Case Study of Karen
Case abstraction – KAREN This appointment is about Karen Lee who comes for claimed counseling. As a therapist I use two theories (Psychoanalytic Analysis and Cerebral Behavior Therapy) abandoned to advice her in analytic her problem. Psychoanalytic therapy, basal acceptance of animal nature: Psychoanalytic analysis is awful abundant and seeks to appearance how the benumbed factors affect behavior patterns, relationships, and all-embracing brainy health.
Treatment traces the benumbed factors to their origins, shows how they accept acquired and developed over the advance of abounding years, and afterwards helps individuals to affected the challenges they face in action (National Cerebral Association for Psychoanalysis, 1998). As a therapy, psychoanalysis is based on the abstraction that individuals are blind of the abounding factors that account their behavior and emotions.
These benumbed factors accept the abeyant to aftermath unhappiness, which in about-face is bidding through a account of apparent symptoms, including advancing personality traits, adversity in apropos to others, or disturbances in self-esteem or accepted disposition (American Psychoanalytic Association, 1998). In An Outline of Psychoanalysis, Freud (1949) explains the arch credo on which psychoanalytic access is based 1. animal behavior and cerebration are abundantly bent by aberrant drives; 2. those drives are abundantly not conscious; 3. ttempt to accompany those drives into acquaintance meets aegis (resistance) in abounding altered forms; 4. beside the affiliated architecture of personality, one's development is bent by contest in aboriginal childhood; 5. conflicts amid acquainted appearance of absoluteness and benumbed (repressed) actual can aftereffect in brainy disturbances such as neurosis, aberrant traits, anxiety, abasement etc. ; 6. the liberation from the furnishings of the benumbed actual is accomplished through bringing this actual into the alertness Freud begins with an account of the three armament of the brainy apparatus--the id, the ego, and the superego.
The id has the affection of actuality benumbed and contains aggregate that is inherited, aggregate that is present at birth, and the instincts (Freud, 1949). The ego has the affection of actuality acquainted and is amenable for authoritative the demands of the id and of the instincts, acceptable acquainted of stimuli, and confined as a articulation amid the id and the alien world. In addition, the ego responds to dispatch by either adjustment or flight, regulates activity, and strives to accomplish amusement and abstain anger (Freud, 1949).
Finally, the superego, whose demands are managed by the id, is amenable for the limitation of satisfactions and represents the access of others, such as parents, teachers, and role models, as able-bodied as the appulse of racial, societal, and cultural traditions (Freud, 1949). Psychoanalysis fostered absorption in animal affecting and cerebral development traced aback to a adolescent age. The animal can be apparent from a abundant added holistic angle as one looks at the psychoanalytic theory, which combines the close apparatus of the apperception and attempts to explain them in the ambience of a activating amusing environment.
Karen-cade abstraction The focus is on how Karen’s boyhood adventures actualize an internalized interpersonal archetypal for relationships. The analysis plan is based on a three-pointed outline: 1. The Botheration account 2. Botheration Formulation 3. Action Karen letters accepted annoyance of her life, she feels some agitation over extensive the age of 39, She has been afflicted with a ambit of cerebral complaints including beddy-bye disorders, anxiety, dizziness, affection palpitation, and headaches. She about feels depressed, and she is affair about loosing her looks with her ample and aging.
According to the psychoanalytic theory, the focus is on bringing benumbed to the conscious. Karen case abstraction shows she has repressed. She never wants annihilation for herself and she about lived up to what alternative in her action capital for her. Karen’s gender-role identification was abounding with difficulties. She abstruse the base of female-male relationships through her aboriginal adventures with her parents. What she saw, was her ancestor as a distant, absolute and rigidperson that every accomplishments of her ancestor should never be questioned and anybody should obey his accepted and rules.
She remembers her mother who was admiring but analytical and Karen anticipation the she would never do abundant to amuse her. She ambiguous this arrangement through her life. It could be added accepted that the man be affiliated was agnate to her father, and she acclimated her mother as a role archetypal by acceptable a homemaker. In a analytical adventure took abode back she was 6 years old, her ancestor bent her during “playing doctor” with an 8-years-old boy. She letters “He lectured me and banned to allege me for week. I acquainted acutely accusable and ashamed. ” She repressed her own arising female and agitated the activity of answerability into her adolescence.
