Who would study psychology if they didn't have some kind of problem?

Chapter 557 Mo Kai: Didn't I just do this question?

Whether out of camaraderie or due to his duty as an invigilator, after some thought, Brother Good Luck walked from the podium to Nan Zhuren's desk.

"Classmate?" Senior Brother Good Luck pretended not to know him and called out to Nan Zhuren softly.

In the state of flow, Nan Zhuren is completely focused and writes furiously.

He didn't even lift his head.

Lucky Senior: "...?"

This situation is even more worrying.

"Classmate." Senior Brother Good Luck lowered his body and tapped Nan Zhuren's desk lightly with his knuckles so as not to disturb the other candidates.

This finally drew Nan Zhuren's attention back.

"Are you feeling unwell, student?"

Nan Zhuren quickly understood the meaning behind Good Luck's words and shook his head: "Sorry, teacher, I suddenly felt sleepy just now..."

He also pretended not to know the other person and used very careful wording.

Good Luck Senior Brother pursed his lips. The way you suddenly lost consciousness and then immediately woke up and started writing furiously, it wasn't just ordinary "sleepyness."

It's fortunate that you're in Beijing right now. If you were to move to the upper right corner of the map of China, some people might suspect that you've been possessed by a shaman.

Is there any shaman who oversees psychological exams?

After quietly confirming Nan Zhuren's condition again and receiving an affirmative reply, Brother Good Luck shook his head and gave up.

But I've made up my mind to report this to the teacher properly later.

After dealing with her senior's sudden concern, Nan Zhuren refocused her attention on the essay question about "married male clients wanting to use money to develop illicit relationships."

When ordinary test takers see this question, they might think that counselors of different genders might have different ways of dealing with this situation.

There's really no need for that.

From the perspective of the question setter, this question only tests the ethics and morality of counselors. Considering gender factors would risk going off-topic.

The solution to this problem is actually quite standard.

First, the counselor's position is stated through ethical guidelines.

Second, let's analyze the specific ethical issues. This topic raises concerns about a dual relationship, potential economic exploitation by the counselor, and an unequal relationship within the counseling process.

Third, explore the underlying motivations behind the visitor's behavior, including [empathy].

Fourth, discuss the follow-up consultation plan. Should we explore transference with the client, or promptly and decisively transfer the case elsewhere?

Nan Zhuren had just finished outlining the framework and was now continuing to recite the relevant content of the "Code of Ethics for Clinical and Counseling Psychology Work of the Chinese Psychological Society" that she had just memorized in the "Memory Palace".

Simply reciting the original text from memory would be too unrealistic, and it's also impractical to memorize it in such a short time.

Nan Zhuren gave an appropriate answer based on his own understanding.

[1. Psychologists must clearly understand the adverse effects and potential harm of multiple relationships on counseling. They must not engage in any form of sexual or intimate relationship with clients, nor provide counseling to individuals who have had sexual or intimate relationships. They must not engage in intimate relationships with current clients' family members, partners, caregivers, guardians, etc....]

2. Psychological counselors must not exploit the trust and dependence of clients, nor may they use their authority to seek personal gain or engage in emotional or economic exploitation.

3. Psychological counselors should clearly define their service fees and ensure transparency regarding these fees for clients.

【4.……】

Nan Zhuren wrote it in great detail.

An essay question might only have a title of three or four lines, but the points-by-point answers can fill a whole page, almost like a short essay.

Nan Zhuren rubbed his wrist. For humanities exams, writing speed is actually the biggest constraint for test takers; they often find themselves in the awkward situation of having the answer in their head but not having time to write it down.

OK, this question is solved.

Nan Zhuren focused his attention on the last major question.

This is a proper case study question. It's the kind of question that most test takers fear most, yet it's also the kind that's most effective in Nanzhuren's test area.

……

Case Background:
Ms. Lin, 28 years old, is a painter with some renown. She was referred to your psychological clinic by her hospital due to "long-term mood swings, identity confusion, and recent severe self-destructive impulses." At her first meeting, she arrived 45 minutes late, wearing expensive but mismatched clothing stained with paint, and had light scratches on her wrists, both new and old.

Chief complaint and present illness:
Ms. Lin described feeling "empty inside, like a black hole" for a long time, but intermittently overwhelmed by intense, unbearable emotions, including anger, sadness, and excitement. These emotional fluctuations last from hours to days and are usually related to external influences.

