Susanna Kaysen Case Study
April 10th, 1969 I. Identifying Information The client Susanna Kaysen is a nineteen year old Caucasian woman who was born on November 11, 1948 in Cambridge, Massachusetts. She still currently resides in Cambridge at 17 Burlingham Road alone in a one bedroom apartment. She recently moved out on her own after being released from The Claymoore Mental Institution. The patient’s home phone number is (617) 234-0998. Currently Ms. Kaysen is a single woman and is not in any significant romantic relationship.Ms. Kaysen’s parents Carl and Annette Kaysen are still actively involved in her life. II. Referral Source
The client has come to ABA Clinic for Mental Health Services as a self-referral. She stated she learned of our agency through her …show more content…
family psychiatrist and was seeking continuous outpatient therapy. Being as though Ms. Kaysen was a self-referral we did not receive any anticipatory information regarding her case; however, the agency was able to have her records from the Claymoore Mental Institution sent over for review. At Claymoore Ms. Kaysen was being treated for depression and had been diagnosed with Borderline Personality Disorder. III. Client’s Presenting Problem/Want/Need; Client’s Initial Expectation of Agency
The client has come seeking psychotherapy from our agency as a stepping stone to the road of recovery. She recently spent 18months at Claymoore where she was coming to terms with her diagnosis and understanding her disease. She is currently seeing the Institution’s therapist Dr. Wick twice a week, yet Ms. Kaysen feels she has grown all she can with Dr. Wick. She stated that due to the fact that Dr. Wick mainly performs inpatient therapy she would feel more comfortable advancing her therapy with a third person who sees her condition from an outside point of view. Dr. Wick in Ms. Kaysen’s opinion helped her understand the underlying stimulus which ignites her Borderline Personality Disorder. Now, her main focus is finding a psychotherapist who will understand her ambivalence and splitting decisions and guide Ms. Kaysen on how to productively function within society and beyond the grounds walls of the women’s ward at Claymoore. IV. History of the Problem/Want/Need
As stated above Ms.
Kaysen was recently released from the Claymoore Mental Institution where she spent the last eighteen months. Ms. Kaysen was voluntary admitted at the age of eighteen as a result of a family intervention after she attempted suicide by allegedly chasing a bottle of aspirin with a bottle of vodka. Ms. Kaysen states she became depressed during her high school years. She was an outsider with not many friends and although she was determined to be a writer, she had no plans of attending college after her high school graduation in 1967. She stated remembering that her only wish was to not be like her mother, a college educated woman who was a homemaker. Ms. Kaysen believes her depression stems from her unclear path of what she wants to do with her life. She was once fascinated and intrigued by death, dying and suicide and while she attempted suicide once she was often rather careless with her body and was quite promiscuous with men. She comes from a wealthy suburban family yet has little communication and interaction with her family because she feels disconnected from them and cannot relate, being as though she has chosen not to live up to their standards. Although Ms. Kaysen did not have the closest relationship with her parents they tried their best to be supportive; maybe not exactly supportive of her diagnosis and behavior but of her treatment. They did decide to intervene after her suicide attempt and during her stay at the institution they often phoned, visited and even participated in family therapy sessions. According to Ms. Kaysen these sessions weren’t exactly productive for two reasons. For one her parents were in denial about the likelihood of her condition being remotely hereditary. It is five times more likely for a patient to be diagnosed with Borderline Personality Disorder if at least one parent exhibits similar behavioral patterns. The family life and environment play a huge role in personality disorders and they are often triggered by
childhood traumas. The second reason as to why Ms. Kaysen felt the family therapy sessions were not beneficial to her treatment had to do with her family status. She felt the only reason why her parents attempted to show face at the facility was to hurry along her treatments to uphold and maintain their social appearances and stature. V. Other Significant Data
Ms. Kaysen is a relatively healthy young woman who does not have any visible signs of physical deterioration and/or illness. Her mental capacity is reasonably high and she does demonstrate high intellectual levels. It is clear that she has a solid educational background. Ms. Kaysen does have difficulty building and maintaining relationships, whether they are with a significant other, family members or peers. While Ms. Kaysen does not have a history of well developed friendships she does refer to the other women at the institution as her friends, although she isn’t in contact with many of them today. She states that while her friendships with the other girls at the facility weren’t always pleasant, it was the first time in her life where she felt like she belonged and bonded with outsiders. She does as well have a history of promiscuity and recalls being chastised by her neighbors for sleeping