New Patient
Chart Entry, Collateral Contact:
This writer has been informed of the newest patient added to their caseload, current caseload being downsized to one due to the severity of this case and the governing restrictions placed upon this writer. Collateral contact made with S.H.I.E.L.D. concerning the history and physical as well as numerous, if not prolific, field reviews and observational consultations regarding this patient’s case. Initial intake and diagnostic formulation are not necessary as the documentation contains all necessary information. All findings, regarding diagnoses and risk assessments, are to be reported immediately to S.H.I.E.L.D. emergency contact Agent Hill, (---) --- ---- and patient’s legal court appointed guardian, Anthony Edward Stark, (---) --- ----.
Chart Entry:
This writer has been granted the opportunity to process with this patient and offer them the highest quality of therapy in line with the harm-reduction model of care. This writer has sought supervision and peer consultation regarding the unique qualities and various challenges in establishing a therapeutic alliance with this patient.
First Appointment:
Patient no-showed this appointment. S.H.I.E.L.D. and patient guardian, have been notified. A chart entry has been made in their hard-chart.
Telephone Contact:
Number used in contact attempt, (---) --- ---. Contact with this patient was attempted, guardian of this patient notified this writer of the refusal of this patient to participate in therapy. “He’s being an asshole about it. We’ll try to get ‘em to come next time.” This writer was informed by the guardian to keep this patient’s next appointment in their schedule in hopes of this patient attending. An entry has been made in this patient’s hard-chart.
Chart Entry, Collateral Contact, Team Meeting:
A Team Meeting was called for this patient regarding their participation in therapy, risk factors, and approach. Consultation was processed through direct clinical supervisors, governing officials, S.H.I.E.L.D. Mental Health Services, and guardian.
Addendum: Questioning Guardian Stability.
Second Appointment:
Patient no-showed this appointment. S.H.I.E.L.D. and patient guardian, have been notified. A chart entry has been made in their hard-chart.
Chart Entry, Collateral Contact, Team Meeting:
A Team Meeting was called for this patient regarding their participation in therapy, risk factors, and approach. Consultation was processed through direct clinical supervisors, governing officials, S.H.I.E.L.D. Mental Health Services, and guardian.
Addendum: This writer has filed a formal grievance with governing agency S.H.I.E.L.D. regarding violation of patient confidentiality and involvement in patient’s case.
Second Addendum: This writer will no longer to filing formal grievances regarding S.H.I.E.L.D.
First Session attempt, SOAP Note:
Subjective: Patient expressed his feelings towards receiving services, “I have no care for this childish prattle. I have no care for such pointless Midgardian exercises!” Patient expressed his feelings regarding those who accompanied him to this session, “Perhaps if you would leave me be I could breathe freely and have no need for your [motions to clinician] healers of thought and heart!”
Objectives and Assessments: Patient was alert and oriented by person, place, and situation. Patient was not communicative nor generally cooperative. Patient appears attentive to their ADLs. Patient displayed irritation and at times aggressive tendencies. A risk assessment regarding their violence factor has been added, with all the rest that apparently already exit within this patient’s chart. Patient displayed emotional irregulation and physical displays of anxiety, though this patient made an obvious attempt was to mask their anxiety response. Patient paced throughout the corridor and office as a manifestation of their irritation and anxiety. Patient made various displays of distain towards this process and those accompanying him. Patient arrived 45 minutes late for this appointment. Patient escorted by S.H.I.E.L.D. security and patient’s legal guardian. Patient remained inside therapy office for 4 minutes before refusing services. Patient appeared assaultive and displayed aggression as well as various emotional irregulation. A chart entry has been made in their hard-chart.
Plan: Patient will continue to meet with their assigned clinician on a regular basis for ongoing individual therapy. A Treatment Plan will be collaboratively created and utilized through the harm-reduction model of care. A Safety Plan will be created and utilized, the patient’s utilization of this plan will be monitored. Patient will build and utilize healthy coping skills. Patient’s safety will be monitored during each session.
Chart Entry, Collateral Contact, Team Meeting:
A Team Meeting was called for this patient regarding their participation in therapy, risk factors, and approach. Consultation was processed through direct clinical supervisors, governing officials, S.H.I.E.L.D. Mental Health Services, and guardian.
