Relational Psychoanalytic Theories
Your Original Post is due by Saturday. There is no prescribed length for your posts, but they should reflect your own work, exhibit a high level of synthesis of course materials, and reflect a high caliber of scholarly writing. Citations and references are to be included in your responses. Your post should reflect APA 7 requirements.
By Wednesday please respond to 2 peers by:
Asking a probing question.
Share an insight from having read your colleagues’ postings. Offer and support an opinion.
Validate an idea with your own experience. Make a suggestion.
Expand on your colleagues’ postings.
Discussion Board Question: (select 1 Case Scenerio)
Using the case below, talk about the case using Individual Psychology (Adlerian).
- How would the client/student fill in the blanks: I am . Others are
. The world is . Therefore, in order to have a place to belong, I .
- Using the terms inferiority, private logic, and birth order, talk about why you think the client/student is experiencing difficulties.
- Select 2 Adlerian techniques you would use in working with the client/student and explain your goal in using them.
- How does the client’s cultural identity impact their experience of their presenting.
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SC Case – FD
FD is a 17-year-old South Asian female senior at the high school. FD came to the school counselor as part of the senior meeting process, though she has been seen in the school counselor’s office since 9th grade for academic and social-emotional support. FD presents as soft spoken and respectful, but it hesitant to talk in depth about her post high school plans.
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FD was called down for her senior meeting midway through the Fall semester to make sure she is on track for college applications. FD admits she has not applied to anywhere, has only done the first part of her Common App, and has instead been spending time with her friends hanging out. She lets you know her parents are not aware of this, and that they had minimal role in her siblings college application process as her siblings were very on top of things.
Relational Psychoanalytic Theories
FD presents with inconsistent academic performance over her high school years paired with anxiety and lack of motivation. When FD initiates a meeting, she often expresses disappointment with herself, anxiety over her future if she cannot do well, and pressure being placed on herself to do better. She acknowledges that this leads to her losing motivation and getting behind. This pattern has been consistent across her years in the school. She often comes to the counselor to share her feelings of being stressed and feeling like a failure when she receives a poor mark back in class. She often talks about wanting to please her family, and that low grades in math and science make her feel like an outcast. FD’s oldest brother (6 years her senior) is a chemical engineer, her older sister (2 years senior) received a full scholarship to a prestigious university studying Biochemistry. Her cousin, who attends the other high school in town, is a recruited athlete who is at the top of his class.
FD first came to the school counselor following receipt of her PSAT-9 scores, at the request of her parents. FD’s parents were upset about her score, feeling it was well below her ability level and concerned about her meeting NJ requirements due to a very low math score. FD finished freshman year over all well in her college prep and honors courses. She earned As in English, Foreign Language, and History, but struggled more in Biology (B-) and Honors Geometry (C+). She began 10th grade in Honors Chemistry and Honors Algebra II, and her grades were failing from the start of the semester. She did not qualify for honors math from her 9th grade final grade, but her parents pushed for her to be in the honors course, and it was approved. Her College Prep English course began to show strain, and by second semester she had to drop down to regular math and science sections. This helped her bring her English grade back up and end of the year she had As in English and History, a B in Chemistry, and a C- in Honors Algebra II. Her PSAT-10 scores improved, but her math was still not meeting state graduation requirements. Junior year, her parents requested her to be in AP courses in her primary subjects including Math, Science, English, and History. The school did not permit her to take AP Statistics, and at the parent’s request, she was placed in Honors Pre-Calculus. She was placed in a study group for the PSAT and her score was just at the passing mark for state requirements. She again finished the year strong in English and History, struggling in AP Environmental Science and Honors Pre Calc, earning B- grades in both classes. Senior year she was permitted to take mostly AP classes, including AP Biology and AP Calculus AB.
Relational Psychoanalytic Theories
The counselor has observed FD in the school being very social, always smiling and energetic, hanging out with a group of other students who would be considered popular but not those who are often in the highest academic classes. The student the counselor sees in the social setting is not the same as the one who comes to the office after getting a low grade. On the occasions when FD has been asked to come to the counselor’s office unrelated to struggling grades, FD does not acknowledge any anxiety, concerns about her grades, and avoids deeper discussions about her post college plans. It has also been observed that on those occasions, she comes in with a smile on her face and any mention by the counselor of her struggles in math and science or talk about her future result in what appears to be fleeting emotions that are quickly replaced with her smile and shrugging things off with not wanting to talk about that right now.
MH Case – KT
KT is a 43 year old divorced, Caucasian female, mother of three children. She was referred for psychological assessment and behavioral intervention for eating problems secondary to gastric bypass surgery. Onset of eating difficulties was two years post surgery. Over the last three years, she has had numerous procedures to determine the etiology of her eating difficulties; however, results have been inconclusive.
