The Psychodynamic Workings of George

Psychologists use a variety of different methods in order to understand, comfort, and comprehend troubles that their client may be facing. One form of therapy is used primarily to reveal feelings that clients may be unaware that they are expressing, it is called Psychodynamic therapy. This approach allows the psychologist to truly understand what the client may be experiencing, whether they are aware or unaware of the emotions. Clients may attempt to ignore these problems because it may involve painful memories in their past that could trigger negative emotions or urges, and they may react with forms of denial or repression. Psychodynamic therapy will help detect and process these feelings in order to resolve them in a comfortable manner.

When you spend time with an elderly person, you begin to realize the majority of them are calm and collected, and content with life. They have tackled the early years of childhood and fun, the rollercoaster emotions that puberty has dragged them along, the stage of finding themselves through their young adult ages, settling down during their middle aged years, experiencing mid-life crises, and finally coming to terms with who they truly are, and realizing that they’ve seen all that life could offer for them. 

Strengths in the psychodynamic therapy system with elderly may be simple because they truly know who they are and can explain their emotions well because of all the trivial experiences they have undergone throughout the years. Another strength will be detecting where their memories or mannerisms come from because perhaps it will be easier for them to share, as opposed to a fifteen-year-old girl who may be too shy or ashamed to tell about her emotions, in fear of being judged or accused. 

The client interviewed was a man named George, a sixty-eight-year-old African American who is divorced, works as a driver, and lives in a one-bedroom apartment with his dog, Spike. He enjoys dressing in a comfortable manner, and still stays in his work uniform hours after his last shift. Even though the uniform is stained and dusty, indicating a long day or a refusal to do laundry, he remains in the clothes. He did his best to answer questions, but often times lost interest, as if he forgot he was being interviewed. 

George sported an unshaven beard and unkempt hair. It is not certain whether or not his disheveled appearance was due to the result of work, exhaustion, or lack of upkeep. According to the Examiner, “Study after study presented…shows that better dressed, better looking, and leaner people are typically paid more money, promoted faster, and rewarded with more positive evaluations!” Normally, people who have given up on their physical appearance or don’t put as much time into their clothes, or their look, don’t seem to have much motivation. They may feel as if they don’t have anybody to impress, and nothing to live for. George stated that he didn’t have any strong, healthy and striving friendships in his life, and no goals to achieve, which may be the reason for his disheveled appearance.

Aside from George’s outward appearance, there was not a drastic change in his emotions. He says he feels empty, and unsuccessfully tried to fill the empty hole with drug and alcohol abuse. His emotions revolve around feeling like a failure and believing that he could barely keep the simplicities of his life together. He mentions his ex-wife, Marie, who had disappeared for the last decade, but recently returned and informed him that was open to the idea of getting back together with him. According to the New Yorker, “By 2000, sixty-two percent of the widowed elderly were living by themselves, a figure that’s unlikely to fall anytime soon. They are insecure, proud of their freedoms, but hungry for contact, anxious, frisky, smug, occasionally scared.” Many elders have given up on reconnecting with new friends or attempts on being social because they feel it will not lead anywhere. George faces feelings of anxiety and fear due to facing Marie because he believes that he is inadequate and socially awkward. Those beliefs hold him back from communicating with Marie and pursuing new relationships and friendships. 

As he told his story, George would slow down in order to detail a heartfelt part of the tale but speed up during the portions of the interview that may have triggered negative emotions he may be in denial about, or simply subconsciously refuse to discuss. He attempted to paint a backdrop for many tragic events that had taken place throughout the course of his life, and constantly used hand gestures throughout the storytelling process. He seemed cohesive throughout the interview, but remained spaced out, and his focused did not seem completely intact. 

Perhaps a good way for George to become more social and create more of a sense of happiness is by putting his mind to work, in different areas. This could help him not only with his mood and personality but also towards his finances. This would also get George’s mind off the fact that he feels lonely, unwanted, and disliked. Finding new activities or a new job could open up more possibilities to help George find what he truly loves to do and connect with others, allowing him to realize he truly is liked. People who make more money are scientifically proven to be happier with their lives. According to the New York Times, “…it’s been a truism for eons that extra crash always makes life a little easier. Studies over the last few decades have shown that money, up to a certain point, makes people happier because it lets them basic needs. The latest round of research is, for lack of a better term, all about emotional efficiency how to reap the most happiness for your dollar”.  Although happiness does not bring instantaneous happiness or the feeling of fulfillment in life, perhaps the thought of knowing a big paycheck is coming in could bring some optimism to one’s mood. Money could help enlighten one’s day because it is a reward for all the hard work that you have accomplished and it could mean a pair of new shoes, getting groceries, putting gas in the tank and visiting a friend, or even seeing a movie, and all of these activities include getting out of the house, walking, getting fresh air, and communication, which is essential to everybody’s daily life. 

