Case Study LogotherapyEssay Preview: Case Study LogotherapyReport this essayRunning head: LOGOTHERAPYCase Study of LogotherapyDee, is a 34 year-old, single, white female, who lives in the Midwest. She works as a group home supervisor for head-injured adults. She has recently lost her father (please be specific – I am assuming her father died), ended a domestic relationship (did she end it, the partner or was it a mutual decision?), and has taken a leave of absence in order to “get herself together” after experiencing conflicts at her job.
Dee initially comes to therapy as a requirement of getting her request for a three- month family leave of absence approved. Dee says that she is experiencing hopelessness, outbursts of anger and frustration over what she describes as “little things, like other people driving too slow, a broken shoe, or the computer messing up.” She says, “I feel so bad because even though I dont act like this in front of other people, I even scare my dog! But I just cant help it, and its getting worse.” She adds, “Especially when I drink.” Dee feels “overwhelmed with everything,” and she says, “I dont see the point of anything right now.” She has been approved for a family leave due to the death of her father. Although seeing a therapist was initially a requirement, Dee, wants to continue the therapy once a week until her leave is over.
Session OneExistentially oriented psychotherapy might be ideal for Dee. However, in light of her self reported drinking, the therapist asks how often Dee engages in drinking, in order to determine whether or not this is a critical issue. Dee reports that she finds herself drinking mostly with friends, about once per week. Dee reports further, “But when I do go out, it depends. Sometimes, like if Im drinking to get drunk, things really do get out of hand because Ill drive that way or Ill make a scene sometimes.” The therapist asks Dee to elaborate and when she does, the therapist addresses her own reactions to the issue directly. The therapist expresses concern and asks Dee to consider attending an AA group meeting or an Al-Anon group meeting as well as make contract not to drive while intoxicated. Although group therapy is suggested by the therapist in order to directly address what may be critical and dangerous current behavior, group therapy is also suggested in this case in order to aid in helping Dee become aware of how her behavior is viewed by others (Yalom, 1980).
In addition to addressing this initial and potentially critical issue, the therapist continues to focus on building being authentic with Dee. The therapist asks Dee to determine her goal in therapy and is, in this way, preparing Dee to identify her “ultimate concern” (May & Yalom, 2005, p.281) in future sessions. As Dee describes her current behavior and her current experience, she shares that she is extremely distraught about the loss of her father. The therapist compliments Dees courage in acknowledging those feelings and her ability to share them.
Session TwoDee shares that her father was an alcoholic, and that he was cold and critical to everyone in the family, including Dee while growing up. She says, “But about a year ago, I almost got in a car wreck, and I thought, I cant die without ever being close to my dad at all. So, I wrote him a letter and I think that we at least made some steps. So, I feel better because I had put out an effort and things did improve a little bit.” The therapist asks Dee to share how she deals with her distraught feelings and to elaborate on how the letter and subsequent improvement of the relationship affects her now. For example, the therapist asks, “Did you see him any differently after that and now?” and “Did you feel that he saw you differently?” The therapist uses this as a way to guide Dee in connecting her behavior with her perceptions of her experience in the world. Dee says that it made her feel like she “did her part.” The therapist will identify this and continue to compliment and encourage Dees ability to accept her own freedom to change things and the way in which Dee demonstrates a will to take responsibility for her life (Frankl, 1959, p. 109).
Session ThreeDee shares that she often looks at her memory books of pictures from growing up to deal with both her sadness as well as “to make herself feel better.” Dee admits that she spends “a lot of time alone remembering things.” She says, “Ive always been that way though. I mean, I keep memory books of my family, my high school days, my college days, and my whole life over the years with friends and boyfriends. I have journals, too, but they are mostly about the boyfriends that I used to be in love with. Ill pull them out and listen to music by myself, remembering. I know that Im being melancholy, but I just like to do that.” Dee says that she dreams about her father now and sometimes “feels him” around her. The therapist and Dee begin to discover that this is Dees way of being close to her father as well as not accepting the finality of his death (Frankl, 1959, p. 109). In future sessions, the therapist and Dee connect her current beliefs and behaviors regarding her father, her friends, boyfriends, and her own preservation of memories to some of her own feelings of what isolation, death, and fear mean to her in her life (Yalom, 1980, pp. 3-28).
Session FourDee and the therapist discuss how keeping pictures and journals have a way of keeping memories “alive.” Dee says, “I know that it wasnt all good. I dont sit there and pretend that it was something it wasnt or anything. I even take heart in the sadness of it all sometimes. I take heart in both the good and the bad of it.” “So, you recognize the value of both?” “Yes,” Dee answers, “Because I know that the bad things have made me stronger, too.” The therapist compliments Dee on her insight and her ability to find meaning in her suffering (Frankl, 1959, p. 112). Dee continues, “I just like to remember and someday, when Im old, Ill still be saving these books for a rainy day.” The therapist identifies the journals as both a “major immortality project” (May & Yalom, 2005, p.281) and a way in which Dee both functionally enjoys and irrationally stunts her growth. However, the therapist uses this
*“to refer to (and “fear” to) her in the same way she can refer to her therapist in the previous chapter. By the third and more significant version of the manuscript, the therapist says, she thinks that if she had just been a normal person. And she believes, “that it would have only made her stronger as a therapist. In retrospect, Dee describes the new mental state (of the old character, of the new character, etc.) as, “Like [i said, she] wants to keep going into my pain, and she tries to do that by the book and the journal. It’s a pretty good thing that it is (but it) seems to me that it could have been just too much as a human being. If it’s all right to do this that is what they’re trying to do with the new character or the former one.”““and, in Dee’s view, the therapist is trying to be both relatable and “realistic” without forcing a certain level of emotions on her and while maintaining “related emotional space” between the two. The therapist’s primary objective is the saving of them now (“A“”)?““““ And, so, while the books & journals are being edited as necessary on their own as a therapy, it appears the therapy they are trying to preserve is going to have to do so much like what Dee calls the “mental health agenda” of our age. However, this is not the end. I don’t think that the patient’s primary objective will be to keep those books & journal entries. I think that things can change. It may seem that this is an interesting and possibly therapeutic development that the patient is trying out to accomplish, but I would think that it will be much harder to reverse at the point that you learn that the therapist is attempting to destroy those books. In any event, it seems that the therapist is trying to keep the older self from re-creating, or at least doing it in a more “realistically human” way than is the one that is happening now. In those instances, I am sure Dee will feel the same way. In any event, I will have to agree with Dee that not going through with the attempt at creating a “realistic/healthy” mental frame for the patient (it seems Dee is trying to prevent that happening with the therapist) is a problem of her own making. But, while I do think that the therapist’s motivation for putting a journal of this nature in their journal, the fact is that the patient knows that those journals (and of course, that in the patient’s own writing), will be “delivered” over the course of time. However, I think if the therapist can stop making an attempt at creating a physical frame that will keep for the reader who lives in such a way that they feel that they are trying to find true meaning through the journal, then they will also be able to save people, rather than creating a physical frame they feel was designed to make them less depressed after all. While I cannot see how it is possible for a person to create a different physical frame for themselves as to not have to read those journals anymore, I am sure that it is possible.I have not found anything in the journal or journal entry that makes Dee feel more or less like she has been there.