ASSIGNMENT CASE STUDY - KAREN

Taking consideration of the implications of various orientation is vital in the process of

choosing the appropriate therapy for Karen.

In Karen case, her presenting problems was interpersonal relationship with husband and
children, psychosomatic symptoms caused by fear and anxiety result from her past experiences.
But underneath all that there seems to be another question more often than not, “What life
means to her?”. Underneath all the worries about practical living of life, Karen was uncertain
about “Who she really wanted to be? and “What she wanted to do?” which Carl Roger view
these as innately striving toward becoming fully functioning; Whereas Freud view these as
energy of life instincts that serve the purpose of the survival, oriented toward growth,
development and creativity (Corey, 2012).

The therapeutic actions and approaches in both person-centred and psychodynamic practice
aim to facilitate insight and provide new experience. Re-evaluation and insight learned by
Karen via explore her inner disputes and engage with the counsellor may change the previous
experiential gestalts of self-identity, the processes of consciousness and approach of relating to
self and others.

By taking person-centered approach, I considers Karen is her own enemy as the authority on
her own experiences and I trust that she is competent to be self-directed to her real self for
growth, which she has stated a goal wanted to be more involved in professional world and
pushing aside the distortions feeling of anxious to challenge the relationship with husband and
make the desire changes in her life. Through the Roger’s humanistic approach, my concern is
to deal with the way in which Karen perceive herself consciously. I encourage Karen to speak
freely about the discrepancy between how she sees herself and the person she would like to
become; about her fearful feeling of not succeeding; about her anxiousness and uncertainties
(Corey, 2012).

As the therapeutic goal of person-centered therapy, I strive to provide an atmosphere in which

Karen feels safe to lower the defences which she’s made to protect herself against thoughts of
being herself, fear of not succeeding in professional world; prospect of challenge the
relationship with husband that threaten her, and becoming increasingly self-actualization
(Corey, 2012).
Karen has a low evaluation of her self-worth and feels unappreciated by her children. Although
she uncertain about what she wants to become, she would like to develop a sense of herself
rather than live up a life of expectation from others. She wants to get more involved in
professionally, yet she is aware she feels inferior. By creating a trusting and encouraging
climate conducive to helping Karen feels accepted of herself with strength and limitations
(Corey, 2012).

Karen has the prospect to express openly the dreariness and drudgery experienced as a mother
and wife by taking care of her family needs, the anxious feeling of branching out from her
current roles, of not being able to be success in professional world.

Furthermore, she can explore how she is limited herself and fostered her family’s dependence
on her; and to express her guilt that she has not lived up to his husband expectation, think and
act selfishly to get more professional involved that might threaten

By exploring how she feels treated on a daily basis as if she is of little value by her family and
express her guilt that she has not lived up to their expectation and let them down, she can relate
her feeling of unappreciated over not having felt approval and needed when the relationship
break down with Jane and her children become independent; her concerned of losing them will
loosing herself. She can express the anxiousness and isolation that she often feels which lead
to range of psychosomatic symptoms.

This is similarly to the free association in psychoanalytic therapy to encourage Karen express
any thoughts or release of intense feeling that have been blocked. In additional, psychoanalytic
believe by doing so which leads to her past experiences aims to unconscious, conflicts and
motivation (Corey, 2012).

In contrast, Psychoanalytic approach focuses on the unconscious psychodynamic of Karen’s

behaviour to bring repressed feeling to light and strengthen her personality which deal with
anxiety to act in ways that are acceptable and appropriate. Considerable attention is given to
understand the nature of moral anxiety experienced by Karen in which she described her father
as distant, authoritarian, and rigid that generalized the fearful adherence to father (men) rules
and standard. Often, her mother was being critical, and she found it difficult to meet her
expectation. Karen’s anxious could be hypothesized as evidence of a phallic fixation because
she never received love and acceptance during her childhood (Corey, 2012). Thereby, she is
still suffering from deprivation of approval and acceptance from other; behave in ways that
other people will approve of, conform to husband expectations, to family value. The fearful
feeling has continued in the relationship with her husband is exacerbated by patriarchal attitude
which instead of accepting and celebrating such biological differences, imply that Karen are
disregarded because of her gender.

Furthermore, Karen struggle with the demands of her family culture expected not to express
feeling of fun or aggression – this would not fit the stereotype of femininity in which she grew
up and live in. Combined with Karen’s gender-role identification was oppressed with
difficulties in which she had learned from the inflicting punishment after her father refused to
speak with her because of caught her play with a boy when she was 6 years old; limited her
socialize with boy until high school ended, inevitable that she kept tight control of her feeling,
turning them inwards toward herself, particularly the feeling of guilt and ashamed that resulted
Karen repressed her own emerging sexuality.

Providing the psychoanalytic view of human nature is quite contrary to person-centered therapy,
both counsellors establish a different role and function in their practice. And yet, both practices
are bid to communicate an open, respectful and accepting attitude towards Karen.

Moving through the therapy processes, I’ll develop a congruence therapeutic relationship with
Karen. To demonstrate empathy and unconditional positive regard and expressing my
acceptance of the facets of her behaviour and personality. With the present of caring and non-
judgement attitude, along with the use of accurate reflection of content and feelings to express
empathy understanding of Karen’s internal frame of reference, she feels heard and understood.
Thereby Karen feel safe to letting me access to her inner feeling and created the opportunity
for herself to clarify her own feelings and attitudes.

Given the varying of counsellor role in psychoanalytic therapy as an interpreter, I listen to

understand Karen’s feeling and behaviour in order to formulate the nature of Karen’s anxiety.
The analytic process is focus on key influences in Karen development years (Corey, 2012). As
Karen revealing and exploring her memories of relationship with her father and mother in her
childhood through clarify and pointing out the meaning of her behaviour, Karen gets increased
understanding of the dynamics of her behaviours from how she generalized her view of men
and women from the family cultured that she was live in. Karen begin able to associate her
present problems with her childhood experiences that lead to re-experience of old feeling and
uncover buried feeling related to critical incident.
Consequently, Karen become to have more integrated self, where feelings split off as foreign
(id), become more apart of what he is comfortable with (the ego). As he comes to understand
how she has been shaped by the past events.

Combined with the congruence therapeutic relationship, unconditional positive regard and
empathy provided by counsellor, Karen feel accepted, and better able to understand her own
feelings which lead to her inner strength to recognize of self-worth and confident, in term of
her relationship with husband & children, and this may dispel her fears thus enabling her fully
express her desire to be more involved and succeed in professional world. Karen gradually
becomes increasingly sensitive to her own internal voice and less dependent on others opinion.
As a result, these will lessen the anxiety which cause the psychosomatic symptom, as she is
much more in control of what she really wanted to be and can make a positive and constructive
decision.

References:

Gerald Corey (2012). Theory and Practice of Counselling and Psychotherapy.