Biopsychosocial History
Ms. London is the primary household member who currently resides in a shelter. She is accompanied by her two biological children: Mary Gilbert and Joseph Gilbert. Ms. London was born on March 20, 1981, while Mary and Joseph were born in 2001 and in 2010, respectively. The race of Ms. London and her children is white. The only language that Ms. London can speak in Spanish, while her children can speak English. All four family members are Christians, and both of her children are American citizens and stay with her in the shelter.
The structure of Ms. London’s family is complex and currently incomplete, although she possesses vital support systems. Ms. London said that she has never been married and is not in a relationship. Mary and Joseph share a biological father, Jose Gilbert Morales. Ms. London has a sister, Magdalene London, who lives in New York. Their relationship creates a new subsystem that fortifies Ms. London’s family through sisterhood. Their bond enables Ms. London to employ assistance in times of need, as her sister may be available when Ms. London has to leave her children without supervision. Currently, Ms. London is unemployed; the last time she was employed as before the COVID-19 pandemic. According to Ms. London, she is not receiving child support from Mr. Gilbert. Her eldest daughter, Mary, works at Dunkin Donuts, providing further support for the family. The availability of this support provides the family with the resilience it needs, as Ms. London is able to perceive the outcomes of her work, while children develop a capacity for taking the initiative (Goldstein, 1995). Ms. London’s relationship with Mr. Gilbert ended in 2016 after he kicked her out, which put the family in peril, as its hierarchy had to undergo a major change.
Ms. London states that she was born and raised in Guerra, Mexico, and emigrated to the U.S. in 1999 to improve her financial opportunities. While in Mexico, she and her sisters were raised by both her parents in a large family where everyone was happy. The cultural sensitivity in this family does not play a significant role, as Ms. London’s children are not exposed to the Mexican culture and do not actively learn Spanish. Family dynamics reveal that the concerns from the past experiences of Ms. London may prevent the family from progressing further. Mr. London explains that her dysfunctional relationship with Mr. Gilbert was traumatic, as her partner was abusive to her and their two children. For example, in 2016, during an argument with Mr. Gilbert, he slapped and punched her, after which he threw her out of their home. In 2017, Mary Gilbert revealed that her father, Mr. Gilbert, had sexually abused her from 2016-2017. After the disclosure, there was an ACS investigation, and both Mary and Joseph were recommended for comprehensive individual counseling. Both children have since finished their counseling sessions. However, this incident is guaranteed to place an additional boundary on relationships for both Ms. London and her daughter.
A critical support system for the family members is the raised protection after Mr. Gilbert’s disappearance from this unit. Ms. London, Mary, and Joseph were victims of physical abuse perpetrated by Mr. Gilbert when they were 36 years old, 10-15 years, and five years old, respectively. Mary also experienced sexual abuse from Mr. Gilbert when she was 16. Additionally, both children were present when Ms. London and Mr. Gilbert were having physical disputes. After this incident, an Order of Protection against Mr. Gilbert was filed and issued on behalf of Ms. London and her children, but it has since expired, and she considers it now unnecessary. However, the psychological barrier that such a traumatic experience places on the family members damages their social relations with outside community members. At the same time, this boundary gives the family a shared event that brought it together and keeps it protected against outside influence, as Ms. London is now more protective of her children.
Session Analysis
My comment: “living in the shelter must be challenging, but it appears that you are doing what is best for her family.”
Ms. London: “I have been working for the last four weeks, so it has allowed me to have extra cash to be able to save money and buy clothes and toys for them. However, me working is also difficult because I do not get to spend time with them as I used to do. I feel like I’m trying to buy their affection because I am not there as much as I used to be.”
My comment: “have any of your children made statements or behaved in ways that you feel like you are overlooking them?”
Ms. London: “no, because I work during the day when they are in school. This way, I can be available when they get home. Sometimes, I would let my sister watch them if I needed to work another job.”
