Al is a forty-year-old woman who has recently presented herself to the PC University Health Center for treatment of certain conditions, and counseling. Her first complains were that she was recently feeling empty after the death of her mother and that she could constantly burst into tears for no apparent reason. Her other concerns were that she could not be able to form any meaningful relationship with her brother, as they were never close. She also expressed concern over her inability to engage in intimate or romantic relations, as well as, over her fear of success. Al has been in psychotherapy before, after the death of her father and during her theological seminary.
Al can be showing signs and symptoms of deeper issues, but it is essential to form case formulations of what might be underlying these deeper problems. One of the things that became clear during her therapies was that her family history and how she grew up could have had a number of implications on how she relates to people and how she feels about herself. Her emptiness, for example, might be a sign of depression or anxiety that results from the fact that she lost her mother, and after she had managed to form a connection with her. She lost this valued relationship with her mother, and this might leave her feeling empty. Another reason for her emptiness might be the fact that she does not seem to have anyone else to talk to after the death of her mother. She is at longer- heads with her brothers and she is completely alone. She did not have anyone to console her or to share her grief after the death of her mother because her brothers did not care for her feelings. This could be another reason why she feels so empty, and the reason why she has become so emotional.
When it comes to her intimacy issues, one can say that her relationship with her family scarred her significantly. Her father never liked her and he even called her a whore and ugly at one time when she reached her womanhood; a time when she should have been provided with all the love. Her mother always picked her over her brothers and she always felt like an outsider at home. The emotional, neglect, physical and verbal abuse she received at home might have affected her development in her abilities to relate with others and to form intimate relationships. On the other hand, this problem could be a result of the low opinion she has of herself. Her father and mother always called her ugly, and she might have believed that she were ugly and unable to attract any male attention. This could be another significant explanation for her inability to form intimate relationships.
When it comes to her fear of success, two explanations could be formulated. One of these is that she was always made to feel inferior at school because she was black by her teachers and her classmates. Though she was an exceptionally bright student, the disbelief her teachers had in her might have made her belief that success is not her best trait. On the other hand, no one ever made her feel proud of her achievements, not even her parents of her brothers. In addition, she never believed in herself because of how she was treated at home. These two combined could have led AL fear success because she did not belief that she could actually attain it.
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