8/19/13: Patient has just returned from vacation, but is still presenting in a highly-agitated state. He says he is still being hounded at all hours by a Mr Vladimir Putin who keeps calling him in order to taunt him about his inadequacies. Patient says previous course of Ativan helped greatly in reducing anxiety and panic. Patient admits to using large quantities of marijuana as a young man which may have predisposed him to paranoia: he is even convinced that his dog looks at him resentfully. Patient talks incessantly about himself and shows other classic signs of Narcissistic Personality Disorder : dislikes criticism, exaggerates achievements and talents, needs constant attention and admiration, has little empathy for others. I informed him that regular talk therapy would be the best treatment, with a renewed prescription for Ativan to help with panic attacks. I agreed to conduct these sessions in Patient's private apartment which is part of much larger accommodations.--Dictated by Dr S.H. Rink
