Sarah's Case

Sarah's Case

Sarah is a 37 year old wife and mother of two teenage boys who lives in a gated suburban community in Los Angeles, California. She is a general practitioner at her own doctor's facility, which makes her busy all day. She received high honors and achievements in college and medical school putting her in the top of her class. She pushed herself to the limit by not wanting to fail. She wanted to succeed at everything even with the stress she was putting on herself. She came from a line of doctors, which put a lot of pressure on her to be the best. When she failed at something, she always felt like a failure and also felt worthless causing her to have panic attacks at times.

In the past 3 months, Sarah's fatigue started to increase and her employees noticed her inability to focus on her job as a doctor. The patients began to complain about how slow the service was from waiting so long to see her. She often was very ill-tempered and reserved, which is nothing like she is normally. She was mostly known for being so happy and cheerful towards her employees. There have been times she would call in sick, which was not likely of her. On her "sick" days, she would be home all day in the bed sleeping or watch television. She even would ignore her calls from work.

At home, she had little to no sexual desires for her husband, which made him uneasy. She has trouble sleeping at night. The insomnia keeps her husband awake from all of her tossing and turning that goes on for an hour or more, if not all night. On some nights when she leaves to go to the bathroom, he can hear her crying. He tries to have a conversation with her but she refuses to discuss what's going on with her. He worries about her and how it's affecting their family and wants her to seek professional help.

Her children also noticed changes in her behavior. She would be very mean to them when they did something she didn't like. She would sometimes avoid every conversation they tried to have with her. This affected them in school because of her distant behavior. Sarah wasn't aware of the damage she was causing to her family.

Occasionally Sarah thought about suicide, but never succeeded in initiating it. She was not happy with her life and she knows that she should be, but can't find a reason why she feels the way she does. With all the accomplishments she has made, she still is not satisfied with herself and her life. She struggles with these feelings everyday and it frustrates her all the time especially with being a doctor.

Case Analysis

In this particular case, Sarah's behavior results from having an ego and a superego. She is pressured to meet her parent's expectation but not her own. Her actions are created by an inner aggression and an inner passivity, which causes emotions to vary from bad to worse making