PSYCHIATRIC EVALUATION

January 30, 2016

GENERAL DATA: The patient AAA, is a 36 year old, female, married, Roman
Catholic, Filipino, residing in Paraaque City. She is the company Vice-President.
She consulted for the first time on January 25, 2016.

CHIEF COMPLAINTS

He hurt me in so many ways, I was spiraling with him according to AAA .

That same evening, one of the brides friends, JJJ, stayed with us. While AAA
wasnt looking, I started touching JJJ in a sexual way. I did ask AAA if she was
interested in doing a threesome with her, but she said no and was turned off by
the idea. At that point, I stopped touching JJJ but the three of us continued
drinking until we fell asleep. I would later admit to AAA that this happened and it
would be one of the reasons that lead to our separation, according to BBB.

Sources of Information:

1) AAA - Petitioner
2) BBB - Respondent

MEDICAL and SURGICAL HISTORY

She has no known medical illness such as Hypertension, Diabetes, nor Asthma.

PSYCHIATRIC HISTORY

20 years old, AAA used prohibited drugs.

AAA admitted, I started doing drugs when I was 20. Although I had my first puff
marijuana at that age and I started using hard drugs back in university.I was a
casual MDMA and cocaine user before I met my ex-husband. During the course
of our marriage, my usage increased to every other weekend (for cocaine.) We
use ecstasy on some occasions.

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She consulted with a Drug Counselor for therapy to keep from using prohibited
substances.

Perinatal and Early childhood:

AAA is the eldest of four siblings. She was born in Pasay City, via Normal
Spontaneous Delivery.

She was breastfed.

Developmental milstones were at par with age.

AAA stayed with her parents and paternal grandparents from birth in Pasay, later
after her grandparents left, they moved to Paraaque City with her maternal
grandparents.

Her father, EEE, was the Senior Engineer for <REDACTED>. He was a known
alcoholic. He was also known touse prohibited drugs. She described, I knew
while I was growing up, that my dad liked to drink a lot, but I didnt think he was
abusive. I do remember him getting into a massive car accident where he was
drunk and slept at the wheel of the car and he crashed into the back of a 10-
wheeler truck. He escaped with his life but had massive surgery and stitches.

She added, My mother did tell me in confidence that my dad was also a
womanizer and a drug addict, and at one time was a dealer.

Her mother, PPP, was formerly, Head of Training at <REDACTED>. She was also
a former Marketing Manager for <REDACTED>

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She recalled, My parents relationship was a bit tumultuous, although I remained
oblivious to the problems up until I could figure it out on my own.

Middle childhood:

AAA was enrolled for elementary at the <REDACTED>. Her grades were above
average. She joined extra-curricular activities, such as debate, art, and drama.
She earned a distinction in drama when she graduated grade school.

She further explained, Being in an all-girl Catholic school, my life was quite
sheltered, and there wasnt much of a problem. I did well in school, I was an
extrovert, and I easily made friends.

During 3rd grade, AAA was diagnosed with bursitis, she had to discontinue joining
any sports activities for 2 years. During that time, she spent her days in the
library and at home.

During her 5th grade, her Physical Therapist advised her she was ready to
remove her leg brace. AAA went through therapy to learn to walk properly again.

She was enrolled in a modeling and proper etiquette course at the John Robert
Powers

She and her parents were residing in her maternal grandparents house in
<REDACTED>, Paranaque City.

She learned more about her parents relationship. My mother was only 18 when
she got pregnant, and my father at that time was 20, both still in university. My
father was the only one in his family (the youngest out of 7 children) to go to a
private university, so it was quite a disappointment to his parents when he got my
mother pregnant. My mothers family was well-to-do, so there was quite a
difference between the two families. My mother stayed with my fathers family for
a few years, but after she (claims) was mistreated, my dad and mom moved in

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with my maternal grandparents who took the family in. My mother and father
were young, would argue often.

Adolescence:

AAA continued her secondary education at <REDACTED>. Her grades were

above average. She joined the Debate, Visual Arts, Drama. She was also a
member of a rock band from third year high school. AAA was an officer for some
of the classes. She was President of the varsity football (soccer) team in
university.

She recalled, I was pretty well-known, since I also had a sister who was 2 years
older than I was who was a bit of an overachiever at school. I dont think I had
enemies or anything like that, and I was fairly sociable when I was in school.