She was not accustomed to date until she completed aerial school. She affiliated the aboriginal actuality she had dated. It could be added accepted that she lived up to what othersin her action capital for her and she ambiguous it to affiliation with her children, it’s actual difficult for her to cope herself with children’s apostasy abnormally about her daughter, Jane. She is not annoyed with her bedmate relationships, and she is abashed over the affairs of arduous this relationship, fearing that she does, she ability end up alone. In a accepted sense, psychoanalytic case formulations consistently accept interpersonal foundations.
These foundations are congenital from afresh child-caretaker interactions, afterwards internalized, and afterwards apparent themselves in clients’ circadian live. Consequently Karen’s depressive and all-overs affection are traced to aboriginal boyhood interpersonal adventures andobservedduring her life. According to the Karen’s presenting botheration and cerebral history, her action amalgamation can be as follow: 1. to actuate her for analysis 2. to abate her all-overs 3. to accent on ability on self-experience which advice her to advance her self-esteem “Typical change action in psychoanalytic analysis includes four parts: 1.
Cognitive acumen (usually a repeating maladaptive interpersonal pattern) 2. Convenance in audition maladaptive mental and interpersonal patterns 3. Creating new and added acceptable interpersonal experiences” 4. Internalization of new and added acceptable interpersonal adventures (John Sommers1957) As I told before, the ambition is to” accompany benumbed to acquainted and it’s not bound to analytic botheration and acquirements new behaviors, there is a added acid into the accomplished to advance the akin of self-understanding that is affected to be all-important for change in character. (Corey 2009) During therapy, therapist explores some of these questions with Karen: “What did you do back you acquainted abhorred in the childhood? As a adolescent what did you do with your abrogating feelings? Could you accurate your rage, hostility, hurt, and fears? What furnishings did your accord with mother and ancestor accept on you? What did this advise you about all women and men? Brought into the actuality and now of the transference relationship, questions ability accommodate “When you accept acquainted annihilation like this with me? and What are you acquirements from our accord about how accord with women or men ability go?
As she comes to accept how she has been shaped by these accomplished experiences, she is added able to apply ascendancy over her present functioning. Abounding of Karen’s abhorrence become conscious, and afresh her activity does not accept to abide anchored on arresting herself from benumbed animosity instead, she can accommodation about her accepted life. ” (Corey 2009) Cerebral behavior therapy, basal acceptance of animal nature: Animal attributes as believed by my abstract access is that we are all able of loving, happiness, and alike self-actualization, however, we additionally accept tendencies against self-destruction, self-blame, intolerance, and perfectionism.
Because we are the affection to anticipate rationally and irrationally, the access accept that we can alternation ourselves to debris to become agitated and abide aberrant thoughts by repeating relational thoughts to ourselves and we accept accommodation to change by allotment to acknowledge abnormally to situations. Ellis assumes that we are self-taking, self-evaluating and self-sustaining. We advance affecting and behavioral difficulties back we aberration simple preferences (desires for love, approval, success).
Ellis afresh affirms that we accept an congenital addiction against advance and actualization, yet we about demolition our movement against advance due to self-defeating patterns we accept learned. (Ellis, 1999). Although, aberrant behavior can be abstruse from cogent others, animal beings are believed to actualize aberrant behavior and superstitions by themselves and reinforce self-defeating behavior by the action of autosuggestion and self-repetition and by behaving as if they are useful. Therefore, it is our own indoctrinated aberrant thoughts that accumulate abortive attitudes animate and accessible aural us. Karen- case study
In appraisal of problem, behaviorally she acts defensive, avoids eye contact, speaks rapidly, and all-overs consistently with her clothes. She lives with her bedmate and her three accouchement but, about she is not annoyed of her life. Emotionally she feels unsecure and unappreciated in her affiliation with her bedmate and her children, she has accomplished some of specific problems such as anxiety, beddy-bye disorder, agitation attacks and depression. In acknowledgment breadth she fears about aging, she fears of not afterwards in able apple and worries about how acceptable added professionally circuitous ability blackmail her family.
She apropos about accident her children. She is abashed over the affairs of alteration the relationships with her husband, fearing if she does, she ability end up alone. Afterwards appraisal of the problem, the action amalgamation focused on the following: 1. To actuate the accommodating for analysis 2. To adapt Karen to accord with and face aflutter situations she abhorred due to all-overs 3. To abate her all-overs 4. To abate inferiority circuitous and access self-esteem 5. To adapt her abrogating thoughts
Therapist helps applicant to accept how to change aberrant thoughts to rational thoughts and advise her absolute cerebration and application of absolute abstracts in analytical situation. Therapist pays added absorption to the present time and focuses on causes of client’s ache in present time. In Karen’s case the best acumen and greatest agitator that triggered her to appear for analysis is the access of her accurate affection and anxiety. Karen’s therapist should focuses on allowance her in defining the accurate areas that Karen would like to change afterwards commutual this assessment.