Her interpersonal relationship history is extremely unstable, describing all close relationships as going "from extreme adoration to utter disgust," accompanied by a strong fear that others "may abandon me at any time."

For nearly a month, she fell into deep despair after a major solo exhibition received a flood of negative reviews. She began frequenting high-end bars, engaging in unprotected sex with strangers, and speeding late at night "in search of a moment of clarity."

A week ago, after a heated argument with an admirer, she overdosed on painkillers (requiring emergency gastric lavage). However, the day after her discharge, she meticulously selected an extremely expensive limited-edition art book as a gift for you and insisted you accept it.

Important Personal History:

The eldest daughter in the family. Her father is a successful entrepreneur who is often absent, emotionally distant, and demanding; her mother is a musician who is emotional and has been hospitalized multiple times for "neurasthenia".

She was sent to an overseas boarding school by her parents at the age of 8, describing that time as "like being forgotten by the world." She began self-harming at the age of 13 (snapping her wrists with rubber bands, pinching herself).

I had two brief experiences with psychological counseling, both of which ended after 3-4 sessions because I felt the therapists were stupid and couldn't understand me.

His artworks often revolve around the theme of "fragmented self-reflection."

【question:
1. Please provide your initial diagnosis and list at least three core diagnostic criteria. Note: This case requires precise differential diagnosis from bipolar disorder. Please elaborate on your differential diagnostic approach.
2. Regarding their "unprotected sex" and "speeding late at night" behaviors, how would you inform them of the risks? Please describe in detail what you would say to the visitor.

3. How would you handle the expensive gift she gave you?
4. For this case, the counseling perspective from the psychoanalytic school was applied, involving the first phase of the counseling intervention plan.

……

Nan Zhuren nodded inwardly; this was indeed a very well-designed question.

The issues involved very standard work required for an initial meeting.

The first question involved diagnostic assessment, and it specifically highlighted the need to differentiate it from bipolar disorder. This means that in addition to reciting the diagnostic criteria from the case materials, candidates also had to identify the differences.

The second and third questions both relate to "risk assessment and ethical responses".

The difficulty of the second question lies in how to inform the client of the risks associated with their inappropriate behavior. It is important to avoid dismissive statements like "it's nothing" or direct criticism, as these can severely damage the counseling relationship during the initial meeting.

The correct approach is to specifically, neutrally, and non-judgmentally identify the direct link between behavior and consequences, and frame it as a problem that needs to be addressed collectively in therapy.

The third question still involves issues of interest, and refusal is necessary, but the method of refusal is crucial. It is necessary to explain that the refusal is to protect the purity of the therapeutic relationship and to explore the deeper meaning behind the client's "gift-giving" behavior.

As for the fourth question, it was the easiest for Nan Zhuren.

Nan Zhuren first analyzed the first question.

Bipolar disorder, formerly known as manic-depressive illness, consists of two phases: a manic phase and a depressive phase. In other words, patients experience cyclical fluctuations between these two extreme states.

Further subdivided, there are Type I bipolar disorder and Type II bipolar disorder. The former has more frequent manic episodes, while the latter has more frequent depressive episodes.

In this case, Ms. Lin exhibits self-harming behavior, but also occasionally displays extreme excitement and impulsivity—superficially, this seems to meet some criteria for bipolar disorder. However, in reality, the bipolar state in bipolar disorder is persistent and intrinsic, with a single episode lasting for days or weeks, and the switching process is usually unrelated to the environment.

This doesn't quite match Ms. Lin's condition as described in the materials.

Ms. Lin's focus is on her "interpersonal relationships going from extreme admiration to utter disgust" and "a strong fear that others might abandon her at any time."

Then came the phrases "The mind is empty, like a black hole" and "The theme of the artwork contains fragmented self-reflections."
"Unprotected sex" and "speeding late at night";
“Old and new scratches on the wrist”, “taking painkillers”;
And “emotional fluctuations lasting from hours to days are usually related to external influences.”

These characteristics correspond to "extreme fear of abandonment", "self-harm", "suicide", and "intense emotional fluctuations", respectively.