AAA was also encouraged to pursue her modelling career, she recalled, My
mom and her only sister were models when they were much younger, so we as
kids got some modelling jobs from their connections. I remember this being
particularly fun, because we were paid and we had some money to go out with
our friends. This gave me a sense of accomplishment, and my dad was
determined to teach us how to handle our money, so we were able to manage
our own finances at a young age.

On her third year in high school, she had a short-lived relationship with someone
from the Rotary club activities in <REDACTED>.

She wanted to take up Fine Arts but her father advsied her, that it wasnt a very
good choice for building a career, so she opted to go into Political Science with
the intent to study law.

Her parents continued to have altercations, AAA was used to it, so she thought
everything was the norm at home, she shared, I didnt see anything that was
wrong until my father decided to tell us right after I graduated from high school
(1996) that he was leaving the family and that they were separating. After my
parents separated, my mom moved us to <REDACTED>, Paraaque.

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Her parents are now divorced. Her mother is single staying in Manila, while her
father has long since remarried and lives in the United States.

Adulthood:

AAA took a course in Political Science at <REDACTED>.

She recalled, I was experiencing teen-age angst. I was rebelling. My parents

thought I was a bit difficult to deal with then, that was when I was breaking
routine and coming into my own and being in a band.

She described herself as stubborn, impatient, sensitive, dramatic.

After graduating, she took two years of law school, until she opted to quit and
work full time.

MARITAL AND RELATIONSHIP HISTORY

AAA was 23 years old, when she met BBB at the Cream (Ministry of Sound)
Halloween Party last October 31, 2002.

She recently came from a bad breakup. While partying she and her friends took
MDMA that night. BBB approached her with a bottle of water and an inhaler and
then got her number. AAA didnt think anything of it, except that he was good
looking.

She thought he was, happy go lucky, chauvinistic, temperamental, impatient, and

stubbborn. She learned he was unable to complete his college degree.

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BBB was a Marketing staff for English Language courses. On the first week of his
employment he misplaced the laptop the company assigned to him. He was
dissatisfied with the pay, so he went to find employment in Hong Kong in 2005.

On the other hand AAA was employed in <REDACTED>.

In 2006, BBB went back to the Philippines and they agreed to get married.

The wedding was in Hong Kong on June 20, 2006. After the wedding they lived
with his mother in Hong Kong for 2 years.

She had difficulty living with her mother-in-law, she recalled, BBB and I would
discuss sometimes that she was a bit irritating to be around. She liked to berate
BBB in front of me, which I wasnt very comfortable with, and this is why I
completely understood why BBB wasnt too close to her. There was a time she
took to asking me to tell my husband off for doing things she didnt like, and I
told her that I wouldnt do that to BBB out of respect for him. I asked her to talk
to BBB directly instead. Going through that experience, I remember it was
difficult for me to live with her, and I was homesick for quite a long time. I didnt
like being put in the middle of explosive arguments between BBB and his mom,
and I didnt have people to talk to about it at that time.

There were times were I would go home first after a night out or not go out at all
because I didnt drink alcohol. During those times, BBB would stay out with
friends and got drunk and sometimes get high as well.

She sometimes smoked cannabis sativa, because BBB used it most often. They
both took MDMA occasionally as well.

She observed, He was depressed quite a lot, especially when I would bring
something up specifically to talk about something he did which I wasnt too happy
about (smoking weed, losing his temper, spending so much money on drugs,

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staying out too late. etc.) He didnt handle criticism well, and many times got
depressed for days after having talks like this. We didnt shout at each other or
anything. But throughout the marriage, I had learned to just not say anything
about stuff and keep quiet because I knew it would just depress him if I bring
things up.

AAA and BBB were both working. Im employed full-time as Vice President for a
software development company (BrillKids). BBB is a full-time NET (Native
English Speaker) for a local primary school in Kowloon City, Hong Kong.

They decided not to have children. She shared, Initially, I really wanted to have
kids. However, talking to BBB through the course of our marriage, we were able
to establish that he was really afraid to have children specifically he was afraid
of making the same mistakes his father has done which was damaging to him
and in the end he was able to convince me not to want kids. We always practiced
safe sex, so the chances of getting pregnant were quite slim.

They continued to have altercations, BBBs drug use (more specifically his daily
consumption of marijuana) lack of fidelity, motivation to keep the marriage, and
consideration for AAAs feelings, was often a topic of arguments.

