Psychological and Sociological Issues: A Case Study on Trauma and its Impact

Psychosocial Experiences

It is to be understood that the various types of psychological and sociological issues determines the health of a human mind and it is critical to consider the various types of life situations that not affect the life experiences of the person but also the way one starts to see and perceive life afterwards (Brownle et al., 2017). Repressed emotions and the experiences of trauma in childhood are repressed in the unconscious in such a manner that the level of understanding of the person and the overall behavior and personality of the person that makes the totality of cognition – is altered in a subtle manner (Balantekin, Birch & Savage, 2017).

As the brain grows and the limbic system is shaped by experiences – the emotional outbursts are chaperoned in a very subtle way and the various types of the learning that the human brain goes through at every walk and moment of life, changes the understanding and realization of the things and the memory has a major role to play in the shaping of learning and developed of more different and effective behaviors (Grilo, 2017). The behaviors of the human beings are very much proportion to the way one has been conditioned by the nature and the environment around and this form of behavior, both disruptive or constructive is very much dependent on the fact that the brain is capable of learning at a faster rate (Berg et al., 2019) and the neuropsychological functions of the brain are altered accordingly, in accordance to wiring and rewiring of the neurological connections of the brain, a phenomenon which is known as neuroplasticity (McElroy, 2017).

Psychosocial experiences are the experiences that occur in a social scenario that leave deep and meaningful impact on the person’s memory (Nwulia et al., 2017). The childhood experiences in a social and a family scenario are shaped by trauma and the various types of the detachment in the social context such as social isolation play an important role in the future experiences of the individual as well (Berg, Rostila & Hjern, 2016). The early memories imparts a certain kind of subconscious and also an unconscious bias on the human mind and this is important that it be analyzed by the therapist in a very pertinent manner (Olguin et al., 2017).. In this case study, veronica who is just 17 years old has a history of trauma that is the death of her sick mother and this traumatic, depressing event occurred when she was just 12 years old and this incident has been embedded in her memory and repressed into the unconscious, which continued to play a role in shaping her future behaviors towards the action taken on the account of her own well-being and on her perception and perspective about the world as a whole. It is to be understood that Veronica is 17 years old and this stage, according to Erik Erikson’s stages of psychosocial development, is the stage where the identity versus confusion are the major cognitive parameters that work towards the development of virtue called fidelity (Schulte, Grilo and Gearhardt, 2016) and this conflict within the individual affects the individual from a period of 13 years to 21 years approximately.

In case of veronica, as she is a teen ager, she is also suffering from the major identity issue and she has negative body image issues as well (McLaughlin et al., 2018). Dysmorphia and other psychosomatic disorder has affected her severely and the friends and the well-wishers who forms her immediate social surrounding play a very critical role in the building of her psychological condition where she is unsure of her appearance, of her sex appeal and completely in a state of under-confidence and low self –esteem (Wikman, et al.,  2018). The main problem is that the causation of her death, that is the expiry of her mother that happened about 5 years ago due to terminal illness and it is considered very imperatively here that veronica has observed and experience the sufferings of her mother when she was a child and as because her father always stayed away without caring for her and her mother, even when she was ill – affected her cognitively, emotionally as well as socially and psychosocially in a very wrong manner that is in a very adverse manner (Yee et al., 2019).

She did not cope with her the death of her mother well as because she was too young and the detachment was never very conditioned for her and the loss of her mother, played a vey traumatic role in her life, thus aiding her to cope very negatively and as she lacked any kind of significant social and family at that time – the burden of loss took a very huge tool on her. It is to be understood very imperative the psychosocial condition that she was subjected too was very negative and as she was negatively coping – she binged on excessive eating and this caused the overweight issue to manifest in Veronica.

The various types of the problems that affected her appearance and biological growth was the very overeating and the binge eating issue that caused her menarche process to disrupt, in a way. But as a result, although she is complex with the size of her breasts and she is so suffering from low esteem due to her perception about the size of her breasts and connecting her appearance of being overweight and having small breasts to the feeling that she cannot be loved or accepted by the society and by the persons, she wants to be with – is delusional. This is a clear case of identity issue that has resulted from a fast shifting self-image issue and the self-concept issue. She is confused in terms of her identity as a lover, as a friend, as a daughter and as a person that she is for herself as well and all these has attributed to her feelings of Dysmorphia and low confidence as well of of autonomy, integrity, self-respect as well the feelings of social isolation and unworthiness, hopelessness has affected her deeply (Bright & Thompson, 2018).

