1. Based on this vignette, how would you describe the presenting problem for clinical social work intervention and/or psychotherapy?

In the case of Donna, it is no doubt that several issues are affecting her, aside from the trauma of a rape experience. First of all, her mum arrives late for the social work assessment, indicating how uncaring she seemingly is to her. As a mother, you need to be there for your child, all the times. Even though Donna portrayed a relaxed attitudeduring the interview, she was suffering inwardlyfrom various issues that the clinical social worker should be aware of. Even though she lives in an extended familywith several social relationships, Donna feels like she is neglect. She feels like she is left out and lonely in her world. The fact that her mother is never there for her is affecting her in some way. Her mother and father have never lived together under the same roof despite being in close contact. From a psychological perspective, this could be having an impact on her life. She is not in close contact with her parents, and her mother is not friendly, does not care much about her, and often beats her when she feels so much out in place.

At the same time, Donna is experiencing trauma from the rape. She may be feeling pain and fear because those who raped her walked free because of lack of evidence. I feel like the parents, especially her mother, werenot there for her during the hearing. Therefore, she did not have someone closer to tell her story. The clinical social worker should understand that Donna has angry feelings towards her family, particularly her mother. Even though she describes her father as someone who is aggressive and affectionate, he is seemingly not always there for her as well. She has spent most of her time with her aunt (Bea) and her grandma, Bessie.

Additionally, it is important to note that Donna is suffering from the loss of her aunt and the fact that her grandma, who used to take care of her is now dying of Alzheimer’s disease. Her relationships have resulted in a loss. It can be a traumatizing feeling to lose those who are seemingly close to you. Those who have remained (her mother and father) do not care about her. Aunt Bea was her ‘other mother’ for discipline and comfort. When her aunt died, Donna was left alone. At some point, she begins wishing she would die and her mother ends up slapping her when she shares the same feelings with her. From this experience, it is no doubt that Donna is frustrated based on the fact that she cannot share her feelings even with her biological parents. The feelings further became paramount, and she responded by trying to hang herself at the age of 10. The suicidal thoughts and attempts often result from depression and the clinical social worker should be aware of the same to effectively help Donna because, from the beginning, she says that she has always desired to goto therapy, meaning that she has been suffering inwardly.

2. What larger socio-cultural issues might be affecting this individual, and what cross-cultural issues might be present in YOURwork with this individual?

Donna is affected by various socio-cultural issues that further impedes on her ability to function effectively and normally. Violence is one of the socio-cultural issues that Donna has experienced. When she informed her mother about the feelings of dying, possibly with the hope of getting parental advice, she received a very hot slap. She is being slapped for sharing what she feels with her parents. It is also evident that Donna is affected by poor parenting. Poor parental care has significant impacts on the development of a child. Consistent, loving careoften shapes the developmental journey of a child. Parents who embrace the role of parenting with enthusiasm enablea child to acquire skills that would maximize their life potential. Poor parenting like the one exhibited by Donna’s parentsaffects the rapid growth and change that takes place in the development of a child from infancy to adolescent, with long-term consequences. Her unmarried parents were in communication for many yearsbut have not lived under the same roof. As earlier mentioned, she was brought up by her grandmother and cared for by her aunt up to age 5. Even though she is currently living with her mom, she sees her as a distant, and bizarre. She does not see her as a mother but as just a lady. This is a clear indication that the impact of the mother’s attention to the child is lacking and she is developing a feeling of neglect and loneliness. These result from poor parenting.

Another issue is the aspect of injustice. The society cannot serve justice to the victims of rape. A proper investigation was not done to ensure that the culprits are brought to book. Donna reports that she had signs of sleeplessness, problemswith concentrating while in school, flashbacks, restricted affect, constant fear, and continuouspanicincidences. And these feelings get worse when her mother disappoints her.

Another key socio-cultural issue is discrimination against transgender individuals. Donna says that she feels isolated because of the desire within her about developing romantic attachmentson her fellow girls. She feels secluded from her family, ignoredand judged by adults, and faulted for liking other girls. It seems the society looks down upon those who have transgender characteristics. They fail to understand that this is something that someone does not just wake up one morning and decide to do. It comes naturally. When she fell in love with Damond, her mom was against it, and she ensured it stoppedwhen sexual activities were involved. She punched Donna in the stomach.

3. Using object relations theories (i.e., Klein, Winnicott, and Bowlby), how would you assess the “internal representations of self and other” of the individual under discussion?What evidence do you see of Winnicott’s True or False Self? What evidence do you see of psychological splitting?How would you describe the individual’s functioning from an attachment perspective? How would you speculate the client’s relational patterns developed, and how would YOU work with this?