She shared, Many times when I would try to bring it up to him to slow down on it,
he would become very irate and defensive about it that it would cause flare ups
between us. Each day when BBB came home from work, he was always tired
and stressed out. To relieve his stress, he would smoke a bowl or two of weed.
By the time I get home, he would be too stoned to interact with me. This led to
my feeling of being neglected. He mentioned a few times as well for me not to
ask him to choose between his weed and myself because he said that he cant
give up his weed. For each time he smokes up, hes just very lethargic and
doesnt do anything but watch television. This led to a somewhat miserable home
life for me. I would try to get on his level and smoke up with him sometimes
something which I dont really enjoy doing but this doesnt make up for the fact
that we do not have clear lines of communication and I cant be honest with him
about it because I am avoiding an argument. Because he was lethargic, it was
seldom we had sex, and when we did, it was on his schedule not mine. He
refused to have sex at night claiming he is always too tired for it, so the few times
we did it, it would be in the morning.

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AAA and BBB also used cocaine frequently causing them to be deep in debt, she
shared, There was also the massive cocaine use for each time we saw our
friends. We spent so much on cocaine over the past few years that it was
debilitating to our savings and we got ourselves into debt. Ive been wanting to
stop for a while, but like the marijuana use, it was a difficult subject to breach
because it would entail a mood swing for him. We had gotten to the point where
we were drugging ourselves with weed, sleeping pills and cocaine 3-4 times a
week. Out of the topic of drugs, BBB also gets angry and depressed easily. He
would constantly lose my temper especially when he was frustrated at work.
When he was feeling down, he would complain a lot and be very negative about
everything: life, the future, family, friends, and this wore me down.

In 2011, BBB also had a history of having extra-marital affairs, which he admitted
to AAA. They almost separated, when she learned he slept with her very close
friend (a girl named NNN from <REDACTED>). She admitted, I would be honest
in saying I felt very betrayed by that.

They continued to use prohibited drugs together. BBB was also presenting with
symptoms of withdrawal, his tolerance for the drugs increased.

April 2015, during their trip to the Philippines and <REDACTED>, BBB was
consuming a lot of drugs and alcohol on a daily basis. This led to a couple of
nervous break downs during the trip. She recalled, BBB was irate about
everything during the trip and he was constantly complaining about the schedule
(it was an Indian wedding so our schedule was packed). His breakdowns came
after nights when he had drunk too much and consumed MDMA, and it consisted
of him shaking in the bed and crying to himself. When we got back to Hong
Kong, I had had enough of his behaviour and substance abuse. So I spoke to
him calmly about it and told him that I could no longer continue to bear the
responsibility of taking care of him because it was making me spiral out of
control, too. I think after two weeks of discussing it openly and honestly, we both
amicably decided that it was best that we part ways.AAA left him and moved in
with her new girlfriend (RRR); BBB stayed behind in their old flat till he moved out
in mid-August 2015.

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PSYCHOLOGICAL TESTS:

Basic Personality Inventory (Brief form)- DSM 5

House-Tree-Person
Draw-A-Person Test
Bender Gestalt Visual Motor Test
Luscher Full Color Test
Zung Depression Scale

DESCRIPTION OF PSYCHOLOGICAL TESTS USED:

The Projective Drawings were used to elicit psychopathology of the client. They
also reveal the client's views of herself, on sexuality, beliefs, principles, and
family orientation.

The Basic Personality Inventory (BPI) is an innovative, multiphasic personality

assessment intended for use with clinical and normal populations to identify
sources of maladjustment and personal strengths.

The Bender-gestalt visual motor test, elicits any form of psychosis, such as
auditory hallucination, delusions.

The Luscher color test reveals the client's desires, dreams, fantasies, coping
skills.

The Zung Depression Scale, is used to elicit any forms of depressive tendencies.

The Mental Status Examination, is an interview that reveals the client's mood,
affect, thought process, thought content, memory impairment, abstract thinking,
visuo-spatial ability, judgment, and insight.

Psychological test results taken by AAA

Subject presents with dependency, low self-esteem, and insecurities. She has
fears of being rejected by people and assuming responsibilities on her own. This
dependency can possibly bring her helplessness for she cannot handle
obligations without the help from others.

In addition, the test results also indicated tendencies of poor impulse control and
self-centeredness. Her pursuit of pleasure and self-gratification can lead to
counterproductive behaviors that would not only cause harm unto herself but also
to other people.

She has difficulty in refusing to get around with easygoing people.

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Moreover, subjects dependency can incite her to go in excessive lengths just to
maintain her relationship with others.

