Case Study #4 – Robin Henderson Robin Henderson was a 30-year-old…

Question Answered step-by-step Case Study #4 – Robin Henderson Robin Henderson was a 30-year-old… Case Study #4 – Robin Henderson Robin Henderson was a 30-year-old married Caucasian woman with no children who lived in a middleclass urban area with her husband. Robin was referred to a clinical psychologist by her psychiatrist. The psychiatrist had been treating Robin with pharmacotherapy (primarily antidepressant medication) for more than 18 months. During this time, Robin had been hospitalized at least 10 times (one hospitalization had lasted six months) for treatment of suicidal ideations and one near-lethal suicide attempt and numerous instances of suicidal gestures, including at least 10 instances of drinking Clorox bleach and self-inflicting multiple cuts and burns. Robin was accompanied by her husband to the first meeting with the clinical psychologist. Her husband stated that both he and the patient’s family considered Robin too lethal to be outside a hospital setting. Consequently, he and her family were seriously contemplating the viability of securing long-term inpatient care. However, Robin expressed a strong preference for outpatient treatment, although no therapist had yet appeared to be willing to take her as an outpatient case. The clinical psychologist agreed to accept Robin into therapy, so long as Robin committed to work toward behavioral change and stay in treatment for at least one year; the therapist later pointed out repeatedly that this also meant that Robin agreed not to attempt suicide. Robin was raised as an only child. Both her father (who worked as a salesman) and her mother had histories of depression and alcohol abuse. Although the therapist did not learn of this until well into therapy, Robin had suffered severe physical abuse by her mother throughout childhood. When Robin was five, her father began sexually abusing her. Although the sexual abuse had been nonviolent for the first several years, her father’s sexual advances became physically abusive when Robin was about 12 years old period. These abuses continued through Robin’s first years of high school. Beginning about age 14, Robin had difficulties with alcohol abuse and bulimia nervosa. In fact, Robin met her husband at an Alcoholics Anonymous meeting while she was attending college. Robin continued to show symptoms of these two disorders (intermittent alcohol binges, restriction of food intake followed by eating binges), as well as the symptoms of major depressive disorder, at the time of her first visit with the clinical psychologist. Despite these difficulties, until she was age 27, Robin had been able to function well in work and school settings. She had earned her college degree and completed two years of medical school. However, during her second year of medical school, a classmate that Robin knew only slightly committed suicide. Robin reported that when she heard about the suicide, she immediately decided to kill herself as well. Yet, Robin had very little insight as to why the situation had provoked her inclination to kill herself. Within weeks, Robin dropped out of medical school and became severely depressed and actively suicidal. A certain chain of events often seemed to precede Robin’s suicidal behavior. This chain began with an interpersonal encounter, usually with her husband, which culminated in Robin feeling threatened, criticize, or unloved (usually with no clear or objective basis for this perception). These feelings were frequently followed by urges to either self-mutilate or kill herself depending to some degree on how hopeless or angry Robin felt. Robin’s decision to self-mutilate or attempt suicide was often accompanied by her thought, “I’ll show you” (“you” being the person she believed was slighting her or abandoning her). At other times, these behaviors seemed related to Robin’s sense of helplessness or her desire to permanently end her emotional pain and persistent feeling of emptiness These stressful interpersonal encounters occasionally led Robin to experience symptoms of dissociation. Following her conscious decision to self-mutilate or commit a suicidal act, Robin would immediately dissociate and, at some later point, cut or burn herself while in a state of what she called “automatic pilot.” Consequently, Robin often had difficulty remembering the specifics of the actual act. At one point, Robin burned her leg so badly (and injected it with dirt to convince the doctor that he should give her more attention) that reconstructive surgery was required. Although she had been able to function confidently in school and at work, Robin’s interpersonal behavior was erratic and unstable; she would quickly — and without apparent reason — fluctuate from one extreme to the other. She was an enigma to her few friends and family members. At times, Robin was personable and reasonable and behaved appropriately; at other times, she seemed irrational and enraged. After verbally berating her friends for no valid reason, Robin would become frightened and worried that she had alienated them permanently, which created a situation that Robin feared the most — feeling alone. Consequently, Robin would frantically do something kind for her friends to attempt to bring them emotionally closer to her. As might be expected from her behavior, Robin had alienated many people. When friends or family members tried to distance themselves from her, Robin would either threaten to commit suicide to keep them from leaving her (thereby holding them hostage, in a sense) or beat them to the punch by ending the relationship abruptly. Roman expected have all her needs met, yet she was unable to verbalize what those needs were. As mentioned earlier, when a friend disappointed her (e.g., cancelled lunch plans), Robin would take this as a personal affront, feel unaccepted and unloved, and want to prove how much she needed them. She viewed people (including herself) as all good or all bad rather than seeing people as possessing a mixture of good and bad qualities. This polarity (sometimes referred to as splitting) was also evident when others commented on her competency (e.g.., compliment her on her school performance). Because she would interpret such remarks as a sign that others viewed her as self-sufficient and gifted, Robin would react by showing them how incompetent she was (e.g., seek more reassurance for the quality of her work, demand extra study sessions) to prove to them that she needed their help and attention.Give a brief summary of the client’s clinical history.State the diagnosis you are giving your client (e.g, bulimia nervosa)What symptoms are being displayed by your client that fit the DSM-5 criteria for the diagnosis you have given your client.Briefly describe the treatment you would recommend for this client and give a brief rationale for why you selected this form of treatment  Social Science Psychology PSYC 2280 Share QuestionEmailCopy link Comments (0)