with one of her professors who is a married man and the father to one of her high school associates. During her stay at Claymoore she did mention having a relationship with a man named Toby, whom she met before entering the institution. Yet while the two initially kept in contact, the relationship ended abruptly after Ms. Kaysen refused to runaway with Toby to Canada to escape his being drafted to the Vietnam War and her being institutionalized. Ms. Kaysen currently has a part-time job at the book store at Harvard Square and also enjoys painting, drawing and writing in her journal. She uses her journal to document her life and feelings as a way to understand her condition. She began to write intensely during her stay at Claymoore and attempted to document everything and everyone she encountered. As per client she does not currently have any addictions to drugs and/or alcohol, however, she is a heavy cigarette smoker and admits to drinking socially and having participated in recreational marijuana use. VI. Bio-Psycho-Social Assessment
The client has a very clean cut disposition. She is very well dressed and groomed and does not display any signs of abuse, harm or apparent illness. She does however exhibit a sense of nervousness which is seen through her constant jitteriness and the biting of her nails. When compared to most young women her age, her rebellion against societal norms is evident through her all black clothing, short dark hair and heavy yet dull make-up. As of currently, she is a nineteen year old woman whose parents are still alive and whom she maintains somewhat of a relationship with. The client is very intelligent, speaks very well and clearly and has a clear sense of basic reality i.e. the year, where she is located and what she is currently doing. Her intellect may be damaging to someone in the position of helping Ms. Kaysen because of her tendency to be manipulative. At first take with client she seemed a bit withdrawn and it is obvious she is not prone to opening up quickly. Within the beginning twenty minutes of the interview her answers were very short and brief. Her melancholy attitude is over powered by her constant cloud of smoke and is usually accompanied with cynicism. The client Ms. Kaysen is fully functioning and capable of working, living alone and attending school. She neither speaks of nor displays any disabilities which hinder her from wholeheartedly operating in society. As of this moment, Ms. Kaysen communicated to me that she does not feel sad very often, however she does continue to have a grave amount of difficulty sleeping, and is still taking her sleeping medications on a nightly basis. In the past Ms. Kaysen dealt with her overwhelming amounts of stress and pressures through her promiscuity, alcohol binges, and her suicide attempt. Now Ms. Kaysen states that while she maintains the one vise of smoking cigarettes, when she is overwhelmed she writes frantically in her journal or sits alone and paints. In my opinion, I believe Ms. Kaysen’s ambivalence as to where she fits into the world, whether or not she is truly crazy or just perhaps a bit lost, and her constant battle with how she can be successful without fitting into her parent’s given norms, is the reason as to why she finds herself with this current diagnosis.
Although Ms. Kaysen does currently hold a part-time job and has communication with her family it is obvious that she does not have a solid support system or foundation. When speaking of her time at Claymoore, while she is repulsed by the idea that she spent eighteen months there, and is happy to have been discharged this is the only time she smiles. She feels as if the women from the institution were her only friends and support. She tells stories of how they would often find ways to cheer one another up when they were having episodes by singing to each other or reading that person’s favorite book.
The nurses and staff she states communicated with her more than her own family members, and took an interest in her recovery and her being released promptly from the facility. She also goes on to say that had it not been for Dr. Wick being patient with her slow admission to opening up she doesn’t think she would have ever passed her stage of denial. Ms. Kaysen is greatly grateful for Dr. Wicks techniques in breaking through her diagnosis not through confrontation, but by interpreting her behaviors in order to make them clear to the client. In my opinion, Ms. Kaysen would have a stronger support system and safety net if she returned to college and began to associate with like peers and people who share her similar passions for writing and the arts. Ms. Kaysen is very hopeful that change will soon come. Upon her release from Claymoore she was labeled as a “recovered borderline.” The reason as to why she now seeks third party interference is because not only does she not understand this diagnosis she does not agree. This labeling of being recovered has made Ms. Kaysen feel as if she has outgrown her therapy at Claymoore with Dr. Wick. Ms. Kaysen states that she deals with constant inner battles on a daily basis. She often feels lost due to the fact that she does not fit in the preconceived plans her parents have made for her. Ms. Kaysen acknowledged that during her stay at the facility she did not seem to take her initial therapy sessions seriously. She often played into the assumption that she was “crazy” and used the institution as a scapegoat to facing her real life problems.
