Ferrer vs. Ferrer 6.

Counsel: Where did you

graduate medical school?
Presentation of Witness Answer: I graduated from Cebu
Institute of Medicine, batch
for the Petitioner 2008.
Direct Examination- Dr. Margie Sy
7. Counsel: Do you have a
I am Margie Sy, 36 years old, married,
license, if any?
resident of Cebu City. Answer: I am a licensed physician.

8. Counsel: Were you licensed

We offer the testimony of the witness to by proper authority?
prove the credibility and qualification of Answer: Yes, I have an PRC ID to
the expert witness, the genuineness of the prove it.
psychological report and assessment, the
psychological incapacity of the 9. Counsel: Is this the ID you
respondent, and for all other matters, were referring to?
facts and circumstances relevant and Answer: Yes.
material to this case. Your Honor, we would like to have
 Qualification of the expert this PRC ID marked as Exhibit
witness P- 10
 Existence of patient-doctor
relationship 10. Counsel: After being licensed
 HPD and its seriousness as a physician, did you
immediately specialize in
 Severity and effect on marital
psychiatry?
obligations
Answer: No.

1. Counsel: What is your

11. Counsel: What did you do
occupation?
after being licensed as a
Answer: I am a psychiatrist
physician, if any?
Answer: I was a resident doctor of
2. Counsel: Where do you
Chong Hua hospital for 1 and a
work?
half year.
Answer: Spring Clinic Institute of
Psychiatry
12. Counsel: What else, if any?
3. Counsel: Can you prove it?
Answer: After that, I was specifically
Answer: Yes.
in the practice of psychiatry for
3 years around 2012 to 2015,
4. Counsel: How?
under the supervision and
Answer: By a certification from my
mentorship of Dr. Alex Junia.
clinic.
13. Counsel: What else, if any?
Answer: From the latter half of 2015,
5. Counsel: Is this the
I was already specializing in
certification you were
psychiatry under my own clinic.
referring to?
Answer: Yes.
14. Counsel: How long have you
Your Honor, we would like to have
been practicing your
this Philippine Psychiatry
profession?
Association Certification
Answer: I have been practicing
marked as Exhibit P- 9
professionally for a total of
almost 4 years now.
 15. Counsel: In a span of four 23. Counsel: How did she become
years, how many patients did your patient?
you have? Answer: She was referred to me by
Answer: I lost count, I have too many. her husband as he was worried
that Cynthia did not take the
death of their child very well.
16. Counsel: Can you say around
100 patients? 24. Counsel: Do you have any
Answer: Yes, around that number. other patients, if any, that
is/are related to Cynthia?
Answer: Yes.
17. Counsel: Who are your usual
patients, if any? 25. Counsel: Like whom?
Answer: I have helped treat patients Answer: Her husband and her two
with schizophrenia, major brothers?
depressive disorders, panic
attacks or anxiety, sleep 26. Counsel: What were they
disorders or post-traumatic consulting from you, if any?
stress disorders. Answer: Her husband was suffering
from anxiety, while both of her
Present the psychological report
brothers had post-traumatic
18. Counsel: Showing this stress disorders (PTSD)
document to you, are you
familiar with the same? 27. Counsel: What happens with
Answer: Yes consultations, if any?
Your Honor, we would like to have Answer: She undergoes through tests,
this psychological assessment therapy, interviews and
marked as Exhibit P- 11 counseling.

19. Counsel: How so? 28. Counsel: Does this apply only
Answer: I prepared this document to Cynthia?
myself. It was my Answer: No, I do the same with some
psychological assessment of a or most of my patients.
patient.

20. Counsel: Is the signature 29. Counsel: What was your

appearing on the last page diagnosis, if any?
above the name Dr. Margie Sy Answer: After almost a year of
your signature? sessions, I diagnosed her with
Answer: Yes Histrionic Personality Disorder,
Your Honor, we would like to have also known as HPD.
this signature on the same
document to be marked as 30. Counsel: Based on your
Exhibit P- 11.1 extensive experience as
psychiatrist, do you consider
21. Counsel: Is the name your ability substantial
appearing on this document enough to give such a
“Cynthia Manalo- Ferrer” diagnosis?
your patient? Answer: Yes, I have had other
Answer: Yes patients with HPD before

22. Counsel: How long has she

been your patient? 31. Counsel: Can you please tell
Answer: Around six years since she this Court what Histrionic
came into my clinic for Personality Disorder is?
consultation. Answer: Histrionic Personality
Disorder is a personality
disorder caused by a
 combination of genetic and
environmental influences, the
38. Counsel: What else, if any?
actual development of which is
usually triggered by a life Answer: They are easily swayed by
situation. opinions of others. They tend to believe
that their relationship with others are
32. Counsel: What is it stronger that they really are
characterized by, if any?
Answer: It is characterized by a
pervasive pattern of excessive 39. Counsel: What else, if any?
emotionality and attention
seeking. Most patients with this Answer: As to their communication style
condition do not believe they – style over substance, it is difficult to
need therapy or help, making find substance but is a very theatrical
diagnosis difficult. way of presenting themselves

