Psychodynamic Counselling Case Study
CASE STUDY
DEBBIE ROGERS - 25/05/11
1. A)
Robert perception of his role as husband and father is that “it’s my job to be the breadwinner and look after my family and its Maeve’s job to look after the kids.” My assumption would be that this response reflects his early childhood experience.
The Psychodynamic Approach recognises that many of our actions and responses reflect the effects of our earliest experiences, which affect our relationships and our perception of the present. Essentially we often, unconsciously, recreate patterns from the past in our current relationships both with other people and towards ourselves. Such thoughts, feelings and behaviour are deep rooted and can be, at times, unhelpful and destructive. …show more content…
Though we may repress our very early experiences, the theory is that the unconscious never forgets them. The Psychodynamic approach aims to bring information from the past into consciousness so that it can inform, but not drive, the way we live in the present.
1. B)
I feel that there could be barriers to using psychodynamic counselling with Tammy, as her most immediate issue is the loss of her mother with whom she had a very close relationship.
A Bereavement counsellor, in the first instance, would support Tammy and help her to accept her loss. Tammy also lost her father at the age of ten, her job, through redundancy and lastly the end to her relationship with Roger. I think that Tammy is still working through the stages of mourning, but has not yet accepted her bereavement. Tammy is still talking things through with her mother, even though she is no longer here and basing some of her decisions on what she knows would be her mother’s feelings or opinion. For example, Tammy said, “I know if mum were still alive she’d have advised me not to have gone down this path. She would probably have reminded me about how hurt she was when she discovered dad had been having …show more content…
affairs.”
DEBBIE ROGERS
-2-
1. C)
I think that the Psychodynamic Approach would be particularly suitable for Robert for two reasons. This Approach has an assumption that everyone has an unconscious mind and that feelings held here are often too painful to be faced. Therefore, if we repress or block out these feelings (repression) this can result in a negative impact on our behaviour and emotional well-being.
Robert talked very little about his feelings and started by saying that he found it “strange how I managed to carry on for so long without worrying about being made redundant.” On some level, he realised that this wasn’t usual and questioned it. This Approach would help Robert to face these feelings, experience and understand them.
Secondly, I feel that Robert’s introjection from his childhood is negatively affecting his life and relationships in the present.
For example he said his wife should teach his children “to have a bit of consideration for the man of the house”.
2. A)
Everyone needs positive Self Regard and in order to gain this positive personal regard even small babies will adapt their behaviour to receive it. Conditions of Worth develop when a child recognises that they only receive positive personal regard when they behave in a certain way. Individuals often cope with this conditional acceptance by others by gradually coming to incorporate these conditions into their own views about themselves. We receive these “Conditions of Worth” from our parents, school, church, society, etc.
These Conditions of Worth then affect our behaviour as adults and can affect an individual’s Self-actualization as they are an External rather than Internal Focus of Evaluation. Because these conditions were created by others and not their own Organismic Valuing System, this could cause conflict because they are not congruent in their own life and it could be harder to maintain any sense of self-esteem.
DEBBIE ROGERS
-3-
Robert says that, “It’s my job to be the breadwinner and look after my family.” I think that his sense of identity and his own evaluations of experience and attributions of value may have been replaced by creations partly or even entirely due to the pressures felt from other people. He has displaced his personal judgements and meanings with those of others.
2. B)
To establish a Therapeutic relationship, the counsellor must demonstrate the Core Conditions, which are: Empathy - being able to understand the client’s issues from their perspective; Unconditional Positive Regard - able to accept and respect the client as a unique individual in a non-judgemental manner and Congruence - being honest and open in the relationship.
There are six elements which are considered necessary and sufficient for personality changes to occur. They are:
* Two people are in psychological contact.
* The first, the client is in a state of incongruence, being vulnerable or anxious.
* The second person, the counsellor is congruent and integrated in the relationship.
* The counsellor demonstrates Unconditional Personal Regard for the client.
* The counsellor demonstrates an empathic understanding of the client’s internal frame of reference and communicates this experience back to the client.
* The communication of the counsellor’s empathic understanding and UPR is achieved.
If the counsellor can demonstrate they care for and value their client, the client also begins to see and believe in the worth and value of themselves.
DEBBIE ROGERS
-4-
PART B
4. A)
To me, I understand the concept of Personal Autonomy to be that an individual is independent, has control over their own life and trusts their own judgement to make any decisions or changes , uninfluenced by external influences or opinions. They must also be able to take personal responsibility for their actions.
4. B)
I sometimes strive for complete Personal Autonomy, because any change in my life does have an impact on my partner and my children, whether positive or negative. Although having a family was my choice, I do feel resentful sometimes when I feel that I can’t do what I want, when I want.
