DOB: MAY 27, 1939



Patient is currently living a double life that has resulted in a personality disorder as well as insomnia. Patient has stated that he has nightmares of clowns and often finds himself stalking clowns in the middle of the night, while dressed as giant bat. Patient is incredibly quiet and does not make eye contact often. Patient seems closed off and cold. Patient reports that because of the double life that he lives, he is not only unable to sleep, he is also unable to work at his own company or hold a stable relationship. Patient does have a pass of severe trauma; this is due to the fact that he witnessed the murder of both of his parents at the age of 8. Patient stated that he would like to resolve his trauma and mental issues so that he can live a “normal” life.


Duration:  For how long has this been happening? Patient has stated that his condition started some time after the murders of his parent. Patient states that since the age of 8, he has undergone a period of severe depression which has caused him to become very reclusive and therefore created “The Batman” as an escape from the regular everyday life.

Frequency: How often does this happen? Patient reports that he dresses as a giant bat every night. He has entrusted his company to his trusted colleague and therefore devotes majority of his time to his adventures as “The Batman”. He often finds himself engaged in dangerous activities because of this secret lifestyle.

Think back to the last time it happened and tell me: Patient stated that the previous night, he was home alone with his butler and decided to go into his “Batcave”. As he describes it, the Batcave is where he conducts his secret experiments and feeds the desires of his alter-ego. He stated that the Batcave is also where he keeps his batman suit. He stated that he had a strange desire to suddenly “hunt” criminals. Mainly clowns. When asked why he did not leave fighting crime to the proper authorities, he stated that he stated that he is the authorities. The patient stated that he then hacked the police radio and started jumping from roof top to roof top. The patient stated that he then started to attack people that he personally determined to be criminals, and brought “justice” to them, without a fair trial of course. The patient stated that this is what excites him in life and that he feels that by doing this, he is “avenging the death of his parents”. The patient did not seem to realize that he put himself and others in grave danger because of his behavior and actions. Patient seems to be very narcistic and believes that he knows it all due to his superior   intellect. Patient stated that he was minorly injured during the incident but “has been hurt far worst in the past”.



During his adventures as “The Batman”, Bruce Wayne was seriously injured by a steroid addict called “Bane”. During his random fight with Bane, Bane injected himself with additional steroids which gave him the idea that he can break men in half. This resulted in Bain breaking the back of Bruce Wayne. After sustaining his injury, Mr. Wayne had to undergo several surgeries. He then had to through a grueling physical therapy to return back to his full health. Mr. Wayne has also had several minor surgeries due to his nighttime adventures. He has sustained several broken bones in the past, as well as a few concussions. Majority of Mr. Wayne’s surgeries were preformed by his butler, who was previously an army medic.

Significant medical issues that have required treatment longer than 2 weeks

The most severe physical injury that Mr. Wayne experienced was his back injury. It was a very traumatic event. It occurred while Mr. Wayne was in his Batman character. He decided to have a street fight with a boxer that was taking steroids, that goes by the name “Bain”. For as powerful as Mr. Wayne believed that he was during this manic episode, Bain was actually stronger. This resulted in Mr. Wayne’s back broken in multiple places. He required a spinal fusion and had to wear a back brace for 2 years. Mr. Wayne stated that the entire time while in rehab, “The Batman plotted revenge on Bane”. Mr. Wayne stated that he told the members of his company that he was hurt in a skiing accident. Mr. Wayne has also sustained several orthopedic and neurological injuries. He is believed to suffer also from a minor case of CTE due to his multiple blows to the head. He expressed that he sustained these injuries during MMA fighting.

Physical/Occupational Therapy

Mr. Wayne stated that he wanted the best health providers that money could buy, and so he used his resources to obtain treatment in several different countries. He went to both natural and conventional healers that worked collectively to help him heal. Mr. Wayne stated that learn to walk again was one of the hardest things to do. Mr. Wayne stated that herbal medicine worked well in helping him to repair inner parts of the body.