What truly meets Ms. Lin's diagnostic criteria is—borderline personality disorder!
As the final question, it was indeed very difficult, since it falls under the category of "Abnormal Psychology," which is something that most test takers rarely memorize.

Nan Zhuren had just glanced at the topic before falling asleep and also memorized the diagnostic criteria for borderline personality disorder in the memory palace.

Right now, I've started writing furiously again.

Brushing, brushing, brushing——

About twenty minutes later, Nan Zhuren raised his hand: "Teacher, can I hand in my paper now?"

...? ? ?
A student at the edge of the classroom felt a strange sense of familiarity with the scene. He looked up and exclaimed, "It's you again!"
I've changed exam rooms, how come I still run into someone like you who messes with people's mentality?

The students in the same exam room were able to comfort themselves by thinking that this person probably hadn't studied well and had just randomly answered the multiple-choice questions, thus giving up.

but now……

Out of the corner of his eye, the examinee could probably see that the answer sheet on Nan Zhuren's desk was indeed densely covered with writing.

To write such a full essay requires real skill.

Comparing his progress to the two essay questions he still needed to answer, the candidate fell silent.

The candidates sitting behind Nan Zhuren were even more confused.

Is this... a real case of being possessed by a deity?

Good Luck Senior Brother blinked, then came down and took Nan Zhuren's answer sheet. He saw that it was indeed filled with writing.

After taking another quick look at the answer, I found it to be well-organized and neatly formatted, not just a jumbled mess.

"...Aren't you going to check it?" Senior Brother Good Luck asked with difficulty.

"No need." Nan Zhuren confidently began packing her things.

"...That's fine."

Watching his junior brother leave the examination room, the lucky senior brother remained silent.

After the bell rang to signal the end of the exam, he first followed the exam procedures to complete the inventory and handover.

Then, I immediately grabbed my phone and slipped into the bathroom.

Click on the note "Mentor" and dial the number.

Beep—beep—beep—beep—beep—

"Hello, the number you dialed is busy, please..."

It's normal if no one answers the first time.

Brother Good Luck seemed used to it, silently counted a few breaths in his mind, and then dialed again.

Beep—beep—click.

"Hello?" This time, the answer came.

"Teacher, my name is Hao Yu," said Senior Brother Hao Yun softly.

"Oh, Xiao Hao, what's wrong?"

"Teacher, I was proctoring the psychology counselor exam today, and I ran into that junior brother who hasn't joined the group yet, that's Zhu Ren." Senior Brother Haoyun emphasized this, as if worried that his mentor might not remember him.

"Then, during the exam, he felt something was off..."

He told Bai Qinghua everything that had happened in the examination room.

"Oh, you mean he suddenly fell asleep, then suddenly woke up, and then started doing problems incredibly fast?"

"Well, that's right."

"Normal~" The answer from the other end surprised Lucky Senior Brother. "Is there anything else?"

Even the lucky senior brother was completely stumped.

"without……"

Beep, beep, beep, beep...

The phone hangs up.

Lucky Senior Brother blinked.

What is considered normal?

In other words, the teacher knew about Zhu Ren's condition?
Come to think of it, this symptom of suddenly falling asleep and then suddenly waking up sounds a lot like a certain illness...

Could it be that... the teacher specifically recruited this junior student to study his illness so that he could write an article about it?
"Go back and check the books, find out what's really going on with this junior brother. He's actually a pretty good person..."

Lucky Senior Brother scratched his head.

……

On the other side, amidst the crowd of people leaving the exam, Mo Kai struggled to squeeze out.

He also took this final psychological counselor qualification exam.

However, unlike Nan Zhuren, he almost failed to finish answering the questions within the allotted time, so he only left the examination room with the rest of the group now.

"Now that you've finished such a big exam, let's have a good meal." Mo Kai felt a huge weight lifted off his shoulders.

He went to one of his favorite upscale restaurants with ease.

As people spend more time together, their colleagues often forget about Mo Kai's background.

But he's actually a big spender. For example, at this restaurant, the average cost per person is over a thousand yuan. People usually come here for group meals and dates.

Mo Kai, on the other hand, could be said to have treated this place as his own canteen.

"Wait a minute..."

While waiting for the waiter to come over, Mo Kai suddenly noticed a couple on a date at the next table who looked familiar.

"That's...the company's manager?"

(End of this chapter)