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When we first meet the main character, only identified as “Jack”, he has a gun to his head battling his split personality, Tyler Durdan. He then takes you back many months so you can know how it is he came to that state. Jack is a 30 year old single white male complaining of insomnia for over 6 months. His job as a liability consultant for an automotive company requires him to take frequent trips to different time zones, usually on a short notice, therefore leaving him jet lagged. This issue has endured for at least six months. He states he is in “pain” and wants something to just make him sleep. Jack states that on several occasions he has woken up in strange places and does not know how or when he got there. He realized that having blackouts (not due to substance abuse or general medical condition) was disturbing and unusual behavior. The doctor he visited dismisses his claims and suggests he attend a support group for cancer to witness “real” pain. An image of his alter-ego briefly appears at that moment. Due to his job, Jack does not have any immediate friends or family. He refers to the passengers on the planes as his “single serving friend.” Jack begins attending a variety of support groups for ailments that he does not have in order to do something during his bouts of insomnia. After the first few meetings, Jack’s insomnia seemed to elapse and he uses the meetings as his sleeping pill. His recovery is short lived due to another fake “survivor”, Marla Singer. Her presence in his groups threatened his sleep because she knows that he is faking.

The patient is coherent and can fully comprehend what is going on around him. His dress is appropriate however his clothes are unkempt. His hair is disheveled and dirty. …

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…automotive company he saw the danger in everything. The split between the conscious happened once Jack was completely frustrated at how his life at 30 years old turned out. He intentionally blew up his condo to start fresh. However, when his alter-ego turned out to be more than he was willing to handle that is when he decided to wipe him out. He did this by attempting to kill himself in order to get rid of Tyler Durdan. Fortunately, he only killed Tyler Durdan not himself.

TREATMENT GOALS

Learn to disentangle Jack from his alternate personalityBoost Self EsteemTeach Jack how to deal with situation stressors rationallyTeach Jack how to control impulsesLearn about healthy defense mechanismsTREATMENT PLAN

Refer to a psychiatrist for long term individual therapyRecommend medication for depression or antic-psychotic behaviorHypnotherapy

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