Essay Sample on Psychology Case Explanation

The case involves Keisha, a 21-year-old woman who is a victim of rape. Following the rape incident, her coping abilities have reduced making her unable to associate with people and to avoid close relations which include her husband and her sister. Her sex life with her husband is also in crisis because she cannot stand the thought of someone touching her after the sexual assault incident. The situation has caused depression to kick in, which has been accompanied by suicidal thoughts, thus the need for the intervention.

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As indicated, the victim is 21 years old Keisha, who before the incident enjoyed her job at a local coffee shop in the downtown area in which she lived with her husband, Mark. She had her off on Monday nights at which time she would be alone at home because Mark worked the third shift at his place of employment. The trauma situation commenced with a brief confrontation with a neighbor who demanded that she turned down the volume of music in her house. She obliged, and when she heard a knock on the door, she did not think twice in the opening, assuming that the neighbor was back to complain. Unfortunately, it was a big man, who raped her in her apartment, causing the series of events leading to depression and the lack of incentive to continue living. In psychology, a crisis is a traumatic situation and event, as well as the reaction of the individual to the event. Ultimately, the crisis presents a threat or an obstacle that creates a milestone for growth or decline for the victim. In the case of Keisha, the crisis was both the event in which she was raped, in addition to her subsequent approach and reaction to the event that included her tendency towards suicide. Stress, on the other hand, can constitute the reaction to the crisis. Stress involves any uncomfortable emotional situation that constitutes predictable biochemical along with behavioral and psychological behaviors. Therefore, while the person experiencing a crisis is moved by a threat and the reaction to the threatening event, the person experiencing stress presents predictable behavior from the uncomfortable emotional situation.

Client's culture and strengths

Before the rape event, it is clear that Keisha was a well-adjusted individual who enjoyed her life, as well as her job at the local coffee shop. Listening to loud music during her free time is a clear indication that she enjoyed music and she had fun in the moments that her husband was away at work. It is also an indication that she is an individual who could stay alone for extended periods without fear of worry (Buber, 1999). Her interaction with the neighbor on the material day is also an indication that she was a reasonable individual. Despite her attitude with the neighbor, she did understand that the music was loud and agreed to turn it down upon his request. She is, therefore, a rational individual who strove to understand a situation before forming her reaction to the situation. Her Mondays included relaxation with loud music while her husband was away at work. She also has a close relationship with her sister and her husband, who are both concerned with her present situation. Her strengths, therefore, include the close relations that she has, in addition to her love for music which is efficient in relaxation and recovery.

Intervention technique

In the case of Keisha, the problem arises because of guilt as she tries to visualize different scenarios that could have changed the outcomes of the day she was sexually assaulted. The ideal technique for intervention is, therefore, the use of Gestalt Therapy. Gestalt therapy is a client-centered approach which was developed in 1951 by Perls, Hefferline, and Goodman (Young, 2001). The intervention technique recognizes the need to focus on the present while attempting the resolve the issues arising from the past. As such, an ideal candidate for the therapy is an individual who has an interest in working on their self-awareness in addition to countering a stressful situation although they do not understand the role that the play in their depressive situation.

Therapists using the Gestalt approach in intervention bring the experience of the past to the present so that the client can confront their fears that are affecting the qualities of their life's (Jacobs, 2006). The technique works from the understanding that human beings are wholesome and dynamic. Thus, the processes within their mind have to align with the processes in the environment and also in the body. The integration of the physical body, with the emotional outcomes and the environment, is essential in the intervention to establish a wholesome experience that can assist the client to identify the source of trouble and act in accordance. Therefore, instead of talking about a past situation, which in the case of Keisha was the night that she was sexually assaulted, the therapist would encourage the client to re-enact the situation and re-live the experience. The methods include role-playing and fantasy, in addition to confrontation (Young, 2001).

In the situation of Keisha, the therapist may take the role of her attacker and guide the client through a response process while allowing her to integrate the situation of the past and develop mechanisms for adaptation (Young, 2001). The theory of the approach is that bringing the situation to the present will allow the client to confront her fears and regrets, while in the process developing mechanisms for adaptation and survival. Therefore, while at the time of the attack, Keisha was caught unaware, because she thought she was opening the door to respond to a complaint from the neighbor, in the controlled setting with the therapist, she understands what is coming and is prepared for a reaction. Therefore, Keisha would benefit from the intervention because it would allow her to relieve the situation and understand that she is not dirty and that the event is in the past. She will also learn to confront her fear of human interaction which was an outcome of the rape, and revive her relationships in the present.

