1/31/14 Patient was looking wild-eyed today, which normally means that he has come off second-best in a verbal altercation with Vlad the Impaler. I have reintroduced patient to the concept of cognitive behavioral therapy which, put simply, is a psychotherapeutic approach that addresses dysfunctional emotions, maladaptive behaviors and cognitive processes. In patient's case it means learning to pluck at a rubber band around his right wrist and associate that sensation with a place of peace and tranquility from his youth. We had a lengthy session with some signs of reduced anxiety.