The first issue to discuss is that Maria is self-referred because she is the one who brought herself to the agency. The doctor or psychiatrist did not bring her but there are sentiments that she is involuntary because she has taken too long to seek psychological advice. She waited until she is diagnosed with a learning disability for her to seek help.
Concerning her bio- social-spiritual information, Maria is a Hispanic American woman whose parents were American immigrants from Latin America. She is had been raised by single parent after her parents divorced when she was three years. Therefore, there was no father figure in her nuclear family.
Maria is well educated with a Graduate Equivalence Degree (GED) and is presently majoring in Psychology. However, she feels she has struggled more than others to achieve this. She has been married three times and she has three children out of the first two marriages who are aged seventeen, twenty-four and twenty-six. She has been employed at a restaurant and has taken up other jobs that provided avenues for meeting her three husbands.
Maria initial appearance seems to be of a confident person who is having problems within herself because she is riddled with inferiority complex. She is also a very controlling especially those who are inferior to her.
That is why she says that her sister thinks that she talks more when she is around unprofessional people than when she is with professional people. She also seems to have a problem with men, which has wrecked her two marriages. She has an issue with the sense that she puts blame on other people and never faults herself (Briere & Scott, 2006).
Maria comes to the agency to seek help due to chronic depression, which she thinks has been caused by her dysfunctional marriage and the knowledge of her learning disability.
Maria’s problems seem to have begun long time ago even before she was diagnosed with the learning disability. She has a problem with coping with the men in her life and this is partly because she did not have a father figure in her childhood. Her problems were compounded by the fact that she was a slow leaner because she had a problem with English language. They are even complicated by her marriage to an abusive man.
Maria has tried to cope with her problems in the past by working hard to cover her failures. She developed a mindset that for her to succeed in everything she has to try it several times. This means that in class she knew she had to repeat in order to pass. She even gets married to her third husband to see whether it will work out after her two marriages failed.
She also copes with her problems by controlling those who are inferior to her. She also controls her children, which is the reason they stay at home although they can live on their own. She also sees others to be the cause of her misery. Her first husband’s abuse is the reason why she left the marriage and the second marriage was as a result of alcoholism of her husband.
The other people around her view her problem as one caused by her incessant need to control if not to dominate. This is shown by the situation where she does not want her children to leave her home even if they are old enough to live on their own. Though the case study does not clearly indicate what other people think about her, one thing is evident that they are unconcerned.
They do not think that Maria needed psychological therapy or assistance no wonder they have not referred her to any of the counselors. This kind of neglect is what has made Maria to feel depressed because it seems that those close to her do not seem to mind about her problems.
Moreover, her parents were divorced at an early age and did not provide her with the emotional support necessary for a child’s development. She had to undergo a divorce twice and from the information provided she is likely to have her third divorce. The fact that she was brought up in a family with no father may have contributed to her poor relationship with her husband’s.
Her poor school performance due to poor comprehension of the English language may have had an impact on her life and eroded her self-esteem. She describes how she felt like running away from school because she did not perform better than others. Her first marriage where she experienced abuse certainly had an effect on her after she went through the painful experiences, which are why she felt bad about her marriages.
Maria wants the society to perceive her as successful which she has not managed to achieve because she failed at school. However, she has pursued GED course and is currently majoring in psychology to avert this. She wants to overcome her anxiety particularly when with professional people and also be in a position to face life independently with or without a husband even after allowing her children to start off their lives. Moreover, she wants to concentrate on her work and not to worry about her life every now and then.
Maria currently stays with her abusive husband and her children. Staying in an abusive relationship contributes to her depression while having the children around shields her from forging new relationships that could help boost her self-esteem. She is not satisfied with her current job since she is pursuing a more education. Further attempts to learn only rekindle her dissatisfaction in her learning ability and consequently aggravate her depression.
The pressure to secure enough income to support the family and withdraw from the abusive marriage could have driven her to seek a better job by gaining better employment. Absence of measures to protect women in abusive marriages in the society and the demand for a good college degree for one secure meaningful employment force her to discover her inadequacies.
In addition, Hispanic origin caused her to learn English as a second language which in turn complicated her studies. Moreover, the Hispanic family organization in which the father has complete authority of the woman may have made it difficult to survive in the abusive marriages.
Traumatic incident involves a particular occurrence, or a lasting or recurring incidences, which entirely devastate the persons capability to handle or put together the thoughts and feelings implicated in that incident (Farlane,1996). The depression, which Maria has had, seems to be related to the problems or the traumas, which she has experienced especially in her childhood. According to Trauma theory, the Trauma, which people experience in life, they face it or they deny it.
Facing it is accepting that it happened and looking for ways to overcome that trauma. Denial seems to be the mechanism, which many of the human beings use to cope with trauma by living as though the problem never was. Maria has seemingly experienced some traumatic problems in her life. The first was the family divorce where her father walked out home and left them completely.
