Janet is a 31-year-old lady, who led a good life, especially when Jim, her father, was still alive. The death of her father, which happened when she was only 14 years old, opened a new chapter in her life. She had to look for a job to help her mother and when she finally got one, she was employed at a local library. Her ambition of attaining a Bachelor’s of Arts in Drama ended prematurely when she dropped out in her third semester and had no option other than to enroll in a secretarial college. Her real troubles began when she married Sam, a prosperous entrepreneur, who was 9 years her senior and widely viewed as a perfect match by her mother, Shirley.
She was divorced two years later despite trying her best to be the perfect spouse and homemaker a man could have. After her divorce, she entered into several relationships that did nothing to change her psychological situation; instead, they left her more frustrated, with most of them lasting for only 8 months. Finally, she met Larry and felt that he was the only person she could open up to, but did not know how to do that. Janet seems to be holding back her fears, ambitions, frustrations, and anger instead of freely expressing them. The cases in which such situations have occurred in her life are many and a good example is the many incidences she was unable to tell her mother that attending the cinemas with her on Sundays was a nuisance to her. Janet’s mother invited her uncle and aunt to stay with her, which was extremely inconvenient. Instead of expressing her true opinion on the matter, she said she would be looking forward to meeting them.
She was unable to tell her friends that she really never enjoyed going out with them and was also having trouble with her current attorney since she did not have the courage of facing him directly. Her troubles are compounded by the fact that she never wants to let people down by rejecting their proposals no matter how they negatively affect her. Simply put, she is unable to express herself, and instead, she gives in so easily even when she feels she should say no.
From a person-centered theoretical perspective, Janet requires the services of a psychotherapist to help her solve her problem; according to the prelude analysis, she suffers from a dependent personality disorder. This is a condition that makes an individual have the fear of expressing oneself; such people would rather keep their worries, aspirations, needs, and satisfaction to themselves, rather than letting others know. Case conceptualization is the process of shortening varied case information into a concise report that explains the patient’s fundamental model of conduct (Sperry, 2005, p. 354). There are three types of case conceptualizations that include: sign-centered, hypothesis-centered, and client-centered approaches (McWilliams, 1999, p. 47). Client-centered conceptualization is the most excellent to deal with Janet’s psychological problem.
To conceptualize Janet’s predicaments, one must consider the following four factors that affect her condition: precipitants, presentations, predispositions, and perpetuates (Sperry, 2005, p. 359). A precipitant is a cause or a stressor that sets the patient’s condition in motion (Sperry, 2005, p. 359). This, in Janet’s case, is her inability to communicate her discrepancies to other people because of the panic of losing their support or endorsement (American Psychiatric Association, 2000, p. 722). The therapist may advise her to join a club that is concerned with poetry where she will be able to express herself without her audience noticing that she is talking about her real-life experiences.
A presentation is the patient’s unique reaction to the precipitant (Sperry, 2005, p. 359). Janet is easily angered and in most cases, she gets furious over insignificant things; she gets mad at Larry every time he comes home late or forgets to call her. She also becomes extremely inexpressive, withdrawn, and distant; ironically, she is afraid of her rage and she feels that she treats him badly. In this case, she may be advised to use medicines such as depressants, anti-stimulants, and sleeping pills to calm her down (American Psychiatric Association, 2000, p. 728). However, caution should be taken since the patient may overuse the drugs and become dependent on them.
The predisposing factors in Janet’s case are her past life experiences, which she feels are unfair to her. She must have felt bad when she had to drop out of college after only 3 semesters and when she got divorced even though she thought she has tried her best to be a perfect wife. The intervention for this would be for her to look for a scholarship to complete her education; she should also open up to Larry about her fears (American Psychiatric Association, 2000, p. 724). Larry already feels frustrated by Janet’s behavior of being distant and inexpressive towards him.
Perpetuates are the procedures through which a patient’s behavior is built by himself together with his surroundings. Janet’s behavior is perpetuated by her fear of letting down her friends. Janet has made her psychological condition worse by failing to visit a psychotherapist for all these years, despite knowing that she had a problem (American Psychiatric Association, 2000, p. 728). Her mother has made it worse by not consulting her when making crucial decisions that directly affect her.
According to the information given about her, Janet suffers from a dependent personality disorder. People suffering from this condition seek out other relationships when the ones they are income to an end; they do that to look for comfort (American Psychiatric Association, 2000, p. 724). This is true in Janet’s life since, after her divorce, she got involved in countless relationships, most of which were with married men. She knew that such relationships were headed for doom, but yet she kept clinging onto them not to lose the care and support she got from them. When she finally met Larry, she was still unable to express herself for fear of being left single again; the fear was made stronger by the gut feeling she had that he was the right man for her.
In conclusion, the recommended treatment for Janet’s disorder involves seeking the services of a psychotherapist, just as advised by her colleague. A dependent personality disorder is a psychological ailment and only an expert in that area can help her recover from it. Psychotherapy focuses on behaviors that differ from what is considered normal human behavior; consequently, it is a relevant approach in the treatment of the dependent psychological disorder. However, the session should not take too long given that the patient may start depending too much on the therapist and this may complicate her problem even further (American Psychiatric Association, 2000, p. 728).
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, text revision (4th ed.). Arlington, VA: American Psychiatric Publishing Inc.
McWilliams, N. (1999). Psychoanalytic case formulation. New York, NY: Guilford Press.
Sperry, P. (2005). Case conceptualization: A strategy for incorporating individual, couple and family dynamics in the treatment process. The American Journal of Family Therapy, 33(5), 353-364.