It was clear that although George may not have been asked about his personal life often, many memories were still apparent to him as if it had happened only a week ago. At times, he would lose focus and drift off into intoxication, but his memory was remarkable given the circumstances. His intelligence seemed remedial at best but possessed a distinct communication style that was perceptive. His clarity of thought was distorted due to the fact he had been drinking alcohol and smoking cigarettes throughout the interview. 

George had wanted to know whether or not he truly had insomnia and a case of depression. Whenever he wasn’t intoxicated or using narcotics but found it hard to fall asleep. I conducted both the CES-D and the Mini-Mental State Questionnaire in order to determine and gauge the presence of depression within the patient in order to gain more insight on his mental status, considering it had appeared skewed. His mood was anxious, and his behavior and responsiveness seemed disoriented. He admits that he rarely enjoys life and that he felt people always disliked him, and couldn’t even shake the blues, even with help from family and friends. 

Perhaps George was ashamed of his condition, which is why he had not consulted a therapist or psychologist after his divorce, or even when his ex-wife and him were experiencing trouble with their marriage. According to Psychology Today, “…many people who experience major depression- and there are roughly 15 million Americans who do”. Depression is not a rare case, or something to be ashamed of, but it is something to be aware of so it can be treated and conquered. It is important that George is aware that he is not happy, and the fact is able to admit it and elaborate on his feelings is a big step toward recovery and finding happiness in his life.

After George’s test is processed and scared, he resulted in an overall score of 43 on a 60-point scale and was at a great risk for clinical depression. George’s score on the Folstein Mini-Mental-Status exam was a fifteen, indicating a severe level of cognitive impairment. This was portrayed throughout the question-based interview with slow and confused responses as well as a short-term memory loss. According to Pavle Joksovic’s article, “A Curious Case of Depression”, he interviews a sixty-one-year-old man who may have a history of bipolar disorder and depression. “During the interview, Mr. Z presents with tired facies and exhibits psychomotor retardation. He has to force himself to stay engaged in the evaluation and maintain eye contact”. In the article, Mr. Z had severe depression problems that were increasing along with his age. George’s condition may not be as intense, but he definitely shows symptoms of depression, and experiences loneliness and wandering eyes during the interview.

George had mentioned earlier that he felt that even his friends and family couldn’t make him feel better. He stated he did not have any tangible relationships with individuals in his life. Once a year, his mother offers to reach out and pray with him, but he no longer communicates with his children, ex-wife, or his brother. He has accepted defeat and refuses to mend the wounds left on his family especially with his brother, and two daughters. He feels as if they don’t care anymore and he probably feels as if everybody else is better off without him bothering them. This may be why he refuses to make friends, because he doesn’t want to become a hassle or a chore to others around him.

It is common to long for affection and flash back to memories where you were once happy with your life, especially if you are alone. George admits being emotionally attached to Marie, his ex-wife, but the feeling is not mutual. He sometimes imagines her wanting to take him back but believes those are simply hallucinations that exist in his mind. He considers the imagined emotional connection as a “slow creeping poison that could kill you in your sleep”. The only other relationship that holds any significance to him is his dog, Spike. He considers Spike his best friend and unconditionally loves him. Spike and his hospice care job is all he finds stable in his life. 

George does not find himself intrigued or excited by anything life has to offer anymore. He lives a very routine lifestyle with work and coming home, smoking and drinking to be his tasks he feels he needs to or wants to accomplish. His behavior is very similar to those who have been diagnosed with depression. According to the New York Times, a woman named Linda Logan experienced depression at an early stage of her life. “I had a preview of depression in high school, when I spent a couple of years wearing all black, rimming my eyes on kohl and sliding against the walls in the hallways, hoping that nobody would notice me. But back then, I didn’t think it was a very serious problem”. Logan went on to face depression even while she was married with three children. The hormonal chaos of being a new mother and working on a Ph.D. dissertation was too overwhelming and she fell into a deep state of depression and losing her identity. It is important to recognize mental health as a serious issue, not something to be horrified about simply because one may not completely understand it. It is never too late to treat depression, or seek help, even at George’s older age of sixty-eight. Happiness is essential in daily life and deserves to be attained by everybody.

