Treatment Plan for Sylvia Plath: - Case Study Example

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Plath was also preoccupied with death whereby, she reported having attempted to commit suicide when she was twenty one years old.
Sylvia Plath was the eldest…
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Treatment plan for Sylvia Plath Treatment Plan Synopsis: I. Demographic Information: Sylvia Plath Age: 30 years Nationality: American
Current residence: London, United Kingdom
Marital status: Divorced
Dependents: two children
Daughter Frieda, born in 1960
Son Nicholas, born in 1962
Occupation: Poet
II. Presenting Problem:
Sylvia Plath presented with a depressive affect mirrored in her literal pieces, which provided a subjective self-report. Plath was also preoccupied with death whereby, she reported having attempted to commit suicide when she was twenty one years old.
III. Relevant History
Sylvia Plath was the eldest child of the two children born to Otto Plath and Aurelia Plath. Her father served as a professor at Boston University whereas, Aurelia worked as a teacher. Otto died from complications resulting from the amputation of his leg compelling Aurelia to move with the children to Wellesley. Otto’s death affected Sylvia negatively whereby, she lost faith in religion’s role in her life. Sylvia attended Smith College, where she received numerous accolades for her riveting literal pieces. It was during this time that her first suicidal attempt failed at the age of twenty one years. Sylvia sought psychotherapeutic intervention for her preoccupation with suicide whereby, she was institutionalized and received insulin and electric shock therapy. In 1956, she married Ted Hughes whom she had met at Cambridge. They had two children, Frieda and Nicholas born two years apart. Initially, they lived in the US; however, they decided to move back to the UK to raise their new family. The couple separated after Sylvia found out that Hughes was unfaithful. She moved to the city and rented an apartment and began raising her children. It was not long before she attempted to commit suicide in spite of receiving a prescription of antidepressants from her psychiatrist (Kirk, 2004).
IV. Symptoms:
Plath suffers from Major Depressive Disorder. She meets at least five of the symptoms listed in Criteria A of the DSM-IV (APA, 2000). They include:
Depressed mood most of the day
Markedly diminished interest or pleasure in all, or almost all activities
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt
Diminished ability to think or concentrate, or indecisiveness, nearly every day
Recurrent suicidal ideation
In addition, her symptoms also mirror those listed by the Diagnostic Statistical Manual (DSM) for the remaining criteria, which include:
Criteria B-The symptoms do not meet criteria for a mixed episode
Criteria C-The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
Criteria D-The symptoms are not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism)
Criteria E-The symptoms are not better accounted for by bereavement
V. Case Formulation:
The constant rejection from institutions and publishers played a pivotal role in predisposing her to attempt suicide recurrently. Her first suicidal attempt was prompted by rejection from a poet she admired and hoped to emulate. In addition, her second suicidal attempt resulted from pent up frustration resulting from her husband’s infidelity.
VI. DSM-IV Multiaxial Assessment (OR DSM-5 Equivalent)
Axis I: 296.2: Major Depressive Disorder
Plath fits the criteria for Major Depressive Disorder as outlined by the Diagnostic Statistical Manual. She displays six of the symptoms listed in Criteria A, and her symptoms are not attributable to other psychological or personality disorders.
Axis II: Personality Disorder
Plath suffers from no known personality disorder.
Axis III: general medical condition
Plath suffered from no known medical condition; however, there was a family history of diabetes.
Axis IV: Psychosocial and environmental problems
Problems with primary support system: Plath witnessed the death of her father at a very tender age. She developed an unhealthy dependent attachment to her parents. In addition, her marriage ended due to her partner’s infidelity.
Problems related to the social environment: Wilkes finds it difficult to pursue her writing career while concurrently caring for her children as a single mother.
Problems related to interaction with the legal system/crime: There are no indications that Plath had problems related to interaction with the legal system.
Axis V: Global Assessment of functioning (GAF)
Although Plath seems functional, her inclination towards suicidal thoughts indicates that her functioning falls below 10. Plath thinks about committing suicide during her depressive episodes.
VII. Treatment Plan:
Successful treatment of Plath’s depression required the combination of psychopharmacological and psychotherapeutic interventions.
Psychopharmacology treatment
The consulting psychiatrist could prescribe a daily dose of 10mg of paroxetine, which is an SSRI. This will be increased to 20mg in the next week and used for the next six months in order to prevent Plath’s relapsing after termination of psychotherapy.
Interpersonal Therapy (IPT)
Interpersonal Therapy (IPT) is most often used on a one-on-one basis to treat depression or dysthymia (a more persistent but less severe form of depression). The current manual- based form of IPT used today was developed in the 1980s by Gerald Klerman, M.D., and Myrna Weismann, M.D (Blackburn & Twaddle, 2011). IPT helps the patient identify troubling emotions and their triggers. The therapist helps the patient learn to express appropriate emotions in a healthy way. The patient may also examine relationships in his or her past that may have been affected by distorted mood and behavior. Doing so can help the patient learn to be more objective about current relationships. The premise of IPT is that treating depression results from improving communication patterns and the ways people relate to each other (Blackburn & Twaddle, 2011). The interpersonal problem areas focused on include:
• Role transition
• Role dispute
• Grief
• Interpersonal deficits
IPT lasts for 12-20 weeks and its main goal is building better social support through the modification of interpersonal problems. In relation to Plath’s case, IPT focused on helping her develop leadership skills needed to successfully transition into her new roles as a single mother and literal artist. Initially, Plath struggled with feelings of rejection when a writer she admired rejected her, and her husband was unfaithful to her. IPT will help her develop coping skills in the face of rejection. Moreover, it will help her find lasting solutions to her interpersonal deficits; for example, her negative attitude towards rejection from those she holds in high regard.
APA. (2000). The Diagnostic Statistical Manual TR-IV. New York: American Psychological Association.
Kirk, C. A. (2004). Sylvia Plath: A Biography. Westport, CN: Greenwood Press.
Blackburn, I.-M., & Twaddle, V. (2011). Cognitive Therapy in Action: A Practitioners Casebook. New York: Souvenir Press. Read More
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