Childcare Case Study

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| 2012 | | | Case study – berne institute diploma | Caroline Le Sueur April 2012 | IntroductionThis case study is about Megan, a 26 year old, white, married, graduate with no children, who works full time in social care. I have been working with Megan for 14 months. Megan wanted to address her relationship with her parents and feelings of loneliness and isolation. The focus of this case study is confusion as a defence and how it was manifested and resolved in the therapeutic relationship. I work in private practice, with adult clients presenting with a wide range of difficulties. The majority of my work is long term. Megan was a private referral and made initial contact by email having found my details on line | Presenting…show more content…
The polarised, unintegrated nature of her A1 and P1 is shown by the solid line. In terms of parenting a pattern of her mother as unable to provide sufficient emotional attunement and meet early relational needs (particularly around safety and security) emerged. Whilst mum clearly ‘strived’ to be available to Megan emotionally, she was unable to do this particularly when Megan’s dad was angry and persecutory, as she herself, we hypothesised became overwhelmed. A good enough provision of emotional stability is necessary for the development of affect regulation in the child which is vital to the development of a core sense of self (Hargaden and Sills, 2002). Megan, had profound difficulties with affect regulation becoming overwhelmed and internally chaotic from what to an outsider might appear as very small provocations or stresses. The strong countertransferential pull I felt from the start to be an idealised, perfect other (the all good other providing the longed for relationship) and, conversely the undercurrents of fear and transferential pull to be the ‘feared’ object providing the feared relationship also confirms this diagnosis. The twinning and mirroring needs which also emerged from our initial meeting also support this diagnosis.Her use of splitting and projection in sessions as well as historical and behavioural evidence supports the diagnosis of a polarised, unintegrated A1 and P1. Treatment PlanMy treatment plan initially focussed on deconfusion of the Child Ego state using a relational model. Working relationally with its emphasis on third order difficulties would enable affect management and early unmet relational needs to emerge, be seen addressed and integrated within the therapeutic relationship. Second order intrapsychic and relational conflicts could also be addressed in a similar way. I

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