Impact of the intervention technique

Gestalt therapy approach required precise methods because bringing a past fear and trauma to the present can have the unplanned outcome of causing the client to recoil further into themselves and close off any future interventions (Buber, 1999). The therapist, therefore, needs to ensure that the outcomes include the positive reaction of allowing Keisha to grow because of the situation. Keisha can learn that her attacker no longer has power over her because he is in jail. The attacker is also not in control of her day to day interactions because the event was a one-time occurrence that will not necessarily repeat as she goes through life. Additionally, she can learn through the re-enactment the need of developing her defense mechanisms that are both psychological and physical. Knowing that she can defend herself is perhaps a method that will allow Keisha to feel safe in the world again and allow for healthy relations.

According to the explanation, Gestalt approach is an intervention method in which the trauma of the past, including the related emotions of fear and anxiety, is re-enacted in the present to allow the client to confront the trauma (Robine, 2013). Therefore, the first approach in the meeting is to reassure the client that the event is already passed and she is safe (Jacobs, 2006). Keisha will have to understand that her attacker no longer presents a threat to her; neither does the attacker represent all the men in her life, including her husband. From the perspective of separating her attacker from the other members of the population, the therapist will succeed in guiding Keisha to focus her anxiety and fear to a specific situation and individual so that she can confront the trauma and continue with her life.

Intervention implementation (clinician-client dialogue)

Therapist: Hello? Thank you for seeing me, you can call me Dee. What is your name?

Keisha: Keisha

Therapist: Nice to meet you, Keisha. You understand from the patient contract that you are supposed to verbalize every feeling and emotion so that we understand each other.

Keisha: Yes.

Therapist: We are going to work on what is called awareness. Do you know what it means?

Keisha: I think so.

Therapist: Now tell me what you think awareness means.

Keisha: Knowing where I am and who I am?

Therapist: Good. In our situation, the meaning can further encompass communicating what you are experiencing in the present moment (Lars, 2011). Can you tell me what that is?

Keisha: I don't understand

Therapist: How about you tell me your impression of this room?

Keisha: I think it has a draft and is a bit quiet

Therapist: That is a good start. Now I want you to keep up with this start and tell me everything from your honest perspective (Lars, 2011). Can you do that?

Keisha: I think so.

Therapist: Before we go on, I want to explain the situation so that you to understand that this is a safe place. If anything or any word I say makes you uncomfortable, you can tell me. Also, the course of events at this moment is entirely in your control.

Keisha: I understand

Therapist: So tell me, what are you thinking?

Keisha: I am thinking how I do not want to be in this place?

Therapist: Why is that so?

Keisha: I am uncomfortable around new people.

Therapist: Why are you uncomfortable around new people?

Keisha: They remind me of an experience I would rather forget.

Therapist: Why would you want to forget the experience?

Keisha: It made me feel weak, hopeless and dirty

Therapist: But you know the mind does not work that way. If you suppress a situation instead of confronting it, it will come back to haunt you in ways you do not expect (Lars, 2011). Unresolved issues from the past are not right.

Keisha: I just don't want to remember it

Therapist: Could you at least describe the situation and why it made you feel the way you do?

Keisha: I would rather not

Therapist: Keisha, we agreed to talk openly and honestly. I also assured you that this is a safe place. Also, your husband and your sister are right outside the room. So for us to make progress, you will have to verbalize everything.

Keisha: It is a bad memory, ok?

Therapist: Keeping it inside will harm you. I am here to listen and help. But first I want you to confront the situation by talking about it. Let us take it slowly. What were you doing on the day of the attack?

Keisha: I was listening to music.

Therapist: Do you remember which song?

Keisha: I think so

Therapist: Can I play it? You said earlier that the room is quiet.

Keisha: I am not sure I want to hear the song.

Therapist: I will play it quietly, and if you still want me to stop after a few seconds of play, I will stop it. Do you think that is a fair compromise?

Keisha: I think so.

Therapist: Now tell me, what did the man look like?

Keisha: He was large, and he made me feel small.

Therapist: Did he say anything?

Keisha: No, he just pushed past me, got into the house and slammed the door behind us.

Therapist: You are doing well. What did you do then?

Keisha: I tried to fight him off, but he was too strong. It was not long before he was holding me down and muffling my screams with his big hands.

References

Buber, M. (1999). Elements of the Interhuman. In J. Buber Agassi (ed.), Martin Buber on Psychology and Psychotherapy: Essays, Letters, and Dialogue (pp. 72-89). Syracuse, NY: Syracuse University Press

Jacobs, L. (2006). That Which Enables: Support as Complex and Contextually Emergent. British Gestalt Journal, 15, 2, pp. 10-19

Lars, A., (2011). Gestalt Awareness and Dialogue. Retrieved from https://www.intawa.com.au/gestalt-awareness-and-dialogue/