Psychoanalytic Theory Paper
Treating therapists apply different approaches when it comes to patient cases presented to them. As such, one of the most popular approach applied by these professionals is the application of Psychoanalytic theory to resolve issues, especially for the patients with mental disorders. Psychoanalytic techniques take into account the relationships of the past and bonds them with present to predict the future outcomes. Having widely been applied in the world of medicine, Psychoanalytic techniques have been found to be effective when the professional applies them accordingly using the right proven methodologies. The effectiveness of theory application in the world of psychology has proven credible results, especially when dealing with mental disorders in patients. However, the institutional, professional and ethical standards must be applied across the board to ensure that every treatment plan and process conforms with these standards for the best quality care that can overall ensure excellent patients’ safety and care. This paper offers an overview of a given mock client case; an aged female with dementia. Psychoanalytic Theory Paper. The paper will focus on the case overview, theoretical approach, case conceptualization, diagnosis, as well as the treatment plan.
Case Overview
The case involved a 74-year-old female (Will refer her as Cherry) who had been referred to the facility due to various complications, key among them hypertension, diabetes, as well as frequent mental loss. The patient looked tired and was talkative, although I could not comprehend most of her statements. The previous treatment according to the facility records showed that 3 years earlier, she was diagnosed with diabetes and high blood pressure, and she has been under medication with periodical clinic visits to manage these two conditions. Of recent, according to the caregiver who had accompanied her, Cherry’s behavior had changed dramatically, turning out to be aggressive and having a frequent memory loss, a situation which had greatly affected her daily life as she would earlier on take care of herself in most personal chores without assistance.
ORDER A PLAGIARISM-FREE PAPER NOW
With this situation at hand, my duty as a treating therapist to the case was to diagnose the issue and the best methodology was first through observation of the patient behavior followed by the application of a Psychoanalytic analysis to establish the extent and root cause of the symptoms that were observable. My best theoretical approach in this context was the application of the Self-psychology which places empathy as the core diagnostic element when it comes to medical issues. Psychoanalytic Theory Paper.Self-psychology approach comprises understanding and sharing of the feelings, which translates to responding empathically to the concerned clients’ needs, thus establishing a therapeutic environment which assures the patients their safety, as well as protection (Lindgren, 2011). Furthermore, responding empathically creates trust and comfort, which are a good sign in the treatment process as this also translates to faster diagnosis and treatment in time therefore making things easier on both the patient’s side, as well as that of the caregiver (In this case the treating therapist) (Clark, 2010).
Theoretical Approach Background and Historical Content
Self-psychology theory was developed by an American psychoanalyst known as Heinz Kohut. The theory was adopted within the field of psychoanalysis as it was discovered that the challenges that most people undergo are as a result of self-esteem regulation and maintenance of a solid sense of self (self-cohesion) ((Smith & Kennerley, 2012). Likewise, its emphases on the application in clinical related situations has increased over the years, as professionals in the medical field such as treating therapist find the self-psychology as one of the best approaches, especially when dealing with mentally disturbed patients (Smith & Kennerley, 2012). The approach empathic nature provides an opportunity to establish a strong bond between the therapist and the patient, which makes it easier to diagnose, as well as reach conclusions on the treatment plans.
Compared with other psychoanalysis approaches, the self-psychology assists the therapist to first create a therapeutic environment that is fundamental in ensuring that the client feels safe and secure thus opening up to the issues that may be affecting them, consequently making it a crucial path in the diagnosis process.Psychoanalytic Theory Paper. Nevertheless, the empathic nature of the self-psychology approach generally brings along the curative effect that is essential in resolving the clinical problem presented by the patient. The historical nature of the theory has not only resolved the fundamental issues of the psychoanalysis, but as well, the approach has assisted a lot in resolving medical and therapeutic issues in the modern clinical era.
Theoretical Case Conceptualization
Case conceptualization involves the investigation of the causes, or manner of causation of a disease or condition. Case conceptualization uses different parameters to establish the mentioned elements which may include the historical data, as well as the observational or laboratory experiments. As such, for the case at hand involving Cherry, it was crucial to first understand the patient has a history of diabetes and hypertension. Secondly, her social life was important pointer of the root cause of the problem she was experiencing. After interviewing the caregiver who had accompanied her, she informed me that Cherry had earlier lost her husband whom they were close and it was now turning a year since the loss. This historical background was important as psychological disturbance coupled with her age can greatly contribute to the dementia issue she was experiencing. After the observation at home that Cherry was developing poor judgement, and as well, she was experiencing unsteady gait, it was crucial for her to be accorded close care as she was already losing the sense of self.
