1. Identify and explain your chosen diagnostic categories for Katherine’s condition. Explain how you came to that conclusion.
During the six-week session with Katherine, she is diagnosed with the disorders as provided in each session.
a) Borderline Personality Disorder
People with this disorder often experience intense emotional instability, particularly in relationships with others. They express their anger, frustration, and dismay through suicidal gestures and other self-destructive acts.
In Katherine’s case, she feels estranged from her parents and unable to love them.
b) Panic Disorder
Its a mental illness in which a person experiences repeated, unexpected panic attacks and persistent anxiety about the possibility that the panic attacks will recur. Symptoms for this disorder include intense fear, apprehension, and discomfort.
While driving to her parents house, Katherine gets a panic attack and drives away. To avoid reoccurrence of this attack, she admits to not calling her parents to tell them of her change of plans.
c) Depersonalization Disorder
In this case, a person experiences An unwelcome sense of detachment from their own bodies. Katherine describes such a moment as she drove away from her parents hou3e. She felt like she war outside her body, watching herself, but she was also aware that she was driving the car.
I found out that Katherine was suffering from Depressive Disorder during this session. This disorder is characterized by gloominess and cheerlessness. For Katherine she admits to feeling sad all day long and cries several times a day for no good reason.
Katherine is suffering from an eating disorder. She admitted to having been hospitalized for Anorexia Nervosa, a condition of self-starvation and had lost 50lbs. During this period. Katherine missed her menstrual for several months but was still in denial of having a serious problem in need of a solution.
Katherine is suffering from delusional behavior. This is a false belief firmly held by a person even though other people recognize the belief as obviously untrue. Katherine has completely lost contact with reality. She describes moments when God has personally talked to her and told her she will be fine. One day she heard someone call her name and is very convinced it was God.
This session further proves that Katherine is suffering from Attention Deficit Hyperactivity Disorder. She speaks with a rambling speech and thought. She also has Dependent Personality Disorder. This disorder involves severe and disabling emotional dependency on others. People with this disorder have difficulty making decisions without a great deal of reassurance from others. They feel uncomfortable by themselves.
During this session, Katherine threatens to commit suicide if the treatment is ending. She is basically afraid of being abandoned.
2.Explain the chosen model and whether or not it was helpful in understanding Katherine’s behavior. Provide examples of instances when the chosen model was helpful and when you had to choose an alternative model to better explain her behavior.
The best model to use was the Psychodynamic model where a persons behavior is determined largely by underlying dynamic psychological forces of which the person is not aware. I use this method to unearth Katherine’s conflict during childhood.
According to Sigmund Feud, unconscious processes direct a great part of a person’s behavior. Although a person is unaware of these impulses and drives, they strive to assert themselves. To probe Katherine’s unconscious mind psychotherapy technique of free association is used. In free association, Katherine reclines and talks about thoughts, wishes, memories, and whatever comes to mind. As a psychoanalyst, I tried to unmask the underlying significance of her verbalizations.
According to Feud, physical immaturity dooms the child’s desires to frustration and his or her first step toward adulthood to failure. Intellectual immaturity further complicates the situation because it makes children afraid of their own fantasies. The extent to which the child overcomes these emotional upheavals and to which these attachments, fears, and fantasies continue to live on in the unconscious greatly influences later life, especially love relationships. In this case, Katherine dresses like a young girl to keep men at bay after she’ sexually assaulted. She also finds solace sexually in engaging in lesbian tendencies with her college roommate. This affects her relationship with her husband as she no longer can be aroused by a man.
3.Explain the treatment options selected throughout your therapy sessions with Katherine and the follow-up you recommend.
Katherine must first undergo therapy, which will focus on helping her understand and become aware of the significance of her personality traits.
Cognitive and behavioral techniques, such as role-playing and logical arguments, thereafter will help alter Katherine’s irrational perceptions and assumptions about herself.
Psychoactive drugs may then help control her feelings of anxiety, depression, and severe distortions of thought.
To treat Borderline Personality Disorder, dialectical therapy is used. Here, focus is placed on reducing Katharine’s suicidal tendencies and other behaviors that disrupt treatment.
Katherine is then helped to develop skills to cope with self-destructive impulses as bad eating habits, in this case self-starvation.
In addition, Katherine will learn to achieve personal strength through acceptance of the many disappointments and interpersonal conflicts that are a natural part of life.
Antipsychotic drugs such as neuroleptics will they be used to reduce Katherine’s delusions, hallucinations and other psychotic symptoms.
4. Discuss the cultural and ethical considerations that you feel are pertinent to this case.
Katherine is African- American. Culture is defined `s a pattern of behavior and thinking that people living in social groups learn, create, and share.
Katherine’s lesbian tendencies may appear strange and wrong to her, but in other cultures, it is very normal and acceptable. Therefore, make your diagnosis with culture background of Katherine in mind.
In helping my clients, as a therapist I must follow a code of ethics. First, all therapy is confidential. I notify others of a client’s disclosures only in exceptional cases, such as when children disclose abuse by parents, parents disclose abuse of children, or clients disclose an intention to harm themselves or others.
Also, as a therapist, I avoid dual relationships with clients—that is, being friends outside of therapy or maintaining a business relationship. Such relationships may reduce my objectivity and ability to work with the client. As an ethical therapist, I also do not engage in sexual relationships with clients, and do not accept as clients people with whom I have been sexually intimate.
The information given to me by Katherine is confidential and cannot be shared by any one else.
Katherine also has a right to privacy and can only disclose what she wants to at freewill.
5. Identify Katherine’s strengths.
Despite her disorders, Katherine hard some admirable strength that includes:
-healthy relationship with her sister, and friends where she gets the much needed support
– She is involved in church activities
-she loves painting
-getting along very well with her coworkers of 15 years.
6. List the childhood disorders you suspect Katherine suffered from.
a) Attention deficit Hyperactivity Disorder
c) Borderline Personality Di3order
d) Mental abuse
e) Panic disorder
7. Explain your concerns on Katherine as she ages.
As an adult Katherine may have the following difficulties if suffering from the disorders;
a) As symptom mf ADHD, Katherine may be unusually impatient and reqtleq3 and may become bored before finishing a task. She may:
– constantly arrive late for appointments
-fail to organize her time and priorities
– have difficulty maintaining friendships and other relationships.
b) Katherine if suffering from depression may have the following:
– sad mood
– sleep disturbances
– lack of energy
– psychotic symptoms such as delusions and hallucinations
c) She may also have psychiatric disorders like excessive anxiety, dissociative identity disorder and increased risk of suicide
d) Katherine may also start experiencing physical pain, which in most cases will be mistaken by medics as physical illness and not mental illness. People who have suffered from disorders for a long time often complain of headaches and nerves.
8.List your future recommendations for Katherine’s treatment.
1. Antidepressant drugs, either tricyclics, or MAO inhibitors
3. Electroconvulsive Therapy (ECT)
4. Regular aerobic exercises to improve mood.
5. Tranquilizing drugs, e.g. Xanax and Valium for panic attacks
6. Antipsychotic drugs for delusions
7. Training in relaxation techniques for depersonalization disorder.
8. Undergo hypnosis to modify her behavior
9. Stabilize her physical condition if suffering from an eating disorder.