Running head: CASE SUMMARY AND PRESENTING PROBLEMS 1
Case Summary and Presenting Problems: Annalise Keating
Miranda Nicholson
Liberty University
CASE SUMMARY AND PRESENTING PROBLEMS
Case Summary and Presenting Problems: Annalise Keating
Client History
Annalise Keating is the main character in the hit drama “How to Get Away with Murder”
produced by ABC studios. Annalise is a 50-year-old African-American woman who came to
counseling to assist with personal, relational and occupational issues in order to assist in
reinstating her license to practice Law. Annalise holds her Juris Doctor degree from Harvard,
where she specialized in criminal defense law. While at Harvard, she began a friendship with a
woman named Eve Rothlo that became romantic in nature. Annalise and Eve were together for a
significant amount of time until Annalise began therapy with Professor Sam Keating.
Throughout her time in therapy, Annalise and Sam began a relationship and fell in love. Sam
divorced his first wife and Annalise ended her relationship with Eve. Not long after the split from
their significant others, Sam and Annalise married. Shortly after their marriage, Annalise
successfully passed the Pennsylvania bar and became a criminal defense lawyer. Two years later,
Annalise and Sam accepted positions at Middleton University where they taught Criminal Law
and Psychology, respectfully (“Annalise Keating: How to”, n.d.). Annalise suffered three
miscarriages before almost carrying a son to term. She was involved in a tragic car accident and
lost the baby while in the hospital (“How to Get Away with Murder”, 2019). Sam and Annalise
did not attempt to try for children again after this traumatic event.
Annalise is the daughter of Ophelia and Mac Harkness, originally born Anna Mae
Harkness (“Annalise Keating”, n.d.). She is the older of her two siblings Celestine (sister) and
Theolonious (brother). Annalise changed her name to disassociate with her southern roots in
Georgia and the memories attached with her previous life. Her father walked out on the family
when Annalise was a teenager. She has never reconciled with him. Annalise’s mother and
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CASE SUMMARY AND PRESENTING PROBLEMS
siblings are not successful in the traditional sense. They each work blue-collar jobs, make ends
meet and live in the same small town. Annalise worked very hard to distance herself from them
and make a name for herself. However, at the passing of her husband Sam, which is suspected as
foul play, she returned to her childhood home and sought comfort from her mother.
Before Sam’s death, Annalise discovered he was romantically involved with one of his
students. Annalise was also engaging in an extra-marital affair with an investigator named Nate
Lahey whom she met during one of her cases (“Annalise Keating”, n.d.). Annalise was
devastated by the discovery of Sam’s affair, but this was quickly overshadowed by his death and
the grief that ensued. Annalise has always been self-sufficient and respected. She did not allow
the tragedy of her husband’s death to keep her from teaching students and defending individuals
on trial (“How to Get Away with Murder”, 2019). To the world, Annalise is an extremely
successful lawyer and professor. She prefers to present herself as intimidating and confident,
while she is sentimental and hurting inside. Annalise begins to self medicate with alcohol and
drinks herself to sleep every evening. Often, she begins drinking in the early afternoon. She
views vulnerability as a weakness and wears a tough exterior in order to maintain her reputation
and career.
Annalise prefers to be in control of her life and the people around her. She hired five law
students to assist her with working on high-profile cases. She is fond of the five and is quick to
protect them even after they find themselves in legal trouble. Annalise is a person who has
dedicated her life to understanding the law and finding loopholes around it. She participates in
activities that are on the verge of illegal as her life, and career, are brought into public scrutiny
(“Annalise Keating”, n.d.). Annalise finds herself suspended from the Pennsylvania bar after a
video surfaces that reveals Annalise slapping one of her previous clients (“How to Get Away
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CASE SUMMARY AND PRESENTING PROBLEMS
with Murder”, 2019). Upon finding out, Middleton University quickly nullifies her contract and
Annalise comes forward with her alcoholism struggles. Anger management, Alcoholics
Anonymous, and talk therapy have been assigned to her as a remediation plan to reinstate her
license to practice Law (“How to Get Away with Murder”, 2019).