In this regard, the self-psychology concept dictates that when individuals lose the healthy sense of self, they heavily tend to rely on others for their various needs. This fundamental concept is widely referred to as self-objects. On that note, when these self-objects are eliminated at a given point in time, they may have a great impact on the social and psychological life of the concerned individual. For Cherry, the loss of her husband can greatly be associated with the psychological disorders that she developed due to unmanageable stress, as well as loss of a fundamental self-object that she had developed a great relationship with for decades.Psychoanalytic Theory Paper. The physical environment that Cherry is living in can be regarded as an external factor that ignites other conducive elements such diabetes and hypertension coupled with advanced age, thereby providing a perfect ground for the dementia to thrive in. The strive for growth and affirmation when it comes to the elderly demands a more subtle treatment dimensions, such as empathy and transference, which can best resolve issues such as the one facing Cherry.
Differential Dx
The differential dx involves establishing causes and symptoms of a disease. My first thing was to apply differential diagnosis methodology as the presented patient had several other conditions that she was suffering from. I had to be cautious not to mix up the symptoms and reach on a wrong conclusion. I performed the blood sugar and blood pressure test, which emerged that they were at manageable levels and truly matched her historical results. Nevertheless, the disorders associated with mental illness are sadness, sleep problems, anxiety or violence. As such, Cherry was showing signs of anxiety and the caregiver advised that she hardly gets enough sleep either during the day or at night. On the other hand, I tested her on the memory fitness and it turned out that she had a bad memory loss as she would not remember events that have happened minutes ago. Furthermore, she experienced the inability to recognize common things (Burns et al., 2012).
After all these observations, it was clear that Cherry was now suffering from dementia after experiencing an uncontrolled Alzheimer’s disease for nearly a year, which emanated from depression and shock suffered during her husband’s demise, as well as the comorbidity of two other chronic conditions (Fishman, 2017). Psychoanalysis interventions here were at core as these types of patients require a deep understanding and a combination of approaches to administer the best treatment for the mental disorder at hand. The application of self-psychology in clinical practice is one of the best methodological approaches that I applied as it places the medical professional in the experiencing and understanding of the patient feelings to get the best out of this in terms of treatment solutions. Psychoanalytic Theory Paper. The diagnostic process must be thorough to ensure that there is no confusion of common symptoms that may end up in making the wrong decision, especially where a patient exhibits several other conditions which may trigger a similar effect such as the one Cherry had.
Treatment Plan
Dementia patients are complex to handle and they require the professionals to apply a number of approaches when it comes to their treatment plan. For Cherry, it was a balance between three conditions (Diabetes, hypertension and dementia), in which any treatment plan that would be settled at must consider. As such, the most visible symptom was aggressive behavior brought along by the comorbidity of age and the conditions she was having at the time. This was a complex matter and handling it required an ethical approach that was most appropriate to balance between the benefits and the current health of the patient (Dragatsi et al., 2019).
Due to the poor judgement and decreased safety awareness, sometimes the dementia patient can cause harm to others and to themselves thus warranting actions that can restrain their aggressive behaviors. Although this may sometimes call for physical restraints, it may result to worsening the situation at hand especially when it comes to elderly patients. As such, psychosocial approaches, as well as the application of psychotropics medications as a chemical restraint can sometimes best fit such situations (Burns et al., 2012). These two approaches have been found to benefit elderly patients with dementia and at the same time, they conform with the ethics of medication, as well as established treatment standards worldwide.
Considering the self-psychology theoretical application, my treatment plan largely applied the psychosocial approaches to resolve the issue. The act of aggressiveness by Cherry warranted a change of environment first and thus I recommended for admission of the patient to manage the situation closely. During admission period, the caregiver was also to be present to gain enough knowledge on handling the patient at home, especially when it came to behavior control. Psychoanalytic Theory Paper. Apart from fostering a safe environment, psychosocial approaches are known to foster social engagement, maximize functionality in daily activities and as well, enhance mood and behavior (Sagbakken et al., 2017). This is similar to the principles dictated by the self-psychology theory where the patient and the caregiver understanding highly depends on the environment that they engage in for the better results, especially where the patient feels being understood and secure (Dragatsi et al., 2019).
