Boundaries; A Case Study
Samaritan Samaritan is a 48-year-old African American elementary school teacher who has been married four times.
She was first married to her high school sweetheart at the age of 18. He died three years later in the Vietnam War. She married her second husband seven years after that, but the marriage ended in divorce, when it was discovered that her husband was gay. Her third marriage was too man who was 10 years her junior and that marriage ended after 3 years when she found out that her husband Nas having an affair with a younger woman.
Now this current marriage is ending because of a lack of passion and companionship, and an apparent general disinterest.
Samaritan dreads the aftermath of this divorce. She has begun to isolate herself from friends and spend long periods moping and thinking about how gloomy her future will be because she has decided never to marry or date again. Cantata’s parents were happily married for 50 years. They are both recently deceased and she continues to miss their support, affection, and guidance. Samaritan has an older brother, whom she greatly admires and loves.
He has been married for 20 years and as two daughters with whom Samaritan has a close relationship. She views both her parents’ and brother’s marriages as perfect. Presenting Problem: Samaritan is experiencing depression because near tour marriage is in dissolution and she feels flawed and like a failure, and doomed to lead a life of loneliness. A life- long marriage has always been a profound desire for Samaritan. She was raised to believe that “people are meant to go through life two by two.
” She believes that the thing she wanted most in life has eluded her. She and her current husband have been married for 7 years.
The marriage has slowly eroded to the point where it is not remotely meeting her needs. Her husband has refused to enter into marital counseling and has stated that if Samaritan wants a divorce she can proceed with neither his support nor interference. Samaritan believes that her choices are limited and is greatly dismayed by the situation in which she finds herself.
ADSM-IV Diagnosis: AXIS l: VI. 10 Partner Relational Problem AXIS II: No Diagnosis Samaritan is experiencing problems with depression, an illusion of the perfect marriage, boundaries in marriage and loss of self and not enough time between third arraign and current marriage.
The therapist will use cognitive behavioral therapy to correct Cantata’s negative and distorted thinking about her marriage and previous marriages in order to change her behavior. The therapist will also attempt to break down the cognitive triad she is experiencing. By stopping the negative thoughts and views and introducing rational explanations of reality, it will help Samaritan get rid of the depression and negative emotions.
She is suffering from the emotional distance that being on the wrong end of a one sided relationship creates.
The therapist will also use Rational-Emotive Therapy to help Samaritan become more realistic about her views on her parents’ and brothers’ perfect marriage compared to her current marriage. Cantata’s past is the cause of her present problems and her beliefs about these problems is distorting her view of reality. The therapist wants to first work on Cantata’s view of reality, slowly introducing her to correct view of reality. The therapist wants to work with Samaritan for twelve sessions and if at the last session there is no progress, the therapist will request that
Samaritan continue to come until there is some progress.
The therapist will request later if the husband can Join the sessions towards the end of treatment. In the first couple of sessions the therapist will get a signed consent and establish trust with Samaritan. There will also be a case history done on Samaritan. The therapist will go on to discuss in the following sessions about Cantata’s depression and what is making her depressed. The depression could be coming from her thoughts of her current marriage failing or that she does not have a “perfect marriage” like her brother or parents.
The therapist will go on to discuss Cantata’s view of the perfect marriage.
The therapist would want to know why Samaritan views her parent’s and brother’s marriage as perfect. The therapist will also do a family history for Samaritan and a marriage history for her parent’s and brother’s marriage to find out what it took to make their marriage happy and “perfect,” and try to help Samaritan understand “hat it takes to make her marriage happy. In the next sessions the therapist will discuss with Samaritan about the boundaries in her marriage and discuss how and Nee did Samaritan lose herself throughout her marriages?
The therapist does not know about the current marriage but will hope to find out more throughout the sessions. The therapist will tint out it there were boundaries set in any to the marriages and if there were boundaries where did the marriage begin to break down. The therapist will also find out what the trust level is in the current marriage. Armorial et al.