33. Counsel: What else, if any? 40. Counsel: What else, if any?
Answer: People with HPD are Answer: Those are the common traits of
frequently labeled as divas or a person with HPD.
attention-seekers. They thrive
on seeking attention, pull
people in orbit with them. 41. Counsel: Did you immediately
diagnose her with HPD?
34. Counsel: What do you mean, Answer: No. There were other prior
if any? diagnoses.
Answer: A person with HPD will act
theatrically or dramatically to 42. Counsel: Like what other
draw attention to themselves diagnosis, if any?
through exaggerated emotions Answer: Many people who have HPD
and expressions. receive a diagnosis after they go
into therapy for depression or
35. Counsel: What else, if any? anxiety, usually following a
Answer: They have intense seeming failed relationship or other
emotional state, their emotions personal conflicts. In this
shift rapidly, as opposed to real patient’s case, she suffered
feeling of emotion major depression for about a
month, as well, prior to my
diagnosis.
36. Counsel: What else, if any?
43. Counsel: What does this mean,
Answer: They value their physical if any?
appearance as a tool to manipulate Answer: It means that Cynthia
people and to continue to be the center of suffered depression while she
attention. has HPD.

44. Counsel: What do you mean,

37. Counsel: What else, if any? if any?
Answer: They are inappropriately Answer: The emotional roller coaster,
seductive or provocative actions where the lack of stable relationships,
other people would not accept as and the unfillable craving for
acceptable behavior, there’s a lack of attention wear on them. In
filter as to when actions are appropriate relation to this, a comorbidity
or inappropriate mainly because of the exists between HPD and
driving force of wanting to be the center depression.
of attention – that trumps all other social
norms on how to act 45. Counsel: How so? Can you
please elaborate to this
 Honorable Court how it came only be after a lot of sessions
to be? that her symptoms became
Answer: In psychology, comorbidity obvious.
refers to more than one
disorders or diseases that exist 52. Counsel: Is it curable?
alongside a primary diagnosis, Answer: Generally, yes, through
which is the reason a patient psychotherapy sessions.
gets referred and/or treated.
53. Counsel: If so, for how long?
46. Counsel: What else, if any? Answer: It depends on the patient’s
Answer: You can remember the word case.
because the prefix, co-,
indicates that things go 54. Counsel: What about
together, and when we think of Cynthia?
serious illnesses, it can Answer: Chances are close to
sometimes make us feel unlikely, in Cynthia’s case.
morbid. HPD is a self-esteem
driven disorder. Naturally, 55. Counsel: In a scale of 1 to 10,
depression comes along with it how severe is her HPD?
since if the patient does not Answer: I would say 8 or 9
receive enough attention she
seeks from others, this creates 56. Counsel: So, is it still curable at
such anxiety and depression that rate?
which affects her behavior. Answer: Yes, however, in this case,
even the patient doesn’t
47. Counsel: How severe was her recognize her condition.
depression when she came to
you? 57. Counsel: What do you mean, if
Answer: Not quite. any?
Answer: The patient refuses to admit
48. Counsel: Why do you say so? that she has HPD. It would then
Answer: When she came to the clinic be difficult to prescribe the
for consultation, it would proper medication and therapy
mostly be about her concern on to cure her or improve her
regaining her previous weight condition.
so she could go back to the
work she loved to do, which as 58. Counsel: So, are you saying
for her, involved dancing on that in her case, her condition
stage. It was more about her is incurable?
weight issues rather than what Answer: Yes
her husband believed to be
caused by their child’s death. 59. Counsel: What gave rise to her
condition, if any?
49. Counsel: What about her HPD, Answer: Personality disorders are
was it severe? normally triggered by a life
Answer: It was. event or trauma experienced by
a person. In Cynthia’s case, the
50. Counsel: In your expert trigger of her HPD was the
opinion, how was her HPD? abuse she had experienced as a
Answer: It was serious. I would say 8 child.
of 10. It was a very difficult
diagnosis. 60. Counsel: How does this relate
to her HPD?
51. Counsel: Why do you say Answer: That was what triggered her
difficult? condition
Answer: It is because HPD is not a
very apparent mental illness 61. Counsel: What does it mean, if
that you see quickly. It would any?
Answer: A trigger is a reminder of a 68. Counsel: Like what traits? Can
past trauma. This reminder can you please elaborate?
cause a person to feel Answer: It would start off as
overwhelming sadness, anxiety, something good in the courting
or panic. stage but if her partner cannot
maintain pampering her or
62. Counsel: Would it mean that giving her compliments to keep
her HPD sprung since her high self-esteem, she would
childhood or teenage years? find it from somebody else.
Answer: Yes
69. Counsel: What else, if any?
63. Counsel: How so? Answer: Most people call this
Answer: This past trauma that cheating, but a patient with
Cynthia experienced as a child HPD will not see this as
makes her continually anxious something wrong because this
and consistently troubles her is part of the process of her
self-esteem. As a reaction to satisfying her self-esteem
this trigger, she would behave needs.
in such a way to forget this
trauma by keeping her self- 70. Counsel: What else, if any?
esteem high. Answer: She would always be
uncomfortable in situations
64. Counsel: Can you elaborate, wherein she is not the center of
if any? attention and would act very
Answer: It is because of this abuse she dramatically, as though
had experienced, to cope up performing before an audience,
with this trauma, her brain gives with exaggerated emotions and
a stimulus that makes her act expressions, to maintain this
differently. attention.