She sees male as the more dominant sex.

Marked depression on Zung scale

Coping mechanisms denial, displacement, repression

Psychological test results taken by BBB

Projective tests indicated his indecisiveness, and lack of confidence. Despite of

being confident about his intellectual ability, he can still be insecure about past
experiences. Furthermore, he is continually pulling back himself and
experiencing difficulties in directly expressing his emotions.

Subject reported that their family problems had pushed him to find another
source of comfort amidst the distressing event. Unknowingly, his desire to
mitigate his burden made him extremely vulnerable to try out anything that can
be a possible source of relief. On the other hand, his poor emotional control
further caused him to encounter difficulties, resulting in immature coping styles
and counterproductive behaviors.

He sees female as the more dominant sex.

Moderate depression on Zung scale

Coping mechanisms rationalization, displacement

MENTAL STATUS EXAMINATON of AAA

Seen an adult female, fairly kempt, blonde hair, with a cap, weariga jacket, and
jeans. Crying spells. Mood is anxious, with appropriate affect. She denies
perceptual disturbances such as auditory or visual hallucinations at present.
Speech is relevant and impressionistic. She recalls her husbands prohibited
drug use, and refusal to have children. She admits to preferring relationships with
females over males. She is oriented to time, place, and person. Intact memory.
Faulty test judgment, and faulty insight.

MENTAL STATUS EXAMINATON of BBB

Seen an adult male, fairly kempt, balding, with a cap, wearing a jacket, and
jeans. Mood is dysphoric, with appropriate affect. He denies perceptual
disturbances such as auditory or visual hallucinations at present. Speech is
relevant. He apologized for his irritable mood. He is oriented to time, place, and

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person. Intact memory. Faulty test judgment, and Faulty insight.

Interview of BBB

Respondent

BBB is 36 years old, male, married, Filipino, Roman Catholic, employee, residing
in Rockwell, Makati City and Hong Kong.

He is the eldest of two siblings. He was born in Quezon City via normal
spontaneous delivery. He was breastfed.

He is a member of his fathers second family. He explained, While I was growing

up, I found out that my father had two children with another woman (they have a
son and a daughter).

His father FFF, was a Life Consultant for <REDACTED>. He said about his
father, From what I know, my father drank a lot. Not on a daily basis but more or
less around 3-4 times a week. He would come home drunk and reeking of
alcohol. He was also a chain smoker, which lead to him having lung cancer. He
passed away in 2000.

His mother, LLL, is Head of the Hong Kong Office for <REDACTED>.

He said about his parents relationship, My mom and dad worked long hours at
work to provide for the family. My dad handled stress poorly. When I was growing
up, I would witness him and my mom constantly arguing and fighting. During the
weekends, he would get drunk with friends or relatives. When we moved to Hong
Kong in 1992, his stress and anger management got worse. He was selling
insurance for <REDACTED> and he was under constant pressure to meet his
monthly sales quota. He didnt handle this very well and almost every night, he

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would be arguing with my mom, saying a lot offensive and vulgar comments to
her, me and my brother. My mom took it in stride. She stayed patient with my dad
and tried her best to console him, even though his behaviour was obviously
affecting their marriage in a negative way.

He described the inconsistent discipline instilled at home by his father. My dad

was very verbally abusive. He would always swear at me and berate me even
though I didnt do anything wrong. There was the one time, before he got home, I
was busy vacuuming the house and cleaning the dust off the shelves. When he
got home he said: Anong ginigagawa mo dito sa bahay? Hindi ka nanaman nag
linis? Putang ina mo! Nag papalaki ka lang ba ng bayag? Please note that I
would always clean the house and wash the dishes on a daily basis. Sometimes,
I would even have to do my brothers chores when he forgot to do his share of
the house duties, which was often.His mother, on the other hand tried her best
to maintain the peace at home by pacifying her father.

Both parents provided for the family.

As a child, he and his family resided in the Philippines, he recalled, We first lived
with my grandparents on my dads side. Then, we moved to Las Pias and lived
there for three years until we moved to Hong Kong in 1992. Weve been based
here ever since.

While living in Las Pias, they had a helper who lived with them.

BBB was closer to friends than family. He did not experince a nurturing
environment at home, In elementary, I just stayed at home and played with toys
most of the time by myself. We were living in Caloocan at the time, and my
younger brother, who was studying in <REDACTED>, would always arrive home
late. When we moved to Las Pias, we moved to a subdivision. I started making
some friends with neighbors from the age of 9-11. When I moved to Hong Kong, I
made new friends when I started school. Most of the things I enjoyed doing
revolved around being with friends.

