June 3, 1992

The patient was seen for 30 minutes. He has now been off medications for more than one month. He claims he does not feel significantly different, is sleeping adequately, does not have a significant degree of suicidal thoughts. Affect continues to remain somewhat blunted and subdued, interactions are relatively quiet. I was more specific in discussing things with him at this time. I think it is clear that individual therapy has been questionably productive and I asked him about what he feels during the silent times of therapy. He commented it seems as if he just spaces out and really doesn't know where he is. I am willing to continue seeming him every two weeks on ½ hour basis which seems to be what financial limitations will permit now. It is important he make the appointments, however, and I will start charging for missed appointments.

The Cheese Doctor, M.D.