Clinical II. Midterm Re-do

Clinical II Midterm Analysis

Name:

Institutional Affiliation:

Professor:

Date:

10/26/2019

Object Relations

1. Choose only 1 client for this paper.

2. Please provide a brief overview of the case, including age, gender, and cultural background of the client. You should address the client's reasons for seeking help. Discuss your role with the client (i.e., advocate, counselor case manager, etc) in relationship to serving the client.

3. Discuss your client's relevant biopsychosocial history. Additionally, you will begin using some of the theoretical concepts from the course.

4. Please discuss your understanding of the client through an Object Relations Lens. Choose 1 Object Relations Theorist.

5. How does this object relations theory and theorist differ from a second object relations theory/ theorist or to compare self-psychology see below?

6. What type of object do you represent for this client? Why did you feel this theory was more clinically appropriate than the other?

7. Please describe 3 concepts from your theoretical choice most applicable to your client. . a. How has your understanding of this theory played out in your therapeutic relationship?

b. How does this theory impact transference and countertransference dynamics?

8. Your paper must remain within 6-8 pages, include 5-8 references and use subtitles to guide your work.

9. You should use standard APA formatting (everything, including: the title page, a refrence page, page numbers, etc).

10. Your papers should be typed and double-spaced. Your assignment should draw from relevant class readings. Paraphrasing and quotes from articles or book chapters must be clearly referenced to avoid plagiarism.

ADD AN INTRODUCTION

Eliza is an eight-year-old female who was born in Guatemala, she came you U.S as an unaccompanied minor. Eliza crossed the border with her alleged father who later on was confirmed it was her cousin. The minor lost her mother due to cancer at a very tender age, when she was 9 months old, and she was abandoned by her biological father. Minor reported to being sad dur to the loss of her mother. Minor reported that after her mother death she was left in the care of her maternal aunt.

When minor arrived to our program she didn’t request for help, she didn’t know she needed it help. Minor was referred to our program by the Office of Refugees Resettlement (ORR). Unaccompanied alien children apprehended by the Department of Homeland Security (DHS) immigration officials are transferred to the care and custody of ORR. ORR promptly places an unaccompanied child in the least restrictive setting that is in the best interests of the child, taking into consideration danger to self, danger to the community, and risk of flight. ORR takes into consideration the unique nature of each child’s situation and incorporates child welfare principles when making placement, clinical, case management, and release decisions that are in the best interest of the child (ORR, n.d).

I was Eliza’s case manager, the minor disclosed to me that she was a victim of sexual abused. She was sexually abused twice✅. On one occasion her caretaker father in law touched her✅ inappropriately, while on another occasion her caretaker brother in law did inappropriate touching✅ and sexually abused her and threaten her not to disclose this to anyone. After de disclosure of the incident minor was assessed for PTSD. Although Eliza was observed stable at all times and presented with happy affect✅. She was receptive, and throughout the session and denied any suicidal ideation or hallucinations✅.

After being in care for 5 months minor started to have tantrums and does not like being redirected. I worked with her as her case manager ✅and engaged✅ her into behavioral management✅ program. She was asked to learn some coping strategies✅ and surprisingly, she was doing well✅. Further assessment tool was also administered on her.

As a case manager I am responsible for the reunification of minors when they are admitted into the program. Minor was not able to provide any contact information in U.S or country of origin. I tried to contact the cousin detained, but by the time I was able to locate him he was removed and deported to Guatemala. After several weeks passed, a person who identified himself as minor’s uncle contact the ORR Helpline to inquire about the minor. Uncle’s information was provided, and I was able to contact him. After screening the uncle as potential sponsor for the minor is was determined that he was not an appropriate sponsor due to sexual abuse to minor, and not having a female figure to care for her.

After a few weeks minor’s uncle provided information on a maternal aunt that was living in U.S and could sponsored the minor. After maternal aunt was screened it was determined that she was not an appropriate sponsor for the minor due to low income and living conditions. Maternal aunt only financial source was her husband, whose income was below poverty line, and residing in an apartment of 2-bedroom apartment for her family (2 adults and 4 children), and a family friend.

When I provided minor with all this information minor was frustrated and stated that she wanted to go back to Guatemala. I explained to her that it was possible even though the process was long and tedious.

