Case Study Katherine And Michelle

Case of Kathrine and Michelle
Biological Components Katherine is a 45-year old widow, who lives with her 16 -year old daughter Michelle. Katherine upbringing described as having a “tumultuous” relationship with her mother and having a cold, strict disciplinarian, grandmother as a caregiver, alludes to an unsecure attachment she had as a child which largely explains her behavior as a parent. As it relates to her relationship with Michelle and her parenting skills, her clinginess, over attach, strict, and helicopter mom approached, is simply her compensating and projecting the love and care she never had as a child. This can turn maladaptive and caused some conflict between them as she described
a pattern of screaming fights only to make up a short time after. The biological factors that affect Michelle should be explored specifically to look for an underlying predisposition to her ADHD pass on by her mother’s depression. Brain development and attachment research show that impaired early relational experience can create psychological and neurobiological vulnerability in the child that is sustained over time (Lott, 1998). While Katherine has obviously suffered from chronic depression alluding to a dysthymic disorder, the possibility of a diathesis forming is real and explained by the transmission of trauma from parent to child which is both powerful and insidious (Cozolino,2010). While ADHD affects brain size, the possibility of affecting the frontal lobes can also cause dysfunction in impulse control, concentration, and inhibition.
Psychological Factors Katherine inability to overcome the tragedy of Jane’s death has impacted her life also making Michelle susceptible to vicarious trauma as they both present with various symptoms associated with PTSD.
Through-out the years Katherine’s trauma has overwhelmed her defense mechanisms altering her neural reflexes, as seen when she is quick to anger, easily startled and her lack of patience. As she regularly dissociates from reality, derealization and depersonalizing reactions allow her to to avoid the reality of her situation or watch it as a detached observer (Cozolino,2010). Her manifestation of avoidance is evidence of her lack of interest in social activities to the point of impeding her to hold a job. As she is unable to avoid relieving her trauma through her nightmares, intrusion keeps a vivid memory of the traumatic event in her life. Her irritability and having difficulty sleeping (nightmares), is also a form of hyper-arousal, another common symptom associated with PTSD. Both of these symptoms overlap with depressive characteristics. Katherine’s PTSD is co-morbid with depression, which has developed to dysthymia based on the duration of her symptoms exceeding numerous years after her exposure to
trauma. Michelle’s vicarious trauma presents with somatic symptoms.
Its possible her irritable bowel syndrome (IBS) is fear induced through the same intrusions (nightmares) she shares with her mother. This suggests she experienced a transferred vulnerability through interactions with her traumatized parent (Yehuda,1999). As ADHD affects various region in the brain, neurotransmitters such as dopamine and norepinephrine, play a big role as they carried signals between nerves in the brain relating to functional regions. As the frontal cortex facilitates high level functioning, a deficiency of norepinephrine cause by ADHD, can cause inattention, problems with organization, and impaired executive functioning, (Silver, 2007). As it relates to the limbic system, a deficiency in this region might result in restlessness, inattention, or emotional volatility, (Silver,2007).
Social
Components While Katherine has become withdrawn, she has made no attempt to form any new meaningful relationships in her life. Guilt for Jane’s death could be a barrier for Katherine to move on. As she has isolated, and alienated herself from of having a social life by becoming emotionally numb through disassociation. Michelle’s relational trauma along with her ADHD has already increases her vulnerability to have poor social functioning. Although Michelle already exhibits minor disruptive behavior in her relationship with her mother, it can also be a sign of a greater social development issue. While being ADHD is known to affect executive functioning, impairment of attention, concentration, emotional regulation and flexibility (Rich, Loo, Yang, Dang, Smalley,2009) can also impact Michelle’s ability to form relationships. One of the key components to the social development of social skills development and practice is observation of others and picking up on social cues and social norms, without this ability, a child will have difficulty fitting in, (Myers,2014). As her secure attachment to her mother leaves her highly susceptible to develop the same coping skills and patterns, Katherine lifestyle approached going forward will continue to be highly influential on Michelle’s development.