Jessica is a 32 year old professional executive who has recently been given the opportunity of completing her Masters in Professional Development with an organisation who value her expertise in her chosen career and have great confidence in her achievement of goals in their particular field.

She has studied hard for over a third of her life and has recently married a family-orientated professional man whom she loves. She now faces the dilemma of whether to pursue her personal goal of completing the thesis she has started or to fall pregnant and hope that being a full time mother will satisfy her individual needs.

Working with Jessica, the Counsellor uses an eclectic approach, opening the session with Person Centred Therapy. Adopting strategies from Solution Focused Therapy, and using Gestalt tools within the client’s frame of reference, she then encourages her to consider her family history and her parents’ impact on her life as it is in the here and now.

Background

Jessica’s mother and aunties have been pestering her to “do the right thing” like her friends from school who by now all have at least one child. Remarks such as “When are you going to fall pregnant?” and “Don’t you think it’s about time you did the right thing?” or “Surely you want to be a mother?” keep ringing in her ears.

Her biological clock has not started ticking for her but she is aware that “time is running away rather than running out”. Her work associates admire and respect her and support her in her studies, believing that her achievements will assist them to gain funding in her particular area.

Jessica’s father, who died just as she was about to start university, had always encouraged her to be more than just a stay at home mother. He would tell her that she could achieve whatever she set out to do. Jessica was extremely close to her Dad and was devastated when he died, feeling that she hadn’t shown him how successful she was.

Even though her mother actively promoted her studies, she would love and accept her no matter what she did and Jess knew this; she had a nagging feeling that she wanted to be successful for her Dad and to prove that women can achieve whatever they hope for.

Issues identified:

Jessica’s symptoms are medium to high levels of stress evidenced by episodes of stomach cramps and breathing difficulties that turn into asthma attacks.

Some workers experience stress “to a slight degree; others may be incapacitated”. ~ Miller et al., 1988 cited Peterson & Gonzalez 2000.

She has a referral from her doctor who suggested that counselling, rather than any medication, may help and, as Jessica is contemplating starting a family, she wants to follow in the footsteps of her mother who avoided drugs particularly when pregnant.

In addition to working for her Masters and trying to fall pregnant, Jessica wants to be a good wife and mother; she is also involved with environmental interests and “Save the Whale” expeditions. With the addition of attending her gourmet cooking classes and doing yoga classes and swimming for relaxation, time management is a huge issue. She wants to do it all.

“Stress can be both good and bad – depending on its nature, duration, and resources available to respond to it. A stress experience occurs when a person is confronted by a demand that is perceived to exceed the emotional or physical resources available to effectively respond to it.” ~ Zacarro & Riley, 1987 cited Peterson & Gonzalez, 2000.

Formulation

Person Centred Therapy is excellent in helping Jessica begin to express her feelings in a comfortable and safe environment. With no formal assessment being conducted, the counselling was primarily aimed at helping her identify and access her inner resources so that she could better deal with her issues of time management, her future and her decisions about child rearing if that’s what she decides she wants to do.

“Some of the earliest psychotherapy research projects showed that when clients were rated as successful in therapy, their attitudes toward self became significantly more positive.”~ Sheerer, 1949 as cited in Corsini & Wedding, 1995.

A Solution Focused approach to the session was introduced when Jessica stated that she was suffering asthma attacks caused by stress.

Session Details

In the first session after Jessica had outlined her story, the Counsellor (C) noticed she became quite agitated and teary when talking about her father.

C: On a scale of 1-10 Jess with 1 being quite calm and 10 being extremely upset where would you rate yourself at this particular time (De Jong & Berg 1998).

Jessica stated she would be at a 9 right now because she is talking about her Dad and feels a total failure because she’s considering giving up the opportunity of completing her Masters in order to have a child.

“More women are winning middle management positions, and organisational counsellors often report a kind of female macho-ness or the superwoman syndrome, where women feel that they have to be the perfect wife, mother and career woman; as a consequence they put themselves under enormous pressure.” ~ Summerfield & Oudtshoorn 1995.

C decided to explore the unexpressed anxious side of Jessica’s personality first using the Gestalt technique known as “Empty Chair” (Perls cited Patterson 1986).

C placed a chair opposite Jessica and asked her if she would like to imagine her father sitting there waiting to hear what she would say to him.

Jessica burst into tears. There was a huge amount of unresolved grief attached to her just thinking about her father at this time. C waited patiently for Jessica to calm down and then quietly asked if she would like to continue.

For ease of reference Jessica has been abbreviated to J in the following dialogues:

J: I didn’t realise how much I was carrying inside of me. I’ve been involving myself in all of these “things” because when I think of Dad it’s too painful, so I make myself busy and pile extra “stuff” into my life so I don’t focus on the sadness.