Current (Medical, physical, psychiatric):

Due to his many adventures as “The Batman”, Mr. Wayne has sustained many injuries. As a result of his many injuries, he has grown accustom to pain medication and has somewhat of an addiction to them. He has express that he often takes codeine, hydrocodone, oxycodone, and morphine for his injuries. He also engages in 15 hours of physical therapy a week. After his fight with Bain, he became addicted to Fentanyl, and his butler has to check him into a detox program. Currently for his depression, Mr. Wayne self-medicates with cannabis. He has stated that he has a slight cannabis dependence. Mr. Wayne is also on Lexapro for his depression, but states that he rather smoke cannabis, due to the fact that he does not like the side effects of the Lexapro. Mr. Wayne meets with a therapist about twice a week for about an hour a session. He expressed that it does help. He has expressed that he was on Lithium for some time, however the side effects were too severe and interfered with his “work”.

Past (Medical, physical, psychiatric):

Mr. Wayne has been on paroxetine (Paxil) and Zoloft for some time because of his PTSD. At the age of 8, he witnessed the violent murder of his parents. This highly affected his world and resulted him going into a temporary psychosis. He would often times re-enact the night of his parent’s murder with his toys and would be violent with other children. He would also be very socially distant. This resulted in his butler admitted him to an inpatient psychiatric hospital for children. Mr. Wayne was there for a total of 2 years. During that time, it was reported that he also experienced panic disorders and was placed on Prozac. Mr. Wayne reports that he was also on Abilify (Aripiprazole) for some time, however the side effects caused him to gain weight and want to sleep all day. He also realized that it was causing erectile dysfunction when he grew order and therefore discontinued use in his teenage years.




PARENTS: Age/living-deceased, client’s age and reaction to death and consequences

Mr. Bruce Wayne’s parents are Dr. Thomas Wayne and Martha Wayne. Both parents were murdered when Mr. Wayne was 8 years old. This occurred while they were exiting a theater. They were approached by a mugger that demanded money and their jewelry. The events leave Mr. Wayne an orphan, and his legal guardian becomes his butler, until he is of legal age.   Dr. Wayne was a gifted surgeon and philanthropist. He inherited billions of dollars from his ancestors, which were left for his son at the time of his death. Mrs. Martha Wayne was the heir to the Kane Chemical Fortune and a member of one of Gotham City’s wealthiest families. Mr. Wayne expresses that his parents were great people and that they did their best to raise him correctly. Mr. Wayne has also stated that his parents did have a dark past. He stated that there were rumors of his parents being involved in drug use and orgies. He also expressed that because his parents were rich socialites, they would often party with other rich people and involve themselves in many activities unowned to him. Mr. Wayne stated that his father had superior intellect and that he most likely inherited his intelligence from him. Mr. Wayne stated that his mother suffered from an unknown mental illness that did not permit her to work. He stated that his mother would often drink, partially in the middle of the day and abuse other unknown substances. This caused conflict between her and Dr. Wayne, who felt that it would be best that she sought out treatment, which she never did and therefore never diagnosed. Mr. Wayne expressed that none of those activities occurred in the home, however he did witness his father smoke cannabis occasionally from a pipe. Mr. Wayne stated that his parents were very loving and supportive. He stated that after their death, he fell into a depression and even contemplated suicide.


How many marriages, duration, description of blended families, siblings, step siblings, and how household is managed

Mr. Wayne does not have any siblings. His mother was pregnant when he was younger, however she had a miscarriage and lost the baby. Because Mr. Wayne lives within multiple realities within his mind or “universe”, he has been married several times. Mr. Wayne at one point was married to one of the “villains” that stalks, a cat burglar and former prostitute named Selina Kyle aka Cat-Woman. He expressed that he married her because she understood him the most. He explained that, similar to how he dresses up like a giant bat and runs around at night time, she does the same but is dressed as a cat. He is also married to his former marital arts teachers’ daughter Talia Al Ghul. He has claimed that he was drugged during the process, and there doesn’t consider his marriage to Talia Al Ghul to be legal.


