The case of Edward and Sarah proves that their marriage has been rocked with numerous challenges. Based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there some of the diagnostic thoughts that emerge after hearing Sarah’s case about their marriage with Edward. From the word go, Sarah displays signs of Trauma- and Stressor Related Disorders, The Posttraumatic Stress Disorder to be specific (PTSD) (Friedman et al., 2011). The fact that her brother was killed when she was only ten years old has surfaced in her life bringing adverse memories. This is because he was killed in drug related crimes and Edward, his husband, is an excessive drunkard. Sarah has adjustment thoughts that what happened to her brother may be reciprocated to her own husband who seems to be the only thing that she is embedded to after her parents (Friedman et al., 2011).
Similarly, Sarah poses high symptoms of depression due to the series of unfortunate events that she narrates. She suffers from Melancholic depression where she lacks pleasure in major humanistic activities such as eating and weight loss. She cries each time she explains her situation and seems attached to her emotions. According to Weitman and Hammer (2015), the excessive weight loss is detrimental to her health and is brought about by depression caused by battering. Sarah showcases guilt of her parents’ displeasure and she feels that she has a role to play in making them happy. Her parents have not moved on with the fact that their son died and they need other children to be associated with. This leaves Sarah to be the only option where she feels that by giving her parents grandchildren will be a very positive gesture. This excessive feel of guilt and anhedonia causes melancholic depression that leads to excessive weight loss as seen in Sarah’s case (Fuertes, Spokane & Holloway, 2013). Unfortunately, the melancholic depression suffered by Sarah requires quick attention as it may be propelled to a Major Depressive Disorder (MDD). The events that are occurring in her life may be repetitive making her disorder to graduate to MDD.
Probably, Sarah faces racial segregation related issues to her background as opposed to that of Edward. Her husband is quoted saying that “her parents relies too much on her…it is time she lived her own life.” Additionally, both Edward and Sarah have been raised through the traditional setting making them acquire ancient societal aspects. Their differences in background may be an issue of contention since they have varied cultural beliefs. Edward might take this opportunity to demeanour Sarah’s race as it is among the minority. Lastly, Sarah suffers from impulsive control disorders delineated by the self-abuse behaviour. She has superficial cuts which are allegedly caused by Edward but Sarah cuts herself. This can also be described as intermittent explosive disorder where an individual reacts by causing self-harm.
On the other hand, Edward has also some psychological diagnostic issues that can be denoted from his story. Firstly, Edward portrays substance related and addictive disorders in relation to his drinking behaviours. The undying zeal for the alcohol use of alcohol can be noticed from the couple’s story. Sarah says that her husband is a friend of the beer and that is why he is detached from his own children. Secondly, the Disruptive and impulsive-control disorders are noticeable in Edward’s life. Oppositional defiant disorder is explained as the situation in which an individual is not willing to abide with other people’s thoughts by becoming argumentative or irritable (Fuertes, Spokane & Holloway, 2013). Edward assumes that Sarah is being paradox for grieving over her brother who met her demise fifteen years ago. Sarah describes Edward as cold and heartless man who is not there for her; on the same breadth, she argues that the cuts on her body are made by Edward which he opposes. These are symptoms of oppositional defiant disorder where the victim is ready to defend him/herself in any argument. It is evident that he was raised by his maternal mother and a grandmother which could be the core reason he is antisocial for lacking a father figure in his life.
The antisocial personality disorder and dissociative disorder are evident in Edward’s behavioural aspects as the couple explains. He has two children who are in college and one is a teenager who has achieved the age of a major. As Sarah explains, Edward does not speak to them whereas people would expect parents to be close to their children as they reach 18 years of age. He also leads an active life without coming into contact with his former wife who they had children together. Edward is also characterized as an individual of high temperament and vindictiveness. Although he tries to hide his anger, it is undeniable that he is an anger disorder. Sarah also describes her husband as a person who can fly the handle anytime. Actually, their narrative does not clearly explain whether Edward is a wife batter but it seems his temper and anger may prove that. This is a serious crime which is protected under the law and both Sarah and Edward should require visiting the authorities to record statements (Weitmann & Hammer, 2015).
Psychotherapy is the process in which a counsellor, psychologist or a psychiatrist among others engages a client in order to relieve them from their mental or emotional problems. It aids in changing humanistic behavioural aspects and brings changes to troublesome behaviours or thoughts. There are numerous approaches and theories of psychotherapy that can be used to treat a client. In the case of Sarah, Group psychotherapy is a precise approach that can be used to treat Sarah’s case. Fuertes, Spokane and Holloway (2013) states that group psychotherapy includes incorporating the victims of emotional imbalances together for exploration under a professional leadership. Developed by Jacob Moreno in 1920s, group psychotherapy allows people to come together and share their escapades under guidance of a leader. This would fit Sarah as she seems to have endured an array of unfortunate events that makes her life feel unjust. The power of groups comes when people share strong and moving experiences making each client feel that he/she is not alone. According to Fuertes and others (2013), a group helps in relieving the emotion burden as the victim feels a sense of belonging. The fact that Sarah has lost a brother and experiences self-abuse may make her feel like she has faced a lot of problems. This may influence her attitude towards counselling; hence, group psychotherapy would be the best.
Edward would also require a psychotherapy approach to treat the challenges he is facing. From the analytical point of view, Edward’s problem lies in his way of thinking and resistance to change. It is quite evident that he thinks his decision should be final and unquestionable. Cognitive behavioural therapy (CBT) is concentrates on an individual’s way of thinking and it would be the best treatment approach for Edward. CBT is a psychotherapy approach that incorporates a number of methods that specifies on constructing people’s cognitions, emotions and behaviours (Weiten and Hammer, 2015). The theory asserts that dysfunctional thinking leads to dysfunctional behaviours. It assists the client to assess, recognize and deal with problems associated with how they think. Edward has a problem with his way of thinking since he seems to be heartless and lacks emotions. This can be denoted by his response to Sarah who is grieving a lost brother and the disassociation with his kids. He had also promised Sarah to have children which is the core reason that she entered into this marriage. Conversely, he did not live to his words and he has no apologies to make. If at all he underwent through CBT, he will be able to respect other people’s way of thinking and keep promises (Earley & Weiss, 2010). Significantly, it would help him to understand that his family should be his closest friend contrary to the current trend where he makes beer his favourite.
The internal family systems model (IFS) is the most applicable model in solving Sarah and Edward case. IFS states that an individual’s mindset comprises of distinct viewpoints and perceptions (Earley & Weiss, 2010). Parts of human brains constitutes of burdens and heavy burdens that keep on haunting his or her life causing an emotional imbalance that can lead to health problems. This process allows the therapist to assess the client’s cognition or self-actualization and replenish the burdens that are constituted in the brain.
Earley, J. & Weiss, B. (2010) Self-Therapy for Your Inner Critic, Pattern System Books
Friedman, M. J.; Resick, P. A.; Bryant, R. A.; Strain, J.; Horowitz, M.; Spiegel, D. (2011). “Classification of trauma and stressor-related disorders in DSM-5”. Depression and Anxiety 28 (9): 737–749.
Weiten, W, Dunn, D.S. & Hammer, E.Y. (2015). Psychology Applied to Modern Life: Adjustment in the 21st Century. (11th). Cengage Learning. 9781285459950
Fuertes, J.N, Spokane, A.R. & Holloway, E. (2013). Specialty Competencies in Counseling Psychology. New York, NY Oxford University Press.