Laura Final - Psychological Report PDF

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Laura Case Conceptualization:

Presentation: Laura is a 29- year-old Caucasian female. Her reason for treatment is unknown. She is currently a doctor, specializing in anesthesiology. On the surface, Laura is able to function and appears to be free of any interpersonal conflicts. She is in a long term relationship, and initially presents as having a decent relationship with her father, and she has been able to maintain her career. She is able to get her work done while at work and does not miss work. Problem: Laura initially presents with the major problem of committing to marriage with her significant other. Her significant other provided her with an ultimatum of getting married or ending their relationship. This ultimatum has served as major frustration for Laura. Throughout her time in treatment Laura reveals patterns of manipulative, sexually seductive behavior with men. Patterns Self: Laura appears to struggle with self-perception. Often, Laura self-deprecates by verbally expressing she is not worthy of being valued beyond sexual engagement, she does not deserve Andrew because she is a dirty women and that she is not a good doctor. Laura is also vulnerable to self-esteem threats. It does not appear she is has developed a strong sense of self. Laura demonstrates behavior that suggests her identity is tied to her sex appeal and ability to please men sexually. She frequently uses others and sex as a way to regulate her self-esteem. Specifically, Laura uses men to regulate her self-esteem. She demonstrates using seduction and sex as a way to gain control and power.

Sense of identity – matches with her ability, Sense of worth is attached how others feel about her if they want her. Being desired physically appealing. Fantasy about herself – she is able to revive Paul; she can fix people. Grandiosity – enticing

She views herself as a being dismissed, doesn’t want to be treated like a child. Relationships: There is not much insight provided into Laura’s interpersonal relationships. From those we are aware of, it appears Laura has difficulty in establishing intimacy beyond sexual intimacy, trust and security in her relationships. On the surface, Laura’s interactions and relationships appear to be driven by sexual desire. Overall, Laura has difficulty with establishing boundaries in relationships that will in turn allow for the development of trust, intimacy and security.

Unstable – instability. Mutuality – Not invested in relationship with Andrew Trust: What happens after marriage, being domesticated … lose herself, looks. Lousy lay. Conflict in relationships, with Paul. – power, aggression Poor sense of others.

Adapting: When conscious or unconscious conflicts arise, Laura tends to use more maladaptive defenses. Frequently, Laura uses the defenses of denial, especially when being challenged to think about

her adolescent experiences. Laura also leans on isolation of affect, as she tends to speak about and remain in thought of experiences but disregards her emotions. When pushed to connect with her emotions, Laura becomes defensive and uncooperative. Laura has also demonstrated using idealization, especially with men, such as David and Paul. Sexualization Acting Out Projective identification Cognition: General intelligence and cognitive functioning is a strength for Laura. Laura has been able to complete medical school and maintain as a doctor all before the age of 30. However, a weakness for Laura is accurate self-reflection. While in treatment, it does not appear Laura self-reflects often. She often reflects on experiences and not herself or her emotions. In the rare instance Laura does self-reflect, she does not accurately self-reflect and engages in self-deprecation. Laura also has difficulty with judgment.

Deficits Mentalization, impulsive, self-reflection, reality testing. Work and Play: Laura appears to have a balance between work and play. Her work is adequate for the care of herself and it was well matched to her developmental level, training and talents. Laura’s work also gives her satisfaction, as she is able to support herself. Laura appears to be play, as she does not demonstrate a lack of play in her life. It appears Laura uses sex as play. Genetics and Prenatal Development:

There is no established evidence that may provide insight into how Laura developed her previously mentioned strengths and weakness, as very little has been shared about her genetics, and prenatal development Earliest Years (Birth to age 3): There is no established evidence that may provide insight into how Laura developed her previously mentioned strengths and weaknesses, as very little has been shared about her earliest years. Middle Childhood (age 3-6): There is no established evidence that may provide insight into how Laura developed her previously mentioned strengths and weaknesses, as very little has been shared about her middle childhood years. Later Childhood (age 6-12): There is no established evidence that may provide insight into how Laura developed her previously mentioned strengths and weaknesses, as very little has been shared about her later childhood years. Adolescence (13-18): During adolescence Laura experienced trauma. Laura lost her mother to cancer and also lost her father, as she reports he was not the same and depressed after her mother’s death. Laura also experienced sexual trauma, as she engaged in a two-month sexual relationship with David, a 40year-old male at the age of 16. It appears Laura’s cognitive and emotional difficulties stem from the trauma she experienced during her adolescent years, specifically at the age of 16.

Not having any value, having to serve and take care of her father.

Adulthood (Young age 18-23): Despite her difficulties, Laura demonstrates appropriate functioning during her early adult years as she has been able to achieve academic success, complete medical school and maintain as a doctor. However, Laura has not demonstrated the skills needed to adjust and work through her adolescent trauma that is currently affecting her young adult years. Hypothesis: The most problematic parts of Laura’s development have occurred during her adolescent years. Laura’s adolescent relationship with David, provided her with her an unhealthy relationship template she unconsciously applies to her relationships with other men. Link: Laura’s difficulty with self-perception may stem from her adolescent years. After the death of her mother, Laura reports that her father was not the same and he was not very attentive to her. Laura reports having to care for her father and make sure he is okay. While Laura’s father was experiencing depression, it may be possible her father may not have provided her with her affirmation and validation which may have led to her self- deprecating views of herself and not feeling she is deserving of a man that wants to offer her more than sex. Laura’s desire to save her father and pull him out of depression, may be related to her desire to save men that she feels are broken or having trouble in their intimate relationship. This is a pattern Laura demonstrates, as she was drawn to David, Alex and Paul. Laura perceived all of these to be broken and as having issues in their intimate relationships with their partners. Laura began to replace sex with emotional expression after her brief sexually intimate relationship with this David. This is a theme that has progressed into Laura’s adulthood years. Laura may have become drawn to Paul, because he listens to her, pays attention to her, notices her, helps her to make sense of her world.

While in treatment, Paul activates Laura’s long frustrated father hunger, that has become intertwined with sex. Life experiences have taught Laura that men either fail to notice her at all or only want her sexually. Paul notices her and so she begins to feel as if she is in love with him. Laura fantasizes about Paul this fantasy is important because it holds valuable information for her about what she does want and how the way she has gone about her life has kept her from it....