PYB306 - Psychopathology and Case Study Nathan - Medical Science Assignment Help

Assignment Task

Nathan, a single man in his late forties who had long-term difficulties staying employed, was referred by a vocational psychologist for a clinical assessment. When Nathan attended his first session, his facial expression was flat, and he spoke in a steady yet monotone voice. His sitting posture was rigid and tense. He often avoided eye contact, and yet at times he stared at the psychologist. He appeared to have difficulties expressing emotions, except for fear and frustration. When describing his circumstances, a common word that he used was that he had feelings of ‘trepidation’. During the session his leg was shaking. When this was probed by the psychologist, Nathan said the shakiness was uncontrollable; it occurred when he felt nervous or uncomfortable. Nathan described ‘living in fear’ since his teenage years, and constantly feeling low and frustrated. He reported persistent struggles in various group and social settings, as well as at work. He attributed his history of highly unstable and short-term employment to these experiences. He was currently unemployed and on social benefits and had been for the past four years. Other than employment, Nathan reported difficulties engaging in romantic relationships. The relationships he had were typically short and ended abruptly. The last relationship was before he graduated from university. Similarly, Nathan had difficulties maintaining and forming friendships and he had lost contact with the friends that he had made at university. When describing the feeling of fear, and in particular, if he had a sense of when it began, Nathan made several comments. He described events at school where he felt bullied by other students and misunderstood and punished by his teachers. Before he finished school, and at his parents’ insistence, he also attended an internship at a job training and technical institute. During this time he felt ‘constantly bullied’ and ridiculed by his supervisors, managers, and peers. He felt that this treatment interfered with his ability to work, and that it had created a vicious cycle for him. Nathan had previously tried to ‘change things’ and open up new opportunities for himself by pursuing a university qualification. However, he expressed disappointment in the experience, saying that it had ‘not helped’. Nathan described similar unfair treatment in jobs gained after the qualification, and the pattern of short-term and unsatisfactory employment continued for him. He also described lacking a sense of achievement with his life, including his work, and a feeling of hopelessness about how to deal with these problems given several prior failed attempts. Nathan reported difficulties falling sleep at night and having poor quality sleep. He described feeling pain and tension around his abdomen and shoulders which was present continually and ‘for as long as he could remember’. He reported visiting his GP several times and tried various pain killers, yet the pain persisted. Nathan was frustrated that the GP could not find an organic cause for the pain, and he otherwise had a clean bill of health. Nathan denied any substance and alcohol use, both currently and in the past. He had experienced suicidal ideation in his late teenage years, and he reported that he was ‘too scared’ to take his own life (now and in the past) and had never attempted it. He also denied any self-harm. Nathan was the middle child in a family with three children. He reported poor relationships with his father, and that his mother has been very critical of him. Nathan described having minimal contact with his siblings; and that he felt envious of their careers, financial security and ability to start a family. Nathan was currently living with his mother due to his unemployment and financial difficulties. He wanted to ‘move out and start a new life’, and he expressed the fear that this dream may not be realised. He reported various past hobbies such as writing and craft, yet he was not able to re-engage with them. He described feeling that he had been ‘twiddling his thumbs’ day to day, not sure what to do. He also anticipated some difficulties and challenges in seeking new employment, primarily because of the fear that it would again lead to negative experiences and he would eventually be forced to leave work, feeling like a failure. Nathan described feeling responsible for the ‘bad things’ happening in his life and being uncertain of the solution. As a result, he expressed feeling very frustrated with his situation and a strong feeling of being ‘stuck’ with his life.

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