The client underwent gastric banding in 2015. She was diagnosed with pancreatitis, secondary to diabetes, earlier that year and was told that if she did not lose weight she would die. She experienced few problems in the post operative period and relates that this time was the “happiest time in her life.” Approximately two years post-surgery, she began experiencing difficulty digesting food. At first, certain foods would be difficult to keep down. Over time, she had difficulty keeping any food down. If she did manage not to vomit after a meal, she would then have diarrhea. She was nauseated all of the time. Over the last year, she has had increasing difficulty with food intake. In March 2021, she had an elevated white count of unknown etiology. Her doctor in Virginia dilated her and performed several upper GIs, still with no conclusive reason for her problems. She felt she was getting “sicker and sicker.” In November, 2021, she was referred to Dr. XX. He converted her banding to a bypass, but she continued to experience feeding problems. She was TPN at home for approximately 10 weeks until she was re- hospitalized. Only in the past week has she been able to eat some solid foods.
Relational Psychoanalytic Theories
The client has a long history of weight and body image disturbance. At 5’6, she currently weighs 138 lbs, but sees herself as “too thin for her structure.” She was teased about being overweight by other children while in the 4th and 5th grade and relates that this hurt her feelings. Although she perceived her weight to be “normal,” she started restricting her food intake at the age of 10 and started 4-5 diets within that first year of dieting. Her weight at age 18 was 120 lbs. Her lowest adult weight, at age 19, was 122 lbs. She remained at this weight for 6 years, although she acknowledges eating as a coping mechanism since age 20. As her marriage became more stressful, her compulsive eating was more frequent. Most eating occurred after fights with her husband. She began gaining weight with her first pregnancy at age 25. She never lost her pregnancy weight, but continued to gain weight as she had two more children. She ate compulsively but denies bingeing or purging or using laxatives for weight loss. She denies hiding her eating, but primarily ate while alone in the car, while running errands, and at home. Before eating, she felt empty, confused, angry, inadequate, lonely, nervous, panicked, and frustrated and disgusted with herself. She typically ate rapidly and felt out of control while eating. Eating did not ease her feelings. Instead, she tended to feel more miserable and guilty afterwards.
Since surgery, she has controlled her weight by limiting her portions. In the first years after her surgery, when she did eat larger portions, she would become nauseous and vomit. In the second post-operative year, she began having difficulty keeping food down. During this year, she went on at least 10 diets. She is very fearful of gaining weight and obsesses over even small weight gains, “I want to take it off right away.” Weight loss or gain seriously affects the way she feels about herself.
Relational Psychoanalytic Theories
KT was raised overseas and then in Virginia by still married parents. Her father was in the military in Europe. Her parents are currently healthy, though both have had cancer. She describes her childhood environment as “privileged.” Her parents were very social while they were in Europe and were in the movies in France. She denies any abuse or neglect. The client did well in school and later graduated with a bachelor’s degree in nursing. She worked as a nurse in several settings including the city jail. She last worked for three years as a psychiatric nurse at a Roanoke hospital. In her last year of work, she was reassigned as a “floater” due to absenteeism. She lost her job in June, 2022 due to continued absenteeism and has been on medical disability since then.
The client was married for 18 years. She described her husband as physically, emotionally, and verbally abusive. She felt like they went “from one crisis to another.” She finally left the relationship in 2018, after she had regained a sense of self-worth. They have three children, two sons, age 18 and 16, and one daughter, age 10. Around the time that she lost her job, both sons experienced difficulties with drug abuse and one ended up attending residential treatment. Both sons are doing well now. Her 10 year-old daughter is overweight and has a significant amount of anxiety about the client’s health fearing she is going to die.
Relational Psychoanalytic Theories
The client has a long history of mental health difficulties. At age 16, her parents moved to Virginia for her father’s job. Just before the move, the client’s boyfriend died of cancer and her mother was diagnosed with cancer. In the weeks following her boyfriend’s death, she spent hours at his gravesite and, after the family moved to Roanoke, would return to Richmond to sit at his grave. At the same time her mother was hospitalized for surgery to remove cancerous tissue, she attempted suicide by ingesting pills and her only thought as she lay in the in the ER was “how could I put my mother through this.”
She has been seeing a psychiatrist and a psychologist in Roanoke. Her psychiatrist works in the same office in which she was employed and later let go. Attending her appointments is often painful for the client, but she continues to see him because she does not want to hurt his feelings.
Relational Psychoanalytic Theories
Required Materials
- , S. V., & Castleberry, J. (2023). Counseling Theories and Case Conceptualization. NY: Springer. Available for purchase from Springer Publishing
Links to an external site.
or purchase/rental from Amazon Links to an external site.
- Videos https://connect.springerpub.com/content/book/978-0-8261-8292-0/ chapter/ch00#copy_link Links to an external site.
- Novotney, (2017). Not your grandfather’s psychoanalysis. APA Monitor,
48(11). https://www.apa.org/monitor/2017/12/psychoanalysis Links to an external site.
