provided unconditional acceptance and reward, Laura's mother made all of the major decisions in the family (such as finances, education, religion) and ensured family life was consistent and reliable (with regular mealtimes and expectations to complete homework and chores). She thus served as the instrumental gatekeeper for the family. Laura's anger toward her mom is in part due to the fact that her mom did not serve as her emotional support system and now, with her father's illness, Laura is replacing this loss with anger. 1You are Laura's therapist, and your family systems orientation is especially useful in her case. In this case, rather than seeking to diagnose Laura, what is the possible way to work with Laura and understand her family?
Laura is a 27-year-old never married Caucasian woman. Laura's father is 67 years old and has early-onset Alzheimer's disease. Laura also has a 56-year-old mother, who is in excellent physical health and a 31-year-old sister. Laura reports her father's health is rapidly declining. He has limited cognitive ability and memory, including loss of recall for faces and names.
Laura is currently seeking therapy because she is experiencing depression and having trouble functioning. During her intake, she also reports having a great deal of anger toward her mom and openly shares her intense feelings of loss due to her father's declining health; she reports deeply missing the emotional bond they once shared. She also reports having a solid relationship with her sister, though she wishes they were emotionally closer.
Before describing to Laura, the basic tenets of family systems, you first commend her for seeking out help. You also assure her that her feelings are real and that she is going through a tremendously stressful period in her life. You want her to know that she has your full emotional support. You share some local and international resources for individuals and families caring for loved ones suffering from Alzheimer's and encourage her to consider participating in a support group. You want Laura to know that she is not alone.
From Laura's discussion of her family, it further becomes apparent that Laura's mom is a highly competent and sensible woman whose strength lies in meeting the functional needs of the family. Unlike Laura's father, who provided unconditional acceptance and reward, Laura's mother made all of the major decisions in the family (such as finances, education, religion) and ensured family life was consistent and reliable (with regular mealtimes and expectations to complete homework and chores). She thus served as the instrumental gatekeeper for the family. Laura's anger toward her mom is in part due to the fact that her mom did not serve as her emotional support system and now, with her father's illness, Laura is replacing this loss with anger.
1You are Laura's therapist, and your family systems orientation is especially useful in her case. In this case, rather than seeking to diagnose Laura, what is the possible way to work with Laura and understand her family?
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