Ms. Kaysen attributes her change in attitude to having viewed death directly. She always toyed with the idea of death and dying and how she would go about to actually doing so, yet when she found one of the recently discharged patients hung in her bathroom after escaping from the institution with another patient, she realized that dealing with death directly made her not want to embrace the idea at all. Looking death in the face had become her motivation. She had become so overwhelmed with the thoughts of how she could’ve saved her friend. What may have been the last few words that may have changed her decision? This incident led Ms. Kaysen to soon realize that the nurses at the ward and the therapist Dr. Wick were all trying to be her last few words of change. Ms. Kaysen however needs a push in how confident she is that she can embrace change within her same environment. She continuously asks how she can welcome change when the external factors which feed into her ambivalence, such as her neighborhood, parents and lack of support systems remain the same.
In my professional opinion I do not believe Ms. Kaysen is crazy or even has any personality disorder. I believe Ms. Kaysen is a adolescent woman who is struggling to find her sense of identity. Ms. Kaysen was born and raised in an affluent suburban neighborhood where the citizens let alone women do not go against the norms. Ms. Kaysen is merely struggling with her wants and desires of being different and not fitting in. Her parents play a tremendous role in Ms. Kaysen’s current situation for they may even be the root of the poisonous tree. Ms. Kaysen’s parents like many others during this time are content with their set ways of life. They maintain social friends, appearances and keep a well maintained home. They themselves have not understood embracing change.
Currently at this time many young college students are moving away from the norms of society and beginning to protest the war, engage in civil rights movements and take art, music and creativity to a whole new level outside the box. I believe Ms. Kaysen is somewhat lazy and spoiled and for these reasons chooses to not bring about her own individuality yet rather be penalized for her differences rather than embrace them. She needs to be reassured that her family will still be around no matter what her life choices are, as long as they remain positive. She may even need to relocate out of Cambridge, Massachusetts and see the rest of the country, find like peers and then she will realize being different is completely acceptable. I believe also if Ms. Kaysen returned to school to will have a healthier outlook on how to channel her creativity, artistic behaviors and writing into positive attributes.
Ms. Kaysen and I have agreed upon meeting bi-weekly to follow-up on her therapy sessions and progress. Ms. Kaysen has also agreed to continue to work at the book store while she attends college open houses and art seminars to see which college program peek her interest. I, the social worker have agreed to keep Ms. Kaysen educated with any and all changes within our services, program and relay and educational information I may have regarding support groups, writers seminars or any services Ms. Kaysen may be interested in outside of our program. We will continue to meet at ABA Clinic until Ms. Kaysen decides to terminate service, since she is here voluntarily on her own free will.
The client has come to ABA Clinic for Mental Health Services as a self-referral. She stated she learned of our agency through her …show more content…
family psychiatrist and was seeking continuous outpatient therapy. Being as though Ms. Kaysen was a self-referral we did not receive any anticipatory information regarding her case; however, the agency was able to have her records from the Claymoore Mental Institution sent over for review. At Claymoore Ms. Kaysen was being treated for depression and had been diagnosed with Borderline Personality Disorder. III. Client’s Presenting Problem/Want/Need; Client’s Initial Expectation of Agency
The client has come seeking psychotherapy from our agency as a stepping stone to the road of recovery. She recently spent 18months at Claymoore where she was coming to terms with her diagnosis and understanding her disease. She is currently seeing the Institution’s therapist Dr. Wick twice a week, yet Ms. Kaysen feels she has grown all she can with Dr. Wick. She stated that due to the fact that Dr. Wick mainly performs inpatient therapy she would feel more comfortable advancing her therapy with a third person who sees her condition from an outside point of view. Dr. Wick in Ms. Kaysen’s opinion helped her understand the underlying stimulus which ignites her Borderline Personality Disorder. Now, her main focus is finding a psychotherapist who will understand her ambivalence and splitting decisions and guide Ms. Kaysen on how to productively function within society and beyond the grounds walls of the women’s ward at Claymoore. IV. History of the Problem/Want/Need
As stated above Ms.