This is a trauma because Maria was very young and her mind must have been tormented by the thought of where her father went and why he never came back. The abusive nature of her father to her mother affected her negatively as it is the only thing she remembers about her father. She could not communicate clearly in English, which saw her fail in class.
This is also traumatic especially if other children teased her about her language. In addition, she was trapped in an abusive relationship. This must have affected her since it was her first relationship and maybe she had many expectations about it. Being a Hispanic could also have resulted in ridicule at school
Due to these traumas, the client must have been affected in her social and tasks development according to the theory of psychosocial development she faces and she is unable to discharge her duty as a mother and a wife effectively. She currently controls her children and this is projection of her inability to do her tasks effectively.
She also cannot cope with the many demands of school life and that is why she finds herself depressed after learning that she has a learning disability. Her background has also affected the way she treats men as she describes and that is what she experienced at home without a father being mothered and mothering men. Her experiences at school also made her conclude that she cannot do something and it succeeds for the first time.
The ego defense mechanisms come into play by the way in which she comes to handle her failures and traumas. Concerning the background of a father who left them painfully she disassociates herself from her father completely which is the reason why she has never seen him ever since and she is not even bothered to contact him anytime soon.
Concerning her failures in school she handles them by repeating and trying harder to succeed where she rationalizes that the natures will not to give her anything until she attempts it twice or three thrice which is why she works harder than everyone else (Corey, 2008).
However, this cognitive theory of rationalizing her problems and traumas in an attempt to maintain ego does not always work to her advantage.
For instance, she got married to her third husband in the hope that another trial might give her a fulfilling marriage, which others do have by their first marriage. Instead, she finds that she is still in an abusive relationship and that all the men who come into her life are the same. She also rationalizes that going back to school will make her a success that she never was in school early in her life.
Her going back to college is not only driven by desire to progress but a drive to prove that despite earlier she failures, she can also be a graduate. This is further shown by the fact that her ego allows her to talk more to non-professional people who will esteem her but she does not talk more to the professional people who might hurt her pride.
Using the theory of cognitive behavior her actions have been developed by the core beliefs that she adopted from her childhood (Asa, 2009). That is why she has a core belief that things are harder for her than for others and that if she had to succeed she has to do it twice or thrice. She also seems to have a core belief that men are there to be mothered. In addition, she seems to mother them only to regret later.
This is probably rooted in her childhood whereby having come from a family of a single mother it is very likely to hear single mothers making such comments about having men who want to be mothered. She also has thinking that others are the cause of her problems. She seems to be putting blame on others but not herself. At no point did she describe herself as the cause of the failed marriages. She could have picked this behavior from her mother who was also divorced.
Maria does not seem to have a spiritual side. There is little or no description of her belief in the supernatural and this may also be a great source of her depression because she cannot displace her problems to another being. She seems to have an attitude of taking the bull by its horn meaning that she solves all her problems by herself. According to (Hunt, 2010) belief in God assists one’s mind to remove stress and worry.
Maria’s background information is vital for a clinical psychologist to address her problems appropriately since it has contributed to her low self-esteem. Though she has the will power and the capability to address some of the problems, she must relearn some of her core beliefs if she is going to do away with depression.
This is because depression is usually caused by anxiety and the inability to express one’s problem clearly, so that they may be solved as they come (Scarre, 2005). Trauma can only be solved by assisting the individual to come to terms with what happened irrespective of how grave and uncomfortable it is. Maria needs assistance to help her cope with previous relationships, which were more hurting by developing other relationships which are healthier to boost her self esteem.
Maria needs to attend a clinic and see how she can be assisted to overcome her learning disability. Forcing herself to learn will be a stress-causing phenomenon in her life and it will only contribute to her misery rather than enhance her relationship. She also has to let go her older children who are staying with her because; what she is doing will affect their future life by being too dependent on their mother for approval. This will also assist her to develop other relationships apart from those at home (Farlane, 1996).
Maria should also be assisted to develop her self-esteem by helping her accept herself as she is. She should not strive for approval but rather she should try to appreciate herself and her achievements as little as they may be. Finally, Maria should join a church or a social grouping which caters for spiritual well-being to get social support system by creating a strong sense of belonging.
In addition, because of the trust developed in these association individuals are able to share their experiences, difficulties and challenges that they are facing and thereby relieving themselves of any depression causing toxins in their body. They also provide a strong sense of unity that makes an individual feel that they are not alone in their problems.
Asa, B. (2009). Post traumatic stress disorder in childhood. New York: American Academy of Experts in Traumatic Stress.
Briere, J. & Scott, C. (2006). Principles of trauma therapy: A guide to symptoms, evaluation, and treatment. California: SAGE Publications, Inc, 37–63.
Corey, G. (2008). Theory and practice of counseling and psychotherapy (8th ed). Belmont: Wadsworth.
Farlane, B. (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford Press.
Hunt, C. (2010). Memory, war, and trauma. Cambridge: Cambridge University Press.
Scarre, R. (2005). The trauma spectrum: Hidden wounds and human resiliency. New York: Norton.
Fig 1. Family genogram