Identify two defense mechanisms used by Karen. Briefly refer to the characteristics of each defense mechanism you chose and explain how each defense mechanism is manifested in this case study.

Read the following case study:Karen, a 22 years old young woman, turned to treatment due to feelings of sadness and low self-esteem which she described to be feeling since the age of 15. At that time, she started experiencing difficulties with her academic performance at school, as well as loneliness and social difficulties. She also described difficulties in maintaining romantic relationships, as well as relationships with friends. When it comes to relationships with others, at first, she tends to easily create a meaningful and close connection, almost to the point of “giving her all”. After a short while, she is disappointed in one way or another, and tends to cut off any contact. In addition, she describes difficulties in understanding what she wants to do with her life, now that she finished her army service. She doesnt find any point or interest in anything and she is confused about her part in the adult world.
Karen is the youngest daughter of three sisters. Karens mom, lost her own mother while she was pregnant with Karen. Karens mom was very close to her mother, and experienced deep emotional distress, lack of strength and feelings of sadness and loss. These feelings lasted also after Karens birth. Karen described how her mother had once confided in her, that she had no energy at all after she gave birth to her. Not even to pick Karen up and calm her down when she used to cry as a baby. Moreover, it seems that Karens father was not able to be empathetic towards her mother, he was angry at her and distanced himself from her. This led to marital difficulties. Other than that, Karens development is described as overall normal. However, she did experience some difficulties in her adjustment to new educational settings.
Karen has been coming to treatment for three months now. She is consistent and doesnt miss any meetings. It’s clear that she values her therapist, as she keeps praising her, and the way therapy has been helping her. In the therapeutic meetings, she describes openly and thoroughly different social interactions as well as the relationships within her family. In the therapeutic relationship, it is evident that when the therapist says or behaves in a way that Karen does not like, she seems for a minute to be surprised and upset, but shortly after, explains why it was reasonable for the therapist to act as she did. When the therapist tries to cautiously relate to Karens initial reaction, Karen usually replies: I wasnt upset by it at all. However, the therapist noticed a pattern in which after such interactions occurred in the therapeutic meetings, Karen describes how other people make her feel angry and upset in the past few days.
Karen describes in therapy how much she loves and how attached she is to her mother. On the other hand, she is disengaged from her father, who she describes as a difficult and aggressive man. She is also very close to her oldest sister, she identifies with her and wishes to be like her. Karen describes her middle sister as being in the same group as her father, and Karen considers her to be as difficult as he is. Karen describes that throughout the years, when her parents used to fight, she used to support and defend her mom passionately. However, when the therapist refers to the role Karen took on herself in the familial relationships, Karen says its the role that every daughter should take. Analyze this case study using the following instructions:
Part A
1. Identify two defense mechanisms used by Karen. Briefly refer to the characteristics of each defense mechanism you chose and explain how each defense mechanism is manifested in this case study.
2. Define and explain the term transference and explain how it is manifested in this case. Part B
From the therapists point of view:
1. Try to sit in the therapists chair: choose a topic you would like to refer to empathetically (from Karens background or from the treatments description) and give an example of an empathetic sentence that could be said to Karen. Explain why you chose this topic and how it could contribute to Karen’s treatment.
2. Give an example of an interpretation that the therapist could give, and Karen would be able to benefit from. Explain why you chose this interpretation, what the goal of the interpretation is, and how it might contribute to Karen and her treatment.

 

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