Helga has spent time in hospitals because of deep depression, marked feelings of worthlessness, and several attempts to kill herself. She was born in Germany and came to live in Maryland in her late teens. She relates that she has never felt at home since she left Germany, but that there is now nothing there for her to return to. She frequently mentions how lonely and isolated she feels. There are no friends in her life, no intimate relationships, and she feels a deep sense of rejection. Although she has been out of the hospital for over a year, she is an outpatient and comes to the treatment center on a regular basis. You are her new counselor and seeing her for the first time. Think about how you might deal with her in the first five minutes of your session. She relates:
“I just dread getting up every morning. Everything seems like such a chore. I’m afraid that anything I do will turn to failure. I see no real sense in going on. I have constant thoughts of ending my life. I’m no use to anyone around me. I couldn’t hold a husband or a job, and then I lost my kids. I just feel so worthless and rotten, and full of guilt and hate for myself. No matter what I do or try, I just can’t see any light at the end of that long, dark, cold, scary tunnel. I look forward to death, because then I won’t have to suffer anymore.”
What are your personal reactions to what Helga is saying? How does it affect you? What are you feeling as you listen to her?
Given the way that Helga presents herself, do you see much hope? Do you believe that there is a positive, trustworthy, and actualizing tendency within her?
In what ways might you use yourself as a person to create a relationship with Helga so that she might work through her depression? Do you think that your relationship with her by itself is sufficient, or would you see a need for interpretation, direction, and active techniques?
To what extent would you want to explore her German background with her, especially since she does not feel at home in either culture?
How would you respond to Helga when she says “you can’t understand how uprooted I feel. I don’t belong anywhere. But I just don’t think you can know what this is like for me.”?
Support your decision to approach Helga from a person-centered approach. What are the benefits and shortcomings of the Person-Centered approach in working with Helga and her presenting problem?