65. Counsel: What do you mean,

if any? 71. Counsel: What else, if any?
Answer: After such trauma, when Answer: This causes her to either
Cythia started to get suitors and dress provocatively or exhibit
realized how she so loved the inappropriately seductive or
attention she was given, flirtatious behavior, or even
opposite to the trauma she both.
experienced, it became a part of
her personality. Since it brought
up her self-esteem, she 72. Counsel: What else, if any?
continued doing whatever it Answer: She would also be sensitive
takes to keep having that to criticism or disapproval.
attention, so she keeps feeling
uplifted.
73. Counsel: What else, if any?
66. Counsel: Will this have any Answer: She would be bored by
effect on her marriage, if any? routine, be self-centered and
Answer: Yes rarely show concern for others.

67. Counsel: How?

Answer: Cynthia did not have any 74. Counsel: What else, if any?
past relationships. This is Answer: Because of her HPD, she
because she cannot maintain would maintain these by being
them because of her HPD. She so manipulative as to engage in
possesses traits which cannot pathological lying and sticking
allow her to be in a true and to them as if it were of her real
long-term relationship. memories.
 prone to cheating with multiple
75. Counsel: What do you mean, partners she would evaluate as
if any? someone more fit or supportive
Answer: It means that in order to keep of her self-esteem needs.
having a good image of herself
and for people to keep giving
her attention, she would do 82. Counsel: What else, if any?
whatever it takes, whether it be Answer: Also, because of her
socially appropriate or not, to manipulative nature that comes
keep the attention she so seeks. with her HPD, she is a
pathological liar incapable of
giving proper and honest
76. Counsel: So, are you saying responses to her partner.
that because of her HPD, she
cannot perform any or most of 83. Counsel: Is her HPD so grave
her marital obligations? to have any effect on her
Answer: Yes. marriage, if any?
Answer: Yes
77. Counsel: How so?
Answer: Like I said, she does not 84. Counsel: How so?
know that whatever it is that she Answer: She is incapable of truly
is doing like cheating, is loving her partner as her self-
something that is wrong. love is so great, it will just leave
Basically, she has a need, and her partner broken into pieces,
she does everything to satisfy it. physically, emotionally and
It is something uncontrollable psychologically.
and uncurable.

No further questions, your honor.

78. Counsel: How so? My witness is ready for cross
Answer: It would be useless for any examination, Your Honor.
efforts to be done by anyone to
convince her otherwise since
she will not accept it as the
correct way of doing. Qualifications
a. Must have a valid license to
79. Counsel: In that sense, what is practice medicine in the
she incapable of doing to Philippines as certified by the
protect her marital relation Professional Regulations
with her husband, if any? Commission.
Answer: Achieving emotional or b. Must have graduated from a
sexual intimacy is difficult. She Psychiatry residency training
may play a victim or try to program in a Philippine
control their partner using Psychiatric Association, Inc.
seductiveness or emotional accredited institution.
manipulations.

80. Counsel: What else, if any?

Answer: As she is more concerned of
herself and is truly self-
centered, she is incapable of Major Depression is a mood disorder
giving any type of support to that presents feelings of extreme
her partner. sadness, loss of interest or
pleasure, decreased energy,
feeling of guilt or low self-worth,
disturbed sleep or appetite and
81. Counsel: What else, if any? poor concentration.
Answer: Also, as she does not have
the concept of fidelity, she is According to reports by WHO,
depression will be the second
leading cause of disability by
2020 and it could also be the
second largest killer after heart
disease by 2020. Depression
affects millions of people
worldwide.

Anxiety disorders are a group

of mental illnesses that cause
people to feel extremely
frightened, distressed, or uneasy
during situations in which most
other people would not
experience the same feelings, as
defined by the National Alliance
on Mental Illness (Nami).