By Dr. Pradnya Ajinkya

The case study is being presented on this site so that the readers and students become more familiar with case histories. Case histories are designed to help oneself to test their ability to think their way through situations. This allows them to make responsible suggestions for treatment plans and goals. These cases themselves are composites of actual client cases or events. Even if you are not in a counseling program, it is still valuable to examine the case studies and try and answer one’s questions.

This couple both described as Indian descents are in my current study seeking marriage therapy with me since three months for issues affecting their marital relationship. The subjects are in good deal of pain and discomfort. Both are in their second marriages, each with one child in their previous marriages. The 46 year old man a dealer in electronic goods is reportedly into physical abuse and attention seeking. The 39 year old beautiful and educated lady a stay-at-home mom exhibits signs of classic abused wife syndrome and has the roots of the problem extending beyond the immediate relationship to her biological, psychological and social histories. They both experience various large stresses like financial commitments and raising their children to smaller issues like redecorating their home and entertaining friends. Their relationship is on the rocks. They are a couple who've experienced multiple failed attempts to conceive their own child, and the man has now recently a much younger girlfriend. They announce their troubled marriage very often in the middle of the night and their home security alarm is activated when the neighbors show up to sell the idea of peace. The commotion wakes the kids, who have overheard their parents' conversations of not being able to be together and fear that their parents are contemplating divorce.
The relationship problem involves direct physical abuse and indirect emotional abuse. The complexities of this case required the intervention of therapists and social workers. To prevent further abuse a complex treatment plan was designed that included individual therapies, family therapy, couple therapy and social worker intervention. I am taking a family systems approach to address the above problem in which the troubled couple are seeking help. The extent of the physical abuse is being assessed in terms of the health of the lady and the other family members involved. What affects one family member is going to affect all the other members of the family. The lady’s father and mother were often involved in physical abuse. This represents a biological or an environmental predisposition to violence. In this study, the biological influence of the lady’s father and mother’s tolerance to the abuse is of particular note. This factor is addressed in individual and group therapy. Family systems psychology looks at the family as an extension of the nuclear system. The lady is a battered syndrome and lives most of her life in fear of her own safety and security for self and children. She is in a historical familial crisis. She is unable to assert her needs or separate from the face of violence of her battered husband who will deny the responsibility of the abuse and blame his wife and others around for his behavior and need to resort to such anger. The lady’s psychological issues are not only with the problems in the marriage but can be correlated to issues in her own history: dependency, non-self-reliance, and low self esteem. In the given situation the lady’s physical well being is also of great consideration. She should rest and eat well and not suffer debilitating stress. Individual therapy program was identified to treat all the above and help her achieve a balanced treatment program. The larger social and cultural context to understand whether they live in a violent society is important and to be considered.
The diagnosis of the problems in the relationship were explored with detailed social, biological and psychological influences and addressed the need to recognize the symptoms and need for intervention. Though the burden was entirely on the couple, as a therapist we had to design a very intricate and complex series of interactions where the goal was to heal and empower each individual. The treatment plan had a strong focus on the marital issues and the problems in the marital relationship could be addressed taking into account the social, psychological and biological factors that influenced the marriage. The solution focused therapies and family systems approach helped to heal the individuals, the family and the potential relationship. Since the relationship was based on very troubled personalities and interactions, creating healthier boundaries and interactions was a primary goal. This case may not be unique but it does present some challenges and adaptability of psychological approaches to individual and interdependent problems.

Author's Bio: 

Dr Pradnya Ajinkya is a psychological counsellor , she could be contacted @