Pregnancies: planned/unplanned; unaccepted/accepted; difficulties; diseases

children, as well as children that he has adopted throughout the years. His children includes Helena Wayne with his wife Selina Kyle. He has father a son by the name of Terry McGinnis as a result of nanotechnology with the use of his DNA to artificially impregnate Mrs. McGinnis. He has an illegitimate son by the name of Ibn al Xu’ffasch with his wife Talila Al Ghul. He also has two son named Tallant Wayne, and Damian Wayne, as well as a daughter Athanasia Al Ghul with Talia Al Ghul. He also has a son named Bruce Wayne Jr. Mr. Wayne expressed that Damian Wayne was born out of rape, when he was drugged by Talila Al Ghul, who hid the child from him for several years.

Mr. Wayne has stated that he has also adopted Dick Grayson, Jason Todd, Timothy Drake, and Cassandra Cain. All of which he has incorporated into his “Batman” fantasy. He has the children dress up like other animals such as robins, and he allows them to go on his midnight advantages with him.


It is unknown if Bruce Wayne has any grandchildren.


Mr. Wayne has stated that he has a law degree from Yale. He also studied criminology, chemistry, and psychology. He also had training in many different areas such as 127 different forms of martial arts and has learned multiple languages. He is also a master of disguises, an expert in espionage and escapology. Mr. Wayne also stated that he has 14 masters’ degrees from multiple different schools in the following concentrations: psychology, forensics, engineering, biology, and chemistry. He stated that his OCD has caused him to have an endless thirsty to acquire knowledge and to know “everything”.


CEO/Owner of Wayne Enterprises /Philanthropist/ Superhero


Mr. Wayne stated that he was never a member of the military and was unable to be drafted because he was the last living member of his family prior to having children.


Technically, Bruce Wayne is a criminal vigilante because of his work and actions as “The Batman”. However, he has yet to be persecuted for his actions. We assume that he has used his money to avoid any legal persecution.


Mr. Wayne reports a long history of psychiatric illness. He grew up as an only child and often times kept to himself and did not play well with others. His mother stated that he was special child. After witnessing the death of his parents, he experienced extreme anxiety and major depression.  He displayed avoidance when it came to coming outside, because he feared that he too would be murdered. This led him to remaining in the home, and fearing going outside. His butler home schooled him, but he eventually admitted him into an inpatient psych-ward. It was in the psych-ward that he began to create ‘The Batman” in his head. He explained that “The Batman” was someone that would be fearless but feared by other. He expressed that he would use “The Batman” to punish evil doers. Once he was released from the psych-ward, he was informed by his butler that he now had complete legal control of his company. Mr. Wayne stated that he was not interested in running a billion dollar company, and would rather dress like a giant bat and jump off of roofs. Mr. Wayne stated that he is barely able to sleep due to his double life. He stated that he has to maintain both lives, and so there is very little time for sleep. Mr. Wayne is very obsessive when it comes to details and control of his life. He does not let others or the law get in the way of him accomplishing his goals. He explained that he at times he sits in front of his super computer for hours, tracking criminals all around the world. Mr. Wayne has stated that he does have flashbacks of the night that his parents were murdered. He stated that because his parents were killed by a fire arm, he does not use fire arms as Bruce Wayne or as Batman. The lack of weapons during his dangerous escapades is even more concerning. The fact that he includes his children into this fantasy is a huge concern. Mr. Wayne has stated that he is now “darkness”, and so he spend hours in his dark bat cave. Mr. Wayne often times has to be reminded to eat by his landlord. He has stated that he has gone multiple days without eating. Mr. Wayne has also informed us that he has anger issues. At times, he randomly has violent outburst. He expresses that he takes out his anger on criminals by “beating the living daylights of them”. Mr. Wayne states that he still experiences back pain from when he fought with Bane. He has expressed that it is a constant reminder of what occurred that night. Mr. Wayne has stated that he is also hunted by the events that occurred the night that he was drugged, married in a secret ceremony, and raped by his wife Talia Al Ghul. He has stated that he felt used and betrayed and that this event has made it very difficult to trust women and have a healthy relationship. His other wife Selina Kyle feels that Mr. Wayne should seek professional help. Mr. Wayne also suffers from a fear and hatred of clowns. During his time at the psych-ward, he was in the same room with a young man that called himself “The Joker”. He stated that every night “The Joker kept him awake by laughing very loud and crying very loudly. He stated that “The Batman” hated “The Joker” and that he would get his revenge on him in the future. Mr. Wayne has spent a total of 10 years hunting “The Joker” and it has come to be somewhat of an obsession strong enough to make both of his wives jealous.