Because of this course, I recognise that my Conditions of Worth are responsible for me struggling to achieve a balance between my personal autonomy and the needs of my family. Therefore, I am encouraging my children to be more independent and to do more for themselves, which then enables me more time to do what I want to do. For example, I do their ironing, but now if one of my older children wants a particular piece of clothing which is clean but not ironed, they would do it themselves. To be honest even with this small example, I was surprised at how well they took it which made me realise that it is my Conditions of Worth which are the problem - not them!
4. C)
In the case study, I feel that Tammy is being autonomous in her own life. For example, Tammy says, “I’ve just had my 28th birthday, and I spent some time taking stock of my life.” As a result of this, Tammy had made decisions to, “finish this course and look forward to a new career in the Prison service.” Tammy has also taken responsibility for her relationship with Robert and thought about the affect on his wife and herself and has decided to end it.
DEBBIE ROGERS
-5-
5.
I found Robert’s lack of respect and stereotyping of women to be offensive and my first reaction was sympathy for his wife. I don’t know whether this is because I am a “stay at home mum” and have experienced this attitude from both men and women, or because I haven’t experienced this in my own relationship and find it hard to understand and not be judgemental.
I would manage my feelings by really working on my Empathy to try and understand how it really feels from his perspective. It is easier for me to feel empathy for his wife as I have not had the responsibility or experience of being the “breadwinner”.
I also need to be able to demonstrate UPR and be able to accept that people have different views from me and that they are valid. What I know is that he has lost his job, so he is no longer the “breadwinner” which has made him lose confidence. Also there is a reason he did not feel able to talk to his wife about losing his job.
I feel my way of managing similar issues would be to actively listen to what the client is saying but with them try to acknowledge and process the feelings behind the words.
6.
If I was preparing a skills practice agreement, it would include the following.
* Number of counselling sessions.
* Length of sessions.
* Limits to confidentiality. For example, if I felt there was risk of harm to themselves or others, I would have to inform the course tutor.
* Inform my “client” that I would write about my counselling skills practice in my journal, but that they will not be identified by name and I would be happy for them to see it.
* Mobile phones switched off or on silent.
DEBBIE ROGERS
-6-
7. A)
Tammy “lost” her father at 10 years and has now lost her mother. They had a very close relationship and her mother was relatively young when she died so Tammy was shocked and is in denial. Then Tammy lost her job.
Tammy misses her mother and talks to her, even though she is no longer around. Her mother’s death has made her evaluate her life and Tammy has taken positive steps to get another job and end her relationship with Robert. She is looking positively to the future, while gradually accepting the loss of her mother.
7. B)
J. William Worden (1994) defined the mourning process in terms of tasks to be accomplished. A grieving person may go back and forward through the tasks.
1. Accepting the reality of the loss.
Tammy’s initial reaction to her mother’s death was shock and denial. Her mother was only 56 and her death was not expected.
2. Work through to the pain of grief.
Being made redundant was another loss experienced by Tammy. Not being at work gave her time to think about and absorb the reality of her bereavement and she describes how she “cried over the slightest thing.“
DEBBIE ROGERS
-7-
3. Adjusting to an environment in which the deceased is missing.
Tammy is adjusting to an environment in which her mother is missing by still “talking” to her. Tammy feels that this is helping her to adjust. Tammy is also thinking about her life and what she wants to change and is taking steps to accomplish this. She is moving forward to a new career and ending her relationship with Robert .
4. Withdrawing emotional energy and investing it in another relationship.
I think Tammy is at this stage and seems able to talk about her mother without intense emotions which is an indication of successful mourning. At the moment it seems as if Tammy is investing her emotional energy into making changes in her life in order to move forward into another relationship.
8. A)
You showed congruence to your client as you were honest that you were finding it difficult to show empathy. Be careful about using “why” in your questions as this could sound accusing and judgemental to the client. Paraphrasing and reflecting back what you hear to the client may help them to think more about the feelings behind the words.
8. B)
You think your wife’s idea to get a job until you get back into work is ridiculous and you sound angry that she would expect you to look after the children while she is at work.
DEBBIE ROGERS
-8-
8. C)
Saying this demonstrates that I have shown Unconditional Positive Regard for the client. It shows that I have actively listened to what the client has said and paraphrased this back to them without expressing judgement and without adding or subtracing to what he said. This demonstrates my empathic understanding of Robert’s internal frame of reference and I have reflected this back to him.
I have also used Advanced Empathy as I reflected back to the client that he sounded angry. Although anger was not explicitly stated by Robert, his language, I.e. “ridiculous”, “I just won’t have it” suggest it.