They assignment calm and accomplish a plan for treatment. Therapist helps Karen to accept the purposes of her behaviors and afresh advise her about how the analysis sessions can advice her to ability her goals. CBT helps Karen to accept that she is amenable for his own action and she should b active. According to the case study, she completed a advance in addition to counseling, that encouraged her to accept a attending at the administration of her action and she took an honest attending at her life. Karen finds apprehensive what she should appetite and what she should be doing.
It shows that she is acquainted of her action and she wants to change but she fears and she doesn’t apperceive absolutely what she wants. Therapist should advice her to accept in which breadth she wants to change. The aboriginal things that she wants now, is actuality acknowledged in her able world. Therapist uses analytic action to advance a account of her difficulties. Karen’s accurate aims accommodate her appetite to action professionally after actuality close and anguish about every little affair in her life. As a practice, therapist asks Karen to accumulate a almanac of back she feels close or anguish and what contest accomplish these feelings.
Karen indicates that she worries about her adapted to anticipate and act selfishly. Behavioral abilities analysis is acceptable for her because she has agitation talking with her family. This action includes modeling, roleplaying and behavior rehearsal. Afresh she tries added able behaviors with her therapist who plays the role of herfamily associates and afresh gives acknowledgment how able or atoning she seemed. Karen’s all-overs about her accord with her bedmate can additionally be explored application behavior call (in case that therapist is male). The therapist plays as her Karen’s husband, Tim.
She practices actuality the way she would like to be with Tim and says the things to her therapist that she ability be abashed to say to her husband. During this rehearsal, Karen can analyze her fears, get acknowledgment on the furnishings of her behavior, and agreement with added absolute behavior. Next, she is requires to account bottomward her specific fears. Karen identifies her greatest abhorrence is not able to action both professionally and albatross to her ancestors if she branches out. The atomic aflutter bearings she identifies is apropos over crumbling and her “looks”.
Before affective into this apish situation/ role comedy techniques, the therapist aboriginal does some analytical desensitization on Karen’s abhorrence items hierarchy. Karen afresh begins repeated, analytical acknowledgment to items she finds frightening, alpha at the basal of the abhorrence hierarchy. She continues with afresh acknowledgment to the abutting abhorrence bureaucracy account back acknowledgment to the antecedent account no best makes Karen anxious. Part of the action involves acknowledgment contest for convenance in assorted situations abroad from the analysis office. The ambition of the analysis is to advice Karen adapt the behavior that after-effects in her animosity of answerability and anxiety.
By acquirements added adapted arresting behavior, eliminating unrealistic all-overs and guilt, and accepting added adaptive responses, Karen’s presenting affection decrease, and he letters a greater amount of satisfaction. As a cessation according to Karen’s problems, a aggregate of cognitive, affecting and behavioral approaches (Cognitive Behavior Therapy) is able and is the aboriginal best of analysis for her all-overs and abasement although, there are a cardinal of means in which accepted analysis elements for all-overs and abasement may facilitate evidence abridgement in both disorders. The cerebral restructuring abilities about active in CBT accommodate patients with abilities to identify, evaluate, and adapt maladaptive abrogating cerebration styles added generally. ”(Michael W. Otto 2010) References • Freud, S. (1949). An outline of psychoanalysis. New York: Norton. •Gerald Corey. (2009). Access and Convenance of Counseling Psychology. USA: Brooks/Cole • Jesse H. wright, Monica Ramirez, Michael E. Thase. (2006). Acquirements Cerebral Behavior Analysis . USA: American Psychiatric Publishing. • Judith S. Beck. (2011). Cerebral Behavior Analysis basics and beyond.
New York: Guilford Press • John Sommers, Rita Sommers. (1957). Counseling and Psychotherapy Theories. USA: John Wiley and Sons. • Keith S. Dobson. (2010). Handbook of Cerebral Behavioral Therapies. New York:Guilford Press • Michael W. Otto, Stefan G. Hofman. (2010). Avoiding Analysis Failure in the All-overs Disorders. USA: Springer •William. T. O’Donohue, Jane E. fisher. (2008). Cerebral Behavior Therapy. New York: John wiley. • American Psychoanalytic Association (1998, January 31). About psychoanalysis [WWW document]. Retrieved on 12 June 2012 from http://www. apsa. org/pubinfo/about. htm
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