Seeing Beyond the Scars: A Testament to "Anna"
Keywords:self-injury, panic attacks, anxiety, eating disorder, depression, psychodynamic therapy, transference, counter-transference, defenses, case study, clinical case study
AbstractThe client, Anna, was an 18 year-old young woman who had a six-year history of self-injury, panic attacks, anxiety, disordered eating, and depression. She presented with a unique pattern of cutting in which she would cut when she felt too much and when she did not feel enough. In a sense, Anna existed in a perpetual cycle of emotional regulation through the induction of physical pain. Her thousands of scars are a testament to her deep emotional pain, which are associated with her relationship with her parents. From a psychodynamic perspective, Anna presented as very defended as she often suppressed her emotions, idealized her father, and dissociated during cutting episodes. The therapy primarily focused on maintaining and fostering the therapeutic relationship while using transference and counter-transference issues in order to promote the growth and understanding of her deeply rooted pain. Anna was self-referred and we met weekly for one hour in a college counseling center. Our work together was ongoing and included a total of 25 sessions at the time the case was written. I received individual supervision one hour per week from Andrea Kelly, a licensed Masters level psychologist, and group supervision two hours per week with Andrea and four other Master’s level interns from various colleges and theoretical backgrounds. Andrea, the client Anna, and I were primarily responsible for treatment planning; however, I did receive some guidance from the other graduate interns.
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