DEBBIE ROGERS - 25/05/11
1. A)
Robert perception of his role as husband and father is that “it’s my job to be the breadwinner and look after my family and its Maeve’s job to look after the kids.” My assumption would be that this response reflects his early childhood experience.
The Psychodynamic Approach recognises that many of our actions and responses reflect the effects of our earliest experiences, which affect our relationships and our perception of the present. Essentially we often, unconsciously, recreate patterns from the past in our current relationships both with other people and towards ourselves. Such thoughts, feelings and behaviour are deep rooted and can be, at times, unhelpful and destructive. …show more content…
Though we may repress our very early experiences, the theory is that the unconscious never forgets them. The Psychodynamic approach aims to bring information from the past into consciousness so that it can inform, but not drive, the way we live in the present.
1. B)
I feel that there could be barriers to using psychodynamic counselling with Tammy, as her most immediate issue is the loss of her mother with whom she had a very close relationship.
A Bereavement counsellor, in the first instance, would support Tammy and help her to accept her loss. Tammy also lost her father at the age of ten, her job, through redundancy and lastly the end to her relationship with Roger. I think that Tammy is still working through the stages of mourning, but has not yet accepted her bereavement. Tammy is still talking things through with her mother, even though she is no longer here and basing some of her decisions on what she knows would be her mother’s feelings or opinion. For example, Tammy said, “I know if mum were still alive she’d have advised me not to have gone down this path. She would probably have reminded me about how hurt she was when she discovered dad had been having …show more content…
affairs.”
DEBBIE ROGERS
-2-
1. C)
I think that the Psychodynamic Approach would be particularly suitable for Robert for two reasons. This Approach has an assumption that everyone has an unconscious mind and that feelings held here are often too painful to be faced. Therefore, if we repress or block out these feelings (repression) this can result in a negative impact on our behaviour and emotional well-being.
Robert talked very little about his feelings and started by saying that he found it “strange how I managed to carry on for so long without worrying about being made redundant.” On some level, he realised that this wasn’t usual and questioned it. This Approach would help Robert to face these feelings, experience and understand them.
Secondly, I feel that Robert’s introjection from his childhood is negatively affecting his life and relationships in the present.
For example he said his wife should teach his children “to have a bit of consideration for the man of the house”.
2. A)
Everyone needs positive Self Regard and in order to gain this positive personal regard even small babies will adapt their behaviour to receive it. Conditions of Worth develop when a child recognises that they only receive positive personal regard when they behave in a certain way. Individuals often cope with this conditional acceptance by others by gradually coming to incorporate these conditions into their own views about themselves. We receive these “Conditions of Worth” from our parents, school, church, society, etc.
These Conditions of Worth then affect our behaviour as adults and can affect an individual’s Self-actualization as they are an External rather than Internal Focus of Evaluation. Because these conditions were created by others and not their own Organismic Valuing System, this could cause conflict because they are not congruent in their own life and it could be harder to maintain any sense of self-esteem.
DEBBIE ROGERS
-3-
Robert says that, “It’s my job to be the breadwinner and look after my family.” I think that his sense of identity and his own evaluations of experience and attributions of value may have been replaced by creations partly or even entirely due to the pressures felt from other people. He has displaced his personal judgements and meanings with those of others.
2. B)
To establish a Therapeutic relationship, the counsellor must demonstrate the Core Conditions, which are: Empathy - being able to understand the client’s issues from their perspective; Unconditional Positive Regard - able to accept and respect the client as a unique individual in a non-judgemental manner and Congruence - being honest and open in the relationship.
There are six elements which are considered necessary and sufficient for personality changes to occur. They are:
* Two people are in psychological contact.
* The first, the client is in a state of incongruence, being vulnerable or anxious.
* The second person, the counsellor is congruent and integrated in the relationship.
* The counsellor demonstrates Unconditional Personal Regard for the client.
* The counsellor demonstrates an empathic understanding of the client’s internal frame of reference and communicates this experience back to the client.
* The communication of the counsellor’s empathic understanding and UPR is achieved.
If the counsellor can demonstrate they care for and value their client, the client also begins to see and believe in the worth and value of themselves.
DEBBIE ROGERS
-4-
PART B
4. A)
To me, I understand the concept of Personal Autonomy to be that an individual is independent, has control over their own life and trusts their own judgement to make any decisions or changes , uninfluenced by external influences or opinions. They must also be able to take personal responsibility for their actions.
4. B)
I sometimes strive for complete Personal Autonomy, because any change in my life does have an impact on my partner and my children, whether positive or negative. Although having a family was my choice, I do feel resentful sometimes when I feel that I can’t do what I want, when I want.
