Paris Holmes
COUN 665
After the news of the FOX television show Prison Break coming back onto the scene and
new episodes are being made, I remembered how interesting of a show it was and how interested
I was in it. There were many different aspects, different storylines, and different characters. After
re-watching season one and two of the show last week, one character stood out to me more than
the rest: Charles “Haywire” Patoshik.
Haywire was very successful throughout his life. Growing up he excelled, eventually
getting his PhD in Mathematics from Harvard University in Cambridge, Massachusetts. Due to
his accomplishments, he received Mathematician of the Year four times. Getting all of those
awards and recognition certainly wasn’t a walk in the park for him. After all of that studying
during his doctorate program, he started getting more stressed out than normal and after a while,
he just broke down. According to the show, without any known previous acts of anger, he
murdered his parents. Haywire committed another murder, that of a father of a girl he came into
contact with. The girl asked Haywire to buy him beer, and he started to develop feelings for her.
The girl, Sasha, was getting abused by her father, and when Haywire found out, that was the end
of that. He murdered him.
After watching more episodes, I would find out more information regarding the fact that
he had no memory of committing the murders, and it was almost a surprise to him. I found out
that his parents “hurt him” during his childhood, which could have contributed to all of this
anger, but the extent of the definition of “hurt him” was never really specified. He has a fear of
crowds, a social anxiety almost, and would go through mood and manic episodes that were more
or less common depending on the situations present. This is what the bipolar tendencies are.
Haywire goes into a cationic behavior at some points during the series, this is noticeable when he
is transferred from the psychiatric ward to general population and housed with Michael Scofield;
a man that robbed a bank to help his brother whom is on death row to escape out of Fox River
Penitentiary. The thing with Scofield is that he is an architect that helped build the prison and
tattooed the blueprints in an elaborate pattern all over his body.
Attention was paid to these intricate designs by Haywire, and overtime, they would
become an obsession. All of the staff and other inmates thought he was having delusions, saying
that the tattoos were a maze, but he ended up being half-way true. While he was off of
medication, these episodes lasted for more than two weeks, which is part of the diagnosis of
schizoaffective disorder in the DSM-5. None of these symptoms started because of medication or
another illness, considering none was present, but there was symptoms of trauma while young.
He didn’t have any previous medical conditions that could have caused it either. With
medication, he goes into a state where he is unresponsive, because the medications acted almost
like tranquilizers. After a while, he realized that and as soon as he took them and was left alone,
he would throw them up.
After being in and out of the psychiatric ward, he went into a deep depression. Haywire
started seeing hallucinations and without his medication that kept him sedentary, his manic
episodes became more frequent. His life goal was to go to Holland and escape all of the
problems that came along with escaping from prison. The ex-FBI officer who was on the case
found Haywire on an elevator, and hold him that although he doesn’t have to go back to prison,
he can’t go to Holland. With his dreams crushed, he jumped to his death.
This treatment plan is something that I would hope could have been used, whether inside
of the prison or out, which could have helped him before feeling the need to commit suicide.
Treatment Plan
Name: Charles “Haywire” Patoshik
Age: 32
Sex: Male
Ethnicity: Caucasian
Education: PhD in Mathematics from Harvard University
Work history: N/A
Medical History: Relatively clean medical history, has had sports-induced asthma since the age
of 8
Family history: Father was an alcoholic, and both mother and father abused Charles emotionally,
physically, and mentally
When did problems arise? While getting PhD, started getting more stressed out and one day after
graduating just “snapped”, in his own word; prompting the murder of his parents
Notes:
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Has never been good in social settings, gets anxious, nervous, and acts out more often
No real social life whether it be romantic relationships, or that of another kind
Seems to be in a constant “trance”, and very paranoid at the same time
Symptoms seem of major concern due to prevalence in all settings, not one more than the
other
Client believes they are fine, and don’t believe that they are experiencing symptoms that
are out of the ordinary.
Concern of prison officials as well as other professionals is that Charles will not be able
to go into general population setting because of social anxiety, and catatonic state in
some instances
When gathering information from same officials, they mentioned that when he is on
medication he is controllable. I asked Charles, and he admitted to me that half of the time
he throws it up because “it makes his brain all fuzzy and make it stop working”. The
other half of the time, he mentions that he stares at the patterns on the wall.
Charles also mentioned to me during assessment that he doesn’t sleep at all during the
night due to a neuroanatomic lesion affecting his reticular activating system
Had no prior violence violations or episodes prior to the “snapping”
Very good vocabulary and knowledge of common information.
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Does realize murder happened, but didn’t remember doing it personallyor at the time of
event
Current Symptoms/Problems:
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Delusions
Disorganized thinking
Racing thoughts
Episodes of Mania
Has lasted longer than two weeks
No previous medical conditions or medical diagnosis before triggering event
Barely any social interaction
Hallucinations
Lacking judgement and insight into illness
Diagnosis: Schizoaffective disorder with bipolar tendencies
Goals/Objectives:
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Client will participate in at least two group activities every day and reflect with counselor
at end of day appointment
Client will identify two (out of four) medications they are on and state why he needs
them, and how they make him feel
Client will eat two meals a day, as well as one snack, out of three and three, respectively
Client will test for reality with staff for at least ten minutes two times a day
Client will report their safety one or more times during a day
Client will report how many hours of sleep they get each night
Treatment:
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Psychotherapy
o May be useful in a prison setting because it would be difficult for client to miss
appointments and be available at most times.
o Due to the social anxiety that the client has, individual counseling may be best.
 After client becomes more comfortable in an individual counseling
session, group therapy may be the next best thing.
o Learning better problem-solving skills and how to cope with everyday life as
opposed to acting out in anger.
o Can look at familial relationships, but must be careful because anger can be
brought out in the client. Abuse was included in his childhood, it’s an important
aspect for him.
o Finding out what can trigger client and stay away from it, or how to deal.
Hospitalization
o Can occur when client goes through manic episodes.
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o Be taught techniques by professionals who deal with diagnosis like this every day.
 This may be difficult since client is an inmate and may only be able to go
to prison infirmary, and they don’t have all tools or professionals
necessary to provide sufficient care.
 Social support is necessary, if not, client may become severely depressed.
Medications
o Ask client what the medications do and how they can help him. If he knows how
they are helping him (as opposed to hurting him), he may be less likely to throw
them up.
o Look at dosage, so medication is less of a tranquilizer, and more of a supporting
mechanism.
o Provide help for the client, but don’t use as much medication as possible, just for
the kick-backs.
o Consider side-effects from medication and how they will interact with his
symptoms that are already present.
Self-Help
o May help seeing other people that are going through the same thing.
 Although it may be difficult for those with social anxiety.
o Developing social relationships and friendships with others
Long-term monitoring
o Symptoms can’t change in a day, and with the long-term monitoring, a counselor
can see the difference with medications and see how therapeutic interventions are
working for the client.
o Looking more into his life and figuring out what settings or objects make him
more likely to be manic or depressive.