ABSTRACT
When George first came to the Community Therapeutic Day School (CTDS) he appeared withdrawn, lethargic, and utterly defeated. His eye contact was fleeting, and his eyes often appeared unfocused. His speech was soft, rapid, tangential, and consequently often unintelligible. Much of it was self-deprecating and designed to arm others with information with which to abuse him. It was often as if he were engaged in two conversations, one overt and the other covert, with the latter seeming to be a compulsive verbalization of what appeared to be unconscious material. Although he and his clothes were generally clean, he was usually disheveled and appeared to have dressed in the dark. His socks were mismatched, and often one of them was his sister’s. Overlaying this apparent depression were short bursts of “acting out,” which seemed driven by anger. Although they were still very controlled by him at school, at home he was reportedly quite destructive. As he became more comfortable in the class, he showed more of his disturbed side, much of which seemed to be sexually charged.