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BBBs family moved to Hong Kong in 1992. He moved back to the Philippines to
study in university from 1999-2005. In 2000, his father passed away from lung
cancer. He lived alone most of the time. His brother lived with him for a while until
he got his girlfriend pregnant. They got married and moved in together.

At 6-8 years old, (Prep to Grade 2) BBB attended <REDACTED> in Quezon City.
Later, at the age of 9-11 years old, he continued Grades 3-5 in <REDACTED> in
Las Pias City. At the age of 12 years old, BBB finished Grade 6 at
<REDACTED> in Hong Kong, where he completed high school.

He recalled further his childhood to early adulthood, I dont remember much of

my years in elementary in the Philippines. I was very shy and not social. I didnt
have a lot of friends. I had low grades and I always got punished in class for not
paying attention or for being disruptive. In Hong Kong, things changed. I made a
lot of friends, I was the class president, I was always in the top 3 of academic
results in class, I was elected as batch representative to the student council in
Form 3 and I was a member of the basketball team in high school. When I was
studying in the Philippines, I was a follower. In Hong Kong, I was a very
outspoken leader. I had a lot of friends and enjoyed making new friends. I also
got into a lot of fights because of my temper, both with classmates, teachers and
kids from other schools.

He added, I was also emotionally sensitive. I didnt do well when someone

criticized me. My temper was getting shorter. I was stubborn and arrogant and I
would often get into fights to prove my point and show people who the boss was.

He coped by acting out and by committing self-mutilating behavior, he shared,

Yes. I tried to slash my wrist. This happened when I had a big argument with my
girlfriend. That was the first time I slashed my wrist.

He also admitted to running away from home at 17 years old.

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BBB did not have any criminal records, but he was caught shop-lifting by the
Hong Kong Police. He shared, I almost had a record, when I was caught
shoplifting with my friend when I was 16. The Hong Kong Police stated that since
we were caught inside the store, the possibility was still open for us to pay for the
items found in our bags. Therefore, all we did was write a letter of apology. They
also called our parents.

BBB wanted to become a lawyer and enter public office in the Philippines.

BBB took a course in De La Salle University Manila. He graduated with a degree

in AB-Literature.

He wanted to go study in UCLA in the US, but his family couldnt afford it.
Fortunately, his uncle in Manila, sponsored his university studies until he
graduated.

He hoped to emulate his uncle. He shared, I looked up to my uncle, TTT. He

was a self-made man who started his own shipping company and made his
fortune in that industry. I looked up to him for his work ethic and how he forged a
positive relationship with his family, friends and colleagues.

On his marriage:

It was October 31, 2002 when I first met AAA at Cream, which was a rave-slash-
Halloween party. I was 22 at the time and she was 23.

AAA was wearing a school girls uniform with a choker around her neck. I thought
she looked super cool like a rockstar. She was really hot and sexy. These were
the things that first got me attracted to her.

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While in a relationship with AAA, BBB admitted that he slept around with other
women while they were together.

They were married in Hong Kong on June 20, 2006. BBB moved back to Hong
Kong after resigning from his first job since graduating from university. The pay
was low and he knew he could earn more in Hong Kong. BBB moved back to
Hong Kong in 2005 and he wanted AAA to come with him so that she could also
savour the opportunities of working in this city. She accepted his proposal and
followed to Hong Kong in 2006.

They stayed in Hong Kong with his mother.

BBB admits that there were disagreements between him and AAA because of his
drinking habits. He shared, There were times when AAA would go home first or
not come with me at all because she didnt drink. During those times, I would
stay out with my friends and got drunk and sometimes get high as well. My vices
were alcohol and drugs (marijuana, cocaine, mushrooms and ecstasy).

AAA frequently complained about BBBs temperamental outbursts. He shared,

She would get angry about my inability to control my stress and anger. And also,
of how I was forgetful of some of the important things that she told me. Example:
she told me she wasnt happy with me smoking weed every day. I might stop for
a week or two, forget about what she said and continue doing it again.

During this time, AAA and BBB were both working and still hold the same job
posts to this day. AAA became VP of Development for Brillkids and BBB was
employed as a full time Native-speaking English Teacher (NET) for a local
primary school in Kowloon City, Hong Kong.

