Case conceptualization from the Ego psychology Conceptualization
Case conceptualization
At the time of treatment, the patient, Nikolai formally Gogol was a 32-year-old married man. Nikolai is an Indian-American born and brought up in New York, USA together with his sister. Nikolai parents had migrated to the USA a few years prior to his birth as a young couple. Nikolai is married to a Bengali girl, Moushumi. Throughout the session, it is deductible that Gogol somewhat struggles to reconcile his dual cultures as an American and an Indian which often affect his individualistic goals. On the one hand, it is apparent Nikolai is impressed by the free lifestyle of the Americans as evident of his description of his former American girlfriend, Maxine and on the other hand, he feels a sense of obligation towards his parents. It is obvious he fact that Nikola is an Indian-American made him a little eager to fit into society.
In several instances in the session, Nikolai lays emphasis that he is indeed an American. When asked why he felt the need to emphasize his nationality, he got defensive and stated his birth certificate attested this fact. He remarked that his need to clear doubt on the issue is the reason he officially changed his name from Gogol to Nikolai (or Nicky) as a young adult. While it is not clear where the patient’s issue with identity began, it is conclusive his teenage years characterized by extensive social interactions with Americans was the tipping point. It is deductible that currently, the superego overruns the id a factor that ignores the client’s individual goals and aspirations.
How changes occur and specific Interventions
Grounded on theories of the development of ego and ego identity, the physician will insist that Nikolai recognizes there is an aspect of discord between his two cultures, Indian and American. Despite being a child of immigrants, Gogol does not think of India as his country as he considers himself purely American. It is crucial for the medical provider to emphasize that Nikolai’s American identity will not, in any case, exist without his Indian parents. Nikolai faces a lot of conflicts both internal and external mainly due to the cultural clash between the Indians and Americans culture. Therefore, the physician will apply the development reflection and person-situation reflection, thus, ensuring Nikolai reflects on his past relationships particularly with his parents, his former American girlfriend Maxine and his current Bengali wife to ensure his gains insight on the existing discord. Both interventions will work as a conflict neutralization technique that will ensure Nikolai can confidently identify as both an Indian-American.
Fit Between the Condition of Change and Social Work Values/Ethics: Relevant Issues of Power, Privilege, and Oppression
It is evident throughout the session the core issue is that in no small extent Nikolai’s life in the USA has made him distaste his heritage. It is common, for Indians particularly of Bengali culture to apply the concept of dual naming where an individual is given a pet name in addition to his or her formal names during his childhood years which is often a persistent remnant of childhood. However, Gogol was not given a pet name in his early childhood, and he distastes his name ‘Gogol’ since it does not reflect either his Indian or American heritage. Therefore, cultural sensitivity is a critical aspect of delivering quality. It is vital for the physician to have a basic understanding of the India culture to empathize with the issues Nikolai faces.
Case Conceptualization from the Structural Family Theory Conceptualization
Case conceptualization
The Ganguli family is a family of four; the parents migrated to the USA prior to having their children a son and a daughter. The parents, Ashoke and Ashima, got married through an arranged marriage a common practice in India (Nair, 2006). The couple migrated from India to the USA with a sense of excitement ready to experience life in the USA. A few years after their migration, the coupled had two children, a son, Gogol who later changes his name to Nikolai and a daughter Sonia.
At the time of treatment, Ashoke and Ashima are in their middle-age, and both their children are grown-ups. Throughout the session, it is apparent the parents’ migration from India to culture distorted the concept of family. For instance, the father expresses his disappointment that his son felt the need to change his name yet the name was inspired by his favorite author and had no reference to either the American or the Indian cultures. From the interactions in the session, it is deductible the parents made efforts to ensure Nikolai and Sonia were connected to their heritage through making a close tie with other Indian immigrants (Nair, 2006). Moreover, it is evident Nikolai obligations to his parents have made him resentful. He called his parents hypocrites citing that they insisted they came to the USA for better opportunities but continue to their Indian heritage rather than embracing the American culture.