Please discuss your understanding of the client through an Object Relations Lens. Choose 1 Object Relations Theorist.

Lens from an Object Relations Theory. Theorist; Mahler, Winnicott, Fairbairn, Guntrip

From an object relations views Eliza appears to think that all male adults are bad objects. Eliza made numerous comments about not wanted to be left by herself with a male when she returned to Guatemala. She always stated that she was harmed by 2 adults males, and that she was abandoned by her biological father who is also male. Eliza stated that once she returned home, she will always be close to her house, and play where an adult can see her.

As Eliza lost her mother when she very young and his father gave her✅ to her maternal aunt guardianship✅. Indeed no one else can fulfil the place of parents in child’s life. Eliza’s life early years without her mother✅ has some significant impact✅ on her development. Object relation theory is centered on people’s relationships with others✅. And according to this theory our lifelong, relationship skills are strongly rooted in our early attachments✅ with our parents, especially our mothers✅ (Fritscher, 2019). Losing her mother and having no sibling, Eliza has shown some behavioral issues in early age.

The client was sexually abused by her grandfather✅ and paternal uncle✅ and was threatened✅ as well. Dodge (1993) hypothesized that early abuse and exposure to aggression might result in the development of insecure attachments✅ with caregivers and internal working models of the world as hostile✅ (Keiley, 2002). Thus, a child will see world as a hostile✅ and may develop coercive and aggressive behaviours. ✅Holland and his colleagues (1993) have suggested that disruption in attachment bonds✅ is actually the critical underlying feature of conduct disorder.

According to my understanding Eliza’s problems started✅ at the very start of her life when she lost her mother ✅and missed that mother-daughter bonding✅ till date. She says that she doesn’t remember anything as she was very young at the time of her mother’s death. As according to psychoanalyst and researcher, Daniel Stern (1985) founded that mother-infant interaction delineated four phases of self-development✅, each domain was codetermined by growing infant’s innate maturational capacities and nature and degree of attunement of the caretaker environment (Goldstein, 2001).

Differences from a Second Object Relations Theorist Perspective

How does this object relations theory and theorist differ from a second object relations theory/ theorist or to compare self-psychology?

Different theorists have explored different dimensions of the object relation theory✅.

Differences between object relation theory and self -psychology

Self- psychology was brought forward in reaction to classical psychoanalysis and ego psychology. Heinz Kohut viewed self -psychology as distinctive. Self-psychology has provided a comprehensive theory of psychopathology and treatment. As the failure of parental empathy to meet the need results inability to develop intrapsychic structures that can reliably regulate self-esteem and calm the self (Baker & Baker, 1987). There are several aspects that differentiate object relation theory to self-psychology. Such as in object relation theory the focus of the theory was on interpersonal relationships and their internalization and impact on psychic structure while in self-psychology the focus was on infolding of self-potentialities and the role of the self –object milleu on self –development, self-esteem regulation and healthy narcissism. Nature of individual in object relation theory was that an individual seeks object from birth and have difference of opinion as to whether aggression is innate caused by early frustration, individual have needs throughout their life. While in self-psychology the individual born with innate potentialities that form nuclear self, self-basic need are present and attuned parenting essential is required and frustration causes aggression. With respect to structural concepts object relation theory has objects and part-objects, self and object representation was present, primitive defenses, affect, ego and super ego, true self and regressed ego while in self-psychology there is nuclear self, grandiose self, bipolar self, cohesive self, compensatory structure and stern’s four senses of the self (Goldstein,2001).

What type of object do you represent for this client? Why did you feel this theory was more clinically appropriate than the other?

Please describe 3 concepts from your theoretical choice most applicable to your client.

a. How has your understanding of this theory played out in your therapeutic relationship?

b. How does this theory impact transference and countertransference dynamics?

Likewise, the countertransference was also emphasized by Stern as according to him the conditions can allow for a new and better experience of self in relationship with others thus relying less on interpretation of the past and more on the object relations aspect and on self-psychology was encouraged✅ (Stern, 1998).

References

Anderson, R.E., Carter, I. & Lowe, G.R. (1999). Human Behavior in the social Environment: A social Systems Approach. Aldine Transaction.