Kaysen was recently released from the Claymoore Mental Institution where she spent the last eighteen months. Ms. Kaysen was voluntary admitted at the age of eighteen as a result of a family intervention after she attempted suicide by allegedly chasing a bottle of aspirin with a bottle of vodka. Ms. Kaysen states she became depressed during her high school years. She was an outsider with not many friends and although she was determined to be a writer, she had no plans of attending college after her high school graduation in 1967. She stated remembering that her only wish was to not be like her mother, a college educated woman who was a homemaker. Ms. Kaysen believes her depression stems from her unclear path of what she wants to do with her life. She was once fascinated and intrigued by death, dying and suicide and while she attempted suicide once she was often rather careless with her body and was quite promiscuous with men. She comes from a wealthy suburban family yet has little communication and interaction with her family because she feels disconnected from them and cannot relate, being as though she has chosen not to live up to their standards. Although Ms. Kaysen did not have the closest relationship with her parents they tried their best to be supportive; maybe not exactly supportive of her diagnosis and behavior but of her treatment. They did decide to intervene after her suicide attempt and during her stay at the institution they often phoned, visited and even participated in family therapy sessions. According to Ms. Kaysen these sessions weren’t exactly productive for two reasons. For one her parents were in denial about the likelihood of her condition being remotely hereditary. It is five times more likely for a patient to be diagnosed with Borderline Personality Disorder if at least one parent exhibits similar behavioral patterns. The family life and environment play a huge role in personality disorders and they are often triggered by
childhood traumas. The second reason as to why Ms. Kaysen felt the family therapy sessions were not beneficial to her treatment had to do with her family status. She felt the only reason why her parents attempted to show face at the facility was to hurry along her treatments to uphold and maintain their social appearances and stature. V. Other Significant Data
Ms. Kaysen is a relatively healthy young woman who does not have any visible signs of physical deterioration and/or illness. Her mental capacity is reasonably high and she does demonstrate high intellectual levels. It is clear that she has a solid educational background. Ms. Kaysen does have difficulty building and maintaining relationships, whether they are with a significant other, family members or peers. While Ms. Kaysen does not have a history of well developed friendships she does refer to the other women at the institution as her friends, although she isn’t in contact with many of them today. She states that while her friendships with the other girls at the facility weren’t always pleasant, it was the first time in her life where she felt like she belonged and bonded with outsiders. She does as well have a history of promiscuity and recalls being chastised by her neighbors for sleeping with one of her professors who is a married man and the father to one of her high school associates. During her stay at Claymoore she did mention having a relationship with a man named Toby, whom she met before entering the institution. Yet while the two initially kept in contact, the relationship ended abruptly after Ms. Kaysen refused to runaway with Toby to Canada to escape his being drafted to the Vietnam War and her being institutionalized. Ms. Kaysen currently has a part-time job at the book store at Harvard Square and also enjoys painting, drawing and writing in her journal. She uses her journal to document her life and feelings as a way to understand her condition. She began to write intensely during her stay at Claymoore and attempted to document everything and everyone she encountered. As per client she does not currently have any addictions to drugs and/or alcohol, however, she is a heavy cigarette smoker and admits to drinking socially and having participated in recreational marijuana use. VI. Bio-Psycho-Social Assessment
The client has a very clean cut disposition. She is very well dressed and groomed and does not display any signs of abuse, harm or apparent illness. She does however exhibit a sense of nervousness which is seen through her constant jitteriness and the biting of her nails. When compared to most young women her age, her rebellion against societal norms is evident through her all black clothing, short dark hair and heavy yet dull make-up. As of currently, she is a nineteen year old woman whose parents are still alive and whom she maintains somewhat of a relationship with. The client is very intelligent, speaks very well and clearly and has a clear sense of basic reality i.e. the year, where she is located and what she is currently doing. Her intellect may be damaging to someone in the position of helping Ms. Kaysen because of her tendency to be manipulative. At first take with client she seemed a bit withdrawn and it is obvious she is not prone to opening up quickly. Within the beginning twenty minutes of the interview her answers were very short and brief. Her melancholy attitude is over powered by her constant cloud of smoke and is usually accompanied with cynicism. The client Ms. Kaysen is fully functioning and capable of working, living alone and attending school. She neither speaks of nor displays any disabilities which hinder her from wholeheartedly operating in society. As of this moment, Ms. Kaysen communicated to me that she does not feel sad very often, however she does continue to have a grave amount of difficulty sleeping, and is still taking her sleeping medications on a nightly basis. In the past Ms. Kaysen dealt with her overwhelming amounts of stress and pressures through her promiscuity, alcohol binges, and her suicide attempt. Now Ms. Kaysen states that while she maintains the one vise of smoking cigarettes, when she is overwhelmed she writes frantically in her journal or sits alone and paints. In my opinion, I believe Ms. Kaysen’s ambivalence as to where she fits into the world, whether or not she is truly crazy or just perhaps a bit lost, and her constant battle with how she can be successful without fitting into her parent’s given norms, is the reason as to why she finds herself with this current diagnosis.