Chart Entry:
It is the observation of this writer that the oversight and restrictions placed upon this patient by the governing party, S.H.I.E.L.D., is exacerbating the patient’s anxiety, appeared intermittent explosive disorder, and triggering their [appeared] Posttraumatic Stress Disorder. A formal request has been issued regarding the participation and oversight of this governing party as it may have detrimental affects on therapy process and establishment of the therapeutic alliance.
Addendum: Request has been denied.
Addendum: Another request has been filed with the advocacy of patient’s legal guardian and sibling.
Addendum: Continued questioning of the stability of legal guardian.
Addendum: Request has been granted.
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Session 1
The room was quiet, the low humming of static noise machines filling the room. They were sitting opposite one another. It was dark yet warmly lit. The colors of the room selected purposefully, the imagery selective and sparse. The chairs were the same size and shape, careful not to show power in one seating over the other. There was nothing between the two chairs, nothing to symbolize a barrier between them.
The two sat for some time in silence. One sitting in professional posture, frame relaxed, gaze soft upon the other before them, a slight smile upon their face. The other sat spiteful, uncaring, and poor postured across from them, an emerald gaze quizzically piercing upon the other, a vicious smile curving up to sharp porcelain cheekbones…. predatory… challenging…
HANNIBAL: “May I call you Loki?”
Loki’s head tilts slowly, an amused hum softly escapes him, his eyes narrow slightly, taking in far more than the other’s simple question. After a moment he rolls his eyes and sighs softly, gesturing ever so dismissively with a flicker of his long fingers, his voice low and eloquent.
LOKI: “You may address as you wish, though it would call to some intelligence within you if you did indeed address me by my name.”
This gaze trailed off, seemingly no longer intrigued by the other before him, his serpentine eyes falling now upon the simplicities within the room, the desk, the lamps, the pictures upon the wall. The other sat unhindered, their subtle smile never faltering, their gentle nature remaining. Their reply was soft-spoken, smooth.
HANNIBAL: “It is important to you that I am intelligent…?”
Loki’s eyes found the other’s again, his false smile returning, his gaze taking in what truths he could gather from the other’s expression.
LOKI: “Is this a question? ...or a statement you felt ever-so necessary to cast upon the air?”
Loki’s head titled again, his smile turning bold, his eyes playful.
HANNIBAL: “It is whatever you need it to be.”
His brow lowered, his head pulled back. He paused before scoffing, slowly shaking his head as he breathed in deeply. He leaned forward, looking much like a wolf crouching, hunting.
LOKI: “Is this Midgard’s idea of healing one’s heart? A game of words?”
An amused hum escaped him, his emerald eyes glistening with this new found encounter.
LOKI: “It is not wise to play such games with a creature like me.”
He leaned back in his chair, satisfied, relaxed, a look of careless affect. His attention moving to his long slender fingers, picking and grooming his nails and cuticles… pompous and yet-… still with a flare of elegance dismissed the other once more.
HANNIBAL: “…..games….hmmm….”
Loki’s eyes flash upward, leaving his hands, and once more finding the other’s gaze. The human’s head tilts slightly, taking in the alien before them.
HANNIBAL: “….tell me of these games…”
A genuine smile finally falls upon him, a curiosity kindling within, his attention ensnared. His posture changes, becoming more confident, his hands once more gesturing nonchalantly with his words.
LOKI: “ What do you wish to know?”
HANNIBAL: “How do you play these games?”
He laughed, his laughter filling the small space, low and dark, humming along the painted metal walls of the hidden facility. Oh how the humans tried their best to make this space look and feel different, domestic, welcoming… oh how they failed.
LOKI: “In all so many ways… there are games of words…”
Loki motions between them with a smile.
LOKI: “As you and I know quite well… ……there are also games of those things gone unspoken, unseen… shadows and mist…. illusions…”
HANNIBAL: “Who are the players in these games?”
LOKI: “All are players, whether they are awake to this truth or not. Some even play games within games and further still… all pieces moving about, scurrying from one point to the next… insects… puppets…”
HANNIBAL: “And what are they playing for?”
He pauses, a small hidden piece of him, a piece of him escaping his collected and contained visage. He seemed slightly, if not minutely taken back by the question, an unexpected train of thought. His gaze drops for a moment, falling upon his garments. His fingertips slowly smoothing over the black leather beneath them as his thoughts swirl. His eyes once more meet the others and his smile dims.
LOKI: “Nothing.”
A pause. A pause strangled the room. It was a demanded silence, with such a powerful reply, how could it not be? Yet, not powerful in delivery, but in revelation, in meaning.
