NURSE

PATIENT

INTERPRETATION

Tremors are getting pretty bad. How are the hallucinations?

Not bad (poor eye contact)

S/S:Blocking Abrupt cessation of speech DM: Therepeutic Communication: Making observation, Giving information, Asking direct question, exploring S/S:Delusion paranoid DM: Therepeutic Communication: Giving information S/S: DM: Therepeutic Communication: Placing the event time, Exploring, Voicing doubt

They'll get worse

I know doctor salondo, She told me about the neuroleptics

Did she now? And when was this?

I found her, doctor, in a cave out by the cliffs. But you'll never get to here

I dont doubt it, considering she's not real. Your delusions are more severe than I thought. Your not on neuroleptics. Your not on anything as a matter of fact. Withdrawal

Then what the fuck is this? What the fuck is this

S/S:Anxiety fear of unkown. DM: Therepeutic Communication: giving information, Presenting reality, accepting S/S:Delusion - paranoid DM: Therepeutic Communication: giving information.

withdrawal? From what? I haven't had a goddamn drink since I've been on this island ( statering voice )

NURSE

PATIENT

INTERPRETATION

Chlorpromazine. I'm not a fan of pharmacology, but I have to say, in your case... Chlorpromazine. The same thing we've been giving you for the past 24 months Not boston. Here. You've been here for two years. A patient of this institution.

chlorproma what?

DM: Therepeutic Communication: giving information S/S:Delusion - paranoid DM: Therepeutic Communication: giving information S/S:Volubility copious, coherent, logical speech DM: Therepeutic Communication: Presenting realtiy, Giving information S/S:Tangeniality response that wanders from original question DM:Displacement serves to transfer feelings such as anxiety from one idea, person, or object to another. Therepeutic Communication: Giving information, Presenting reality, offering self.

So for the past 2 years, you.. you've had somebody slipping me drugs in boston. Is that it? ( statering voice ) after everything i've seen here doctor, you really think you're gonna convince me i'm crazy? Do you know the kind of people that I deal with every day? I'm a U.S. Marshal, for god's sakes.

You were a U.S. Marshal. Here's a copy of the intake form, you broke into the Ward C for. Proof of the 67th patient if you'd gotten it to the mainland, you could have blown the lid off this place. Yet somehow you couldn't find time to look at it. Well read it now. Go ahead.

Wait.. where did... where did you... (reading the form) I've had enough of this bullshit.! Where's my partner? Where's chuck? Where is he?

NURSE

PATIENT

INTERPRETATION

Lets try this another way. Your wife's maiden name is chanal. Am I correct?

Dont you even talk about her. Dont you...

S/S:Blocking abrupt cessation of speech DM:Supression Therepeutic Communication: seeking information, exploring S/S:Tangeniality response that wanders from original question Incoherence no logical connection DM:Substitution Therepeutic Communication: Focusing, exploring, Seeking information, S/S:Delusion - paranoid Tangeniality response that wanders from original question DM: Therepeutic Communication: Focusing, exploring, Seeking information, S/S:Blocking abrupt cessation of speech DM: Therepeutic Communication: Giving information, S/S:Tangeniality response that wanders from original question DM: Therepeutic Communication: Giving information

I'm

afraid

have

to.

Notice anything in these four names have in common? It's your rule of four. Andrew what do you see?

If you've done anything with my parnter, doctor that is a violation of...

Focus, andrew!!! what do you see? The names have the same letters. Edward daniels has exactly the same 13 letters as andrew laeddis. The same as rachel salondo and dolores chanal. The names are anagrams for each other. You came here for the truth. Here it is. Your name is andrew laeddis. The 67th patient at ashecliffe is you, andrew. You were committed here by court order 24 months ago. Your crime is terrible, one you can't forgive yourself for, so you invented another self.

your tactics, they're not gonna work on me.

Bullshit.

All right let's get down to the facts, all right?

You've created a story in which you're not a murderer. You're a hero, still a U.S. Marshal, only here at ashecliffe because of a case, and you've uncovered a conspiracy so that anything we tell you about who you are, what you've done, you can dismiss as lies, andrew.

My name is edward daniels.

S/S: DM: Therepeutic Communication: Focusing, Giving information

NURSE

PATIENT

INTERPRETATION

I've been hearing this fantasy for two years now. I know every detail. Patient 67, the storm, rachel salondo, your missing partner, the dreams you have every night. You were at dachau but you may have not have killed any guards. I wish I could just let you live in your fantasy world. I really do. But your violent, trained, dangerous. Your the most dangerous patient we have. You've injured orderlies, guards, other patients. Two weeks ago you atttacked george noyce. Of course I didn't! Because he called you laeddis, and you'd do anything not to be him. I have a transcript of the conversation you had with noyce yesterday. This is about you and laeddis, that's all it's ever been about. When you asked him about what happen to his face, he said, now here I'm quoting again, You did this.

