This was not an easily managed case! He was wildly psychotic, on heavy doses of chloropromazine, with many bizarre behaviors. Besides talking to himself continuously in gibberish, he collected bugs, moss, sticks, piles or dirt, and switched to smoking oak leaves instead of cigarettes. He was such a fire hazard that I had to move him to a downstairs room with concrete floor. Even in the basement he was a fire hazard with his smoking and piles of sticks and other inflammables next to his bed, but all of this debris was his "precious." I knew that I was in for trouble if I disturbed his precious, but the insects and dirt piles seemed to be expanding exponentially. One day the dirt exceeded my tolerance level. To make a long story short he caught me in the act of cleaning up his precious. Was he furious! All 350 pounds of him! (By this time he had lost 50 pounds.) He barreled into me, fists flying, and knocked me into the pipes next to the furnace and seemed ready to really teach me what was what. I prefer to avoid fights, but if they are inevitable, I can really get into the spirit of the thing. I'd had lots of childhood practice defending myself because I was an incurable tomboy who loved to wrestle; I could usually pin big boys who considered themselves tough. So I began using my fists and what little martial arts training I had to good use. After I hurt him a bit he realized that I was not going to be easily intimidated, and that in fact he was in danger of getting seriously damaged. So he called a truce before either of us were badly beaten up. He had only a few bruises and welts, nothing serious. After that he refrained from collecting things inside the building (he continued to collect outside). This compromise was fine with me, and the incident allowed me to maintain the authority I needed to bully him into co-operating with the program: taking his vitamins, and sticking to his fast until he finally reached 200 pounds. After 90 days on water he actually looked quite handsome, he no longer smoked, he was off psychotropic medication, and his behaviors were within an acceptable range as long as your expectations were not too high. He was well enough to live outside a hospital and also clear-headed enough to know that if he let too many people know how well he really was, he might have to give up his mental disability pension and actually become responsible for himself. No way, Jose! This fellow knew a good thing when he saw it. So he continued to pull bizarre stunts just often enough in front of the right audience to keep his disability checks coming in, while managing to act sane enough to be allowed to live comfortably at home instead of in the hospital. By keeping to my program he could stay off mind-numbing psychotropic medication if he kept up his megavitamins and minerals. This compromise was tolerable from his point of view, because there were no side effects like he experienced from his tranquilizers.