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Aspects of Dear Doctor Letter

Introduction

The role of stressful events in childhood as risk factors for mental health disorders, particularly the formation of negative trends, has long been studied by psychiatrists and psychologists. It is essential to know that a traumatic event can be excluded from conscious memories or remembered as a shadow of the event – vague ideas and images that do not cause any particular emotions or experiences (Hughes et al., 2017). And often, already as an adult and being present under similar circumstances, a person suddenly experiences an inexplicable fear, an extreme degree of rejection of something. At this moment, the child’s mental trauma emerges and changes one’s state.

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The letter makes a reader contemplate the importance of the doctor’s role in each person’s life. The main goal of a doctor’s professional activity is to preserve human life and improve its quality by providing emergency, planned, and preventive medical care. Not only do they heal physical deformities, but they also affect individuals’ mental health (Klatsky, 2002). In general, the letter aims to inform that even though people try to fight their symptoms by themselves, the doctors remain the main factor for successful recovery.

Background Information

The first problem disclosed in the case study refers to the author’s adverse childhood. The woman claims that the majority of her relatives were alcoholics, which affected her alcoholism (Klatsky, 2002). Family alcoholism has a highly unfavorable effect on the child’s physical and mental (cognitive and personal) development. Children of alcoholics are characterized by neurotic and neurosis-like disorders, psychopathic personality development, and difficulties with social adaptation. As a result, the author had severe mental breakdowns (Klatsky, 2002). These children have stability problems with learning and behavior and are much more likely to be in a state of fear and grief, are prone to depression, may misbehave, and suffer from low self-esteem and sleep disorders. The aggravation of a child’s mental trauma always occurs in the presence of similar circumstances (Newsom & Myers-Bowman, 2017). The presence of alcohol is traced throughout the author’s life and caused other addictions: her husband was prone to drinking; she smoked heavily and had a co-dependent relationship.

The other major problem raised social anxiety, which led the author to suicidal attempts. She narrates that she would escape from her feelings and emotions while having deep depression. She also worked part-time due to her fear of communicating with people she thought would eventually harm her. Besides, she was a victim of “covert” sexual abuse (Klatsky, 2002). Her parents and relatives would tell dirty jokes in front of her and give her undesirable and “funny” back rubs (Klatsky, 2002). Usually, child abuse leaves a trauma on a kid’s mental state, which leads to chronic diseases that can only be cured by resorting to both a physician and a psychotherapist. As a result, the author’s life was full of traumatic experiences, which took their toll on her mental and physical health.

Analysis of Developmental Issues

The client’s behavior and functioning were primarily affected by heart murmur identification when she was a newborn. In addition, the author experienced a range of diseases in early childhood which impacted her immune system. Notably, her parents drank alcohol which might have influenced her genetic structure and weakened her general well-being (Klatsky, 2002). The heart problems guided the woman throughout her life and made her feel uncomfortable, causing additional cardiovascular syndromes.

The major environmental factor that has caused many deviations in the author’s behavior was her family. Since they abused alcohol and indirectly harassed their daughter, she became increasingly reserved, used to hide her feelings, and even kept a baseball bat in case someone wanted to attack her (Klatsky, 2002). Moreover, the author’s husband drank much and abused her, but she could not leave him (Klatsky, 2002). Pregnancy was one of the key moments that altered the client’s body (Klatsky, 2002). Generally, she suffered from many mental and physical threats, yet, managed to overcome them.

Proposed Solutions & Application of Developmental Theory

Erikson’s Developmental Theory may be implemented to treat the author’s mental problems. Based on the approach, she should work on developing several stages that she missed. The primary step is Trust vs. Mistrust should help her work on the trust development towards people so that she can start working full-time. Moreover, she skipped the third stage, Initiative vs. Guilt; passing this stage means letting go of fear to move on and focusing on her interests first. Finally, the Intimacy vs. Isolation stage presumes the ability to give a part of yourself to another person of any gender without fear of losing your own identity (Maree, 2021). Working with a psychologist on these stages will help her let go of disappointing past events and restore resourcefulness.

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Besides, a counselor should understand that childhood traumas are the most difficult to work with. Hence, it is vital to recognize patients’ needs and feelings and provide emotional comfort to ensure the therapy’s further success. Moreover, it is necessary to respond to the client’s feedback by integrating procedures and practices related to trauma. Some techniques can help a counselor recognize the negative patterns learned in childhood and “re-educate” the inner child. For instance, schema therapy can be efficient because it combines the approaches and principles of cognitive-behavioral therapy and other methods (Mouchan et al., 2016). In treatment, the therapist uses “re-education” techniques to help the patient’s vulnerable inner child learn to meet their basic emotional needs with healthy practices.

The first stage of therapy is a comprehensive assessment of the patient’s condition. The main purpose of such an assessment is to determine the patterns of behavior and ways to overcome them, which are most significant in the psychological portrait of the patient (Mouchan et al., 2016).

As a counselor, I can ask my patient to imagine that they are talking to a person to whom their emotions are directed. In such a dialogue, patients can take on the role of another person and express how they imagine their feelings. Or they can write a letter to another person, even if they are not going to send it, and express their feelings without suppressing them.

Recommendations

Resilience depends on various factors, many of which are beyond control. The ability to be resilient helps to survive a traumatic event, but does not make it less traumatic; thus, acceptance is a prerequisite for solving a problem. Another psychological paradox: the greater the willingness to accept pain, the fewer pain people feel (Capuzzi & Stauffer, 2016). It is explained by the fact that a clear awareness of your emotional state gives you a sense of control over the situation, even if you cannot change it.

Another effective strategy for increasing resilience is the ability to find opportunities for growth in a difficult situation. Such a change of perspective in the perception of stressful and traumatic events is called a cognitive reassessment. It is necessary to turn a negative situation into an incentive for positive development and find new opportunities for growth in it. To develop this ability, it is useful to ask such questions when faced with problems: “What can I learn in this situation? What benefits can be derived from this negative experience?” To strengthen general well-being and develop oneself it is necessary to take time out every day to reflect and sit quietly (Capuzzi & Stauffer, 2016). It is vital to remember that resilience is a dynamic indicator; what gives an advantage in one situation may turn out to be a weakness in another. Therefore, if one approach does not work, do not give up, but try something else.

References

Capuzzi, D., & Stauffer, M. D. (Eds.). (2016). Human growth and development across the lifespan: Applications for counselors. John Wiley & Sons, Inc.

Hughes, K., Bellis, M., Hardcastle, K., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet. Public Health, 2(8), e356-e366

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Klatsky, A. (Ed.). (2002). Dear Doctor: What you didn’t ask, and what I didn’t tell you. The Permanente Journal, 6(1), 48-51.

Maree, J. (2021). The psychosocial development theory of Erik Erikson: Critical overview. Early Child Development and Care, 191(7-8), 1107-1121. Web.

Mouchan, R., Bahmani, B., & Askari, A. (2016). The effectiveness of schema therapy on reducing symptoms of emotional breakdown. International Journal of Medical Research & Health Sciences, 5, 1-11.

Newsom, K., & Myers-Bowman, K. (2017). “I am not a victim. I am a survivor”: Resilience as a journey for female survivors of child sexual abuse. Journal of Child Sexual Abuse, 26(8), 927-947. Web.

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