Extract 1A:

Patient: D. James / Psychological Assessment 6/1/2007 / Westmoor Hospital, Berkshire / Consultant: Dr. Cassandra May285

*A summary of case notes following sessions conducted between 3/8/2007 to 30/11/2007*

Pg.1 (below)

The patient was initially referred to me by his employer, News International, under instructions that he must undergo psychological evaluation or face disciplinary action following months of erratic, self-destructive behaviour, possibly due to post-traumatic stress after xxxxx xx xxxxx xxx. As a result, he was less than cooperative during our first session, but I soon found him a likeable and highly intelligent subject who was able to talk eloquently about his experiences. If anything, I was surprised by the distance he displayed toward his time in Afghanistan during 2006/07, especially given what he had reportedly witnessed while he was there. This, in itself, suggested to me a high degree of dissociation and repression in his personality that may need further observation. Despite his relaxed manner there was an aspect of ‘performance’ to the patient’s personality. This manifested itself a number of times, where he appeared to slip into a carefully constructed ‘persona’ in order to avoid answering difficult questions.

When asked him about subjects unrelated to his career such as his personal life or childhood, for instance, the patient was more guarded, and I sensed that while he may have anticipated and conditioned himself to deflect enquiries regarding his time in Afghanistan he had not been as prepared for the rest of his life to come under the spotlight. Subsequently, later sessions focused more on his past. It later emerged he had not known his real parents, having been fostered at an early stage, and although I was not able to investigate further I felt it was important to his psychological profile, particularly the ‘emotional deprivation’ this caused in his childhood, and the psychological ‘hunger’286 in his adult life, which has manifested in repeated attempts to prove himself and demonstrate his talents/intelligence to the world. This may seem strange considering his achievements, but I believe it is the key to understanding why he continues to push himself so hard.

The patient comes from a working-class background in Newcastle, where opportunities were few and far between. Despite this he excelled academically and has worked relentlessly to create opportunities for himself. There have been no gifts along the way and he prides himself on having earned everything he has through sheer willpower. He is highly-educated, with two Master’s degrees and a PhD on Samuel Beckett’s prose novels, which he completed while training as a journalist for a daily newspaper. This occupation, initially seen as a day job while he worked to become an author, slowly became all-consuming, leading to the incident at xxxxxxxxxxx involving xXXxxxxxx and xxxxxxxxxxx, which in many ways has led to this assessment. The search for the truth is hugely important to him, both as a journalist and on a psychological level. In his mind the truth is interchangeable with the success, recognition, and adoration, he internally craves and hungers for. I suspect no amount will ever be enough to fill the void he feels inside and I believe he knows this too, but he cannot stop, for he has become addicted to the search itself. When we discussed other paths that his life could have taken a deep and genuine sadness came over him. He asked if I was aware of the term ‘Hauntology’287 which he described to me as the sensation of being haunted by futures that never happened. I tried to get him to explain this feeling further, but he refused. Neither his childhood, nor the trauma experienced during xxxxxxx xxxxx xxx xx, fully account for the depth of grief – a nameless grief – which I sensed in him, and I must admit this concerned me on a number of levels.

As my sessions with the patient continued I also saw clear signs of borderline Narcissistic Personality Disorder, specifically vanity, obsessive tendencies, histrionic and exploitative behaviour, a sense of being ‘special’ or ‘unique’ combined with deep, underlying insecurities, a degree of paranoia, and the need for regular positive reinforcement (this is closely linked to his obsessive womanising and addictive relationships with women to fulfil this need). While there is a definite rage just below the surface, he is clearly practised at keeping this in check, beneath the smooth, polished, exterior that he presents to the world. Similarly, while capable of acts of self-destruction, he is more likely to sabotage his own happiness and quietly dismantle his life in subtler ways.

Results from a Thematic Apperception Test (TAT) and Rorschach Test,288 both conducted in our early sessions, proved inconclusive, although I suspected the patient was not answering honestly at times. Again, there is an aspect of ‘performance’ to his personality that is difficult to breach. I suspect he considers his day-to-day life a mode of play-acting, whereas the world he inhabits while he is writing is vividly real and therefore more important in his mind. He seeks to return to it more and more but, like any addictive substance, this is clearly dangerous.

When later sessions revealed signs of a deterioration from melancholia into depression, I suggested a course of antidepressants (I would have prescribed an (SSRI289) class drug such as Citalopram), but he refused. I feared he may be self-medicating, if only with alcohol rather than recreational drugs, but he also showed signs of highly-addictive behaviour and I expressed concerns about escalation. Certainly, his relationships with women already border on addiction and it was clear he was using both alcohol and sexual relationships as coping mechanisms.

In fact, I think he has already reached a critical point where he has gone beyond ‘the pleasure principle’.290 There is no joy in these activities for him anymore. No amount of alcohol, sex, fantasy, or escapist literature, will ever satiate him, for he has become addicted to the negative highs provided by these empty simulations, and the opportunity they provide to stare into the void, which he has come to identify as the ultimate truth of the world.

My fear is that he will need to create a new high that goes beyond the rest, specifically that he will develop a lust for death – the ‘death drive’291 being the ultimate negative high. In terms of treatment, I had hoped to introduce high-intensity CBT292 or Interpersonal Therapy, in parallel to medication, but the patient was resistant to the idea and our sessions were ultimately cut short when he resigned from News International.

It is my professional opinion that…

Pg.2 (not included)293

Notes

285. It must be noted that Dr May’s assessment has been accused of being unreliable. It was later revealed she was in a personal relationship with Daniel for several months in 2007 during these sessions. Whether this positively or negatively impacts her assessment of his psychological state is unknown. Certainly, in some respects, the document reads less like a psychological evaluation and more like a character evisceration by a former lover, which may account for the variation in tone and blurring between personal and professional insight, yet Daniel chose to include it in his notes for the book – Anonymous.

286. Rosenfeld, Isaac, Beyond the Red Notebook: “Dissatisfaction was an integral part of his character. This led to hunger in the psychological sense…because hunger was strong in him he must always strive to relieve it, but precisely because it is strong, it has to be preserved.”

287. The French philosopher Jacques Derrida originally coined the term, Hauntology, in his book Spectres of Marx. Hauntology is a portmanteau of the word ‘Haunt’ and ‘Ontology’ – the philosophical study of what can be said to exist. It was later adopted and popularised by literary, cultural, and critical theorists including the blogger and academic K-Punk, aka Mark Fisher, who explored the term in his book Ghosts of My Life, relating it to Franco Berardi and his phrase the “slow cancellation of the future” while adding that “not only has the future not arrived, it no longer seems possible”.

288. The Rorschach Test is a projective personality test, originally created by Hermann Rorschach in 1918 to diagnose schizophrenia, and inspired by his love of the popular game Klecksographie. It was adapted for psychiatric use, as a personality test, in 1939. It remains in use to this day. Interestingly, it has made its way into popular culture and the art world, including Warhol’s Rorschach prints from the 1950s – Anonymous.

289. Selective serotonin reuptake inhibitor.

290. The ‘pleasure principle’ is a psychoanalytic term by Sigmund Freud, which describes the instinctive seeking of pleasure and avoiding of pain to satisfy biological and psychological needs. Beyond the Pleasure Principle is a 1920 essay by Freud.

291. In Freudian psychoanalytic theory, the ‘death drive’ is the drive toward death and self-destruction.

292. Cognitive Behaviour Therapy.

293. The second page was not included in Daniel’s notes and may have been destroyed. It is unknown how the conclusion of this assessment expanded on Dr May’s evaluation as presented here – Anonymous.