BBB admits having difficulty maintaining his moods, specially under stress. He
recalled, I think when AAA and I started 2015, there was a lot of promise and
hope that 2015 was going to be a good year. AAA was actively involved with her
career, her band and her involvement with PLUG Magazine. I, on the other hand,
was relieved that I had already completed my Post Graduate Diploma in
Education (PGDE) Course with the University of Hong Kong in June 2014.

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Working full time and studying at the same time, was a very stressful experience
for me. I felt really burnt out after I graduated, and that carried over when the new
school year started at work on September 2014. I was happy that I was able to
complete my PGDE course. I even graduated with honours. But the stress got to
me and to cope with that experience, I started doing more drugs and alcohol.
Smoking weed was my resource of relief. I didnt drink on a daily basis, but when
the weekend came, I drank very heavily. I also did harder drugs over the
weekend like cocaine and ecstasy. Im not really into heavy drugs, but whenever
Im in a social situation with AAA and my friends, I felt like I wanted to take the
happiness that I felt with them and take it to a higher level. This life of excess
continued every weekend. It started affecting my ability to work and think clearly
because I was coming down from the all of the drugs and alcohol I took over the
weekend. During the week, I was mentally and emotionally drained. It was weed
that helped me to relax and clear my mind. Unfortunately, I wasnt present. I was
high at home most of the time and because of that, I became less involved with
my marriage.

He recalled one vacation in the Philippines when they used and mixed different
prohibited substances together, AAA and I were looking forward to our trip in
April. AAA planned a big trip to the Philippines with our friends for the Easter
holidays. We planned to stay at Stilts in Batangas. I helped AAA in whichever
way I could, but I have to admit, she did most of the organizing herself.

He further described his frustration on his addiction and his wifes lesbian affair,
We had a lot of fun during our trip to Batangas, but it also wore us out. We
stayed there for three days and four nights. During that time, we were doing a lot
of drugs with our friends everyday weed, cocaine, ecstasy and mushrooms.
There were times where I was awake but I didnt feel conscious. This was also
the time that AAA had become close with RRR, her current partner.

BBB admitted having a sexual affair with another woman he was attracted to with
AAA in the same bedroom, which eventually caused her to leave him, he shared,
After Batangas, AAA and I, with our friend Liam, flew straight into Sydney,
Australia for our friends Indian wedding. We stayed in Sydney for almost a week.
While we were there, I continued drinking and took ecstasy on the first night I
was there. That same evening, one of the brides friends, JJJ, stayed with us.
She and AAA took ecstasy with me as well. While AAA wasnt looking, I started
touching JJJ in a sexual way. I did ask AAA if she was interested in doing a
threesome with her, but she said no and was turned off by the idea. At that point,
I stopped touching JJJ but the three of us continued drinking until we fell asleep. I
would later admit to AAA that this happened and it would be one of the reasons
that lead to our separation.

The Sydney trip took a toll on me. I was always stressed out while I was there. At
some point, I felt like I had a nervous breakdown. The night before the last day of
the week-long wedding, I was drunk, I couldnt sleep, I was thinking negative

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thoughts and started to panic. I had no idea what was going on with me. AAA
helped me to calm down, but what happened really shook me.

When we came back to Hong Kong, AAA told me that she was in love with RRR
and she wanted to pursue a relationship with her, possibly within the realm of an
open marriage. She fell in love with RRR and I was deeply hurt by this revelation.
I think I was ok with the fact that she and RRR can have sex but I didnt accept
the fact that they were in love with each other. I felt left out and alone. For one
week, I was very depressed and entertained the idea of killing myself. But my
joint counselling sessions with AAA really helped. I knew that our separation was
inevitable at this point, so going to counselling together was just a way of getting
our issues out in the open so that we can understand why this happened in our
relationship.

In the end, we were open and honest about why we felt this way. There were
certain expectations that werent met, and I stopped by an active participant in
our marriage. I became so engrossed in finding ways to deal with my anger and
stress that I forgot to take care of my marriage.

After AAA and I separated, I stayed in our flat for 4 months while AAA moved in
with RRR. AAA would still pass by our flat from time-to-time to get some clothes
and some of her belongings. We would chat and catch up and sometimes talk
about our feelings. We understood that this needed to happen. My counsellor
said that I showed signs of clinical depression and I have issues stemming from
experiences as I child that I needed to deal with. AAA and I felt that I needed to
deal with these issues by myself and not within our marriage. AAA has done so
much on her end to support me but my anger, stress and drug/alcohol use just
continued to escalate.

