DSM-V Case Study: What is My Charisma?
Gene, a 58 year-old businessman complained that he had difficulty getting the respect he felt he deserved and that he felt “financially dissatisfied”. The patient stated that he is “a major rock star” and had been a member of “the biggest, loudest, ass kicking show in history”. He also stated that he had engaged in sexual relations with “over 4,000 women”. In the interest of putting this comment (and his claims of rock stardom) into perspective, it should be noted that the patient is a somewhat overweight, late middle aged male with stringy, dyed hair, of no particular physical attractiveness. Noting some skepticism on my part, the patient stated that “you wish you were me, pill pusher” and proceeded to pull out a shoe box full of Polaroid pictures, featuring naked women in various lurid poses. The patient then presented what he called “a business proposition”, suggesting that I act as a consultant for a national chain of female “KISS-iatrists” When I asked him what this meant the patient stated (and I quote) “TWO WORDS: TOPLESS THERAPISTS !!!”. I informed the patient that entering into such a business relationship with a patient would be a violation of the ethical standards of my profession and considered the matter closed.
A week later, the patient showed up for a follow-up session wearing a bizarre demon outfit, consisting of 6-inch heels, kabuki make-up, a suit of chains and a cod-piece (!!?!). The patient was removed from the building by security.
Discussion of “What is My Charisma?”
The patient’s grandiose claims were clearly not consistent with reality, suggesting a delusional disorder and possibly cognitive impairment. His desire to be noticed, as evidenced by his sexual boasts and outlandish costume are symptomatic of severe Axis II pathology and his lust for money bordered on the pathological. The patient is therefore given a diagnosis of Attention Starved Personality Disorder, Avaricious type. This diagnosis is provisional on a thorough assessment to rule out the presence of a cognitive impairment or thought disorder.
Follow Up
As the patient had been forcibly removed during his follow up session, we were unable to track the case further. Two months later, however, a young woman knocked on my office door, wearing a small bikini that barely covered her breasts. “Gene sent me” she said “I’m your Kiss-iatrist”.




