Case Study Of Dr. Harpin's Dysthymia

Upon the discovery of the stuffed puppy Paula once owned, Dr. Harpin asked if Paula remembered the puppy in the next session. She remembered and found the puppy up in her mother’s attic. After finding the puppy, it became a source of aggravation for Paula. Over the course of the next few nights, Paula would leave the puppy in one location, and then wake up to find it in bed with her. This would explain Caroline waking up crying because she wanted the puppy, and Sherry would retrieve it to console her. Paula would be left confused. There were four names; Paula, Sherry, Janet, Caroline, and soon to be added to the list, Heather. Heather is the identity that would still have relations with Cal. Heather was completely in love with Cal, and if

At first, Dr. Harpin’s diagnostic impression of Paula, before the appearance of her alter personalities, was dysthymia and borderline personality disorder. Dysthymia is a long-lasting form of depression that is not severe enough to meet the criteria for major depressive disorder. In the first year of treatment, Dr. Harpin’s approach was to focus on the management of frequent, specific crisis; the numerous suicide threats, fights Paula had with her mother and daughter, confusion and anger over the relationship with Cal, difficulties in school, and conflict with her employers. After the emergence of her altering personalities, Dr. Haprin thought she may have been malingering, or the deliberate faking of a physical or psychological disorder motivated by gain. He was skeptical of DID. However, he decided to abandon this view because of Paula’s lack of knowledge of the disorder, which would make it hard to fake. She also had no motive to fake

Harpin for several years. They had a healthy, working relationship that included a strong trust. Paula eventually accepted her diagnosis of Dissociative Identity Disorder. Together, they worked on an interpersonal, problem-solving approach. This encouraged Paula to learn and apply new, non-dissociative coping skills to handle stressful situations. There was emphasis placed on the identification of strong feelings, and logical connections between said feelings and specific life events. She learned to become more self-aware. Paula finally realized that Cal provided a trigger in her dissociative responses and cut the relationship off. Heather stopped appearing shortly after this. Paula also recognized the brokenness in the relationship with her children because of her disorder. There were sessions that included her daughter to try to mend what was harmed. Their relationship improved greatly. Dr. Harpin also highly avoided addressing the alters and speaking to them. When alter came about, he would immediately ask to talk o Paula. Over several months, the alters would stop making appearances and seemed to have no influence on Paula’s behavior. Lastly, Sherry’s attitude toward Paula changed. Their personality traits seemed to integrate and had become more