A month or two after our separation, things got worse for me. Even while I was
still seeing my counsellor, I didnt want to deal with my depression head on.
Instead, I did more cocaine, drank more frequently and started a lot of sex with
regular women and prostitutes.

In August, I went to San Francisco and travelled by myself for the first time. It
was an amazing experience but while being away from Hong Kong, the trip made
me realize that I was very sad and depressed. When I returned to Hong Kong, I
moved into my own flat and tried to take care of myself more. I was in deep
depression till October. My counsellor was my main source of support at the time
and she really helped me get through a rough patch. I still take drugs but not as
much as before. I still smoke weed every day but I only take cocaine every other
weekend. The longest I didnt do any hard drugs was three weeks. I took cocaine
again on Halloween and at my friends birthday on November 6. Since then, I
havent taken any cocaine and my consumption of alcohol has also decreased.

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BBB described himself as pessimistic, stubborn, arrogant, quick tempered, and
over-sensitive.

Multi-axial system

The DSM-IV organizes each psychiatric diagnosis into five dimensions (axes)
relating to different aspects of disorder or disability:

Axis I: Clinical disorders, including major mental disorders, and learning

disorders, Substance Use Disorders
Axis II: Personality disorders and intellectual disabilities (although
developmental disorders, such as Autism, were coded on Axis II in the
previous edition, these disorders are now included on Axis I)
Axis III: Acute medical conditions and physical disorders
Axis IV: Psychosocial and environmental factors contributing to the
disorder
Axis V: Global Assessment of Functioning or Children's Global
Assessment Scale for children and teens under the age of 18

Diagnostic Impression of BBB

AXIS I- Partner Relational problem

Poly-substance dependence (Cannabis sativa, MDMA, cocaine, Alcoholic
bevrages)

T/C Mood disorder, Bipolar II, Depressive

AXIS II- NARCISSISTIC personality disorder

AXIS III- No known medical illness

AXIS IV- Primary support group (Dysfunctional family)

AXIS V- Global Assessment of Functioning- 90

Diagnostic Impression of AAA

AXIS I- Partner Relational problem

Poly-substance dependence, in remission, in an uncontrolled environment

Gender Identity Disorder

AXIS II- DEPENDENT personality disorder

AXIS III- No known medical illness

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 AXIS IV- Primary support group (Dysfunctional family)

AXIS V- Global Assessment of Functioning- 95

REMARKS :

Based on interview and examination of BBB, the Respondent is suffering from a

NARCISSISTIC PERSONALITY DISORDER.

The Diagnostic and Statistical Manual of Mental Disorders fourth edition, DSM
IV-TR, a widely used manual for diagnosing mental disorders, defines the
NARCISSISTIC personality disorder (in Axis II Cluster B) as

1 Has a grandiose sense of self-importance

While AAA was living with them she felt she was being treated like
a housemaid. Kailangan mauna ako magising sa kanila, para
mapaghandaan ko sila. Anak kasi nila nagtrabaho, ako walang
trabaho sa bahay lang nag aalaga ng bata..

She recalled, ayaw nila mga kalaro ng mga anak ko, dahil mga
magnanakaw dawmasyado sila mataas mag salita

2 Is preoccupied with fantasies of unlimited success, power,

brilliance, beauty, or ideal love

BBB had extra marital affairs, before an during the marriage.

He was manipulative.
He spends excessively on items and easily tires of them.

3 Believes that he or she is special and unique and can only be

understood by, or should associate with, other special or high-
status people (or institutions)

4 Requires excessive admiration

He dislikes being reprimanded.

He does not listen to advise. He purchased a property without

involving his wife.

5 Has a sense of entitlement, i.e., unreasonable expectations of

especially favorable treatment or automatic compliance with his or
her expectations
He expects his wife to tolerate his extra marital affairs.

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 6 Is interpersonally exploitative, i.e., takes advantage of others to
achieve his or her own ends

7 Lacks empathy: is unwilling to recognize or identify with the feelings

and needs of others

BBB told AAA, he was not interested in their marriage anymore. He

admitted having an affair. He left her to care for the children . he
stopped communicating with her.