Although Ms. Kaysen does currently hold a part-time job and has communication with her family it is obvious that she does not have a solid support system or foundation. When speaking of her time at Claymoore, while she is repulsed by the idea that she spent eighteen months there, and is happy to have been discharged this is the only time she smiles. She feels as if the women from the institution were her only friends and support. She tells stories of how they would often find ways to cheer one another up when they were having episodes by singing to each other or reading that person’s favorite book.
The nurses and staff she states communicated with her more than her own family members, and took an interest in her recovery and her being released promptly from the facility. She also goes on to say that had it not been for Dr. Wick being patient with her slow admission to opening up she doesn’t think she would have ever passed her stage of denial. Ms. Kaysen is greatly grateful for Dr. Wicks techniques in breaking through her diagnosis not through confrontation, but by interpreting her behaviors in order to make them clear to the client. In my opinion, Ms. Kaysen would have a stronger support system and safety net if she returned to college and began to associate with like peers and people who share her similar passions for writing and the arts. Ms. Kaysen is very hopeful that change will soon come. Upon her release from Claymoore she was labeled as a “recovered borderline.” The reason as to why she now seeks third party interference is because not only does she not understand this diagnosis she does not agree. This labeling of being recovered has made Ms. Kaysen feel as if she has outgrown her therapy at Claymoore with Dr. Wick. Ms. Kaysen states that she deals with constant inner battles on a daily basis. She often feels lost due to the fact that she does not fit in the preconceived plans her parents have made for her. Ms. Kaysen acknowledged that during her stay at the facility she did not seem to take her initial therapy sessions seriously. She often played into the assumption that she was “crazy” and used the institution as a scapegoat to facing her real life problems.
Ms. Kaysen attributes her change in attitude to having viewed death directly. She always toyed with the idea of death and dying and how she would go about to actually doing so, yet when she found one of the recently discharged patients hung in her bathroom after escaping from the institution with another patient, she realized that dealing with death directly made her not want to embrace the idea at all. Looking death in the face had become her motivation. She had become so overwhelmed with the thoughts of how she could’ve saved her friend. What may have been the last few words that may have changed her decision? This incident led Ms. Kaysen to soon realize that the nurses at the ward and the therapist Dr. Wick were all trying to be her last few words of change. Ms. Kaysen however needs a push in how confident she is that she can embrace change within her same environment. She continuously asks how she can welcome change when the external factors which feed into her ambivalence, such as her neighborhood, parents and lack of support systems remain the same.
In my professional opinion I do not believe Ms. Kaysen is crazy or even has any personality disorder. I believe Ms. Kaysen is a adolescent woman who is struggling to find her sense of identity. Ms. Kaysen was born and raised in an affluent suburban neighborhood where the citizens let alone women do not go against the norms. Ms. Kaysen is merely struggling with her wants and desires of being different and not fitting in. Her parents play a tremendous role in Ms. Kaysen’s current situation for they may even be the root of the poisonous tree. Ms. Kaysen’s parents like many others during this time are content with their set ways of life. They maintain social friends, appearances and keep a well maintained home. They themselves have not understood embracing change.
Currently at this time many young college students are moving away from the norms of society and beginning to protest the war, engage in civil rights movements and take art, music and creativity to a whole new level outside the box. I believe Ms. Kaysen is somewhat lazy and spoiled and for these reasons chooses to not bring about her own individuality yet rather be penalized for her differences rather than embrace them. She needs to be reassured that her family will still be around no matter what her life choices are, as long as they remain positive. She may even need to relocate out of Cambridge, Massachusetts and see the rest of the country, find like peers and then she will realize being different is completely acceptable. I believe also if Ms. Kaysen returned to school to will have a healthier outlook on how to channel her creativity, artistic behaviors and writing into positive attributes.
Ms. Kaysen and I have agreed upon meeting bi-weekly to follow-up on her therapy sessions and progress. Ms. Kaysen has also agreed to continue to work at the book store while she attends college open houses and art seminars to see which college program peek her interest. I, the social worker have agreed to keep Ms. Kaysen educated with any and all changes within our services, program and relay and educational information I may have regarding support groups, writers seminars or any services Ms. Kaysen may be interested in outside of our program. We will continue to meet at ABA Clinic until Ms. Kaysen decides to terminate service, since she is here voluntarily on her own free will.