Another very important perspective that is required to be analyzed is the fact that veronica served her mother till her last days and her father who is ought to be a very important person in veronica’s life has never played a significant paternal part in her life and veronica, in her childhood has been alienated with the feelings of isolation and detachment, as far as the relation between her and her father is concerned. It is to be understood very pertinently that not only the death of her mother but the going away or parting of her father, gave her ideas of detachment which till later, in her adolescent to near adulthood life, has reflected in her relationships as well (Vågerö & Rajaleid, 2017). She lost trust in relationships observing how her own father left her and her mother, even though she was suffering from a terminal disorder, in loneliness and left them both in state of hopeless sufferings.

This incident was very traumatic for Veronica and she continued to have relationship issues with her father who was never there for her and this of course, played a great role in the shaping of her life through the development of inferiority complex,  psychosocial issue, eating disorder as a negative coping mechanism and subsequent detachment from the society (Drislane et al., 2019) and huge problems with maintain herself as human being in a state of sanity as she continued to go through state of relationship problems with her boyfriend and friends. Her father demonstrated poor relationship skills, poor emotional management skills and guardianship attributes as well that later on lead to the development of same in her as well.

The point here, is that, the children and their experiences are greatly experiences, almost unconsciously and even consciously plus subconsciously by the factors determining observational learning and this has lot to do which how an individual enacts out in situations of life and how the bias of previous experience has been created. Thus, it is to be noted very pertinently that as Veronica learned observationally from her father, the behavior and the relationship skills he exhibited as a romantic partner to her mother, wired her cognition adversely, thus diffusing the areas of right and wrong and this is one of the prime reasons that negatively coped with the situation and became overweight.

Veronica's Case: Trauma and Coping Mechanisms

Presenting Problem

The problems that are presented in this case are negative body image issues, detachment issues, social isolation, repetitive behaviors (looking multiple times in the mirror), low self-esteem, loss and grieving followed by depression and negative coping mechanisms, relationship issues, binge eating and over exercise, eating disorders, dysmorphia that has led to more complex psychosocial complexes, thus affecting the development and presentations of her issues in a more subtle manner. Veronica has developed eating disorder post the death of her mother and the detachment from the only person from her life, to whom she was very much attached resulted in the shift of her eating habits and she took on binge eating and she put on more weight in a very complex manner.  The shifting of self-image and the self-concept is important that they are studied and considered well why analyzing this case of Veronica. As because, she lacked the support from her anybody else after the demise of her mother such as her relatives, neighbors or friends who would guide her and support her through her neuropsychological development at the time of puberty and the negative coping while she was depressed with the death of her mother led to negative coping and more eating disorder.

This caused the negative body image to grow more vibrantly as she was getting overweight day by day and this together with the pubertal changes (Cooper, 2018) – left her in an uncontrollable psychosocial situation. Moreover, it is to be considered that she developed in her puberty and the more the fact that she was putting on weight due to binge eating caused by the death and non – supportive attitude of her father who never understood or at least attempted to understand her problems caused her a lot of deep seated emotional issues and emotional detachment as well. While she had relationship issues with the persons she thought to a romantic connection with – also failed due to reason which was not only due to her physical appearance (as the fact was glorified by her friends thus affecting her self-esteem in a more negative manner) but due to her confidence instability as well, due to low self-esteem and lack of dignity for own self that caused the very situations to arise.

Not only the negative self-image and the overweight issues caused a lot of low dignity, low confidence and low self-esteem issues in Veronica but also led to the development of a shifting self-image and a dire self-conflict of whether or not to stay with a person caused a lot of relationship issues in her life. The problems in her present life and present condition, although seems very new and acute but the development of the same was predisposed by various types of predisposing factors that pertains to her childhood trauma and the repression emotions being bought to surface by the series of concurrent events of her present life. Moreover, last but not at all the least, the friends who reasoned her body shape and the sizes of her parts being the reason she is not accepted by her lover, is not ethically correct and instead of helping to reconcile her emotions and confidence that is lacking very much, they made her feel guilty for the state of her being and this disrupted her confidence even further and this along with the aforementioned reasons has [played a really important role in the current state of life with her low confidence and body image issues that are very much disturbing as well. The different triggering factors and the various types of the precipitating factors that led to the causation of these negative body image issues in Veronica that she is overweight and she has small breasts and this depressed her even more, when her ex elucidated on the fact that she should have breast implants if she has to marry her. Not only this, Veronica is also concerned about the condition of her skin and that she has disproportionate ears as well.

