Sigmund Freud's Psychodynamic Case Study

Ellen is a thirty-nine year old women currently in the throws of a midlife crisis. She claims to be seeking therapy due to general unhappiness and dissatisfaction with her life. Ranging from psychosomatic conditions to crying over trivial matters Ellen is not happy with her current situation. She was recommended by her doctor to a psychotherapist. Created by Sigmund Freud, the origins of psychotherapy stem from the belief that there are certain forces that cause human behavior, feelings, emotions and their ability to relate to early life experiences.

Upon reading the case of Ellen, it was evident that there are some major issues that were underlying factors for this case. Firstly, Ellen’s relationship with her mother was toxic. Growing up,

Ellen lived in a household with an overly critical mother and a father who was rigid and unbending. She had no affection as a child and was most likely unable to express any form of individuality. She grew up in a very religious household, with a fundamentalist minister which most definitely did not help her expressiveness. This upbringing led to a stereotypical cookie-cutter lifestyle of the perfect housewife, from the constant need for approval to her repressed sexuality.

According to Freud, Ellen is dealing with a disturbance in the relationship between the impulses of her ID (the unorganized part of the personality, where our instinctual drives come from) that need to be satisfied by our impulses and the superego (represents social ideals, prohibits the id’s drives that are not socially acceptable).

A person who is said to have a strong ego (a part of a person’s conscious mind that serves a mediator between the id and the superego) has a good balance of drives and morality and thus leads a good and happy life. On the other hand, if a person has a weak ego the person could be seen as either immature or too inflexible depending on whether the id or the superego are more powerful. In the case of Ellen, her superego is more dominant than her id; resulting in anxiety. This anxiety is a signal to the ego that it is facing a situation that requires action. The action is usually conquered by defense mechanisms that people unconsciously use to diminish their anxiety and become happier. In psychodynamic theory, symptoms (such as depression) are seen as an intrapsychic conflict resulting from the superego harshly repressing the id. This is the only way the emotions can be concisely acknowledged. Ellen seems to be dealing with introjective depression, a form of depression that occurs when a person feels as of they have failed to meet either their own standards or that of important loved ones. Thus, making them feel like failures. This type of

depression also arises from the superego being highly critical and unrelenting. A symptom of her depression is her weight gain and sleep disturbances.

Although Ellen did not suffer from any childhood traumas per se, her childhood lacked affection and is remembered by her as one that is rigid and lacking fun. Therefore, she grew up to be someone who lacks self confidence and has a destroyed self image. She thinks of herself as someone who is incapable and that everything she does is of less quality than everyone else. All this is resulting in her being isolated in her own home which is the only place she finds comfort. This is proven by the lack of motivation she has to leave her house when her husband and kids are not around. A possibility as to why she feels this way is due to her mother’s constant negative comments and her father’s continuous disapproval. Ellen exhibits symptoms of lack of self confidence when she avoids eye contact and keeps fidgeting with her clothes.

According to the object relations theory, early interactions with important caregiver help shape the way one thinks, feels and behaves.

These experiences from childhood are then internalized and exist in one’s unconscious. When one gets older, the process of internalization switches to that of identification, as the person already has a set of ‘templates’ from all of his past experiences that affect all future relationships. This explains Ellen’s relationship with her husband, as her past templates are the relationships she had with her father and mother which consisted of fear and lack of emotional connection, Ellen does not know anything else and is consequently dealing with an emotionally unavailable

husband.