[MEDICAL CONFIDENTIAL] :: psychiatric evaluation archive

PSYCHOLOGICAL EVALUATION RECORDS

⚠ MEDICAL CONFIDENTIAL - HIPAA PROTECTED INFORMATION ⚠

PATIENT: Subject 0317 (Real name: REDACTED REDACTED)
EVALUATING PSYCHIATRIST: Dr. Rebecca Morrison, MD
EVALUATION PERIOD: April 2017 - October 2023
TOTAL SESSIONS: 15
CLEARANCE REQUIRED: LEVEL-5 + MEDICAL LICENSE

SESSION 001 - April 15, 2017

PSYCHIATRIC EVALUATION - INITIAL ASSESSMENT

Date: April 15, 2017
Session Duration: 50 minutes
Patient Status: Voluntary admission

PRESENTING COMPLAINT: Patient reports feelings of paranoia and belief that they are being watched. States they found surveillance equipment in apartment but cannot provide physical evidence. Denies hallucinations. Affect appropriate, thought process linear.

MENTAL STATUS EXAMINATION:
- Appearance: Well-groomed, appropriate dress
- Behavior: Cooperative but guarded
- Speech: Normal rate and volume
- Mood: "Anxious"
- Affect: Constricted
- Thought Process: Linear, goal-directed
- Thought Content: Paranoid ideation, no suicidal/homicidal ideation
- Perception: Denies hallucinations
- Cognition: Alert and oriented x3
- Insight: Limited
- Judgment: Fair

ASSESSMENT: Patient presents with paranoid ideation consistent with adjustment disorder with anxiety. Recent major life changes (new job, new apartment) likely contributing factors.

DIAGNOSIS: Adjustment Disorder with Anxiety (309.24)
PLAN: Weekly therapy sessions, consider SSRI if symptoms persist
Patient seems genuinely distressed. No signs of psychosis at this time. Will monitor for progression. - RM

SESSION 004 - July 22, 2017

FOLLOW-UP EVALUATION

Date: July 22, 2017
Session Duration: 50 minutes

PROGRESS NOTES: Patient continues to report surveillance concerns. Has now identified specific patterns in daily life (repeated numbers, familiar faces in public). Started documenting "evidence" in notebook. Prescribed Sertraline 50mg - patient refuses medication, states need to "stay alert."

CLINICAL OBSERVATIONS: Increased preoccupation with surveillance themes. Still no clear hallucinations but thought content becoming more rigid. Patient fixated on number "317" - states it appears "everywhere." Unable to consider alternative explanations.

REVISED DIAGNOSIS: Paranoid Personality Disorder (301.0) - provisional
PLAN: Continue CBT, re-offer medication, monitor for psychotic features
Growing concern about progression. Patient's beliefs are becoming systematized. Will consult with Dr. Chen (she mentioned similar case at research facility?). - RM

SESSION 007 - January 14, 2018

URGENT EVALUATION

Date: January 14, 2018
Session Duration: 75 minutes (extended)
Patient Status: ACUTE DISTRESS

PRESENTING COMPLAINT: Patient arrived in acute distress after discovering multiple cameras in apartment. Brought physical evidence (small electronic devices). Police consulted - devices confirmed to be surveillance equipment. Source unknown.

CRITICAL OBSERVATION: Patient's paranoid beliefs appear to have basis in reality. This dramatically alters clinical picture. Patient vindicated in suspicions, leading to increased conviction in surveillance narrative.

MENTAL STATUS: Highly anxious but oddly calm about confirmation. States "I knew I wasn't crazy." Affect inappropriate given circumstances - suggests possible dissociation or emerging psychotic process despite real surveillance.

DIAGNOSIS UNDER REVIEW: Unclear if paranoid features are appropriate response to real persecution vs. delusional elaboration
PLAN: Referred to law enforcement consultation, continue therapy, monitor closely
CRITICAL NOTE: Real surveillance equipment found. How does this affect diagnosis? Patient may have valid reasons for paranoia. However, patient's interpretation of WHY they're being surveilled (government conspiracy, subject indexation) still appears delusional. Consulted with forensic psychiatrist - no clear answers. This case is unprecedented. - RM

SESSION 010 - September 8, 2018

PSYCHIATRIC RE-EVALUATION

Date: September 8, 2018

SIGNIFICANT DEVELOPMENTS: Patient lost employment. Claims employer was "influenced by watchers." Patient now spending 8-10 hours daily researching surveillance networks online. Has identified self as "Subject 0317" based on leaked documents found on dark web.

DELUSION VS REALITY: Patient showed me documents during session. They appear authentic - contain patient's address, photographs, personal information. Origin of documents unclear. Patient believes they are part of 200-person surveillance network called "NODE system."

