Mary Jones Case study Essay
Mary Jones Case study
Coping styles can simply be defined as a person’s characteristics or strategies that are used in responding to various life problems and trauma. This can involve some thought, emotional or behaviors used by the affected individual to cope with such problems or circumstances. There are two broad types of copings styles, these are internalizing and externalizing coping style.
Patients who “tend to locate the cause of their problems, even more than the resolution of the problems, within themselves” (Beutler & Marnat, 2005 ) are consider to exercise internalizing coping styles. Patient that exhibit externalizing coping style tend to get angry more easily and blame all other people for their predicaments. They tend to enjoy social gatherings, active parties, and other activities that allow them to externalize their behaviors.
Patient that exhibit Internalizing coping styles with disease condition tend to experience a very high level of distress and tend to make some self depressing comments about themselves. Such people may also show great capacity for insight. Internalizers also tend to withdraw from most social gatherings, prefer solitary environment and activities such as staying indoors, reading and listening to music.
They want to do everything to reduce stimulation, reduce participating with other people in various social events and they also want to enjoy some relaxing event such as watching television. The aim of this paper is to objectively identify the causes of Mary Jones coping styles and help design adjustment plan which will integrate a strategy that will improve on herself image and worth , improve upon her present interpersonal relationship with people around her and her partner and also help her cope with the prognosis of the disease condition.
It will also evaluate level of responses to her anxiety. Mary Jones In the case of Mary Jones, a 36 years old woman in a De Facto relationship and lawyer by profession with a medical history of ovarian cancer, unilateral ovariectomy, chemotherapy and ongoing task of coping with several situation and conditions such as adapting to loss of personal image and function, increase dependency, hospitalization, her partner’s need of children, fear, anxiety and anger.
She tried to coping with those situations by externalizing her behavior and coping styles in the sense that she tend to blame others for her condition, punish and manipulate others, demand them to solve her problems, sole dependency with no sense of personal responsibility and resentment towards her partner. The major reasons for all these coping styles can be attributed to the psychological and emotional trauma that are associated with ovarian cancer, the changes in symptoms commonly seen in the condition and the increased anxiety level in regards to the prognosis of the disease state.
Since we all experience and react to psychological and emotional trauma differently, Mary’s past experiences, relationship status, beliefs and the knowledge of signs and symptoms related to her condition all contribute to her present coping styles. She might have been so much concerned about the prognosis or the recurrence of the disease and the associated side effects of the medications.
Since an ovary is needed to produce egg which will be fertilized by her partner’s sperm, now the ovary has been removed and there is higher tendency for the other ovary to have been affected and other parts of the body such as the lungs, the gastrointestinal tracts and kidney (Koushik & Siemiatycki, 2009). Since the disease condition is associated with a very poor prognosis and actual removal of the ovary, which might result into infertility and inability to actually give birth to a child.
This will affect her De Facto relationship because her partner wants children. Since there are several physical changes that are associated with chemotherapy and hospitalization, she might find it difficult to actually cope with all those changes both physically and her perception self. These changes will also affect her self esteem making her to act to actually prevent her from relating normally with her partner and her health care givers.
Chemotherapy normally affects her sex life and also results in early menopause. Hence all these possibilities can lead to an increase in anxiety level which will subsequently affect her relationship with her partner. She might feel very tired hence depending on those people around her for help. Mary also needs to adjust to Pain, Fear and Anxiety associated with her condition, hence a need to change her present personality and behavior to the people around her and her partner.
Her maladaptive coping styles actually cause more harm than good simply because she try externalizing her behavior by blaming and solely depending on her partner and health care provider whenever she needs help instead of helping herself out in those areas she still have the capacity to do so. Since there are no psychological or emotional intervention for helping her cope with her present condition, her negative behavioral modifications had hinder the development of good interpersonal relationship between her partner, care givers and her.
Behavioral manifestations and their effects on Mary’s interpersonal relationship • Blaming and punishing others for her problems- this coping strategy by Mary can be attributed to the psychological and emotional trauma associated with management of ovarian cancer. She’s actually trying to trying to transfer her feelings to the people around her by blaming them, making them feel they are somehow responsible for her predicament and also make them feel that they need to do something to help her. She might also try blaming others so as not to take the responsibility of her predicament or by trying to avoid the reality.
This coping style will hinder the development of effective interpersonal relationship between Mary and the people around simply because the affected individual will get to a stage whereby they will not be able to cope with her actions hence they try withdrawing from helping her. • Covertly punishing and manipulating others- this coping style or strategy is still within the context of her trying shifting her blame to others in the sense that she want to manipulate people around her to get what she want.