This part of the session highlights the boundaries and subsystems described above. It is apparent that Ms. London strives to provide her family with the needed finances herself, which creates an inner conflict that she is yet to resolve. Her sense of self can be described as anchored in reality and comes with a solid understanding of the situation. At the same time, a subsystem from sisterhood causes Ms. London to struggle with acceptance from the outside help, as her views on such relations are affected by her previous experience. As there were no earlier interactions between the client and the worker, the expression of Ms. London’s ego was not significantly affected by her perception of the interviewer. However, transference can be seen in Ms. London’s reaction to the provided comments, as her history affects the way she explains her struggles (Goldstein, 1995). Responses evoked by the questions resemble Ms. London’s subconscious desire to protect her children from outside influence.
In order to evoke an appropriate response, I used a question format that would least likely trigger a defensive mechanism. The family dynamics were apparent in Ms. London’s answers, who posed herself as a driving force for the betterment of her children’s future. Countertransference, which is my reaction to the client, had to be curbed for the initial session, as I did not intend to appear as protective, which would be detrimental to my social work (Goldstein, 1995). In my future meetings, countertransference will be more appropriate as a communication strategy for giving Ms. London the assurance of the direction of our conversations and actions.
Overall Impression of the Client
The overall impression from Ms. London’s assessment will be conducted by incorporating the five ego-oriented questions posed by Goldstein. Goldstein’s five ego-oriented questions focus on a person’s ego functions, defenses, sense of mastery, coping capacities, and life cycle stages, while ego functions refer to ego strengths and ego weaknesses (Goldstein, 1995; Goldstein, 2020). Ms. London’s ego strengths include an accurate sense of inner and outer reality. She has an accurate perception of her external environment and can identify the possible course of action for her life. For example, she is aware of the direness of her situation, and she is ready and willing to play her part in making her life and her children’s lives better. Ms. London’s defenses were showing in her attitude toward children and her sister. Ego defenses are an unconscious mechanism instinctually employed as defensive functions (Goldstein, 2020). Ms. London’s ego defenses include referring to the work she performs in order to provide for her children. While she has shown the ability to reveal her intentions, it is apparent that her protective instincts have been elevated since the father left the family.
The safety Ms. London seeks for her children shows her resilience and will. Reitz et al. (2022) explain that in the sense of mastery, a person can change their outside reality, change themselves, or move to an environment that already suits them. For Ms. London, she searched for an environment in which she could perform to the best of her abilities to raise Mary and Joseph in such a challenging position. Ms. London also presents a mature view of the world through her planning skills. Psychosocial development refers to the mastery of developmental tasks at every stage of the human life cycle (Reitz et al., 2022). Ms. London’s psychosocial development can be seen in her fortitude in seeking opportunities that make her better. She left her country to improve her financial status, and even though she has had challenges, she is still hopeful and effortful. Diamond & Hersh (2020) define objects of relations as a significant thing or person that is the target of the patient’s drives or feelings. This ego function highlights the motivation that Ms. London draws from her relatives, although it might prevent her from establishing new connections.
My work with the client is strictly positive, as Ms. London is evident in her intentions and opens up about her feelings as much as is expected in her situation. Despite the traumas this family sustained, Ms. London’s strong ego gives her children a solid chance at succeeding. Life in shelters is not a burden that hinders Ms. London, as she realizes the temporality of her position. However, I sense that there might be additional traumas in Ms. London’s past that shaped her social interactions. Her tendency to remain autonomous may serve as an obstacle to the future of this family.
References
Diamond, D., & Hersh, R. G. (2020). Transference-focused psychotherapy for narcissistic personality disorder: An object relations approach. Journal of Personality Disorders, 34(Supplement), 159-176. Web.
Goldstein, E. (1995). Ego psychology and social work practice (2nd ed.). The Free Press.
Goldstein, E. (2020). Ego psychology and object relations theory. In R. A. Dorfman (Ed.), Paradigms of clinical social work (7th ed., pp. 19-43). Routledge.
Hinshelwood, R. D. (2019). Countertransference. Key Papers on Countertransference, 41-79. Web.
Reitz, A. K., Den Boer, L., Van Scheppingen, M. A., & Diwan, K. (2022). Personality maturation through sense of mastery? Longitudinal evidence from two education-to-work transition studies. PsyArXiv. Web.