Presenting Problems
Occupational Functioning
Annalise Keating has recently been suspended from practicing law in the state of
Pennsylvania due to malpractice with a previous client. She made the decision to approach the
Pennsylvania Board of Law Examiners and be forthcoming with her struggles in coping with
grief, depression and alcoholism. Upon witnessing Mrs. Keating’s moving testimony, the
Pennsylvania Board developed a remediation plan, which included the involvement of
counseling to assist with her depression. Annalise is a woman who finds her worth in her work
and success. As a consequence of her misconduct she has been suspended from practicing law,
which creates a sense of loss and a restless feeling because she has nothing to keep her busy.
Unfortunately, her contract at Middleton University was compromised due to her suspension so
she is no longer able to teach Criminal Law or work in pro-bono immigration court hearings.
This leaves Annalise feeling helpless and guilty because she was forced to abandon clients that
were at risk of deportation. Annalise describes her relationship with her coworkers as tense and
uncomfortable as she finds herself unemployed and with no one to turn to. She has burned
several bridges with her fellow faculty and the administration at Middleton. Annalise is
determined to have her license reinstated and work towards a compromise with the University.
Although Annalise puts on a tough exterior, the thought of losing the right to practice law is
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CASE SUMMARY AND PRESENTING PROBLEMS
extremely terrifying to her and without the constant distraction of work, she is left to explore her
past hurts and grief.
Relationships
Annalise expresses grief and guilt towards the death of her husband, Sam. On one hand
she is angry towards Sam after finding out about his second affair with a young college student.
She is given no way to reconcile such anger since he is now gone. There is an investigation open
into the death of Sam Keating and Annalise defends her position that she is unaware of who may
be the culprit. The confusion of Sam’s apparent murder mixed with the discovery of his affair
create conflicting feelings of grief and anger. Annalise feels guilty when she is angry and also
because she engaged in an affair that Sam never discovered. Annalise shares that she felt
undesirable and broken after suffering multiple miscarriages. After her car accident and loss of
her son, she chose not to speak with Sam about it and withdrew into herself. Annalise blames
herself for driving Sam away, but says the affair with Nate allowed her to feel different. She
claims the history between herself and Sam was too painful to talk about with him so they both
lived separate lives outside of their marriage. The last time Annalise participated in counseling
she began a relationship with her therapist and married him. The inappropriate nature of her
previous therapeutic relationship must be taken into account, but counseling at this time is still
considered a viable option.
Personal Functioning
Annalise is a self-professed alcoholic. She began drinking in the evenings to assist with
her insomnia and stressful workload. She found that when she retired to bed her brain was unable
to “shut off” and when she did sleep she awoke from a series of night terrors. The occasional
glass of wine to de-stress slowly became daily and eventually the wine transitioned to straight
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CASE SUMMARY AND PRESENTING PROBLEMS
liquor. Annalise did not realize her dependency on alcohol until her close friends and boyfriend
(Nate) began to comment on her drinking in the afternoons. She found herself hiding liquor
bottles from her loved ones and promised them she was done drinking. There was even an
instance when Annalise took prescribed painkillers with Vodka. During this episode, she began to
hallucinate that she had an infant child in her arms. At first she was terrified of the baby, but as
the hallucination progressed she began to dance with the child and sang him to sleep. Of course,
Annalise realized her hallucination as she came down from the high and immediately threw out
the painkillers. This hallucination elicited a deep emotional response from Annalise as she
grieved the loss of her son. Annalise has attended one AA meeting so far and describes the
encounter as embarrassing. She knows she has a problem but appears prideful in her search for
help. Annalise has recognized her problem and although she has been asked to participate in
remediation for her reinstatement, a healthy therapeutic relationship will assist her in exploring
her feelings while reinforcing what she learns through Alcoholics Anonymous.
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CASE SUMMARY AND PRESENTING PROBLEMS
References
Annalise Keating. (n.d.). Retrieved from
https://howtogetawaywithmurder.fandom.com/wiki/Annalise_Keating
Annalise Keating | How to Get Away with Murder. (n.d.). Retrieved from
https://abc.go.com/shows/how-to-get-away-with-murder/cast/annalise-keating
How to Get Away with Murder. (2019). Retrieved from
https://en.wikipedia.org/wiki/How_to_Get_Away_with_Murder
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