“Doctor, your three thirty is here: Ms. Millen.”
“Do I have her chart?”
“Yes doctor, I put it on your desk.”
“I see it. Give me five minutes to review it, then send her in.”
“OK doctor.”
Doctor Carl Hague released the button on the intercom and leaned back in his overstuffed leather chair opening the blue folder containing Dawn Millen’s chart and began to scan the contents.

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Green Oaks Psychological Assessment Center

PSYCHOSOCIAL ASSESSMENT

Prepared by: David Leeding PhD., LMSW-ACP, LPC, LMF, LCDC
Prepared for: Dr. Carl Hague
Patient release of information signed? YES
Reason given? Continuity of Care

Name: Dawn Millen
DOB: 21 April 1963
Height: 5’4”
Hair: Brown
Eyes: Green
Weight: 115 Lbs

Physical presentation: Patient presents as somewhat younger looking than her 40 yrs. Patient is dressed provocatively in an opaque white halter-top, and a short leather skirt. Patient’s appearance and demeanor suggest that it would be unwise to conduct this interview in a closed room. I conducted interview in room directly across from receptionist with door completely open, and informed receptionist Carly Baker of my intention to do so, that she might be aware of interview and act as a visual witness in case of negative occurrence.

Possible Diagnosis:

V71.01 Adult Antisocial Behavior: Patient has history of sadistic-sexual relationship patterns since before the age of 15 and possible intermittent cult involvement: cult fits no known pattern. Was member of “Rogue” biker gang from age 16 to age 32. Arrested numerous times for incidents involving biker gang. Significant arrest:
Possession of a Controlled Substance.
Assault with Intention to do Bodily Harm.
Co-conspirator Racketeering (Car theft ring).1
Patient has not held gainful employment for longer than three months at a time, with the exception of working in a topless bar as a dancer (302.4 Exhibitionism), and prostitution. Currently, Patient works as an independent “escort,” specializing in sadomasochistic role-play. According to patient’s own account, her clientele are mostly men, and are evenly divided between submissives and dominants. She self-divulges that she enjoys her work, and gains sexual pleasure from playing both the dominant or submissive role (301.50 Histrionic Personality Disorder). Patient self reports sexual arousal from object insertion, vaginally, anally, and orally during role-playing (302.9 Paraphila). Patient has been hospitalized on numerous occasion related to injury suffered during this type of sexual activity. Her last hospitalization was approximately six months ago on January 29, 2004. She required a blood transfusion because of sever internal bleeding from wounds received vaginal and anally. She was hospitalized for ten days, at which time she was released, and instructed to stay bedridden for the next week; she was then scheduled for a follow-up. She did not go to the follow-up, but appears to have made a full recovery, and states she is experiencing no current pain or problems related to the injuries. 2

Presenting problem: Patient states that she has realized that her behavior has become progressively more self-destructive. She states that she nearly constantly feels the need to be hurt, and no longer just for sexual arousal. For the last year and a half, patient reports that she has been “cutting” on herself (301.83 Borderline Personality Disorder) as a way to control these urges, but she is now becoming frightened because she feels she is losing control. She reports that she knew that she was being hurt badly during the incident that precipitated her last admittance to the hospital (see above), but did not want to stop the abuse. Patient reports suffering nightmares most nights, and being unable to sleep unless she takes some form of sleep aid, usually of the Benzodiazepine class, which she acquires from an illicit source. Currently she reports needing 20 mil. valium, or the equivalent to induce sleep. Patient states that she rarely gets more than three hours sleep a night.

Family History:
Patient reports that Father (William Carl Millen, age 62) was a violent and abusive man. He is currently serving a life sentence in the state penitentiary for the beating death of the patient’s mother (Patty Anne Millen nee, Wilkerson). Patient states that her mother died in 1985. Patient has one sibling, a younger sister (Shelly Anne Millen), who is in a continuing care facility. Patient reports that her sister suffers from a catatonic state, brought on by sever abuse when she was kidnapped, and subjected to sever physical trauma. Patient reports that when her sister was found outside of the county hospital, she was nearly dead.