This patient is a 58-year-old lady. A short woman about 150 cm, she has a fine face, a little gray hair, a good figure, and was polite to everyone. She was very talkative,and I got to know a lot about her life and her family during the three days I spent with her in the behavioral institute.

She graduated from an engineering related program in Harbin Institute of Technology, and her husband was her classmate. After graduation from college, she was working in a state-owned company in Beijing and her husband was enrolled in a PHD program in Computer Science in Tsinghua University in the same city. After obtaining a PHD degree from Tsinghua University, her husband was accepted in a PHD program in Computer Science in the USA, and came to America in 1996. One year later, she reunited with her husband with their first-born child in the USA.

According to the patient, her husband is a genius in Computer Science. He published several important papers during his graduation study in the USA, and got the green card and a great job offer before graduation. He took the job without getting his PHD degree in the USA, and moved his family to the DC area, where his family has lived ever since.

 The patient got a Master degree in the USA around 2000, and worked in a small local company for a while. In 2001, when she was pregnant with her second child, she quit the job. Thus, she only worked in an American company for a little over one year. In 2003, her husband opened his own company which mainly acquires contracts from governments, and the patient works in this company. The company has been operated well all these years, and afforded good lives for every member of the family. Recently, her husband established his second company, a start-up company, which is supposed to be a new internet platform, a cherished innovation of her husband. If this company succeeds, they will not only become billionaires but also celebrities.

Since she received graduate education in the USA, and worked in a US company before, her English is fine, and she can communicate about routine daily contents without any difficulties. However, her English capacity did not allow her to freely express her emotions.       

The couple has three kids, two daughters and one son. Their oldest daughter has already graduated from medical school, and now is a resident in psychiatry and engaged to a neurologist. The second daughter, an all-around student in high school, is studying in an Ivy league University with double majors. The youngest son is still in high school.  

Therefore, the patient has a great family, and amiable relationships with her husband and her kids as well as solid financial status. Then why was she hospitalized in a mental hospital? It all began with a fence, the fence built by her neighbor.

They bought their house shortly after they moved to the DC area. Pleased with their neighborhood so much, they never moved. Their neighbor is a lady from Iran, who lived in this neighborhood even longer than them. This year, their neighbor built an ‘ugly big’ fence in their property, which the patient hated vehemently. She said this fence blocked her view from her window, stood beyond the front line of her house and decreased her house value. 

From July, they began to make complaints about this fence to HOA. However, the manager of HOA, a lady hired by the HOA, took their neighbor’s side. According to the patient, her neighbor had not filed a requirement for the fence before the construction, and the manager just asked them to atone for this mistake by filing the requirement after they began to protest about the fence.

She has been stressed by this fence for seven months. She claimed that each time she saw this fence, her blood pressure increased. She became insomnia, anxious and lost about 20 Lbs in these 7 months. Although she and her husband already hired a lawyer to deal with this situation, she was still extremely agitated. At the night of passing Saturday, she could not sleep and told her husband that she dreamed about committing suicide in front of the manager by swallowing large amount sleeping pills. So her husband sent her to the emergency room and then she was hospitalized after the assessment.   

I was quite puzzled by the situation of this patient. I thought that a dispute like this should not cause so much stress in most people. After talking to her for many hours in these three days, I thought I found some aspects of her personality which could contribute to her obsessing over the fence.

First, she is a person with an enormous sense of self-esteem. She would never like to accept generosity from other persons, even her family or friends. She felt degraded if she could not pay back any money or gifts she received. As a result, she proudly told me that she returned the money given by her family as a gift when her family first moved to the USA with high interest as soon as possible (within the first year of her stay in the USA).  

Secondly, she is dogmatic. She would not consider disparate opinions with an open mind, but insisted her belief is the absolute truth. For example, when she mentioned that another female patient  stated her strong support of abortion rights in their group meeting, she got the conclusion that the girl was an extremist. She thought as long as the baby could be put to adoption, the woman with this undesirable pregnancy should give birth to the baby. When I argued that in that case, the woman would experience a lot of avoidable suffering, including the discomfort of pregnancy, the agony of childbirth and the guilt of giving away her very own child, she did not want to listen to it.   

Third, she only completely trusts and believes her family, especially her husband. During our conversation, I heard she highly applauded her husband and her children, and I could feel that she was very proud of them. But she rarely mentioned any of her friends, and told me that all she needs and cherishes is her family. However, when I asked her about this, she insisted she made a lot of friends over the years.      

Her mental status was greatly stabilized in the mental hospital very soon, and she also agreed to relax and let their lawyer handle the disputes with their neighbor and HOA. So she was released from the mental hospital within two weeks after her admission. I wish the best for her and her family.