The patient, Maggie, was a 27-year old female who was tall and attractive in an angular way, with dark, intelligent eyes. She was a graduate student in paleontology and she loved her field of study so much that she always talked about it. In the beginning, when she met the psychotherapist, she would communicate politely and factually without being curt. Generally, she was withholding information from the therapist. However, this deportment changed later in the therapy sessions when she confronted her past and started trusting the therapist.
At the time of the therapy, Maggie was working on a small project in Arizona in her area of specialization – paleontology (Weinberg, 1990). She had a boyfriend named David and her mother was alive and she would visit her from time to time. Maggie would also visit David’s parents and his brother called Robert. She had a geologist friend and another man whohad sponsored her thesis. Out of this group of family members, friends, and acquaintances, David was closely involved in her treatment. He would drive her to appointments and wait for her until she was done.
The problem Maggie presented with was childhood trauma, which can be defined as adverse childhood experiences that happened to her (Weinberg, 1990). As a child, the client witnessed a traumatic event when her father attempted to strangle her mother using a scarf. Her father’s bodyguard intervened and averted her mother’s impending death. This experience troubled Maggie for years and as a way of dealing with it, she deliberately assumed forgetfulness. However, this mental condition needed intervention because it was affecting her relationship with David. She could not kiss him on the lips and she was terrified at the idea of getting married. She had developed an unexplained phobia, she had terrible nightmares, and she would get upset easily, hence the need for treatment.
The psychotherapist worked with this patient using the behavior therapy approach, specifically exposure therapy, which is defined as the practice of allowing patients to confront their fears through leading questions. For instance, the therapist would arrange for sessions where the client would be encouraged to talk about her past and face her fears (Weinberg, 1990). At the beginning of the sessions, the therapist was quick to note that Maggie was deliberately trying to forget her past, and thus he knew the underlying problem was associated with an experience that had happened in the past. Exposure therapy was the best-suited approach to address this problem and thus the therapist adopted it.
Different elements of psychoanalytic personality theory, which is defined as the dynamics of personality development, can be applied in understanding how Maggie developed her problems. For instance, after witnessing the traumatic incident where her father tried to kill her mother through strangulation, the father left never to be seen again (Weinberg, 1990). Therefore, she deliberately chose to forget her past, specifically when they lived in Weston where the incident occurred.
She could not confront this experience on her own because it would be devastating. In addition, her grandfather had become what the therapist calls a “pious fraud” by lying to Maggie that her father cared about her (Weinberg, 1990). In other words, the grandfather cushioned Maggie from the possibility of confronting her past to overcome it. Therefore, from a psychoanalytic personality perspective, the client buried her trauma, which developed into the problems that she was facing before seeking therapy services.
Due to Maggie’s experiences as a child, specifically issues surrounding the attempted murder of her mother, her behavior changed and it could be explained through behavioral personality theory, which defined as the belief that people behave in a certain way without questioning why they are doing it. For example, Maggie developed a phobia for kissing anyone on the lips and wearing scarfs or anything around her neck (Weinberg, 1990). As a child, she would see her father kiss her mother until she could not breathe every time she started an argument with him. In addition, the father had kissed her mother right before he tried to kill her through strangulation.
Therefore, Maggie associated kissing with loss of freedom, breath, and ultimately death. This explained why she could not stand the thought of kissing David. Similarly, Maggie had witnessed how terrible marriage could be from both her grandparents and parents. Her grandmother was brutal to her husband while her father tried to kill his wife. Therefore, Maggie associated marriage with failure and death, which explains why she would suffer panic attacks when David hinted that he would marry her.
The development of Maggie’s problems could also be explained using the humanistic personality perspective, which is defined as the need for people to strive for self-determination and self-realization. For example, she immersed herself in studies as a way of running away from her past (Weinberg, 1990). Additionally, she would receive congratulatory cards allegedly from her father – the very person that had caused her pain and suffering.
Therefore, she could not reconcile her love-hate feelings towards her father. As such, to avoid confronting the issue, she committed to working hard in her studies, which explains why she was almost starting her doctorate degree when the therapy sessions started. This commitment diverted her thoughts from her trauma and shielded her from the possibility of confronting her past.
The therapist used some elements of psychoanalytic personality theory during his sessions with Maggie. First, he used the free association technique where he would let the client talk about whatever she wanted (Weinberg, 1990). His only input was to ask leading questions so that the client release repressed emotions and confront her past. Weinberg (1990) says, “Over the next few weeks I asked her a great number of questions” (p. 154).
For instance, he asked numerous questions concerning Maggie’s relationship with her father and how she felt when he was banished from their house in Weston in a bid to allow her to confront her past. After Maggie admitted to what happened during that fateful day when her mother almost got killed, the therapist would ask her to retell the story until to the point when she could narrate it without discomfort. He also used the concept of dream analysis whereby every time Maggie had a dream, he would try to analyze it within the context of her experiences. Ultimately, she opened up and confronted her past thus paving the way for a wonderful future with her husband David.
Through elements of behavioral personality disorder, the therapist kept on looking for an opportunity to influence Maggie’s behavior so that she can open up about her past. For example, after realizing that she had problems with anything worn around her neck, he convinced her to pick a scarf that had been dropped by another client(Weinberg, 1990). She was hesitant but ultimately she picked it up and wrapped it around her neck. This act changed the course of the therapy sessions because Maggie passed out and went into a trance where she confessed what she had been hiding all along.
After this occurrence, the patient was on her way towards full recovery and ultimately she overcame her fears. She finally kissed David on the lips and changed her view concerning marriage to embrace it. The therapist suggested that she should do anything that she is afraid of doing because of her past. He explained to her that all those avoidances and fears were ways of burying her past, but she had to confront it, put it to rest, and have a wonderful life ahead.
The therapist also integrated the concept of humanistic personality theory in his sessions with Maggie. For instance, when she hinted that she would probably end her relationship with David, he convinced her not to give up due to a few disagreements (Weinberg, 1990). The therapist knew that anything that could lead to self-determination and self-realization was helpful to lead Maggie on the path of recovery. He also encouraged her to talk about her work and education because earlier in the sessions, he had noted that Maggie took pride in her achievement as a paleontologist. This assertion explains why she would talk about the subject for hours until the therapist intervened.
In my opinion, the therapy sessions with Maggie, as a form of treatment, were successful because, in the end, she overcame her fears, confronted her past, and started leading a fruitful life. The client had sought therapy because she was afraid of marriage, she could not kiss David on the lips, and she was experiencing unexplained phobia for walking or driving alone. Additionally, she was experiencing terrible nightmares together with becoming offended easily.
However, at the end of the therapy sessions, all these problems were solved and she kissed David, married him, and started raising a family. Additionally, the nightmares disappeared and thus it suffices to conclude that the treatment was successful.
Reference
Weinberg, G. (1990). The taboo scarf and other tales of therapy. New York, NY: St. Martin’s Press.