Academic journal article Journal of Psychology and Christianity

The Case of Mr. P

Academic journal article Journal of Psychology and Christianity

The Case of Mr. P

Article excerpt

The case verbatim which follows is an assembled version of clinical material which was generated for the purpose of providing a uniform case that symposium presenters could utilize for their respective topics. This expanded case material is an enhancement by the author of the case of Jim in Terrell's (2007) Journal of Psychology and Christianity article, "A Discussion of Intentional Incarnational Integration in Relational Psychodynamic Psychotherapy." The case is organized in two parts which are both partitioned into sections.

Case Verbatim

Part I

Section 1. P had been in once weekly individual psychotherapy for 21 weeks. In the last month he had increased to twice weekly due to P's rising level of anxiety as well as signs that the possibility of reconciliation with his wife was in jeopardy,

P: Hi Doc . . . sorry I'm a couple minutes late. I had to take a call from Singapore just as I was leaving. Then my secretary handed me a note that a shipment was going to be delayed if I didn't call Central Supply and authorize a customs application. Normally that wouldn't have bothered me, but the shipment was worth 3 mil. and was going to one of our best customers - a tycoon. Made his money just sitting in a chair and selling his own brand of throat lozenges. Must be nice.... Some of us have to go running around killing ourselves to get ahead. . . . Oh well. But in any case, I took care of everything and I'm here now. What do you want to talk about?

I could not help but be surprised at the level of casualness with which he treated the session. Gone was the man that was in fear of losing his marriage, I was abo feeling impressed and quite intimidated by the wealth and connections of this man. Perhaps I was also feeling a bit inferior to him and his accomplishments. It was almost as if he was doing me a favor to see me. And the part about "making money by just sitting in a chair selling throat lozenges" felt like an indirect appraisal of what I do, that is, just sit around and offer palliative care. Clearly P was feeling a need to assert his sense of superiority. Had I done something to trigger a return to this behavior? He seems to want me to carry the ball with his final question.

J: With all that you handle, I can see why you would want me to take the initiative in the session.

P: Nah, I work hard but I have a lot of people doing stuff for me. I just didn't have time to think about what to talk about today.

I had attempted to speak to the side of P that really wanted to be cared for, but I experienced him as shifting his need for care into the all too familiar pattern of disowning his need, while demanding that he be catered to. This dynamic had an all too familiar ring to me and I was beginning to feel trapped like I did with my father when he would expect me to accompany him wherever he went without admitting that he was really lonely and needed me to keep him company, I felt locked between a temptation to resist his demand, and the fear that if I didn't initiate a topic to talk about he might retaliate in some way. Fortunately, he began to speak.

Section 2. P: You know, there is something I want to talk about. Me and the "Mrs." are more you might say "on the outs" with each other than ever.

J: Really? What happened?

P: Well, I came home from work the other day, and mind you, I had had one heck of a day. Paulette (my VP for sales) just walked off the job. Just plain walked off the job...! All because I asked her to stay a little later for a few nights and get those spreadsheets on inventory done. No work ethic anymore! She just hauled off and quit!

My suspicion about a theme that was developing for the day was beginning to be confirmed: His sense of entitlement had alienated one more person, I waited to see if the altercation with his wife might follow the same pattern.

P: So, I come home and Patsy hadn't made dinner, hadn't picked up, and the worst of it, hadn't gotten the cable company to repair the internet problem. …

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