Psychodynamic case formulation of 47 years old man


Author: Ushna Nawaz
The client is 47 years old man who is seeking therapy because of increasing tension in his marriage life and despondency over his career. The case formulation is based on the psychodynamic model. According to this model, the client’s past experiences, feelings, and hidden desires negatively influenced the client. As a kid, the client was scrawny and shy, therefore he was unable to help out his parents in their grocery store, due to this reason the client’s father was always angry with him which made the client believe that his father was sneering and contemptuous of his weakness. The client had a good time with his mother and aunts but not with his father. Consequently, the client felt detached from his father and more attached to his mother and referred her as a warm-hearted woman. He felt safer with his mother hence the client experienced the Oedipus complex. The detachment from his father increased with his budding interest in theatre. Although the client was shy and awkward he was very comfortable being on the stage, therefore, he selected to be a theatre artist but his parents especially the father did not support him and contempt his decision, this contradiction triggered emotional instability in the client. On one occasion his parents came to see him star in a college production, he felt that his father was unimpressed that serves as a subtle factor for his insubstantial self-esteem.
According to the attachment theory (Rholes, Simpson, & Friedman, 2006), the client experienced avoidant attachment with his parents, he went away from his parents to college to fulfill his dream of becoming a theater artist. As his parents were not supportive, so to avoid this situation he detached him from them. John was emotionally detached from his father during infancy and adolescence that also had a negative influence on his later life and relationships. More on, the death of his parents was traumatic for the client, the death of parents or continuously living with both parents’ dead disturbs the psychological well-being of an individual (Marks, Jun, & Song, 2007).
All these events that happened in his early life had a significant impact on his adulthood. As the client had been swayed by the Oedipus complex, during his childhood he was more vulnerable to social interaction defects and the problem with intimate relationships. The client was anxious about his intimate relationship due to the effect of the Oedipus complex, hence faced elevated tension in his marriage (Oros, Encenzo, Takling, Apugan, Lingatong, & Pon, 2019).  Another factor of increasing tension in marriage was being nagged by his wife about being a theater artist. Though he understands his wife’s worries when his wife asked him to find another job and undermined his confidence he had those negative flashbacks that made him angry for his wife. The client had difficulties not only with romantic relationships but also with other relationships. He was working in an industry where contacts were important, but he was not capable to maintain his social relationships. Due to attachment issues with his father he became short-tempered with his son.
Although the client was not on good terms with others in the industry, he was sincere with his profession and struggling to be approved as a great theater artist. He was experiencing frequent slights, dismissals, and apparent lack of interest in the industry towards him which increased his frustration created a self-complex and disruption that’s why he might be showing aggressive behavior (Leiscester, 2017). The negligence from the industry evoked his repressed memories and feelings of not being approved as a theater artist by his father- elevating emotional instability and low self-esteem. Consequently, when the client with affected self-esteem faces any problem such as a financial problem and the marital issue, he would be unable to manage them. More on, due to low self-esteem, he was not capable of making effective decisions. And because of emotional instability, he could not handle his emotions and feelings- causing frustration, irritability, and anger.
According to Freud’s model of personality (Bonifacio, 2013), the client was driven by Id as he was persisted to be a theatre artist instead of using other ways of earning, even when he was having financial problems. The client was using his self-deprecating humor so he can release his tensions and failures. Such clients constantly seek reassurance from their therapist and act like a child who after getting scold or hurt comes to their parents to get comfort. Therefore, the client tends to seek confirmation and validation and is emotionally attached to the therapist. There is also a possibility that he came late for therapy most of the time, not paid his bills on time, and never pays full amount because he has developed transference with the therapist (Phillips, 1980). The client’s problem could be decoded by working on his ego and by solving his unresolved conflicts.

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