Understanding Sarah: Trauma and Resilience

History of Trauma: Sarah experienced emotional abuse from a previous partner, which has impacted her ability to trust and form intimate relationships. She also witnessed domestic violence in her childhood home, contributing to her anxiety and fear of conflict.

Factors of Diversity: Sarah identifies as a Caucasian woman from a middle-class background. She struggles with gender expectations in her workplace and feels pressure to balance career success with traditional gender roles.

Psychosocial Effects of Oppression: Sarah experiences alienation from herself and others due to societal pressures to conform to unrealistic standards of success and beauty. She copes with these pressures by striving for perfection and avoiding vulnerability.

Grief Issues: Sarah is grieving the loss of her grandmother, whom she was close to. She experiences feelings of guilt and sadness, as well as difficulty accepting the finality of death.

Attitudes Toward Parenting and Nurturing: Sarah desires to have children but fears repeating the patterns of dysfunction she experienced in her own family. She expresses ambivalence about parenting and worries about her ability to provide a nurturing environment.

Social Networks: Sarah’s social network consists primarily of coworkers and a few close friends. While supportive, she often feels disconnected from others and struggles to open up about her struggles.

Home Environment: Sarah lives alone in a well-maintained apartment. While her living conditions are comfortable, she experiences feelings of loneliness and isolation.

Other Relevant Information: Sarah is a legal immigrant from Canada and holds a work visa in the United States.

Clinical Formulation

Sarah’s current struggles can be understood through a psychodynamic lens, focusing on her unconscious conflicts and early childhood experiences that continue to influence her behavior and relationships. Her history of emotional abuse and witnessing domestic violence has led to internalized feelings of inadequacy and fear of intimacy. Sarah’s perfectionistic tendencies and avoidance coping strategies serve as defences against underlying feelings of vulnerability and worthlessness. Additionally, Sarah’s grief over her grandmother’s death may be exacerbating her symptoms of depression and anxiety, as she grapples with unresolved feelings of guilt and loss. Interventions aimed at exploring Sarah’s unconscious conflicts, building self-esteem, and processing her grief may be beneficial in addressing her presenting concerns and promoting overall well-being. APA