Ryan was telling me about the rage he sometimes feels when people get into his space, or “impinge” on him, linking it to the trauma of a forceps birth and spending his first weeks of life in an incubator, tubes stuck into his head.

He also feels enraged when he enters a crowd with too many people around him. Upon entering Walmart, and seeing all the other shoppers, the thought will come into his head, “I’d like to kill someone.”

The rage seems to come up in response to an impingement from the outside that feels threatening.