HANNIBAL: “Then… why play? You play for the sake of the game? Or to fill the role? What is the intent? What is the need being met?”
His jaw locked, his long spine growing tall in his seat, his chin lifting, a shadow of dominance, defiance, cast upon him now.
LOKI: “And why does one play the roll of the healer? The balm to the troubled mind, the troubled heart?”
The other’s smile shifted ever so slightly, not in any adverse manner but in one of small success.
HANNIBAL: “Do you often deflect questions regarding yourself onto others? Do you often find success in doing so?”
Loki paused, his smile faltering yet still remaining. His eyes flickered, another escape of something real within him. His posture softly relaxes once more, his fingertips again finding the smooth leather upon his knee comforting to toy with.
LOKI: “If I knew I were meeting with a wordsmith then I am sure I would have found my way here far sooner… for such an entertaining venture… rather than dance such a folly towards it....”
Loki’s gaze trails off for a moment, a devious smile casts upon him.
LOKI: “Although-… I do enjoy such dances.”
The other’s head tilted slightly, gazing now upon the long ivory fingers tracing gently along the cold black leather of the other’s knee.
HANNIBAL: “You are very tactile… always fidgeting, toying, playing, feeling… “
Loki smiles and looks to his hands. He takes a moment and then softly escapes a subtle chuckle with a breath.
LOKI: “I suppose I am… though-… I am many things… tactile… sensory… a hunger yes? … Hedonism isn’t it all?”
Loki grinned again and looked to the other. The other smiled…
HANNIBAL: “Whether you are a hedonist or not there is no need for those before mentioned games nor dances here. Games can and should remain outside that door… regardless of whether or not it has been your intent all along to play them here…. or-…. Everywhere you go…”
The other pauses, observing the shapeshifter before him, the magician, the fallen would be king, the alien-…. The murderer.
HANNIBAL: “Here you have an opportunity to be, not a piece in a game, but a man… open and devoid of any masks or walls he has built up to protect himself from the world he perceives to have betrayed him so… and even those walls he has built to protect against himself… “
The master of magics sat quiet, his eyes locked upon the other as they spoke, his smile all but gone. He was seemingly frozen in place, unreadable as he took in the other’s words.
HANNIBAL: ”However… that is going to be quiet difficult for you, since you do not even perceived yourself as being a man…”
His serpent eyes flickered, another piece, once hidden, now seen. He remains quiet, still listening intently to the man seated before him.
HANNIBAL: “You referred to yourself in the beginning of our dialogue together as a ‘creature’… not as a man…”
The human shifted slightly, their gaze lowering as they took in a breath. The alien before them still unreadable, perhaps ready to escape the ‘prattle’ or lash out and strike.
The other’s words came matter-of-fact yet respectfully, blunt and clear.
HANNIBAL: “Whether you are aware or accepting of it you are desiring of some form of release, some form of healing from this process.”
The tall leather clad form shifted in his seat and scoffed, a wicked smile forming upon them as he slowly shook their head.
HANNIBAL: “You revealed it in our first encounter, as well as in our journey today.”
His emerald eyes widen slightly in curiosity, his head tilting, his voice dripping in amusement.
LOKI: ”Oh?... did I know?”
The other did not react to the change in his mannerism, nor did their gaze move from the note pad upon their lap, where a pen scribbled unknown conclusions and secrets lost upon its surface.
HANNIBAL: “You have referred to this process twice now as that of the heart… ’medicines’ and ‘healings’ of the ‘heart’ not just of the mind…. a wordsmith such as yourself certainly knows the profound difference between the two… heart and mind. You try your best with all your masks and walls to cast out a manner of indifference, or cool intent or thought…. While you are indeed a master of doing so you are still governed far more by your heart than your mind. This creates conflict… amongst others concerns…. You do your best to mask emotional but in doing so release some of the rawest forms of emotions such as anger and fear… anxiety is a fear response, very primal… fight or flight… Anger is a defensive reaction to an emotional wound… all very clearly read upon you… a man of masks.”
Loki’s jaw was locked, his eyes alone expressing a cascade of emotions, rage and sadness dominating. While it was evident emotion was flooding through his blood and heart his ever persistent need for control harbored them back from spilling over, from leaving him bare in a place so foreign.
He slowly stood, the other still writing findings upon their lap. His tall slender stature looming over the room, overbearing, demanding. Before vile words could escape his wicked silver-tongue the other broke the silence first.