Presenting Problem

The predisposing factors that has led and made way to the present problems of seventeen year old Veronica, are many and multi-faceted as well. Firstly as mentioned above as well, she cared for her mother alone during her terminal illness stage and the fact that her father was not there with them and abandoned them in such severe situations left a deep trauma and isolation as well. Then she was at the age of 12 years, she experienced the death of her mother when she was still at a very tender age and this shock, although she has seen her mother suffering through the stages of terminal illness but still for a 12 year old daughter, the death of a very close person, her mother, whom she was connected and attached too, self her in trauma as well.

This predisposed to feelings of loss and detachment that caused the various types of the relation problems in the future as well. It is important to be understood that the various kinds of feelings that she went through as a teen and a child, in her developmental years, caused and added to more self-conflict between the attainment of identity or confusion and it can be said, after having analyzed that the case in details, that the ongoing conflict in her that made the confusion to overpower her identity and she put on more weight day by day that apparently made her breasts look small, that again triggered her in an adverse way and manner. The other problem was that her father was not with them her mother was advancing through the stages of terminal illness and this abandonment done by her father, made her feel detachment from relationships as well. When after the demise of her mother, when she was overeating and going through pubertal changes that distorts the body image drastically – her father was not there to listen to her issues or attend to her issues and life condition in a very fatherly and protective way and this made her lose faith in relationships and paved the way to future relationship disruptions.

The triggers are many and this has added to the negative body image issues in Veronica, more adversely. Firstly, the most important trigger was what Veronica mentioned for herself that her ex-partner with whom she was in a romantic relationship with - said that she must get a breast implant if she wants to be with him and if she actually wants to marry him and this comment from her partner whom she would have believed so much for desiring her for the person she is – triggered her the body image perception in a very negative manner. Not only this, her self-concept was distorted as well. Next was the incident where veronica said that she started to feel self-conscious regarding the breasts size as Veronica described in a situation, that the breasts were very resembling to that of the aliens and this was the second trigger, as mentioned in the case study, as Veronica started to feel, ever more, that her body and especially her breasts are not normal and the fact that she is overweight, she feels very adversely and negatively about her body image and in the process, she has grown negative feelings for herself. She feels isolated and feelings of loneliness have taken over her, as she associated the reaction and response rather the behaviour of her partner with that of her father who was never there for her and never cared for her as well.

Perpetuating Factors

The factors are that are likely to maintain and then worsen the main problems that Veronica is suffering are many-faceted. Firstly, if she continues to go on eating, that is binge eating and keeps maintain her low self-esteem as well as negative body image without doing anything to change it - would add to the issues as well. The other fact is that if she is not being able to transform her negative thoughts into positive thought, that is alter the cognition patterns – that would again lead to more problems psychosocially and more so, the same would serve as perpetuating factors that would maintain her low self-esteem as well as negative body image. The main issue is binge eating and somewhere and somehow, the eating disorder that begin initially as a negative coping mechanism as a reaction to her mother’s death – was embedded in her mind and integrated with her cognitive pattern that is till perpetuating her present problems in the present situation (Rajaleid & Vågerö, 2019).

Protective Factors

Other than all the above mentioned adversities that has already analyzed, there are certain protective factors that is acting strengths both individually and support system. Another protective factor is that she herself has the desire to feel healthy and fit by losing weight and then undergo the plastic surgery only. Then as she has visited the general practitioner, that means she is willing to change her and herself in a more positive manner and the medical resource that she is touch with, in the current condition – is also a protective factor. This is important to be considered that in order to improve her willingness towards a more confident and positive life – the protective factors must be taken into practice.

Rreatment Intervention

The treatment and the intervention are important that they are delivered properly to the Veronica. At first, her binge eating has to be controlled at first and then, the general practitioner can collaborate with a nutritionist in order to improve the diet and plan the diet intake of Veronica, in a therapeutic manner. She must exercise on a regular basis but in a proper way, without burnout and without over exercising which is problem with her and here, a collaboration with the physical therapist is important as well. Lastly, she has repetitive behaviours (with looking at herself in the mirror) that need to be desensitized as well, through cognitive behavioural therapy and desensitization therapy, where a psychotherapist can be collaborated with.