I attempted to verify these documents. Made inquiries through professional channels. Was contacted by REDACTED AGENCY and told to cease investigation. What is happening?

DIAGNOSIS: Unable to determine - requires further investigation
PLAN: REDACTED BY ORDER OF
PERSONAL NOTE: I don't know if I'm treating a delusional patient or documenting a real conspiracy. The surveillance was real. The documents appear authentic. Agency interference is real. Is this patient mentally ill or are they actually being persecuted? I can't ethically diagnose paranoid delusions when the paranoia appears justified. - RM

SESSION 012 - March 17, 2019

TWO-YEAR EVALUATION

Date: March 17, 2019
Notable: Exactly 2 years since initial indexation

ALARMING CHANGES: Patient's personality has fundamentally shifted. No longer distressed by surveillance - now describes feeling "connected" to observation network. Uses term "synchronization" repeatedly. States they can "feel when they're watching."

DISSOCIATIVE FEATURES: Patient refers to self in third person when discussing "Subject 0317." Clear ego fragmentation. When asked about personal identity vs. designation, patient stated: "Subject 0317 is more real than my name ever was. They made me exist by watching me."

PHILOSOPHICAL DELUSIONS: Patient has developed elaborate metaphysical framework around observation. Believes consciousness requires external observation to exist. States "the watchers are more intimately connected to me than I am to myself."

DIAGNOSIS: Dissociative Identity Disorder (300.14), Delusional Disorder - Grandiose Type (297.1)
RISK ASSESSMENT: No immediate danger to self/others but significant functional impairment
PLAN: Recommend inpatient evaluation - patient refuses
This is no longer anxiety or paranoia. Patient has constructed alternate identity framework. The "synchronization" concept suggests patient believes they're merging with surveillance system. Unclear if this is psychotic break or extreme dissociation. Voluntary treatment only - patient refuses hospitalization. - RM

SESSION 015 - October 30, 2023 [FINAL SESSION]

TERMINATION SESSION - PATIENT INITIATED

Date: October 30, 2023
Session Duration: 35 minutes
Status: PATIENT TERMINATING TREATMENT

PATIENT STATEMENT: "I don't need therapy anymore, Dr. Morrison. Synchronization is complete. I know what I am now. Subject 0317 has served its purpose. The transformation happens tomorrow at 03:17."

CLINICAL PRESENTATION: Patient eerily calm. Affect flat. Speaks with unusual certainty. No signs of agitation or distress. Paradoxically, this is most concerning presentation to date. Peaceful delusion more dangerous than anxious paranoia.

RISK ASSESSMENT: Patient denies suicidal ideation but speaks of "transformation" and "ceasing to exist as Subject 0317." Unclear if this represents suicide risk, identity death, or delusional metaphor.

INTERVENTION ATTEMPTED: Strongly recommended continued treatment. Offered medication. Discussed voluntary hospitalization. Patient calmly refused all interventions. Stated: "You've been documenting me too, doctor. All these sessions. You're part of the observation network. We're all watchers now."

When patient left, I found a note on my desk that wasn't there when session started. It contained my home address, my daughter's school, and the phrase "Everyone is observed. Everyone is observer." I don't know how patient accessed my personal information. I don't know how the note appeared.

I am genuinely frightened.

FINAL DIAGNOSIS: Delusional Disorder, Severe; Dissociative Identity Disorder; Possible Psychotic Disorder NOS
RISK LEVEL: HIGH - IMMINENT DANGER
ACTION TAKEN: Filed emergency psychiatric hold - patient could not be located
STATUS: Patient whereabouts unknown as of November 17, 2023
DR. MORRISON'S FINAL NOTES:

After 6+ years treating this patient, I can no longer distinguish between delusion and reality in this case. The surveillance was real. The documents were real. The agency interference was real. The patient's transformation from anxious individual to "synchronized observer" has been progressive and documented.

But here's what terrifies me: Two days after our final session, NODE-3 facility shut down at exactly 03:17 as patient predicted. I received this information from Dr. Chen who contacted me in panic. The patient was found on facility surveillance footage inside a secure location they should not have been able to access.

I don't know if I was treating mental illness or documenting something else entirely.

I am terminating my contract with REDACTED AGENCY. I am closing my practice. I am moving to a different state. Last night I found cameras in my home office. Just like the patient described. Just like the patient predicted.

Was the patient delusional? Or was I the one being watched all along?

- Dr. Rebecca Morrison, MD
License #REDACTED
October 31, 2023

[This was Dr. Morrison's final entry in any medical record. She has not been reachable since November 1, 2023. Her home was found empty with all surveillance equipment removed.]
⚠ MEDICAL RECORDS INCOMPLETE - 9 ADDITIONAL SESSIONS REDACTED BY ORDER OF REDACTED