Mr. Wayne has stated that he does not drink caffeine or alcohol. He stated that he saw the effects of alcohol on his mother and that he did not want to continue that cycle. Mr. Wayne has also informed us that he does not use tobacco. Mr. Wayne has stated that he does not do any drug besides smoke cannabis. Mr. Wayne has expressed that it helps him to relax as well as heal from injury by helping to relax his muscles.


Mr. Wayne reports that he does not have any history of sexual abuse. He stated at one time he did have an ACS case, due to the fact that he had his young children out late night, while wearing their underwear outside of their clothes. Mr. Wayne stated that he had loving parents, however he always felt that he “could not live up to the Wayne name”.


Mr. Wayne expresses having a low sex drive. He has admitted that he “would rather be with his children and sidekicks fighting crime then be around any woman for too long”. He has stated that he has had commitment issues as well as trust issues. He has also expressed that he great’s enjoyment from fighting with female supervillains. He even married one, and was forced to marry another. Mr. Wayne expressed that in the past he had erectile dysfunction as a result of his psych-meds.


Mr. Wayne appears to be well dressed and groomed. He does not seem to have any hygiene problems. His facial expression seems still and a bit bored. He is very short with his answers. His posture is very still. His motor activities are normal. His eyes seem to dart around the room, as if he is studying everything around. Mr. Wayne seems very educated and is well versed.


Mr. Wayne has stated that he has very bad sleeping patterns and barely speak at all. He believes that he suffers from Insomnia. He expressed that the thoughts of clowns and criminals keep him up and he has no other choice but to go out at night and stop them. Mr. Wayne stated that his butler reminds him to eat, mostly by bring him food. Mr. Wayne state that at times he is so fixated on work that he forgets to eat.

Mr. Wayne stated that his daily activities are going into his office for about an hour or two for attendance reasons. He then goes home to work out and stares out the window for hours. Afterwards he does his physical therapy with his butler. Afterwards he spends hours in his bat cave until nighttime, when he is able to go out and hunt the “bad guys”. Mr. Wayne expresses that during his “hunt” he feels excitement as well as anxiety. He state that Bruce Wayne and Batman are two very different individuals and are nothing alike.


Mr. Wayne is exceptionally good at problem solving and has self proclaimed himself to be “The Worlds Greatest Detective”. He is incredibly good at finding clues and resolving complex mysteries. This is mainly due to the luxury he has of not having to work a full-time job and the fact that he has unlimited resources at his disposal.


Mr. Wayne has good short- and long-term memory. However, there are parts in his life that he seems to black-out in his memory and there’s points in his memory that continues to play over and over again in his head. Mr. Wayne expresses that certain things he is unable to block out of his mind no matter how hard he tries. He expressed that these particular memories include the murder of his parents and visions of clowns.


Mr. Wayne pays remarkably close attention to detail. During this assessment, it felt as if he was investigating us. Even though he did not seem trilled to be assessed, he was extremely focused during the interview and the sessions. He also took notes of the questions being asked and his responses.


Mr. Wayne has a high concentration and is able to obtain a vast amount of knowledge in a small amount of time. He has stated that this is one of the skills that he applies during his nighttime adventures. He went on to say that when he “zeros in, there is nothing that can stop my focus”.


