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What counselling therapy would be best here?


Mary has sought counselling because she is feeling depressed. She has recently been off work for 8 weeks and is taking antidepressants. Although she does not feel well she is back at work and very afraid that if she takes more time off she will lose her job. She works as an auxillary nurse on a maternity ward. Due to the difficulties she is only working nights. She loves her job and describes it as the only good thing in her life.
Mary feels that her problems stem from her relationship to her father who was both physically and mentally abusive towards her, her two sisters and mother. She is the youngest child by 10 years her two sisters are very close in age. She is 28 and her sisters are 37 and 38 years both are happily married with children. Their father died 12 years ago and at that point Mary dropped out of education. Mary still lives at home with her mother and feels dominated by her sisters and also marginalized within the family group. She describes herself as still having loving feelings towards her father and would visit his grave. Both her sisters are described as hating their father and still talk about him with anger and bitterness. They feel that Mary鈥檚 feelings are a betrayal of family values. She feels that they are trying to force her to think like them and be like them and do not give her any respect as an adult with her own views. She feels the key to her current feelings is in the nature of her relationship with her father but she cannot talk about him without getting upset. She also tells you that her memories of childhood are patchy and she has no memories before the age of nine.

I sort of suspect this is an assignment you have to do for a course you're taking - and really, you should be thinking about this from what you've learned on the course!! However, because the answer I'm going to give is something you've probably not been taught, I'll break my own rule of not doing people's assignments for them.....

What I think could be really helpful for Mary is psychosynthesis psychotherapy. The reason for this is as follows.
1. Mary finds it difficult to talk about her father, but she feels this is the very thing that she needs to address. She is also living with her mother and so it is tough to be brought up against the reality of the failings of her parents in her childhood when she has to face her mother daily.
2. Not remembering childhood may or may not have particular significance. Of course, you know that we block memories that are too painful to be borne - but also, we forget for many other reasons. She will remember what she needs in the course of the therapy, so this isn't a reason not to go for psychodynamic therapy.
3. The issues underlying her current difficulties are obviously deep-seated and relate to unconscious material. Therefore I would be reluctant to see her go down the person-centred route, because I fear a good deal will be left untouched, only to come up and grab her again in the future.
4. What she needs is a context that can hold the understanding of unconscious material, of the inner playing out of external realities of the family. But the context must be able to deal directly with here-and-now realities. Gestalt might be an interesting option, but I am not sure she would be able to deal with what can be experienced as quite a confrontational approach.
5. If Mary gained some sense of her strengths, of the meaning and purpose in her life, it would provide her with a strong internal context to face the current difficulties and their underlying causes.
6. Psychosynthesis offers a context of purpose and meaning, of the individual's inner strength and knowledge, and uses means to access this understanding which don't require going straight into deep unconscious material. Often, images and understandings are evoked through drawing, writing with the non-dominant hand, sub-personality work etc. It can hold the psychodynamic context and work with this as Mary becomes more comfortable and confident in her self.

I could write tons more, but I just remembered it's you writing the assignment, not me!!

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