Jenny Curran has developed a complex traumatic stress disorder (CTSD) due to traumas obtained in her childhood. Jenny’s alcoholic father physically and sexually abused Jenny and her sisters and as a child, she tended to try to escape from him and used to pray, “Dear God, make me a bird, so I can fly far, far, far away from here” (Zemeckis, 1994). Being a little girl, she could not resist or fight back effectively and she saw her escape as the only way out. She did not have adults who could assist her or whom she could trust, so she developed a strong affection to her peer, Forrest, who could help her live her hardships through. Soon, she was taken to her aunt, though she never trusted her and never found a person who she saw as her protector. Therefore, from her very childhood, Jenny chose escape and she would run from numerous issues which she would inevitably encounter.
In her late teens and yearly twenties, she has quite a meaningless life as she took drugs and drank heavily. She worked as a stripper and had numerous sexual partners; those were men she barely knew. Later, she became a hippie and led corresponding life with no goals as she only tried to “learn how to live in harmony” (Zemeckis, 1994). In actual fact, everything she did was making wrong choices. She tried not to accept the help of her own and closest friend, Forrest, as she thought she was not worth him.
Now, she has a son and she is trying to start a new life. She works in a hospital, but she is still unable to develop proper relationships with people around her. This young woman has addressed a social worker as she wants to be able to live in the society for the sake of her son.
According to Courtois and Ford (2012), people affected by CTSD often have certain reactions. In Jenny’s case, these are depressive reactions as she feels hopeless and desperate. Jenny is not disgusted by her body, which is not typical of survivors of sexual abuse who try to punish their body by unhealthy life styles. However, she does have very low self-esteem. She also regards herself as an undeserving woman has no right to live and, especially, be happy. The only reason for being alive for her is her son.
To help Jenny cope with her problems, it is necessary to set certain treatment goals. Courtois and Ford (2009) note that it is crucial to increase psychological stability; enhance trust and self-esteem; improve social relationships and adaptive functioning. The goals should also include recovery from the problems and bad memories, reduction of CTSD symptoms and “reengagement in life” (Courtois & Ford, 2009, p. 89). When the goals are reached, Jenny will be able to develop proper relationships with people and become an active member of the society.
To achieve the goals set, it is possible to employ a phase-oriented integrative model. Ford, Courtois, Steele, Van Der Hart and Nijenhuis (2005, p. 440) point out that the three phases include “engagement, safety, stabilization”; “recalling traumatic memories” and “enhancing daily living”. It is difficult to identify the number of sessions needed, but it is possible to assume that Jenny should have two sessions a week. She does not need any pharmacotherapy as she is committed to enhance her interaction with people around her and she can have the necessary support from her son and her close friend Forrest.
Thus, first session will be devoted to phase 1, i.e. stabilization. Blaz-Kapusta (2008) describes a similar case of a woman who tried to isolate herself from the society. Thus, it is essential to make Jenny feel safe and stabilize her behavior focusing on her present life and refer to it as an example of her empowerment. She has to realize that she has already started making correct decisions as she has a little boy to take care about. At the end of this phase, she must feel secured and safe and this, in its turn, will help her start enhancing her self-esteem and develop trustful relationships. When she is stabilized, it is possible to start phase 2.
The goal of the second phase is to make Jenny reconciled with her past. She should talk about and reflect on her past and her traumas since this can help her understand that some of her memories became distorted and this deviated past causes pain and unease. She will also learn that trying to escape is a natural reaction and many people do the same. Recollection of her behavior in her twenties will also help her understand that even though she made many mistakes, she is able to correct them at present.
Finally, the third phase will help Jenny develop proper behavioral patterns and ability to interact with people. At this point, it is important to remind her that she had a deep connection with Forrest. After all, they wanted to protect each other and this model can be used to help Jenny move on. A good advice for her is to meet Forrest and start developing a friendly (or even romantic) relationship with him. After that, she will find it easier to find friends and start being a part of the society rather than an emotional recluse.
Reference List
Blaz-Kapusta, B. (2008). Disorders of extreme stress not otherwise specified (DESNOS) – a case study. Archives of Psychiatry and Psychotherapy, 2(1), 5-11.
Courtois, C.A., & Ford, J.D. (2009). Treating complex traumatic stress disorders (adults): Scientific foundations and therapeutic models. New York, NY: Guildford Press.
Courtois, C.A., & Ford, J.D. (2012). Treatment of complex trauma: A sequenced, relationship-based approach. New York, NY: Guildford Press.
Ford, J.D., Courtois, C.A., Steele, K., Van Der Hart, O., & Nijenhuis, E.R.S. (2005). Treatment of complex posttraumatic self-dysregulation. Journal of Traumatic Stress, 18(5), 437-447.
Zemeckis, R. (Director). (1994). Forrest Gump. Hollywood, CA: Paramount Pictures.