Question

Paul is a 34 year-old male, at his wifes request, entered therapy for his anxieties. He has suffered from bouts of depression and anxiety, feels like he must "prove" himself, and had friends who chose a different path than his and became successful while he has not attained their level of success. Describes how his self-identity revolves around his art or drawing(s) and is very affraid of failing. Suspect of therapy and suffering from unfullfillment, Paul dreams of being in an eastern European train station surrounded by lots of people, is visible shaken, when telling the part of the dream of his inability to get back where he came from. The train station is described as old and decreped like a video game he spent a week playing because of his work in animation. Paul from the age of 10 to 12 lived in Germany where missiles flew over head and it was said the German government was launching them. He also confused to drawing up in his room for hours at a time at that age. The therapist, from countertransference, starts to feel fear of not being able to help Paul fully, Paul intern answers the therapist with response of "oh, it's fine", to show he doesn't want to someone getting close. Using reality theory,
Given what you know about your client’s situation, identify one cultural issue that is significant in the client’s life outside of therapy or could become an issue between the client and therapist in the therapy session. After explaining the issue, explain two ways the therapist could sensitively address this cultural issue with the client in a way that that avoids stereotyping or bias.

Answer 1

Note: This response is in UK English, please paste the response to MS Word and you should be able to spot discrepancies easily. You may elaborate the answer based on personal views or your classwork if necessary.

(Answer) Reality theory is one that focuses on the person’s present situation as opposed to their past experiences. This is a subjective theory that can be applied to a case where there has not particularly been any traumatic childhood experience or such.

According to this theory, Paul would be counselled to focus on his present situation, the solutions and his current state of mind. The basic issue that Paul faces here is that he simply compares himself too much to his peers. On the other hand, Paul clearly has his doubts about therapy. He is seeing a therapist as per his wife’s request. Paul might have decided to be “closed” to the therapist and simply finish the sessions to please his wife.

The cultural problem here might not really be Paul’s past or that actual culture around which he grew up. However, it might be in reference to how Paul deals with people. The cultural problem here is that Paul opens himself up to notions and bonds that are harmful and he closes himself to people that might get to his core to help.

For instance, Paul has let his peers inside his head which has led him to make comparisons and in turn be unhappy with his own life. With the therapist, Paul has pre-emptively decided to close himself even though the therapist actually wants to help.

For each person we meet, it will either turn out to be a healthy interaction and or relationship or a degenerative one. It is up to our brain’s to decide whether we might close ourselves to the negative and absorb the positive interactions. For instance, a bully might tell us that we are stupid and our friend might tell us that we are nice. It is up to us to ignore the bully and focus on the good comment from our friend. This is a healthy culture that would promote better self-esteem.

Paul needs to learn to be kind enough towards himself and learn to close himself to the bonds that are causing him harm and open himself to the ones that are going to benefit him. If Paul masters these fundamental cultural tangents, he might see a great improvement in his relationships and with his anxiety. Therefore, closing himself to the effects of negativity and opening his mind to the positivity around him are the two ways in which Paul could ease his anxiety.