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Santa Claus - A Cognitive Behavioural Case Formulation

Little is known of Santa Claus's early life. He was probably abandoned as a child and eventually taken in by kindly folk.

He has a compulsive tendency to climb down chimneys, thereby gaining unlawful access to homes. He tries to mitigate this by leaving gifts for children. We can only speculate on what kind of schemas underlie this behaviour.

These activities are confined to a 24-hour period in the year, suggesting a dramatic burst of energy after months of relative inactivity. There could be poor organisational and time management skills (maybe a role here for further training and psychoeducation?), or this could be indicative of a bi-polar disorder. Current evidence suggests he is in fact uni-polar (north).

Although Santa presents as a benevolent character, there is an underlying punitiveness as manifested in his assertion that there are no gifts for naughty children. Again, we can only speculate as to what schemas and early experiences are playing out here.

Santa's size is another concern - we have to suspect some kind of eating disorder. The evidence points to binge eating without self-induced vomiting. At the bottom of every chimney there is some kind of snack for him, and not infrequently an alcoholic beverage. Some environmental changes might be helpful here (e.g., placing the mince pies out of reach so he has to exert more effort to get them), and he should be encouraged to complete a drink diary. There are a number of alcohol-free alternatives available - this is particularly important because he risks being charged with SWI - sleighing while intoxicated.

Santa appears to lead a solitary life with no known significant other. He has eleven helpers. Correction - he has elven helpers, but I am not sure they count as carers.

We have recently been alerted to a possible safeguarding issue involving the exploitation of the elven helpers. It is not clear if they are being paid the minimum wage and they are also subject to zero hours contracts in sub-zero temperatures.

Further assessment has revealed that Santa Claus is plagued with self-doubts. Despite being widely believed in by others, he struggles to believe in himself. This form of biased information processing is known as discounting the positive. The underlying schema of worthlessness is fuelled by schema maintenance behaviour, which in Santa's case takes the form of compulsively visiting discount stores around the world. In CBT terms, this is a case of globalisation.

To wrap up and conclude this formulation, I'm afraid I do not have good news to present. Santa is not suitable for therapy and he is fearful of being labelled. It is difficult to suggest a suitable package of care, one that is not caught up in a lot of red sticky tape. I am happy to review him again next year to see if there are any changes, but I am not hopeful of this or of receiving any nice presents this year.

Dr Rood Olf Rayn-Dere
Clinical Psycholojest