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Dr. Gregory House is the main character in the House television series. He is currently working as the Head of Diagnostic Medicine with a double specialty in infectious disease and nephrology at Princeton-Plainsboro Teaching Hospital. He is portrayed as narcissistic, sarcastic, and appears to dislike most people. He prefers superficial relationships with others, sometimes using prostitutes to satisfy his sexual needs. Descriptive Information: Gregory is a 52 year old Caucasian male. He prefers to be called House, as he views being called Greg as too personal.
Dr. House has a permanent disability in his leg.
Dead muscle tissue had to be removed and left a divot in the skin. He is also very sensitive about the appearance of his thigh, being badly scarred from multiple operations. He is very reluctant to talk about this disability and is easily offended if it is brought up. House has been in constant pain since the surgery and has become addicted to painkillers. He does not acknowledge his using as a drug problem; he reports it is a pain problem.
He states that it does not interfere with his ability to work. At the present time he has been to npatient treatment for detoxification, however still struggles with his addiction.
House is above average in his intelligence, having been accepted to John-Hopkins University for his pre-med studies. It is his disregard for ethics and protocol that has caused him problems. He lost an opportunity for an internship at the Mayo Clinic when he was caught cheating and expelled.
His inability to work well with others has been a source of employment issues for him in the past. House’s father was a Marine pilot, and he spent most of his childhood moving to different countries.
As a result he isolated, and concentrated on a variety of interests. He is fluent in several languages, and plays the piano and guitar. At the age of 12, discovering the timing of his conception did not correlate with a time his father was around, he confronted his parents on the paternity. It was revealed to him that his mother had an affair with the family minister. House feels this was the turning point in his relationship with his father, John. He feels he was mistreated by John for this reason. John was cold and controlling, showing House limited affection.
House was rebellious and was often punished harshly both physically and emotionally. House and his mother had a loving relationship, however in his desire to avoid his father he does not have her in his life. Presenting Problems: House’s presenting problems at this time are: his addiction to painkillers, his fear of intimacy, and anti-social traits. He also displays a problem with impulse control. Dr. House states his main reason for using Vicodin was for pain management, however he has admitted to recreational drug use in his past. His dependence has caused him professional problems, getting him into trouble on several occasions.
His addiction has also caused him problems with Lisa, the woman he has feelings for. Dr. Lisa Cuddy and House have had an ongoing attraction spanning 25 years. They were beginning to form a relationship when she had a scare with cancer. When House couldn’t face losing her, he turned again to the Vicodin. Lisa ended their relationship when she realized his inability to cope without the use of drugs. Dr. House has been afraid to experience any real closeness to others in his life. He has issues of trust due to his mother’s dishonesty and his father’s distance and hostility towards him.
This is the primary source of his fear of intimacy and cynicism. He hides his fears with a narcissistic attitude, and pushes people away instead of exposing any vulnerability. House can be extremely defensive, and it is likely he uses his personality in a deliberate attempt to alienate anyone who tries to get close to him. He is conflicted when facing his feelings for Lisa, while trying to hold onto his belief he is entirely self-sufficient. House has acted on numerous occasions without regard to his health and safety. He also takes his behaviors to the extreme. When Dr. Cuddy starts dating after their reak-up, he reacts by driving his car through her front window.
He states his reason as simply “returning her hairbrush. ” He uses himself as a test subject for drugs and medical tests, sometimes just to satisfy his curiosity. He has taken experimental drugs in hopes of restoring his leg muscle, which eventually led to tumors. House has also injected himself with questionable blood received by an ill patient to see if a blood transfusion caused their symptoms. Model: I believe that person-centered therapy would be the model best suited for House. I would also incorporate some cognitive-behavioral techniques.
House would not respond well to any theory that is confrontational, he needs to feel in control. I also recognize that although his past plays a big part in why he has relationship issues, he does not seem to want to revisit these occurrences. I believe very little time should be spent on the subject of his parents specifically, with more time spent on how he’s dealing with relationships now. House would be a difficult client to build a therapeutic relationship with; however I do feel it could be done over a period where he felt he was in a safe and non-judgmental environment.
