Your philosophy about what causes a mental illness will determine the type of treatment you will apply. For those trained in the Medical model, the treatment of choice will always be medication; after all, if you believe the problem is biochemical, then it makes the most sense (to you) to try to change a person’s biochemistry.
Let’s treat a person with Depression using one of the theories of personality that you’ve learned.
Remember Brittany from last week’s forum prompt? Well, she’s been diagnosed with Depression. What?! Hers was a classic case of Anxiety Disorder! Yes, yes, but it turns out we have more information. Here is Brittany’s revised case – you’ll see the new information interspersed with the old information.
Brittany is a 21-year old married woman who came to the mental health clinic with the chief complaints of depression and anxiety. In the last month she has experienced insomnia, wept frequently, and had poor concentration, fatigue, and diminished interest in activities; she also reported ongoing bouts of anxiety, especially when alone with her 2-year old daughter. As a result of exhaustion, she has missed several weeks of work, and has been put on notice.
In meeting with Brittany, you notice that she is overweight and constantly sucking on candy. When you comment on her candy consumption, Brittany tells you that she is “addicted” to sweets; she laughs harshly and adds, “I’ve been stuffing my face since as far back as I can remember.”
Brittany relates that her father deserted the family when she was 5. Reportedly, he was disappointed because she, being the last born child, had not been a boy.
Brittany graduated from high school at 17 and began working as a clerk and bookkeeper at a local department store. She married two years later, when she accidentally got pregnant by the store manager. The marriage is not a success; she has frequent arguments with her husband, but she stays with him because “…[her] daughter needs a father;” she adds, “Besides, who else would want me?”
Brittany’s bouts of dizziness and sweaty palms began soon after the birth of her daughter two years ago. Brittany is usually able to calm herself, but more recently, she has felt the need to leave the room. Brittany is concerned that she may inadvertently have to leave her young child in an unsafe situation because of these feelings.
Brittany is the youngest of five children. Brittany’s sisters tell Brittany that they raised her since their mother was mostly unavailable. One sister recalls how she would feed Brittany cold bottles of milk when Brittany was a baby, sometimes giving Brittany water when no milk was available; another sister remembers Brittany crying throughout the night and how no one would get up to feed her. As an adult, Brittany tries to avoid getting together with her sisters, but when she is obligated to attend a family function, she is teased by her sisters for having been “sensitive” as a child, and a “crybaby.”
Brittany remembers her mother as being indifferent; her father was said to have been cold. Brittany remembers little of him though she recalls his arguments with her mother about producing all girls. The family struggled financially after father left, but each of the girls managed to graduate from high school and find jobs. Brittany had always wanted to go to college and pursue an art degree, but she knew it would have been financially impossible. Even now, in her current life, she says there is no way she could afford to hire a babysitter and go to school; her husband would expect her to work if she were not staying home with the child.
Brittany reported that she always thought of her childhood as “average,” but she recently began to recall episodes of physical and verbal abuse by her father toward her mother. She had memories of beatings or verbal assaults of her father against her mother; afterwards, her mother would hide in her bedroom, while her father would continue to throw things and curse as the children watched in fear. Soon after this memory emerged, Brittany had a particularly frightening dream of a woman holding Brittany down while Brittany’s father chewed at Brittany’s hands and feet.
Using ONE of the following techniques, explain how you would help Brittany deal with her depression:
psychoanalytic*/psychodynamic therapy OR
client-centered therapy OR
cognitive behavioral therapy
In discussing the therapy you have chosen to use, identify three (3) concepts associated with the technique: briefly explain each concept and say how it could be applied in helping Brittany’s depression. If the information is available, be specific and concrete as to which of Brittany’s issues would be addressed by the techniques you are applying; if the information is not available, it is alright to be theoretical about how a technique might effectively address Brittany’s issues.
*if you decide to do dream interpretation, it might help to know that hands and feet represent the things that help you get things accomplished; for example, feet take you where you want to go, and hands let you do the things you want to do.