Mr. Wayne passed the mental status exam. He was able to recite his full name, date of birth, and occupation. He was also able to name his butler, his two wives, and his several children. He was able to provide us with the location of where he lives as well as where he went to school. He was able to provide us with the time, the date, and the current president. He was also able to identify objects such as pencils and pens correctly. After a while he looked a bit annoyed with the test and felt like it was an insult to his intelligence.


Mr. Wayne possess no superpower, yet he considers himself to be a “superhero”. He has even aligned himself with other “superheroes” such as “Superman” aka Clark Kent from Smallville, Kansas. He believes that everyone is evil or has the ability to become evil and so he has created weapons that are capable of killing his own “super friends”. Mr. Wayne feels that it would be a waste of time to actually become a member of law enforcement to fight crime. Instead he rather dresses like a giant bat and swing from building to building in the middle of the night.


Mr. Wayne reports having suicidal ideations as a child following the death of his parents. He contemplated suicide, but quickly changed his mind. In a sense he is on a suicide mission every time he chooses to go outside in a giant bat outfit and attempt to fight dangerous criminals. Mr. Wayne expressed that he has had homicidal ideations in the past, especially when it comes to Bane and “The Joker”.


Mr. Wayne has admitted that his “night job” is extremely dangerous to himself, his children, his sidekicks, and others. Yet, he has stated on multiple occasions that he refuses to let go of this duty. Mr. Wayne has also stated that he is aware of obsession with clowns and engaging in dangerous activities when he has no need to do so. Mr. Wayne has stated that “The Batman” gives him purpose and excitement.


Openness- Mr. Wayne is very imaginative and creative. He lives a remarkably interesting life to say the least.

Conscientiousness- Mr. Wayne works hard every night to “fight crime”. He is very dedicated to this duty. He has an array of weapon and such to help him complete this task.

Extroversion- Mr. Wayne considers himself to be a loner and he is incredibly quiet and passive.

Agreeableness- He is very suspicious of others and critical with the way that he thinks. He is also ruthless in his action to destroy “The Joker”.

Neuroticism- At time Mr. Wayne can be very unemotional. He has expressed that there is no need to show emotions. Mr. Wayne has also stated that “The Batman” is very temperamental.



Mr. Wayne has informed us that he has been able to establish adjustment due to the fact that he has limitless income so that he does not have to worry about his finances and therefore able to afford a double life. He also expressed that the children and the home are cared for by his wife and the butler, respectively. Mr. Wayne divides his life in two, in which the daytime is for Bruce Wayne and the night is for The Batman.


Mr. Wayne is able to balance multiple task, women, and lifestyles at the same time. He pays awfully close attention to detail and is well educated in a vast number of subjects. Mr. Wayne is able to accomplish several tasks, while operating on an extremely limited amount of sleep.


Mr. Wayne is unable to differentiate between the two lives that he lives. At times he remains in his Batman character for days and neglects all other personal responsibility. He is also limited in his ability to show emotions, which limits the strength of his relationships. `


Mr. Wayne support system consist of his wives, his children, and his butler. They support his Batman habit and help him whenever he is injured or require assistance in crime fighting. He is also friends with a gang of alien superpower individuals called “The Justice League”.


The client seems to be suffering from a personality disorder, depression of some sort, as well as obsessive behavior and delusions. He seems very disconnected to people and things and seem to be fixated on his nighttime activities. He continues to place himself in danger for no particular reason other then to “fight crime”. His lack of sexual desire and his poor relationship with his wives and children has us in question. The fact that he is relentless to give up his dangerous nighttime activities is overly concerning.


Mr. Wayne states that his only concern is protecting his family and his city. Mr. Wayne states that his only goal is to protect Gotham City and to defeat “The Joker”. Mr. Wayne does admit that his lack of sleep is a concerning problem, and at times he falls asleep while stalking criminals.