This attitude will hinder the trust between her and people around. Trust is vital to development of an effective relationship, hence when she manipulate people she directly or indirectly affects her interpersonal relationship and also the treatment meant to be given to her. • Demanding others solve her problems for her- demanding others to help solve her problem can something be good coping styles because patients in her situation will need the help of people around her so as be able to reduce the level of stress and anxiety associated with the condition.
Excessive demand of people to solve her problems will have a negative effect on herself responsibility • Resentment towards her partner believing he “does not understand”- Mary’s feeling of resentment can be attributed to her belief that her partner does not really understand what she’s going through presently simply because he still articulate his need for children. This feeling will affect her thoughts and perception of her De Facto relationship and subsequently increase her anxiety level.
There is high possibility that the fear of her losing her partner will be the major factor leading her to such feeling towards her partner. Helping Mary cope with her present medical condition Helping Mary out of her present maladaptive coping style, require a multidisciplinary approach that will have to focus on the psychological, emotional, social, health and the interpersonal relationship aspect of her behavior. She will be referred to behavioral therapist, psychologist, psychiatrist, social workers and physician.
the behavioral therapist will help identify the causes of the maladaptive behavior, measure the coping styles by the use of scales like Minnesota Multiphasic Personality Inventory which is a software that can help measure and analyzed the coping styles (Frankel, 2009) or the use of direct questions in regards to her actions, thoughts, feelings, how she view her problems being caused by other people or external situations. The therapist intervention can then be focused on the result of the analysis which can either be towards the control of symptoms or insight (symptoms in the case of Mary).
Psychologist will try and identify previous psychosocial and environmental factors leading to her present behavior and find ways of eliminating such predisposing factors. The psychologist will also try and adopt new viewpoint or set of behavior which will influences are interpersonal relationship and help her adjust to good coping styles. Some of the adaptive coping styles can be in form of knowing what to expect, maintaining a strong support system, let people help her, be proactive, taking time for herself, and setting reasonable goals.
Social workers will try and invite the partner and educate both of them on the present condition so as to help her solve the issue of resentment towards the partner and also build trust between both of them. The physician will educate her on the prognosis of her condition, the fact that she might still bear children with other ovary and reassurance of good life after therapy. The physician will also educate her on the associated side effect of the chemotherapy and the facts that the side effect are only for some time and when properly manage, she can still live a good life with her partner.
Strategies helping her partner and health care givers • Patience- the partner and the health care givers should try and be patient with her so as not to take her present coping style against her. They should also try and understand her feelings in regards to her situation • Encouragement- people in Mary’s situation need words of encouragement and support from the family members and health care giver. Her partner must ensure to always encourage her so as to create a sense of support which will ultimately affect the interpersonal relationship between both of them
Responses to anxiety level Everybody has various degrees of responses to anxiety. These degree or level of response are mild, moderate, severe and the panic level. Mild and moderate level of responses to anxiety is still normal but in the case of severe and panic level, the individual is said to have anxiety disorders. In the case of Mary Jones her responses to anxiety level are as follows; cognitive or perpetual response at mild level by showing disorganized thought which tend to be uncontrollable.
At the moderate response level, she tend to show uncomfortable experience by her interpersonal relationship while at the severe level of response she tend to show a response that can be attributed to a narrowed perpetual field and difficulty in problem solving, hence she tend to depend on her partner and health givers to solve all her problems. The last level of response was the panic level where she tends to show emotional or behavioral changes or responses by showing loss of control and feel angry and terrified and tend to be angry with her partner and care givers.
Conclusion Considering Mary’s present health status and maladaptive coping strategies or styles, there is strong tendency for her status and coping style to change for better simply because of the various outlined interventions which would help her cope with life after ovariectomy and chemotherapy. Also some strategies that can help her partner and health givers cope with her present and the proposed coping styles have also been outlined.
Besides, removing one ovary is not the end of her life, even women who have undergone bilateral ovariectomy can still have children with the help of advancement in technology. References Beutler, L. , Marnat. , (2005). “Integrative Assessment of Adult Personality”. Second Edition. Retrieved August 5, 2009 from http://books. google. com. gh/books? id=4puU3KqlEjcC&pg=PA115&lpg=PA115&dq=externalizing+coping+styles&source=bl&ots=K1V89eXR6a&sig=xRaYZ6xi4e_SB1zhpjSGF9j96Is&hl=en&ei=lVV5SpXzKoSIMY7alaMO&sa=X&oi=book_result&ct=result&resnum=1#v=onepage&q=externalizing%20coping%20styles&f=false