By Tim Stevens

Piotr "Peter" Rasputin is an adult male of above average height and musculature. The client presents as quiet and thoughtful. He speaks with a slight Russian accent and occasionally uses expressions like "Comrade" but seems to be largely integrated into American society at this point in his life. In session, the client is stoic and reticent to offer emotional reactions. Discussion of his family or his former teammate and intimate Katherine Pryde—currently missing and presumed possibly deceased—however, does shake him. At these times, the client's voice can be observed to being more hushed than usual and his eyes become glassy with tears.

Rasputin, at this time, lives in San Francisco as a member of the mutant rights group the X-Men. He is the metallic team member known as Colossus. While he does live and work with the X-Men, it should be noted that he has greatly reduced his role in the wake of Pryde's apparent death and the physical trauma he suffered at the hands of the Hulk (see case file).

After several sessions, the writer has concluded that Rasputin most likely is not experiencing a long term mental illness. This having been said, without the proper care now, it is likely that he could develop one.

This possibility stems from the amount of grief that the client has not yet processed. Over the past several years, Rasputin has lost his parents, seen his sister aged, de-aged, and then killed by the so-called Legacy virus, and dealt with the death of his brother only to falsely think he had found him again. Most recently, as noted twice above, the client was powerless to save Pryde, with whom he had just restarted an intimate relationship, from sacrificing herself. In most of these instances, the client attempted to take time away from his life with the X-Men, but was almost immediately sucked back into the fray. Thus, in essence, he has been waiting to truly grieve and come to term with some of these losses for years. If the client continues to delay this process, the psychological damage could be quite significant.

Also worth attention are two significant events in Rasputin's life that were similarly pushed quickly aside. The first of these is the client's apparent death, a sacrifice to cure the mutant population of the same virus that killed his sister. The client was apparently resurrected by an alien being who believed Colossus to be the key to the alien's home planet's survival or destruction. The fallout of dying, being dead, being resurrected, and then tortured for a time has the possibility of being immense. While the client denies any lasting concerns about events in question, the writer is recommending that he be given the Clinician Administered PTSD Scale (CAPS) to fully verify these claims.

The second event of concern stems from a traumatic brain injury (TBI) the client suffered that led him to join a mutant terrorist group led by the radical supremacist Magneto. This is worth exploration for dual reasons. The first is that TBIs are rarely just "cured" as seemed to be the case in this instance. It is possible that there is remaining damage that could threaten the client's mental or physical health going forward, especially in combat situations. The second is that, even under the influence of a TBI, Rasputin still made a decision to align himself with a terrorist organization. The thought process involved in that decision must be further explored as it is a highly antisocial choice.

Additionally stemming from the choice is an issue that the writer believes has dogged Rasputin since he began his involvement with the X-Men: the gap between his ideal self and his real self. His ideal self is a pacifist who enjoys creating through art. His real self is a fighter who often uses violence to solve issues, has killed, and once belonged to a terrorist organization. This does cause psychological strain for the client.

Based on these factors, the client and the writer have worked together to designate two goals. Goal #1 is to deal with negative emotions, like grief and guilt, with the therapist using art therapy. Goal #2 is to reconcile the client's ideal and real selves to give him a more realistic image of himself and thus engage in destructive self judging. To do this, the writer will utilize therapy with an emphasis of H.S. Sullivan's approach to Interpersonal Psychology. For the next month, the client will have two sessions as week. At the conclusion of the month, he will be reassessed and the sessions will most likely be scaled back to weekly or biweekly.

Mr. Rasputin's next appointment is with Doctors Brubaker, Fraction, and Dodson. It is set for November 19 and details can be found in the file marked UNCANNY X-MEN #504.

Tim Stevens is a Mental Health Supervisor currently pursuing his Psy D who has experience in dealing with individuals with PTSD.

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