July 24, 2016
Patient “Ash Ketchum” came into my office for the first time today since our phone consultation. His primary problem, in his words, is that he wants “to be the very best, like no one ever was.” A telltale perfectionist. He seems to be highly dependent on his own evaluations of himself, trapped beneath self-imposed standards of excellence. He continues his fruitless desire to “be the very best” despite the risks it puts on his life. I explained to Mr. Ketchum that success is both relative and highly subjective, but he found it difficult to accept. He insisted that “to catch them is [his] real test, to train them is [his] cause.” It is my professional opinion that Mr. Ketchum defines his self-worth solely by his ability to capture and train Pokémon and that re-examining this drive through cognitive behavioral therapy will lead him to a happier and more fulfilling life.
August 7, 2016
Mr. Ketchum insists on bi-weekly sessions, rather than weekly, in order to accommodate his busy training schedule. I pointed out to him that dedicating so much time to catching Pokémon is what’s causing him the mental distress in the first place, but travel seems to be a substantial part of his regimen. “I will travel across the land, searching far and wide,” he told me. “Each Pokémon to understand the power that’s inside.” This emotional relationship is unhealthy. The patient seems to think that without him, the Pokémon will be unable to achieve their true potential, even though he previously showed me that his own self-worth is defined by his ability to train Pokémon. Could this toxic co-dependence be the root of his anxieties?
August 21, 2016
Today’s session was a troubling one. After a grueling multi-week trek to the gym in Saffron City, Mr. Ketchum returned to Pallet Town, defeated. Under his breath, he muttered with eyes glazed over, “gotta catch ‘em all.” It seems his need to catch all of them is a compulsion, fueled by his obsession with destiny; although he cannot control the uncertainties of his own life, he can control the number of Pokémon he captures.
September 4, 2016
He seemed tearful today. At one point he told me I was his best friend in a world he believes we must defend together. He is unsure of what we are defending the world against; his anxiety is vague in that way, but he believes both of us have the courage to take on this monumental task. However, this “us vs. them” thinking indicates that perhaps Mr. Ketchum has a black and white view of the world. I briefly wondered if perhaps I were breaching some kind of professional boundary by entertaining his delusions of grandeur, but it worked in the interests of the patient.
September 8, 2016
Mr. Ketchum stopped by my office without an appointment today. I chose to accommodate him as I had a gap in my schedule and he seemed quite nerve-wracked. He paced around my office and demanded he teach me and I teach him about Pokémon. I suggested we try something new: an exposure treatment. If Mr. Ketchum’s greatest fear is being unable to capture Pokémon, why not emulate that fear in a safe, controlled environment? I started by showing the patient pictures of empty Pokéballs and rare candies long forgotten, laying stale in the back of the freezer, but the exposure was overwhelming for Mr. Ketchum. He kept repeating to me, over and over, “Gotta catch ‘em all.” I am unable to get through to him and undo his negative patterns of thought using traditional psychotherapeutic methods, so the next course of action will be to start Mr. Ketchum off on 20mg daily Clonazepam and monitor his condition. Perhaps the pills will help him understand the power that’s inside of him and will remain there regardless of how many Pokemon he gotta catch.