Due to his emotional troubles of feeling neglected, lonely, and worthless, George has turned to the use of medical marijuana, drugs, smoking cigarettes and drinking, in attempt to drown his sorrows. Although he denies any homicidal or suicidal ideation, plan or intent, he is most likely depressed and scarred with a poor judgment style in which he does not consider alternatives, instead relying on his own morals, which are seemingly skewed by his desolate life. 

George opens up about his ethnicity about being an African American, and how that affects him mentally. He believes that it is too hard “to make it as a black man in a white world”. But he still remains proud that the discriminatory world seems to be opening up to accepting diversity with an African American president in the White House. Diversity has truly spread around America over the years. “…the Fire Department’s persistent underrepresentation of minorities and the continues use, between 1999 and 2007, of the entrance exams. In 2007, there were 303 black firefighters, accounting for 3.4 percent of the department’s ranks; black residents make up 25.6 percent of the city’s population”. As America has become more accepting and open to people of different beliefs, ethnicities and views, citizens have become more comfortable blending in with “minority” races and working together as a family.

It is possible for George to head down the path of destruction if he does not seek more help at this point in his life. Another factor that was unspoken of was perhaps the exclusion of the world and the majority of unwelcoming individuals that make it hard for declining people such as George to make new connections to get a new lease on life like he had once felt at church. His choices dug him into a hale, but there isn’t anybody around to hand him a shovel in order to dig himself out. Perhaps George should attempt to attain new friendships, there are always loving and welcoming people in the world who are willing to offer a helping hand, or even just an ear to listen and words to comfort and console. Perhaps finding the right church or attending a men’s group could help George connect with other people who may be his age or have gone through similar things in his past. 

Being able to connect and share with others is why parents and teachers encourage children and students to make friends, and why group activities and play dates are common while growing up. According to Kommein, “In order for a particular neighborhood or area to succeed, community must exist. There must be people willing to support the local businesses, rally around local leaders and spend time as a group to ensure the nabe’s well being”. Same with neighborhoods applies to people. It is important to have a strong circle of friends to care for one another, listen to one another and feel comfortable enough to express and open up about daily triumphs and troubles. The ability of friendship allows people to laugh and cry together, and that is what allows us to grow.

When there are obstacles to overcome, the art of healing and recovery is always on the other end of the tunnel, and although it may seem dark and hopeless at times, the light is always there, creating a goal to work towards. Mental health services are critical for George at this point, seeing as he could very well drink himself to death, become suicidal, or overdose on narcotics. It is important to maintain healthy relationships and accountability partners in life, and George has managed to exclude himself from any form of social activity, which has led him to a remorseful, pitiful lifestyle. His longevity and motivation will remain in his strength and willpower, which is sure to build up over time. Therapeutic services and sessions where he can not only open up and express himself but also give him a chance communicate with another being that isn’t Spike, will be a healthy and easy start along George’s truly capable ability and journey towards recovery.

References

Baker, Al. (January 13, 2010.) The New York Times. Retrieved from: http://www.nytimes.com/2010/01/14/nyregion/14fire.html?_r=0

Heller, Nathan. (April 16, 2012). The New Yorker. Retrieved from: http://www.newyorker.com/arts/critics/books/2012/04/16/120416crbo_books_heller

Joksovic, Pavle; can Wattum, Pieter Joost; Chiles, Catherine. (n.d.). Questia. Retrieved from: http://www.questia.com/library/1G1-277000280/a-curious-case-of-depression-mr-z-age-61-has-a

Logan, Linda. (April 26, 2013). The New York Times. Retrieved from: http://www.nytimes.com/2013/04/28/magazine/the-problem-with-how-we-treat-bipolar-disorder.html?pagewanted=1&_r=0&ref=mentalhealthanddisorders

McGowan, Kat. (March 1, 2009). Psychology Today. Retrieved from: http://www.psychologytoday.com/articles/200903/good-morning-heartache

Mitchell, Jeffrey. (July 16, 2009). The Examiner. Retrieved from: http://www.examiner.com/article/the-effect-of-physical-appearance-the-workplace

Ng, Deb. (December 14, 2008). Kommhein. Retrieved from: http://kommein.com/why-is-community-important/ 

Rosenbloom, Stephanie. (August 7, 2010). The New York Times. Retrieved from: http://www.nytimes.com/2010/08/08/business/08consume.html?pagewanted=all