Nevertheless, the psychosocial approaches that I applied included involving Cherry in simple exercises, participation in playing mind games, as well as engaging her in interesting discussions which are vital in the overall improvement of their memory functioning. On the other hand, to stabilize the patient gait, I made a schedule for guided outside walk, which was crucial both in interacting with the physical environment, as well as improving the physical fitness for a stable gait (Lindgren, 2011). I much avoided application of the restraints for the aggressive behavior of the patient as most of the times it can cause more harm than cure, especially for the elderly dementia patients with poor physical fitness (Tom et al., 2015). On the other hand, after the improvement on physical and mental stability, I recommended for frequent medical checkups following a scheduled visit to the facility to examine progress for any necessary intervention. This will also assist in managing the diabetes and the hypertension conditions which are a comorbidity to the dementia ad may contribute in worsening the situation if they are not kept in close check. Psychoanalytic Theory Paper.
Transference and Countertransference Issues
When it comes to resolving mental issues, countertransference and transference issues becomes vital as they dictate the level and quality of treatment for the patient. Transference issues are mostly emotions that patients redirect towards therapists, while countertransference on the other hand are the reactions redirected by therapists or caregivers in response to their patient’s behavior or emotions (Rosenberger & Hayes, 2002). Due to sensitivity of the issues at hand, especially when a patient is exhibiting aggressive behavior, it calls for a deeper understanding and full application of the existing ethical standards for the medical professional or the caregiver in handling emerging transference and countertransference issues.
For my patient (Cherry), it was a balance between ethics and medical application to counter both transference and countertransference issues that emerged between us. First, Cherry was exhibiting a very aggressive behavior and as such, she was angry with everyone she came across with, a situation which had made it difficult for the caregiver to administer the much-needed care at home. With this situation at hand and considering the dementia situation, this called for a sober reaction on my side giving her simple instructions that she could understand and as well, making sure that we take every step together during the behavior control sessions (Lindgren, 2011).Psychoanalytic Theory Paper. Psychosocial interventions such as playing simple and engaging games together completely established a calm environment, and Cherry would smile and hug me at some points which I would appreciate and smile back. This was a calculated move of countertransference to limit the aggressiveness she was exhibiting to maintain a good relationship both with me and the caregiver (Rosenberger & Hayes, 2002).
On the other hand, I am very emotional, especially when handling elderly patients with complex medical conditions such as dementia. As such, this may bring a negative result in the overall treatment journey, especially when connecting with the patient. To avoid this negative countertransference, I strive my best to establish a sober mood by engaging in constructive conversations that drives away my emotions for a better understanding of the situation at hand. Although countertransference has been widely attributed as negative, there exists a room where positivity can be achieved with it, through ethical applications that considers the best avenues to handle the emerging transference issues as well as observing the set boundaries in terms of right to privacy and care (Rosenberger & Hayes, 2002).
Moreover, the transference and countertransference issues should also observe the multicultural aspects where the beliefs and cultural values of the concerned patient must be handled with care and respect in order not to violate their treatment preference or existing beliefs that may further deteriorate their mental state or jeopardize the relationship of the patient and that of the caregiver.
Conclusion
Treating therapists engage patients differently, a situation which is warranted by the cases at hand. As such, each case may present a unique challenge, which the involved therapist must derive an approach that will best fit the situation at hand. The decision by the caregiver must as well be considerate of the existing institutional policies and the ethical standards that guide the professionals in the line of duty. For dementia patients such as Cherry, it proves a challenge to strike a balance between the medical application, as well as the psychological wellness. Self-psychology approach has exhibited to be a perfect approach in such situation as it creates a conducive therapeutic environment that best fits both the medical professional and the patient at hand. Combined psychosocial approaches have proven success in the overall treatment engagement of patients with mental disorders. Proper application of
On the other hand, treating therapists should be in a position to come up with a treatment plan that is best for the presented clinical situation. The treatment plan should conform with the existing professional and ethical standards in order to benefit the patient at length. Furthermore, the emerging transference and countertransference issues must be addressed positively, not to jeopardize the treatment process. For the therapist, application of the countertransference issues should always be positive even when situations present an ethical dilemma. Emotional control is thus vital, especially when dealing with mental disorder cases such as the Cherry’s case. Psychoanalytic Theory Paper.