8 Is often envious of others or believes others are envious of him or

her

9 Shows arrogant, haughty behaviors or attitudes

Kahit sino dinuduro niya, AAA recalls

BBB presented with 6 out of 9 traits of a Narcissistic Personality, fulfilling

the criteria.
According to another scientific diagnostic criterion:
Millon's subtypes
Theodore Millon identified five subtypes of narcissist. Any individual narcissist
may exhibit none or one of the following:
Unprincipled narcissist - including antisocial features. A charlatan - is a
fraudulent, exploitative, deceptive and unscrupulous individual.
Amorous narcissist - including histrionic features. The Don Juan or
Casanova of our times - is erotic, exhibitionist.
Compensatory narcissist - including negativistic (passive-aggressive),
avoidant features.
Elitist narcissist - variant of pure pattern. Corresponds to Wilhelm Reich's
phallic narcissisticpersonality type.
Fanatic narcissist - including paranoid features. An individual whose self-
esteem was severely arrested during childhood, who usually displays
major paranoid tendencies, and who holds on to an illusion of
omnipotence. These people are fighting delusions of insignificance and
lost value, and trying to re-establish their self-esteem through grandiose
fantasies and self-reinforcement. When unable to gain recognition or
support from others, they take on the role of a heroic or worshipped
person with a grandiose mission.

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Respondent is an Amorous narcissist - including histrionic features. The Don
Juan or Casanova of our times - is erotic, exhibitionist

Based on the interview and examination of AAA, she is suffering from a

DEPENDENT PERSONALITY DISORDER, which is characterized by a
pervasive and excessive need to be taken care of that leads to submissive and
clinging behavior and fears of separation, beginning by early adulthood and
present in a variety of contexts, such as difficulty making everyday decisions
without an excessive amount of advice and reassurance from others ,needs
others to assume responsibility for most major areas of his or her life ,has
difficulty expressing disagreement with others because of fear of loss of support
or approval ,goes to excessive lengths to obtain nurturance and support from
others, to the point of volunteering to do things that are unpleasant, and
unrealistically preoccupied with fears of being left to take care of himself or
herself.

RECOMMENDATIONS:

Based on the above findings, it is therefore recommended that BBB s marriage

to AAA, be declared null and void, on the basis of his psychological incapacity to
handle essential marital obligations. Manifested during early adulthood.

The Narcissist described by Kernberg frequently appear to have nothing but the
most superficial form of object relatedness. If the patients is male he may have a
Don Juansyndrome in which he seduces women systematically and discards
them when his idealization of them turns to devaluation Viewing them only as
conquests. He has no capacity to empathize with their internal experiences. He
is incapable of love. He as not much interest in what others have to say unless
the content is flattering (Gabbard 1990)

The root cause is his dysfunctional family, classified as pseudo-mutuality. His

personality disorder is GRAVE and INCURABLE.

Based on the above findings, it is therefore recommended that AAAs marriage to

BBB be declared null and void, on the basis of her psychological incapacity to
handle essential marital obligations. Manifested during early adulthood.

The root cause is her dysfunctional family classified as pseudo-mutuality. Her

personality disorder is GRAVE and INCURABLE.

N.B.

Dysfunction.
A deviation from the healthy and normal. Dysfunction occurs when one of the

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following occurs. Rigid, diffuse or unclear boundaries coalitions formed against
third party. Coalitions cross generational boundaries. Denied or concealed
coalition.

Adaptation.
Developmental changes within a family requiring alteration of boundaries. When
adaptation does not occur it results in dysfunction.

Pseudo-mutuality and Pseudo-hostility

Wynne described family communication patterns which lead to perceptual and
thought disorders as they denied reality of feelings.
Disjointed or fragmented communication leads to disrupted interactions.
Pressure is put on the child to maintain the faade to avoid meaningless of family
relationships.

Pseudo-mutuality - A faade of togetherness. Absorbed with fitting together at

the expense of developing separate identities.
Pseudo-hostility quarreling that is merely a superfical tactic for avoiding
deeper and more genuine feelings. A way of maintaining connection without
becoming either deeply affectionate or deeply hostile to one another.

A personality disorder is developed over a long period of time, typically from early
childhood. It is deeply entrenched in a person, such that the person feels very
comfortable with it that he/she does not think that it is a problem. A person with
such personality disorder is unable to acknowledge the existence of the problem
therefore professional help is of no avail.

Even assuming that the person acknowledges the problem and decides to get
treatment, there is yet no known medical cure to effectively reverse the
development of a personality disorder, since the coping mechanisms were
learned from experiences as one is growing up. It is ego-syntonic.

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