Include specific criteria met from DSM-5 including specifiers

Include two rules out diagnoses

Mr. Wayne was Diagnosis with the following disorders:

Dissociative Identity Disorder:

  • The existence of two or more distinct identities (or “personality states”). The distinct identities are accompanied by changes in behavior, memory and thinking. The signs and symptoms may be observed by others or reported by the individual.  Mr. Wayne basically shares his body with “The Batman”. It would also seem at times that “The Batman” looks down on Bruce Wayne, so he spends the majority of his time as “The Batman”. The Batman was created from the trauma of losing his parents and so he created someone more powerful then himself.
  • Ongoing gaps in memory about everyday events, personal information and/or past traumatic events. Mr. Wayne blocks out many things of his youth as well as parts of his adult life. This is either for secret reasons or due to lack of memory. He is able to retain a high decrease of information but has several lapses in memory.
  • The symptoms cause significant distress or problems in social, occupational or other areas of functioning. Because of his obsession of being “The Batman”, he is unable to run his company or spend time with his family, besides when they are working with him.


  • Depressed mood most of the day, nearly every day. Mr. Wayne has stated that he spends majority of his day in his Batcave or simply looking out of the window. He often has a depressed grim look on his face.
  • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. Mr. Wayne barely if ever attends work. He also barely interacts with his wives or children. His only interest is crime fighting.
  • Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day. Mr. Wayne reports going days without eating and has to be often reminded to eat by his butler.
  • Feelings of worthlessness or excessive or inappropriate guilt nearly every day. Mr. Wayne often blames himself for the death of his parents every day. This is why he goes on suicide missions every night. He believes that this will resolve the survival guilt that he is currently living with.
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. Mr. Wayne has had suicidal thought in the past as a child. However, as an adult he goes on suicide missions every night as The Batman and is surprised that he is still alive every morning when he returns back home.

Obsessive-Compulsive Disorder DSM-5 300.3 (F42)

Obsessions are defined as:

  • Recurrent and persistent thoughts, impulses, or images that are intrusive and cause marked anxiety or distress; but are not excessive worries about real-life problems.
  • The person attempts to ignore, suppress or neutralize these thoughts, impulses, or images.
  • The person is aware that the obsessional thoughts, impulses, or images are a product of his or her own mind, as opposed to delusional in nature.

Compulsions are defined as:

  • Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession.
  • The behaviors or mental acts are directed at preventing or reducing distress or a dreaded event or situation.
  • These behaviors or mental acts may not always be associated with the content of the obsessional theme. For example, if the theme is Contamination, the ritual may involve mental rehearsal or counting.
  • The symptoms of OCD are not the result of another psychiatric disorder present or caused by a medical condition or substance abuse.

Bruce Wayne has admitted to his unhealthy obsession with “The Joker” and “fighting crime”. To get over his obsession, Mr. Wayne feels that “The Batman” must destroy “The Joker”. Every night when he is dressed in his costume, he searches high and low for “The Joker”. Majority of the time he does not find him and takes his anger out on other petty criminals. There was a time that “The Batman” severely injured “The Joker”, however he did not kill him because he needed an archenemy to give “The Batman” purpose. Mr. Wayne has also stated that he has a giant photo of “The Joker” in his Batcave so that he could never forget him.

Posttraumatic Stress Disorder (PTSD) DSM-5 309.81 (F43. 10)

  • Direct exposure. Bruce Wayne was 8 when he witnessed the murder of his parents
  • Nightmares/ flashbacks. Mr. Wayne often has nightmares of the night his parents were murdered.
  • Trauma related thoughts or feelings. Mr. Wayne believes he has to stop criminals in his city because of what occurred to his parents.
  • Overly negative thoughts and assumptions about oneself or the world. Believes that majority of the world is evil and does not trust anyone.
  • Risky or destructive behavior. He dresses up like a giant bat and chases armed dangerous criminals all night.
  • Has been engaged inthis behavior since the age of 16.
  • He is unable to run his company because he is too occupied with fight crime.

We ruled out the following diagnoses:

  • Schizophrenia Disorder – Did not meet the full criteria
  • Bi-Polar- Did not meet the full criteria


Rickard Jean-Noel – May 1, 2020
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