C: What would you like to say to your Dad if he was here?

J: I’d say I was sorry for not meeting his expectations.

C: His expectations, Jess?

J: Well he did keep saying how proud he was of me because I was good at school and he knew I would make something of myself.

C: Go over there and sit in that chair, Jess, and pretend you are your Dad for a few minutes. Try imagining what he would say to you now.

Jess wipes her face and blows her nose, striding over to the chair, so much in the role she even sits differently, like I supposed her father used to sit. She sits and stares back at the empty chair she just left, imagining herself to be her father and looking intently at the chair getting her head around what to say and finally:

J: God, Jess, I didn’t mean you had to become educated to the point of forgetting what really matters in life. I just wanted you to achieve the best for you. I wanted you to succeed at being and doing whatever you wanted in life because you had all the opportunities.

C: What would you say back to Dad, Jess?

J: I don’t know whether to have a baby or go on with my Masters, Dad. My time is running out, my biological clock is ticking. Everybody’s at me.

C: What about Dad, Jess? What do you think he would say back to you now?

J: Jessica, you can have it all. Study for your Masters degree and have a baby -nothing would make me more proud than to be a Grandfather. You are still young. You have the time.

At this point Jessica burst into tears again.

J: “Oh my God, this is so intense but the relief I feel is huge. I know that I do have time. I’m normally good at time management, I do it all the time, but it was this personal dilemma that was pushing me to achieve the career success that my associates have been urging me to.”

C: What else is on your mind Jess?

J: I’m feeling a bit overwhelmed at the moment with these new emotions that I’ve been suppressing for years. I feel I’ve been like a robot doing and doing and doing and not being.

C: Yes, we do forget to just “be” sometimes. What would it feel like for you if you were just being?

Jessica takes a huge deep breath, sits back in her chair (prior to this she was very rigid) and noticeably relaxes, her shoulders drop and she closes her eyes and smiles.

To calm Jessica at this stage C introduces a breathing technique to steady her system by using her own physiological way of breathing, reminding Jess that she can utilise this technique whenever she feels herself getting uptight (Booth 1985).

J: Good grief I’ve been learning this in yoga for years and I go through the process while I’m there but I don’t practice it when I should.

C: You know Jess I think we’re all guilty of that at times. We’re all so caught up in the business of living life to the max, we often forget about what is important for our own well-being.

There’s a quote from a Handbook of Counselling which states:

“It is not possible for an individual to remain unaffected at work by problems based in the home or vice versa. This invasion will and does occur, no matter how great the effort by the individual to prevent it taking place or being detected.” ~ Palmer 1997

Session summary for future sessions and homework:

  1. Acceptance of herself as she is, with or without children.
  2. Time to herself, just being in a place of peace once a week for 2-3 hours.
  3. Establish a Personality Need Type Profile to help Jessica understand why she needs to establish herself as a career oriented superwoman.
  4. Learning better communication strategies with her partner.
  5. More ‘talking’ with her father to enable her to accept her grief and the loss of time she could have had with him, in a safe place such as the counselling room.
  6. Understanding the ‘now’ as part of the whole picture in a lifetime of events.
  7. Accept the fact that there may not be enough time to do everything she wants to do and work out priorities and a timeframe.

Instead of trying to do everything perfectly, Jessica needs to accept that this is not possible in reality. That’s why it’s essential to work out what the most important things are for her personally. If she focuses on the most important things to her, both in her professional and personal life, Jessica is likely to make a greater contribution, by using her time in a way which provides personal satisfaction and fulfilment.

Author: Kathleen Casagrande

Reference List

  1. Booth Dr. A., 1985, Stressmanship, Severn House Publishers Ltd. London.
  2. Corsini R. & Wedding D., 1995, Current Psychotherapies, 5th Edition, F.E. Peacock Publishing, USA.
  3. De Jong Peter & Berg Insoo Kim, 1998, Interviewing for Solutions, Brooks/Cole Publishing Company USA.
  4. Palmer S., 1997, Handbook of Counselling, Second Edition, British Association for Counselling, Routledge, UK.
  5. Patterson, C.H., 1986. Theories of Counselling and Psychotherapy, Harper and Row Publishers, New York.
  6. Peterson N. & Gonzalez R. 2000, The Role of Work in People’s Lives, Brooks/Cole Publishing co., U.S.A.
  7. Summerfield J. & van Oudtshoorn L. 1995, Counselling in the Workplace, Institute of Personnel and Development, UK.

Related Case Studies: A Case Outlining How to Focus on Solutions, A Case of Using Logical Consequences, A Case of Stressful Life Change