How changes occur and specific Interventions
Applying the structural family theory, the physician will insist that the family can adopt both the Indian and American cultures that better apply to them. The specific intervention is grounded on the emphasis of the strengths and weaknesses both at a familial and individual level in efforts of putting the familial issues in context. Moreover, intervention encompasses collaborate and productive discussions between and among the family members. It is crucial for Ashoke to realize while he came to the USA to achieve his dreams, the same is not the case for his son who enjoys the privileges of the American society but feels like an outsider due to clashing cultures. Primarily, the physician will provide stress management techniques in addition to facilitating open communication channels and role-playing to ensure the Ganguli family understands each other and their position in the USA society as immigrants.
Fit Between the Condition of Change and Social Work Values/Ethics: Relevant Issues of Power, Privilege, and Oppression
It is vital for physicians to acknowledge while the structural family theory was initially developed or immigrant families such as the Ganguli family it lays too much effort on the family structure as such higher chances of ignoring underlying emotions which is the core issue in the family at hand. Moreover, for the intervention to be effective, it is necessary for the practitioner to be sensitive to the macro-social situation of the family. For instance, in this particular case, it is paramount for the healthcare provider to acknowledge the position of the Ganguli family as immigrants. In many cases, immigrants are often at a worse socio-economic place compared to their counterparts who are natives of a particular country. Therefore, it is vital for the practitioner to be conscious of the socio-economic status of the family.
Case conceptualization from the Behavior Theory Conceptualization
Case conceptualization
At the time of treatment, the patient, Nikolai is a 32-year-old married man. Nikolai reports feeling a sense of regret even though his life appears to be great (Nair, 2006). Throughout his adult life, Nikolai formally Gogol felt the need to fit in the society a factor that made him behave in ways that would otherwise have not been the case. For instance, the client’s decision to change his name as a young adult illustrates his desire to belong. Indeed, throughout the session, it is a clear majority of Nikolai’s decisions, and by extension, actions are influenced by the desire to intertwine his Indian and American heritage. He appears to have difficulty feeling unfulfilled.
A case in point is his decision to marry a Bengali girl mainly to appease his parents who despite efforts of embracing the American culture still felt insecure about the free lifestyle of the Americas. The client recalls that his former American girlfriend could not fully adapt to the Indian culture; thus the reason for the break-up (Nair, 2006). It is apparent the patient’s regrets are rooted in his actions and inactions which were mainly motivated by the desire not only to appear American but also to impress his Indian practices s such he rarely made decisions for himself. It suffices to say the superego has been continually the core influence in Nikolai activities and as such the leading cause of regret currently.
How change occurs- Specific goals and interventions
The core issue under review is the notion that Nikolai is distressed and to a certain extend regrets the life choices he made. To facilitate the idea of decision-making grounded on his desire rather than the necessity to belong, it is crucial to change the reinforcements and punishments that the Nikolai currently receives. Specific interventions will encompass exposure therapy which works to bring his regrets into consciousness in addition to prompting him to face the unwanted emotions that bring about the disappointment. System desensitization might also be suitable since he could engage in thinking about his regrets and the issues associated with it while physiologically relaxing in productive and enjoyable activity. Moreover, the physician will employ cognitive-behavioral coping skills therapy which will assist him in creating a balance in the conflict of his desire to meet his traditional obligations and fit in the American society versus his individualistic goals.
Fit Between the Condition of Change and Social Work Values/Ethics: Relevant Issues of Power, Privilege, and Oppression
It is vital for physicians to realize to no small extent behavior theory addresses various social justice issues in contemporary society. For instance, in the case of Nikolai, the approach addresses the socio-economic and cultural issues associated with immigration and by extension issues of race and marital discourse. Therefore, the theory often urges medical providers to familiarize themselves with life experiences of the oppressed and culturally diverse groups in efforts of delivering quality healthcare. In recognizing how the Indian culture differs from the American culture, the practitioner understands the different types of reinforcement and punishment that influences Nikolai behavior. Moreover, it is essential for healthcare providers to recognize behavior theory tends to ignore individual differences in life experience which is vital in delivering care. Therefore, practitioners should make a point of emphasizing biopsychosocial perspective in providing care.
References
Nair, M. (Director). (2006). The Namesake [Motion Picture].
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