“A Perfect World: Case Study A” by Adam Frank Boretz
--page 3

Institute of Living
Norris Outpatient Campus
Office Visit LR004

- I made the Behavioral Inventory(5).
- How was that for you?
- Fine.
- Fine. Just fine?
- Yeah. It was ... I don’t know. It was fine.
- Alright. Well, let’s hear it.
- Ok. I’m affected in the following situations: walking, sitting, eating, drinking, listening to the radio, looking in mirrors, reading, writing, driving, doing laundry, putting on clothing, lying down, tying my shoes, cleaning, bathing, brushing my teeth, flossing, turning things on, turning things off, going through doorways, shutting doors, cooking, going up stairs, going down stairs, touching things, being touched, seeing lights, seeing reflective surfaces, looking at clocks—
- Levi, you can stop there(6). How do you feel about all of that, about that list?
- I don’t know. Not good.
- Exactly. Not good. Look at all the things you have to control every day—little things, petty things, like turning on a light or shutting a door. Your every action has to be perfect, you every movement synchronized to some arbitrary standard your mind created. And if you’re perfect? What then?
- I don’t know?
- Yes you do. Go on and say it.
- Say what?
- That no one will get hurt? That she won’t die? Levi, the world doesn’t work that way.
- I suppose not, but—
- All of this is just anxiety. The behaviors and little rituals, they’re just ways of relieving anxiety. Isn’t all of this just about control?
- I suppose so, yes.
-Yes, exactly. But not control—the illusion of control. Control you don’t have.
- I know, but?
- No, you don’t know.
- No, I do, but—
- Levi, this is me telling you it isn’t real. You don’t have control over the world. You don’t have special powers. This is me telling you you aren’t God.


         I am no longer able to perform simple comma everyday tasks period Soon comma they will discover this period Soon comma they will fire me period It is pathetic period I am pathetic period Temp job after temp job after temp job colon annuity transfers and medical billing and accounts receivable period Trying to function period Trying to save face period Trying to live period Again period
         I slouch in my cubicle behind the water coolers and fax machines and it takes me forever to type one fucking memo period A single invoice or list of action items takes hours period I look around and hope no one walks by because I can’t hide it anymore period
         Again I type y but my finger grazes the edge of t so I hit backspace and try again period
         y backspace
         y backspace
         y backspace
         y backspace
         all afternoon period
         All around me comma everyone taps away at keyboards and scribbles down notes on legal pads and sends emails period All around me comma it is so easy, so automatic period All around me is a wasteland of men and women piddling away their perfect simple beautiful sanity period
         And I type y again and then hit backspace period
         And it still is not right period


Institute of Living
Norris Outpatient Campus
Office Visit LR007

- Do you still have the dream?
- No. Not for years.
- Well, I suppose those images relate to a fear of rejection, to your feelings of inadequacy. But to be honest, I’m not sure how relevant dream analysis is in your case. Not that it doesn’t matter, but—
- Right. Well, like I said, it’s been years so ...(7)
- It’s just that there are more important, practical things we need to address.
- Such as?
- Such as, where are you living right now?
- At a motel.
- What motel?
- It’s called The Grant Moore—over on the Bangor Turnpike.
- Do you like it there?
- No. It’s a total shit-hole. Of course I don’t like it.
- So, how long do you plan to live there?
- I don’t know.
- Do you plan on getting an apartment? Are you going to stay in Maine? Are you going to move? I think what I’m asking is do you have any plans at all?
- I don’t know. No. I have no plans, alright? And I don’t want to talk about it now. I—
- Levi, this type of therapy is about changing your thought patterns. Right now, those thought patterns are set. They revolve around anxiety, around negativity, around fear, around inaction. What we need to do is alter those patterns.
- That would be nice.
- To start, I want you to make a set of what we call Truth Cards. The way it works is you make the cards and then read them over and over—kind of like you did in school with flashcards—and eventually, you replace old dysfunctional reactions with new functional thoughts.
- OK. So, what do I put on the cards?
- Things that you know—intellectually know—are true. In your case, things like: I don’t have special powers, I can’t control the world.
- I don’t know...
-What don’t you know, Levi?
- I don’t know. It just ... I don’t know(8).

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