the case:
George is a 45-year-old attorney who has made an initial appointment only because his wife has insisted. She has thrown down the relational "gauntlet", telling him that she is fed up with their marriage. Her strong complaints include George's emotional coldness, rigid demands, bullying, sexual disinterest, long work hours and frequent business trips away from home. Curiously, George is experiencing minute distress in the marriage and is coming only to humor his wife.
As George begins to answer questions, it becomes clear that there are severe problems at work. He has a " Tarzan" reputation to defend as the hardest-driving member of his " jungle" of a law firm. He was the youngest full partner in the firm' s history, and famous for his work load. However, he now is finding himself unable to keep up. The pressure compounds because he is too proud to turn down a new case, while also being too perfectionistic toward the work of his assistants. He constantly corrects their written work in their briefs, pushing him farther and farther behind in his own work. Other attorneys are beginning to complain about his inability to maintain efficiency.
In personal matters, he talks about his children as if they were mechanical dolls, but it is also clear that he has strong affection toward them. He describes his wife as a "suitable mate" and has no insight into why she would be so dissatisfied. George is punctilious in his manners and dress. His speech is slow, ponderous, dry and humorless. He is the son of upwardly mobile, extremely hard-working parents. He describes his youth as a time when he was never working hard enough. He was a bookworm, a superior student, but awkward socially, especially in adolescence. He has always seen himself as competitive, as high-achieving and driven. He "drives" even on vacation, making elaborate plans for his family and becoming furious when they refuse his efforts.
Case Study Help:
Axis I: 300.3 Obsessive Compulsive Disorder
Axis II: none
Axis III: none
Axis IV: Occupational problems, Marital problems
Axis V: 58
Criteria A- He attempts to ignore or suppress his compulsion with perfectionism and neutralizes them by his driven nature and rationalizes it by his ...
Conceptualization and diagnostic impression of Attorney presenting with marital problems. Works with the axes of the DSM5 and gives rationale for diagnosis in 206 words.