Up Close With Dr. E

Treatment of personality disorders


Waco County Jail: Clank! Cell #13 opened. “Get out” barked the burley jailer, “You’ve got visitors upstairs.” A tall handsome man stepped out of his cell as the guard handcuffed him and led him up the stairs. The tall prisoner wore jailhouse garb — pumpkin orange jump suit — but, his $200 haircut, dazzling white teeth and swaggering walk were evidence that this was no ordinary criminal.

What species of jailbird is he?

Six Months Ago: Standing on a podium in front of a new hospital, Vice President Robert Browning held a magazine cover high over his head. “Man of the Year,” see this photo? This is the face of Burt Maslam, the one who made this Children’s Hospital a reality. “Let us give a round of applause for Burt.”

A tall man with blonde hair and ice-blue eyes swaggered up to the microphone. He was flanked by his beautiful wife, Cindy, and his twin daughters, Amber and Carrie. (Since you are not yet acquainted with Burt, who is a habitual liar, I will help out).

“Thank you, Mr. Vice President. Well folks, this hospital was a dream of mine for many years. You see, I grew up poor (Lie — his mother was wealthy), and my brother Tommy died of cancer when he was six (Lie: Burt was an only child). My daddy, a drunk who beat my momma, left us, so, at the age of nine, I became the man (true). I put myself through school at Baylor University by working three part-time jobs (lie). When my business became successful, I decided to take $10 million and set up a fund to build this hospital (lie: Burt stole the money from his wife, which is why he will be sent to jail).

Back To Jail: The jailer un-cuffed Burt and pointed to the far corner table, where his identical twin daughters were seated. He sat down and tried to talk, but for the first time since age nine, he broke down and sobbed.

Having never seen her father cry, Amber became alarmed: “Daddy, why are you crying?” Burt reached across the table and held hands with his twins. “I’m afraid of losing you both — I’m so sorry that I never spent time with you. Amber, Carrie, do you believe in miracles? I could sure use one right now.”

Carrie perked up — “Daddy, you don’t have to lose us.” She handed over a letter, which he opened and read. “Dear Burt: Against my attorney’s advice, I’m giving you one last chance. If you comply with the following terms, all legal charges against you will be dropped, and eventually, you might be able to move back home.”

1. Stop all destructive acts: Lies, infidelity, theft of my money and the twin’s college savings, alcohol abuse, gambling, and absentee fathering.

2. Begin psychiatric treatment for at least two years.

3. Come with us to church each Sunday.

4.Set up regular visits with your daughters and do activities they like to do. Sincerely, your wife, Cindy.

BACK In Cell #13: Sitting in his jail bunk, Burt read the letter, over and over. For the first time, he caught a glimpse of who he really was. “I’m a 21st century pirate who plundered family and foes alike, never once caring who I hurt.”

“I believed I was above the law. I used my own daughters to create my image. On golf outings with politicians, I positioned my twins around me, just like a master chef garnishing a juicy ham with fresh green parsley. I created a mosaic of immorality, with inlays of black behaviors. I was without rules or restraints. Oh Lord, can a bad man like me change? Is it too late?”

Burt began treatment. For two years, Burt worked hard in a treatment program designed to help personality disorder patients. Here are three key elements of his treatment:

1. Accurate diagnosis and the identification of skill deficits. Burt was diagnosed with Narcissistic Personality Disorder. His NPD skill deficits were as follows: lack of empathy, inability to read the emotions of others and an inability to form high trust relationships.

2. Burt’s problems were re-defined as survival skills. Burt was taught that his sense of entitlement was actually just a cover for his impaired self-worth and his massive insecurity, which came from emotional neglect in childhood. Since his survival skills were all learned behaviors, he was taught how to ‘unlearn’ them.

3. The power of ‘hope’: With an optimistic tone, Burt said: “I used to believe in that saying, ‘you can’t teach an old dog new tricks.’ Treatment taught me to never give up my hope of becoming a good husband and father.”

The content of this article is for educational purposes only and should not be used as a substitute for treatment by a professional. The characters in this story are not real. Names and details have been changed to protect confidentiality.


Dr. Richard Elghammer contributes his column each week to the Journal Review.




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