No. no. I'am fucking on to you, doctor. You had noyce beaten.

S/S: delusion false belief/ DM:Projection - scapegoat defense mechanism Therepeutic Communication: Giving information, Focusing, Exploring

No. no. he's saying this is about me and laeddis.

S/SThought insertion patients belief that thought of self is inserted into his mind DM:Projection - scapegoat defense mechanism Therepeutic Communication: Giving information, Exploring

No, no. he meant that it was my fault.( stuttering voice )

S/S:Thought insertion patients belief that thought of self is inserted into his mind DM: Therepeutic Communication: Giving information.

You almost killed him. The warden and the board of overseers are determined something be done. It's been decided that unless we can bring you back to sanity now, right now, permanent measures will be taken to ensure you can't hurt anyone ever again. They'll lobotomized you andrew. Do you understand?

Yeah I understand. I understand just fine. If I dont play along with your little game here, Dr. Naehring's gonna turn me into one of his ghosts. But what about my partner? You gonna tell the U.S. Marshal's office that it's a defense mechanism? (voice stattering)

S/S:Delusion - control DM: Therepeutic Communication: Giving information, Focusing

NURSE

PATIENT

INTERPRETATION

Hello, Boss.

What the fuck is going on here? You working for him You've been watching me, huh? Watching me every minute. Who are you? Who are you? Tell me. I told you.. I told you about my wife. I...

S/S:Delusion - paranoid DM: Therepeutic Communication: offering self. S/S:Delusion - control DM: Therepeutic Communication: Offering self. S/S:Incoherence no logical connection. DM: Projection Therepeutic Communication: Seeking information. S/S:Ideas of referece interpretation of unrelated events as having personal reference or self significance. Incoherence no logical connection. DM:symbolization Therepeutic Communication: Accepting, Giving recognition

I'm sorry there was no other way. Someone had to stick with you, keep you safe.

Don't you recognize me, andrew? I've been your primary psychaitrist for the last two years. I'm lester sheehan

I know.

I climb down a cliff to get you. I trusted you. I risked everything to come here in here after you. Everyhing!

I know Boss.

Andrew. Your children. Andrew, your children. Simon. Henry.

I never had any children.

S/S:Depersonalization feeling of strangeness from one's self DM:Dissociation Therepeutic Communication: Giving information

Your wife drowned them at the cabin by the lake. And here, the little girl the one you dream of every night.

I never had a little girl.

S/S: Depersonalization feeling of strangeness from one's self DM:Dissociation Therepeutic Communication: Giving information S/S: DM: Therepeutic Communication: Giving information, Asking direct question.

The one who tells you over and over that you should have saved her, save them all. Your daughter , her name was rachel. Are you going to deny that she ever lived? Andrew are you?

(Silenced)

NURSE

PATIENT

INTERPRETATION

Why are you here?

Because I killed my wife

S/S: Therapeutic communication: seeking inormation, broad opening

S/S: And why did you do that? because she murdered our children. She told me to let her go. Therapeutic communication: seeking inormation, focusing

Who is teddy daniels?

He doesnt exist neither does rachel salondo. I made them up

S/S: Therapeutic communication: seeking inormation, asking direct question S/S: -Delusion self accusation Therapeutic communication: seeking inormation. Seeking clarifications.

Why? We need to hear you say it.

after she tried to kill herself for the first time. Dolores told me she... She had an insect living inside her brain. She can feel it clicking across her skull. Just pulling the wires just for fun. She told me that. She told me that but I didnt listen. I loved her so much you know.

NURSE

PATIENT

INTERPRETATION

Why did you make them up?

Because I cant take knowing that dolores killed our children and I... I killed them cause I didnt get her help I killed them you know. I killed them. I dont remember that.

Therapeutic communication: seeking inormation. Seeking calrification

Here's my fear andrew. We broke through once before, nine months ago and then you regressed. I know You reset andrew like a tape playing over and over on an endless loop. I hope that what we've done here will be enough to stop it from ever happening again, but I need to know you've accepted reality.

Therapeutic communication: Giving information, Presenting reality

You came after me, huh, Doctor? You tried to help me when no one else would. My name's andrew laedis and I murdered my wife in the spring of '52

Therapeutic communication: summarizing, accepting, giving information, offering self.