According to object relations theory, relationships are more important for development as compared to an individual’s ability and drives. The aspect of self is accorded much attention –a personal structure created out of interpersonal interactions. From infancy and early childhood, the self is made from metabolized and internalized interactions between Donna and significant people around her. From when she was born up to the age of 5, Donna lived a life away from her parents. She had no intimate interactions with them, only a little bit with her father. At the same time, it can be seen that her parents lived far away from each other and she has not spent time with her father and mother at the same time. She, therefore, misses the parental metabolized and internalized interactions. Donna, thus, grows up as a lonely and angry individual. When she faces rape, no clear evidence is garnered to help serve justice, possibly due to lack of parental closeness and support. She does not get some actions that ensure maintenance as well as enhancement of the self.For the establishment of a self, certain conditions are necessary. First of all, I agree withWinnicott’s dual unityconcept (an initial time of undifferentiated symbiosis) with a caregiving and mothering figure, separation from the figure, attaching to the caregiver, and other essential objects, traveling to and frofrom the attachment figures and ultimate individualization because the self – other interactions that turn out internalized and metabolized takes the nature of a secured self. This is evident in this case because from birth; Donna was separated from her mother to be taken care of by her aunt and grandmother up to the age of 5. She lost the attachment with her mother and father and got closer to her “other mother” and grandmother. She later got back to live with her mother but did not have a close personal attachment with her. She could beat herwhen she needed to be helped.

When Donna was narrating her traumatic experience of rape, she remained calm and relaxed. This was evidence of psychological splitting because rather than being sorrowful of the experience she went through; she decides to narrate her story with ease and calm. Additionally, when Aunt Bea died, she feltalone and lost. Even so, she did not cry at the funeral, meaning, possibly meaning that she did not feel the pain, but in the presence of her grandma, she smiled.

From an attachment perspective, Donna personal development is inferior. She lacks the attachment of her parents. Those close to her who she could turn back for the attachment are not available. Aunt Bea is dead while her grandma is dying from Alzheimer’s disease. This means that she is lonely. When she tries to form a romantic attachment with Damond, her reads it ill and ensures the relationship ends. The other members of the community see her as an outcast because of her sexual orientation. Therefore, because she cannot form a physical and emotional attachment to another person, she lacks grows as a person lacking a sense of stability and securityto branch out, take necessary risks, develop and grow as a person. It is important to note that a secure attachment, particularly to a caregiver gives an essential sense of foundation and security. Donna’s relational patterns, especially with her parents areone build on hatred and anger. The two are not there for her. Therefore, while working with her, it is important to note that she may need close attention to cooperate for assistance.

4. Using self-psychology and inter-subjectivity, what “self-object transferences” and “self-object counter-transferences” do you anticipate might develop with YOUand this client and why?How would you work with this?

While working with Donna, it would be essential to enhance the facilitation and development of self in the entire life cycle of therapy. Specific themes of self-psychology and inter-subjectivity, self-object transferences, and self-object counter-transferences would be used to help work with Donna. First of all, I would ensure she enjoys the experience of being seen, of being recognized for who she is, and the feeling of being understood. I also anticipate making Donna experience the feeling of having a reliable, knowing, and steady person. She should know that that there are other people around she can still count on. Additionally, I would develop the experience of being essential alikenesswith another. Donna would need to feel that she can recognize herself in another and think that others can recognize themselves in her.Generally, working with Donna would require a great deal of understanding her and making sense of her experience from within her personal world. It describes the significance of being empathetic. Believing in the value of commitment to the empathetic mode of observation and marinating the value of self-object transferences would enhance the development and transformation of Donna’s self.

5. Using contemporary relational theory, what ongoing enactments would potentially develop with YOU and this client and why?How would you work with this?

The contemporary relational theory would help me understand to a higher level, what is happening in the life of Donna, in myself, and within the therapeutic interactions. Those in therapy do not come into treatment to work on the relationship with the therapists. But clients always try without understanding, to involve the therapist as a new actorin their relational issues. Therefore, it is essential to remain empathetically regulated and constant and also be authentic and emotionally responsive. I would ensure that Donna explores new and healthier ways of developing profoundly fulfilling emotional attachmentswith those they desire to be close to. New patterns will start to replace old ones during the therapeutic process, to enable her experience positive carryover within and outside therapy. These would ensure that positive changes would occur in Donna’s relationship with others, especially her parents.

References

Bacal, H. A., Newman, K., & Newman, K. M. (1990).Theories of object relations: Bridges to self psychology. Columbia University Press.

Bifulco, A. & Thomas, G. (2012). Understanding adult attachment in family relationships: Research, Assessment and Intervention. London: Routledge.

Cassidy, J. & Shaver, P.R. (2010).Handbook of Attachment (2 nd Ed.) New York: The Guilford Press.

Michelle Lynn, W. (2010) Therapists’ attachment style and the use of touch in the therapeutic relationship: a project upon anindependent investigation. Theses, Dissertation, and Projects, Smith College.Smith Scholar Works.

Miller, A. (2014). Social work jobs in the mental health profession. [Online] Retrieved from: http://work.chron.com/social-worker-jobs-mental-health-profession.

Pete Harris (2014) An analysis of Melanie Klein’s “The Psychoanalysis of Children.” Newman University Publications.

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