CASE STUDY MAHINDRA

Name: Mahindra age 40 male.

Coimbatore.

Background rural but in US since 2018.

Education: 2004 mca

2007-2009 he was in California.

2009-2018 Bangalore.

Chief complaints: Not a good decision maker.

Avoidance of work/cleanliness since 3 years.

Sexual preoccupations.

History:

Patient reposts having sexual urges since he was age 5. As experimentation he touched private parts of a classmate in bus at age 6. At age 8-9 he had sexual relations with his maid. He reports it to be enjoyable but he did felt abused. He reports of preoccupations of sexual thoughts since then. Around age 17 when he was in class 12 he has incest relationship with his sister with a distant sister for 6 to 7 years on and off. He was emotionally attached to her but they ended sexual relationship when she fell in love with someone else.

At age 14 has a homosexual relationship with his uncle. He felt this as a abuse. At age 18 he had another homosexual relationship with friend which was consensual. Since then reports of guilt and anger. He reposts of high sexual drive and libido.

From the same time reports of obsessive thought with sexual content. Mood swings, agitated and thought “I am not clean”. He felt obsessive need of clean everything. Very organized and rigid thought till 2016 after which became disorganized by postponing to clean from the time he broke his friends vacuum cleaner and felt cleaning is very time consuming. His belief pattern “I have to do everything with perfectionism or else will not do”. He looks for reason to not clean.

He is married twice. First marriage 2011 to 2013 arrange marriage broke because wife was not much sexually active. Second marriage arrange marriage 2017. She is sexually active here he feels less than her and have urge to have sex once a week. They are pregnant with their first child currently.

2008 went to prostitute and 2010 again has sexual relationship with same sister once.

Since a year feel weak for a week after masturbating.

Since last 20days feel depressed.

Reported of improvement after fc but now feels that symptoms are coming back.