(2008) stated that, “Although trust is a central component of marital relationships, it appears that establishing trust in the new relationship is especially Important for remarried couples” (p. 385).
Samaritan pretends to be who her cabanas wanted her to be instead of being the person she really is; losing her life in their lives. The therapist will try to find out what is missing in the marriage and Inch party wants the divorce. The therapist will use Bowen theory on family systems and find out what the symptom is in the system and treat that symptom in order to treat the system. The therapist will also want to discuss time with Samaritan.
Ere therapist would want to know how much time Samaritan waited in between the previous marriage and current marriage.
The therapist would want to know if Samaritan gave herself time to heal. Wolfing (2007) found that, “Many individuals rush into another relationship after one ends and research was done to test the effect of rebound time. Remarrying quickly may represent an inadequate search process: overly eager divorcees may choose second husbands or wives who are no DOD bets for lasting unions. ” (p.
1 1). Second marriages are divorce prone and Anteater may have happened in the first marriage that caused it to break up, may possibly be the cause of the new marriage.
For the treatment plan and what the therapist hopes to accomplish in each session would be as follows: Talk about family story (Give homework on family history-find out about parents and brother “Perfect” marriage) The therapist will point out what it takes to make a marriage happy and slowly help Samaritan realize that there is no such thing as a “perfect marriage” Talk about depression, what is making her depressed (give homework on building self- esteem) Build Communication (Give homework on how to build communication in the house hold for both and her husband to work on (A 20 Questions worksheet on what made each other fall in love with the other and how do each make the other feel DOD when they do… Suggest going on date nights, vacations etc.
) The therapist will also assign the book “The Love Dare” by Stephen & Alex Kindlier, to work on throughout the time while in session, at home with spouse.
The therapist will have Samaritan keep a Journal of her daily activities and feelings for that day. If she did her homework, she would write how it made her feel; as she follow along in the “Love Dare” at home, she will write if that day was a success and how it made her feel to accomplish the task. Talk about boundaries (Give homework on how to apply boundaries in the marriage, how to look for them and establish them) Talk about how he will take responsibility for her issues and how to work on the relationship/ How to establish the boundaries to make her marriage the “perfect marriage”. Help Samaritan learn how to love instead of complying with what husband wants.
Help her learn how to make the marriage strong and help her to understand how to make marriage work. Letter Writing/Empty Chair Technique (for current & past relationships). The therapist will have Samaritan write a letter of her feelings and concerns to current husband, also taking ownership in the letter for her part of the marriage failing. She also will express to her husband what made her fall in love with him. The therapist will have Samaritan do the empty chair technique with past relationships to release built up emotions.
Doing a personal history and tint out Inhere she lost herself/where she stopped caring about boundaries in her relationship. Help her take ownership of her life.
Help her find out where she lost herself and help her reclaim what she lost/setting boundaries in the relationship. Ere therapist hopes to accomplish success in helping Samaritan find herself and strengthening her failing marriage. The therapist would also hope to have Cantata’s current husband attend one or two sessions as progress allows.
Progress in the session will be shown when Samaritan starts to realize that there Is no such thing as a perfect marriage but knows how to build a strong marriage, when she learns what the boundaries in her marriage are, and when her husband and her accomplish coming to the session as a couple or Samaritan gives report on success in her marriage regaining the happiness it once had.
In the end the therapist hopes that Samaritan has found herself and that her marriage becomes more intimate. Samaritan and her husband will learn how to be separate people who are free to love each other. The missing ingredient would be deep intimacy and boundaries and without clear boundaries they could not know each other or truly love each other. Later with progress, the therapist can find out about entering Samaritan and her husband into the PREP program. Leper et al.
, 11995) found that, “The PREP program, discussed in the article, is designed to teach partner skills and ground rules for handling conflict and promoting intimacy in six 2 hour sessions.