ABSTRACT
Ted presented himself at the Veterans’ Administration Outpatient Clinic seeking a second opinion on his psychiatric diagnosis. He said that he had been evaluated at a local hospital and found to be “a hopeless psychopath.” Put somewhat off balance by this odd initial presentation, I quickly rallied my clinical energies to assess this curious situation. Before me sat a tall and very burly, latemiddle-aged guy dressed in traditional Western cowboy boots and jeans, carrying a tan Stetson hat. Apparently accustomed to taking charge of social situations (I soon learned that he had been a law-enforcement officer), he continued to dominate our initial session with a lengthy description of dissatisfaction with previous “shrinks” and his inability to control his decaying marital situation.
