Summary Case Studies in Psychotherapy - Case study 1 PDF

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Case Study 1...

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Case Studies in Psychotherapy Case Study 1: The Case of Simone/Jeremy D. Safran Focus on: Presenting problem of the case study, major ways of formulating problems, what strategies did the therapist use to treat the patient. 

Simone was a 26-year-old woman who sought treatment for general feelings of emptiness and a mild problem with bulimia

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Extremely attractive, intelligent, articulate and well-dressed.

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Tendency to vacillate between narcissistic grandiosity (denied any self-doubts, was defensive) and less frequent states of openness and vulnerability (admitted for feelings of loneliness)

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Denied any feelings of being the only African-American in a predominantly white school just as she denied feelings about being treated by a white therapist.

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There may have been a semi-incestuous relationship with her father whose appearance in her life was a come-and-go basis.

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Simone had to take care of her mother emotionally as she alternated between periods of intense anger and fragility & dependence. This dependence on her contrasted with Simone’s view of her independent father.

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Simone viewed her first sexual intercourse relationship to be traumatic. She also had a sort of semi delusional ideation in thinking (ex: she would give birth to messiah, certain people she met had special powers).

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She was in a lesbian romantic relationship before therapy; and she generally tended to end relationships when her partners became too “emotionally needy”.

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She expressed a desire to improve the quality of her relationships when she was being more open.

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Simone believed that the therapist could not understand or would not be able to embrace her beliefs (this was often a discussion topic).

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Had a desire to fill this “hole or emptiness within her”. This was linked to binge eating and also pouring over new-age books.

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She began very involved with a cult during treatment; found it extremely appealing to have a cult leader tell her exactly what to do and what not to do.

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Treatment focused on exploring Simone’s skittishness towards treatment, her absences/late comings and how her anxious feelings about dependency led to a lack of commitment to therapy.

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Therapist engaged in countertransference as he found Simone to be a little bit attractive.

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Her primary concerning conflicts were: (1) feeling dependent towards the therapist and that nobody including the therapist would have anything of value to say to her (2) desperately wishing that others would help her feel less alone.

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Her old counselor Emma represents neediness to her. o Does this relate to the therapist—does Simone view the therapist as a representation of neediness as a result of his attempts to help her.

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Simone doesn’t like the dream about the dog with the udders because she doesn’t want to be nurtured/feel dependent on the therapist.

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“Sexual energy” with her father—that he makes sure people are aware that she is his daughter and not to confuse her with a romantic partner. She attempts to desexualize the therapist in her mind.

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After Jim (her 30 yr. old boyfriend) left her Simone attempted to leave therapy & join an ashram; the therapist provided treatment by largely attempting to emphasize with her and provide support.

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Simone began to once again become afraid of feelings of dependence and her ambivalence towards intimacy, and was scared by the intimacy of the patient-therapist relationship.

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Over the course of therapy her tendency to vacillate between periods of openness and shutting down completely reduced.

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Patient and therapist set a termination date in advance and explored her feelings about termination.

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Therapist was concerned whether her plans to terminate treatment was related to her feelings of intimacy and abandonment and her distaste for dependency....