HANNIBAL: “That will be the end of today’s session. I will see you again for our next discussion in a few days.”
With that the other stood as well, though tall, their height did not match Loki’s. They walked to the desk at the end of the room, opposite the door, their back dangerously facing the raven-haired man looming behind.
The other set the notepad down and began shuffling papers on the desk, seemingly unmoved by the wrath behind them.
Quiet and ever so slowly the taller man glided towards the other, his back still facing him. His gaze murderously locked upon him. The other paused, sensing the shapeshifter ever so close behind, yet he did not move or speak, he gave him no acknowledgement, played nothing into his game. The otherworldly figure leaned in, placing a large hand upon the desk, his lips close to the other’s ear, his voice low and dark, his words slowly spoken…
LOKI: “There are not many who would turn their backs to me… who would dare speak to me in such a manner… to challenge me in such a way…”
The darkness did not leave the taller man’s eyes but a bitter smile did form, his tone growing lighter.
LOKI: “I think I shall rather enjoy our ‘talks’ together…”
At that the other’s gaze left the desk, a smile accompanied their curious smile. Loki slowly leaned back and turned, moving for the door. Before he reached for the handle the man at the desk turned his head towards his direction, their gaze still not meeting one another.
HANNIBAL: “Do be sure to be prompt with your appointment time.”
Loki paused at the door, his long tactile fingers wrapped gently around the handle, his smile growing, amused with this new game.
LOKI: “I shall wordsmith… “
With that he opened the door, several S.H.I.E.L.D. agents alerting to this movement in the hall. He then paused in the doorway, tilting his gaze back over his shoulder. His words soft,”
LOKI: “…..and yes…. You may call me Loki…”
The man at the desk smiled once more and turned to face him, their eyes finally meeting once more.
HANNIBAL: “….and you may call me Hannibal.”
Loki paused momentarily as he took in the other’s name and smiled, his emerald eyes playful, a breath of enjoyment within him… and with that he moved on down the corridor, agents in black moving about, yet keeping a distance.
Stark sat at the end of the hall by the elevator, masterfully playing with a newly tinkered device some would be bold enough to carelessly label a phone. He perked up at the sound of Loki dominating the long metal hall and smiled up at him as he approached. Stark stood and pressed the button to ascend to the surface, away from the bowels of the S.H.I.E.L.D. base which imprisoned his ever fleeting attention span.
STARK: “Ah! Thank God! ……You weren’t in there for very long…”
Stark’s dark eyes scanned Loki’s features, reading amusement upon him. He chuckled to himself and walked into the elevator and leaned back against the far wall after pressing their desired floor.
STARK: “Well that certainly wasn’t the reaction I was expecting from you TinkerBell… whats turned you into such a ray of sunshine?”
Loki looked over to Stark and nodded to the gadget in his hands,
LOKI: “Are you not the one who ‘tinkers’ ?”
Stark scoffed and rolled his eyes, ever so amused. He often found a battle between annoyance and amusement when the golden boys of Asgard would fall short with his cultural references they never seemed to pick up on… and thankfully so as he was sure Loki would have kicked the shit out of him by now if he had.
Loki smiled and gracefully leaned against one of the side’s of the elevator, nodded down to the end of the hall towards the room he had just left, and casually replied,
LOKI: “Our next play session shall be in a few days…”
A look of total confusion fell upon Stark at his reply and Loki’s soft laugh filled the small compartment as the elevator doors closed.
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Initial Diagnostic: First Full Session and History
DIAGNOSES:
AXIS I Posttraumatic Stress Disorder;
(with panic and triggers of acute Megalomania)
Major Depression, recurrent, with psychotic features;
Adjustment Disorder;
Rule Out Schizophrenia;
Rule Out Bipolar Disorder ;
Rule Out Intermittent Explosive Disorder;
AXIS II Questioning Paranoid Personality Disorder, acute features
Question Borderline Personality Disorder
AXIS III Hulk injury per Hx,
Tesseract exposure per Hx,
Recent fall through space and time per Hx,
Mjolnir damage to chest per Hx.
AXIS VI PsychoSocial Stressors are Severe:crisis of identity, difficulty adjusting, chronic questioning of self-worth, family conflict, lack of social supports, chronic and acute mental health concerns, suicidal ideation per hx, and pending criminal action, relationship conflict [once again questioning guardian’s stability].
AXIS V Current Global Assessment of Functioning: 30 (questionable)
Highest in the past year: unknown