Case Study and Application of Explanatory TheoriesArticle Review

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¶ … client for this case study is Andrea, who is a 37-year-old American-Indian female. She belongs to the Baptist faith and was referred by the Family Services Department to the caseworker. The client had seen a physician and was also prescribed some medications for treatment of her depression at the Health Center. She was then referred to the Family Service's case worker as a general procedure of the Health Center. At that time, Andrea was going through the first anniversary of the death of her brother, her grandmother's recent death, and also the pregnancy of her teenage daughter. When she filled her form for the case manager, Andrea selected the symptoms that included over-anxiousness, tension, dizziness, inferiority complex, phobia of losing control, low self-esteem, feeling worried all the time, less energy, shyness, bowel disturbances, panicky, depression, and headaches. Andrea stated that she had been suffering from all this for a few months now; she also stated that she had become very short-tempered and irritable. Andrea checked anxiety in the symptoms; however, this did not completely fulfill the anxiety disorder category. Her symptoms of guilt and lesser ability to concentrate on things would fall under the category of depression. Andrea had also suffered from alcohol dependency; thus, her history also included treatment of Alcohol Dependence and Full Remission. However, it is important to note that she was sober for eight years now (Kenny, 2006).

Modern Attachment Theory

Andrea was suffering from depression and had a long history of it. However she felt there was no need for any treatment until she underwent some symptoms that she was unable to ignore anymore. Her teenage daughter became pregnant, her grandmother died, and she was also going through the death anniversary of her brother. All these events at once made her lose control over her life and she finally decided to get treatment for herself. Her future according to her was hopeless and she was highly into depression. The skills that she mostly used to her help to cope with life were not helping her anymore, and she motivated herself to go for diagnosis. The main objectives of her diagnosis included continuing her soberness, helping her to adopt a confident attitude when in communication with others, help her to decrease the negative mindset she had about herself, helping her to increase the social network around her, and helping her to decrease the depressing feelings.

The theory of Modern Attachment talks about the importance of attachment and that it is necessary for building elasticity and emotional growth. Many theories of attachment talk about counseling for the death and loss. If a person is not attached to another person who is important in his or her life, the emotional growth of a person is left broken, and he or she might experience difficulties when going through different phases in life. When a baby is crying, people look after the infant; through this, the infant acquires the feeling of trusting others. This further helps him to empathize with other people and relate with their situations. Further in his life, that child gets attached to his parents, siblings, and friends, and then later on possibly with his own children. Such attachment is termed to be primary and when someone close to them dies or is separated, the grieving part takes over (Attachment and Loss, Death and Dying, 2008). The client was also helpful to others and solved their problems. For example, Andrea's mother shared with her that Andrea's sister was taking advantage; Andrea wanted to help her right away. However, she discussed the situation with her therapist and instead discussed different ways that would help her mother without getting stuck in the center of the problem. In this instance, Andrea then listened to her mother's problems, but did not act for her (Kenny, 2006).Moreover, Reactive Attachment Disorder (RAD), takes place when the normal cycle that includes the care and love received by the baby from his/her parents, is disrupted. The baby might be abused and neglected instead of being taken care of. Then when the child grows up and moves on with the social life, he or she might have difficulty in trusting other people or even allow anyone else to take control over them. A person with RAD might find it difficult to go through grief counseling, because building empathy for others might not be possible for them. The more traumatic the event is, the more it is difficult for the person to go through the loss counseling. Talking about the event and remembering the people involved in it can make it difficult for some individuals to go through the counseling (Attachment and Loss, Death and Dying, 2008).

Andrea was going through the death of her brother exactly a year before she entered the treatment. Her brother was killed in a bar fight. He was also an alcoholic, and his sudden death was a shock to everyone in her family. These types of death are not common, but Andrea and her family were also attending the trial of the person who had allegedly killed her brother. Thus, going through the treatment, and attending the trial at the same time was difficult for her to cope with (Kenny, 2006). Grief counseling is much more difficult and requires in-depth psychiatric or psychological intervention (Attachment and Loss, Death and Dying. 2008).

Self-Psychology paradigm -- a Kohutian Framework

Self-Psychological psychotherapy is a relaxed and easy-going method as compared to the previous one as suggested by Kohut. However, a strong attachment to rigor and ethics is preserved, so that the main belief of self-psychology, vicarious self-analysis, or empathy is considered to be important for the research development and psychotherapy. This method is also used as a pattern of thinking about psychotherapy and human beings; it also provides an opportunity for clinicians to invest in different modalities and modes of psychotherapy (Carus, n.d.). These are sometimes stated as a disorder of self-object; this is important and marked by failure of the self to reach harmony. This can also be obvious in Narcissistic Personality Disorders, Narcissistic Behavior Disorders, borderline states, psychosis, and depression, all of which depend on the level of loss or failure that emerges as the outcome of self-objects. In every disorder, the self is affected in the maximum way and can be measured by the high and low levels of its frequency. The higher the union level, the less responsive the self-psychology becomes (Carus, n.d.). Andrea, during the diagnosis, was taking help from the psychiatrist who had medicated her with Trazadone, Buspar, and Prozac. When she sought help from the case manager, she had been taking the medicines for twelve months. Andrea stated that she started her medication when anxiety and depression took over her because of her brother's death, and the medicines brought her relief. Andrea also had a history of alcohol and depression which included dizziness, and long hours of sleep and lower motivation. When she came for help, she did not fulfill the criteria of Generalized Anxiety Disorder despite the symptoms she selected, but met the requirements for Major Depressive Disorder (Kenny, 2006).

Empathy

Kohut in his framework states that empathy is the first step in the method for the cure of psychoanalysis. He states that it is considered to be a data gathering about the person and tells about the capacities of the person during investigation; this helps the case worker to know the inner life of the person. Furthermore Kohut talks about the different ways that empathy can help in curing the person (Bacal & Carlton, 2010). According to the framework, empathy takes place in the developmental stages of a person, who learns to build different relationships and the trust between them. Despite all the losses that one has suffered, empathy can help in regaining the trust with social network around him/her.

Kohut, by giving importance to empathy, struggles between how a person would tell about his inner self, either through personal experiences or through psychic life (Lessem, 2005). He also states that the receptivity of empathy is mediated and performed by the person's awareness of self-receptivity (Agosta, 2010). During the treatment, Andrea met a man in her AA meetings and she was not ready to get intimate with him because she was afraid at that point. She wanted to take it slow and discussed this with her therapist. They went through her history of abusive relationships, which were the reason that she was still scared to get intimate with anyone. Andrea and her boyfriend, Jason went on a vacation, after which she felt close to him and she described him as a caring man. In her previous relationships, Andrea was not treated with care so this was new for her and also became difficult for her to accept right away. She sought help from the therapist who supported her and talked to her in positive ways so that Andrea would accept that she deserved someone nice (Kenny, 2006). Empathy is considered to be the… [END OF PREVIEW]

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