Mike, While it does initially sound like a possibly stress related 'breakdown' from med school that freightens him still has taken on characteristics of a generalized phobia, it is also growing in a fertile soil of under employment and aging and his thoughts about his inadequacy. I would not advise him to do anything except urge him to seek psychological help in his own city. It sounds as if he has given enough information to conclude that he has a valid 'psychiatric' problem. But with his depression, apparent anxiety, employment and probably financial difficulties, as well as his interpersonal problems, he needs to see someone live and not long distance in writing. Sorry to not be more creative in this, but if he is a real person and not a hoax or a research project in Pakistan (or whatever), he doesn't need to debate advice and weigh it when we have not seen his face or heard his voice, etc. He may need to be advised that seeking help is permissible even for MDs. And, he should go now to begin. It would be interesting to discuss such a case, for sure, and we can - but I don't think it would be right to do it in the context of sending it on to him for his 'life changing' experience. Other comments are welcome, but those are just my thought on it. BTW, the Erickson Foundation ~may~ know a referral in his city, if you know where he is living.
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