He is intelligent and lives to figure out the “pieces” in difficult medical diagnoses. House may have a little trouble in using this in regards to his own mental health, since he is so enveloped in denial, but he does have the capacity to do so. The person-centered model works on the premises that the client is the expert, and I believe it is one he would respond to best given his personality type. Treatment Goals: House’s primary issue is addiction, and a lack of having a recovery plan. He has been trying to deal with this on his own terms, and has had relapses.
His untreated condition contributes to his anti-social personality, interferes with his relationships, and causes issues at work. I feel his other presenting problems can never be fully addressed until he can gain control over his addictive behaviors. Until he comes to terms with his addiction, he will remain isolated and continue to be self-destructive. Dr. House needs to address his difficulty with any type of relationship. It is apparent at times that he does have the capacity and this facet of him is not part of a personality disorder. He displays a need for people despite his not wanting to.
He shows jealousy when Lisa dates others and does has a close friendship with Dr. James Wilson from the hospital. Dr. Wilson provides House with consultation about cases, and often personal issues. James is one of the few who can away with calling House out on behaviors. They sometimes have real moments on a deeper level, and at times they can let go and share laughs. House has displayed many instances of problematic impulse-control. He has experimented with Methadone, self-induced insulin shock, and tried deep brain stimulation with an electrical prod.
The electrical current caused him seizures, brain leeding, and ultimately led to him being in a coma. He often shows no regard for his well-being. Once in an agitated state, he dove from a balcony into a pool. These behaviors horrify others around him. Techniques: The person-centered therapy is flexible enough to be adapted to most personalities. I feel a technique building a person profile would help House to address his addiction issues and in building a plan. This would begin with listing his attributes and strengths. Learning what is likable and worthy about himself, instead of focusing on negatives, will present to him a view of himself in wish he wants to be seen.
Next he should verbalize what is important to him. Having clear, concrete thinking on what he wants in his life can help when addressing what his drug use will take away from him, and how it is a barrier in achieving his desired outcome. Finally House should look at what has been working and what is not working as support in his life. This includes relationships, both ones that may be unhealthy and those he needs to build. Recovery is greatly impacted by support systems. These can include relationships on a personal level, and outside support groups.
House needs to consider what should be changed, what should stay the same, and what makes sense as far as being realistic. Rational emotive behavioral therapy (REBT) could be beneficial to House in dealing with his fear of intimacy. The basic hypothesis is that people are not disturbed by events, but by the views in which they take on them. Therapy would dispute his irrational beliefs and engage him in activities that can counter them. Showing House the faulty belief system he imposes on everyone he meets, he can begin to work on seeing how his actions are self-sabotaging.
If he can really grasp how his beliefs are blocking him, he can find ways to change and control them. It will help him to communicate more effectively with others. I believe social skill groups could help House with his impulse-control. Group therapies help with accountability of the behavior, and provide for feedback. This therapy is a powerful venue for growth and change. Participants receive tremendous understanding, support, and encouragement from others facing similar issues. House could also gain different perspectives, ideas, and viewpoints on those issues.
I feel a variance outside of one-on-one would be beneficial for House. As narcissistic as he can be, I think too much attention to solely his issues at once would force him to become more defensive and less open to treatment. Assessment: House’s treatment goals will take some time to be actualized. Addiction is rooted not only in behaviors, but also his biology. He will need to have some strong support built in along with coping skills. Given the fact relationships with others need to exist for the support to be effective, these treatment goals are dependent on one another.
His treatment with addiction will not show promise until a minimum of a year without use has been met, and regular involvement in a self-help group has been established. I do not expect House to develop newer relationships at this time; however I will gauge his success in fostering his existing ones. His changes should include learning how to express his feelings maturely, and learning to give of himself without the use of sarcasm to hide when it feels uncomfortable. There is also a strong correlation between addiction and impulse-control, by identifying coping skills for urges, House could utilize some of these with his behaviors.
In addition, low self-esteem can be part of the problem in engaging in such dangerous and high risk activities. House needs to address both his physical condition that causes him embarrassment, and his abandonment issues with his family. I feel as time goes on, and he gives recovery and relationships with others a chance, he will begin to see himself as a person worth caring for. Once he begins to feel that he is valuable and deserving of love from others, he should be able to accept this within himself. It is my hope through those changes his disregard for his safety will dissipate.
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