maybe the patient was beginning to think forward when he left. his mother had spent all of her cash and needed to pay for everyday items. until then he hadn’t thought of her atm card. of course she would have to go to an atm and use her pin, but at least it was forward rather than reverse thinking.

my concern is this … the patient presents himself as calm, rational and composed except for his obsessive and compulsive, acting out tendencies. these only show when he is being slipstreamed into societal norms and only then under thorough observation. someone has to detail his thought processes to see why he is acting out.

the message he’s getting is that he should leave people alone until he’s unable to leave them alone whereupon they will care for him in a way that will make him leave them alone.

what he is fighting against is that slipstream which is slowly removing his personality which is just enough to be shared and interesting to be worthwhile not to be left alone.