Conclusion

The freedom of thinking and psychological counterpart of the same phenomenon is cognitive flexibility but it is to be understood that the age, as according to the Erik Erikson’s stages of psychosocial development, the development of the human mind is shaped greatly by the various psychosocial experiences. Hence, it can be concluded saying that in Veronica, the various types of disruptions occurs due to trauma resulting from loss of mother and subsequent ill relationship experiences with her father and then with her boyfriend that resulted in negative coping but with the right awareness, desire and intervention, the same can be addressed as well.

References

Balantekin, K. N., Birch, L. L., & Savage, J. S. (2017). Eating in the absence of hunger during childhood predicts self-reported binge eating in adolescence. Eating behaviors, 24, 7-10.

Berg, L., Rostila, M., & Hjern, A. (2016). Parental death during childhood and depression in young adults–a national cohort study. Journal of child psychology and psychiatry, 57(9), 1092-1098.

Berg, L., Rostila, M., Arat, A., & Hjern, A. (2019). Parental death during childhood and violent crime in late adolescence to early adulthood: a Swedish national cohort study. Palgrave Communications, 5(1), 1-8.

Bright, M. A., & Thompson, L. A. (2018). Association of adverse childhood experiences with co-occurring health conditions in early childhood. Journal of Developmental & Behavioral Pediatrics, 39(1), 37-45.

Brownley, K. A., Berkman, N. D., Peat, C. M., Lohr, K. N., & Bulik, C. M. (2017). Binge-Eating Disorder in Adults. Annals of internal medicine, 166(3), 231-232.

Cooper, R. (2018). Diagnosing the diagnostic and statistical manual of mental disorders. Routledge.

Drislane, L. E., Sellbom, M., Brislin, S. J., Strickland, C. M., Christian, E., Wygant, D. B., ... & Patrick, C. J. (2019). Improving characterization of psychopathy within the Diagnostic and Statistical Manual of Mental Disorders, (DSM–5), alternative model for personality disorders: Creation and validation of Personality Inventory for DSM–5 Triarchic scales. Personality Disorders: Theory, Research, and Treatment, 10(6), 511.

Grilo, C. M. (2017). Psychological and Behavioral Treatments for Binge-Eating Disorder. The Journal of clinical psychiatry, 78, 20-24.

McElroy, S. (2017). 451. Treatment of Binge Eating Disorder. Biological Psychiatry, 81(10), S184.

McLaughlin, K. A., Gureje, O., Kawakami, N., Koenen, K. C., & Kessler, R. C. (2018). Effects of Childhood. Trauma and Posttraumatic Stress Disorder: Global Perspectives from the WHO World Mental Health Surveys, 163.

Morgan, C., & Gayerâ€ÂAnderson, C. (2016). Childhood adversities and psychosis: evidence, challenges, implications. World Psychiatry, 15(2), 93-102.

Nwulia, E. A., Rai, N., Sartip, K., Hipolito, M. M. S., McLean, C. K., Flanagan, K., ... & Kapetanovic, S. (2017). A Pilot Study of Reduced Olfactory Bulb Volume as a Marker of PTSD in Childhood Traumaâ€ÂExposed Adult HIVâ€ÂInfected Patients. Journal of traumatic stress, 30(5), 537-544.

Olguin, P., Fuentes, M., Gabler, G., Guerdjikova, A.I., Keck, P.E. and McElroy, S.L., 2017. Medical comorbidity of binge eating disorder. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(1), pp.13-26.

Rajaleid, K., & Vågerö, D. (2019). Stress resilience in young men mediates the effect of childhood trauma on their offspring's birth weight–An analysis of 250,000 families. SSM-population health, 8, 100429.

Schulte, E.M., Grilo, C.M. and Gearhardt, A.N., 2016. Shared and unique mechanisms underlying binge eating disorder and addictive disorders. Clinical psychology review, 44, pp.125-139.

Vågerö, D., & Rajaleid, K. (2017). Does childhood trauma influence offspring’s birth characteristics?. International journal of epidemiology, 46(1), 219-229.

Wikman, A., Mattsson, E., von Essen, L., & Hovén, E. (2018). Prevalence and predictors of symptoms of anxiety and depression, and comorbid symptoms of distress in parents of childhood cancer survivors and bereaved parents five years after end of treatment or a child’s death. Acta Oncologica, 57(7), 950-957.

Yee, K., Serrano, D., Kando, J., & McElroy, S. L. (2019). A psychometric analysis and revalidation of the Yale-Brown Obsessive Compulsive Scale modified for Binge Eating in adults with binge eating disorder. Quality of Life Research, 28(12), 3385-3394.