Because of this course, I recognise that my Conditions of Worth are responsible for me struggling to achieve a balance between my personal autonomy and the needs of my family. Therefore, I am encouraging my children to be more independent and to do more for themselves, which then enables me more time to do what I want to do. For example, I do their ironing, but now if one of my older children wants a particular piece of clothing which is clean but not ironed, they would do it themselves. To be honest even with this small example, I was surprised at how well they took it which made me realise that it is my Conditions of Worth which are the problem - not them!
4. C)
In the case study, I feel that Tammy is being autonomous in her own life. For example, Tammy says, “I’ve just had my 28th birthday, and I spent some time taking stock of my life.” As a result of this, Tammy had made decisions to, “finish this course and look forward to a new career in the Prison service.” Tammy has also taken responsibility for her relationship with Robert and thought about the affect on his wife and herself and has decided to end it.
DEBBIE ROGERS
-5-
5.
I found Robert’s lack of respect and stereotyping of women to be offensive and my first reaction was sympathy for his wife. I don’t know whether this is because I am a “stay at home mum” and have experienced this attitude from both men and women, or because I haven’t experienced this in my own relationship and find it hard to understand and not be judgemental.
I would manage my feelings by really working on my Empathy to try and understand how it really feels from his perspective. It is easier for me to feel empathy for his wife as I have not had the responsibility or experience of being the “breadwinner”.
I also need to be able to demonstrate UPR and be able to accept that people have different views from me and that they are valid. What I know is that he has lost his job, so he is no longer the “breadwinner” which has made him lose confidence. Also there is a reason he did not feel able to talk to his wife about losing his job.
I feel my way of managing similar issues would be to actively listen to what the client is saying but with them try to acknowledge and process the feelings behind the words.
6.
If I was preparing a skills practice agreement, it would include the following.
* Number of counselling sessions.
* Length of sessions.
* Limits to confidentiality. For example, if I felt there was risk of harm to themselves or others, I would have to inform the course tutor.
* Inform my “client” that I would write about my counselling skills practice in my journal, but that they will not be identified by name and I would be happy for them to see it.
* Mobile phones switched off or on silent.
DEBBIE ROGERS
-6-
7. A)
Tammy “lost” her father at 10 years and has now lost her mother. They had a very close relationship and her mother was relatively young when she died so Tammy was shocked and is in denial. Then Tammy lost her job.
Tammy misses her mother and talks to her, even though she is no longer around. Her mother’s death has made her evaluate her life and Tammy has taken positive steps to get another job and end her relationship with Robert. She is looking positively to the future, while gradually accepting the loss of her mother.
7. B)
J. William Worden (1994) defined the mourning process in terms of tasks to be accomplished. A grieving person may go back and forward through the tasks.
1. Accepting the reality of the loss.
Tammy’s initial reaction to her mother’s death was shock and denial. Her mother was only 56 and her death was not expected.
2. Work through to the pain of grief.
Being made redundant was another loss experienced by Tammy. Not being at work gave her time to think about and absorb the reality of her bereavement and she describes how she “cried over the slightest thing.“
DEBBIE ROGERS
-7-
3. Adjusting to an environment in which the deceased is missing.
Tammy is adjusting to an environment in which her mother is missing by still “talking” to her. Tammy feels that this is helping her to adjust. Tammy is also thinking about her life and what she wants to change and is taking steps to accomplish this. She is moving forward to a new career and ending her relationship with Robert .
4. Withdrawing emotional energy and investing it in another relationship.
I think Tammy is at this stage and seems able to talk about her mother without intense emotions which is an indication of successful mourning. At the moment it seems as if Tammy is investing her emotional energy into making changes in her life in order to move forward into another relationship.
8. A)
You showed congruence to your client as you were honest that you were finding it difficult to show empathy. Be careful about using “why” in your questions as this could sound accusing and judgemental to the client. Paraphrasing and reflecting back what you hear to the client may help them to think more about the feelings behind the words.
8. B)
You think your wife’s idea to get a job until you get back into work is ridiculous and you sound angry that she would expect you to look after the children while she is at work.
DEBBIE ROGERS
-8-
8. C)
Saying this demonstrates that I have shown Unconditional Positive Regard for the client. It shows that I have actively listened to what the client has said and paraphrased this back to them without expressing judgement and without adding or subtracing to what he said. This demonstrates my empathic understanding of Robert’s internal frame of reference and I have reflected this back to him.
I have also used Advanced Empathy as I reflected back to the client that he sounded angry. Although anger was not explicitly stated by Robert, his language, I.e. “ridiculous”, “I just won’t have it” suggest it.