References
Burns, K., Jayasinha, R., Tsang, R., Brodaty, H. (2012). Behavior management a guide to good
practice: managing behavioral and psychological symptoms of dementia. DCRC and DBMAS Commonwealth, Canberra. http://dementiaresearch.com.au/images/dcrc/output-files/328-2012_dbmas_bpsd_guidelines_guide.pdf
Clark, A. J. (2010). Empathy: An integral model in the counseling process. Journal of
Counseling and Development : JCD, 88(3), 348-356. doi:http://dx.doi.org/10.1002/j.1556-6678.2010.tb00032.x
Dragatsi, D., Norian, I., & Minkoff, K. (2019). American association of community psychiatrists
position statement: Putting patients first by improving treatment planning and reducing administrative and clinical burden of treatment plan documentation. Community Mental Health Journal, 55(1), 4. doi:http://dx.doi.org/10.1007/s10597-018-0351-8. Psychoanalytic Theory Paper.
ORDER A PLAGIARISM-FREE PAPER NOW
Fishman, E. (2017). Risk of developing dementia at older ages in the united states. Demography,
54(5), 1897-1919. doi:http://dx.doi.org/10.1007/s13524-017-0598-7
Lindgren, H. (2011). Towards personalized decision support in the dementia domain based on
clinical practice guidelines. User Modeling and User – Adapted Interaction, 21(4-5), 377-406. doi:http://dx.doi.org/10.1007/s11257-010-9090-4
Rosenberger, E. W., & Hayes, J. A. (2002). Therapist as subject: A review of the empirical
countertransference literature. Journal of Counseling and Development : JCD, 80(3), 264-270. doi:http://dx.doi.org/10.1002/j.1556-6678.2002.tb00190.x
Sagbakken, M., Naden, D., Ulstein, I., Kvaal, K., Langhammer, B., & May-Karin Rognstad.
(2017). Dignity in people with frontotemporal dementia and similar disorders – a qualitative study of the perspective of family caregivers. BMC Health Services Research, 17
Smith, D., & Kennerley, D. (2012). Enhancing dementia care. Nursing Management (through
2013), 19(7), 11.
Tom, S. E., Hubbard, R. A., Crane, P. K., Haneuse, S. J., Bowen, J., McCormick, W. C., . . .
Larson, E. B. (2015). Characterization of dementia and alzheimer’s disease in an older population: Updated incidence and life expectancy with and without dementia. American Journal of Public Health, 105(2), 408-413. Psychoanalytic Theory Paper.
The paper should be on a client that is either a patient you are working with or a mock client taken from a book or movie. Approach this paper as the treating therapist on the case. The components of the paper include an overview of the case (e.g. presenting problem, reason for referral, behavioral observations), chosen Psychoanalytic theory (e.g. Object Relations, Psychoanalysis, Self Psychology, Attachment Theory etc.) Provide a thorough, yet concise background of your Theoretical approach, including relevant historical content. Provide a theoretical case conceptualization using your chosen theory. The case conceptualization should address the etiology of your client’s presenting problems, providing a deeper understanding of the origin of the client’s issues (this section should be an in-depth analysis of the etiology of your client’s presenting problems from this theoretical perspective). Please also include a diagnosis and how your arrived at your diagnosis (differential dx). Additionally, you will need to provide a treatment plan (the treatment plan must be based off the theory chosen to conceptualize the client, and provide research in support of the effectiveness and limitations of the treatment (please use only peer reviewed journal articles or works by primary authors, no textbooks). Lastly, you will need to address transference and countertransference issues (please pay special attention to this and the impact it has on the therapeutic relationship), please address any multicultural issues throughout your paper. This is an 8-10-page paper (excluding title and reference pages), and you will need to cite at least 4-5 references to support your work. Psychoanalytic Theory Paper.