노년기 우울증 여성의 통합적인 가족상담 다중사례 = Multiple Case Study of Integrated Family Counseling for a Depressed Woman in Old Age

다국어 초록 (Multilingual Abstract)

The study is based on multiple case study consisting of an individual counseling for a depressed disorder female client in old aged, an individual counseling for the client’s daughter, and a couple counseling. The client’s depressive tendencies emerged as primitive anger and aggression in interpersonal relationships, and thereafter, feelings of empty emptiness and meaninglessness appeared repeatedly due to regret, self-destruction, and grief. The purpose of this case is to examine the client’s background and psychoanalytical insight into depression, and to understand how an unrealistic client, such as anxiety, low self-esteem, feelings of emptiness, emotional anger expression, and helplessness, builds a safe self-world and the process of change. is to reveal. In addition, the client’s depressed state was transferred to her eldest daughter, who also complained of difficulties, raising the need to improve the relationship.
The problem addressed in this study is that the object relationship patterns that the client experienced in childhood were formed internally due to anxiety and fear, and were a convergent relationship pattern that appeared later as an adult. In her relationship with her boyfriend and her eldest daughter, she showed tendencies toward borderline personality disorder due to repeated expressions of anger and self-blame rather than forming appropriate relationships. The client’s depression was triggered by a conflict with her boyfriend and an assault incident, and she sometimes showed lethargy and emptiness, and sometimes became aggressive.
The approaches covered in this case are as follows. As a multiple case, 2 sessions of family counseling were conducted for the entire client, 20 sessions of individual counseling, 1 session of individual counseling for the daughter, and 2 sessions of couple counseling for the daughter. During the COVID-19 period, non-face-to-face counseling was provided to the client living in a rural area and the client’s daughter living abroad. In this case, the crisis intervention was due to the client’s depression and a violent incident, and the counseling proceeded well as the entire family participated and cooperated. The theoretical background was an integrated family counseling approach, including object relations theory, attachment theory, Kohut’s self-psychology, and Murry Bowen’s psychodynamic family system theory.
Therapeutic intervention strategies used included forming a safe relationship with the counselor, being a mirroring selfobject and contain, idealizing transference, holding environment, transmuting of psychological structure, transference feelings and acceptance, and moving from division to integration.
The client’s daughter’s couple applied Imago couple relationship therapy and had time to connect emotionally through the “Imago Dialogue Method”, empathize with each other, reflect and reflect the other person’s words as they are. Through the “Imago Parent-Child Dialogue Method”, an empathetic conversation was attempted to share what kind of phenomenon the wife’s past childhood wounds are appearing in the relationship between the two now.
As a result of the counseling, the client’s family, who had a low level of self-differentiation, attempted to help the mother and daughter differentiate themselves better and establish their individuality, independence, and identity. The client’s daughter’s relationship as a couple improved from being cold, cold, and combative to becoming softer and smoother. After the counseling, in the mother-child relationship, rather than relying on the eldest daughter and demanding her own way, the mother showed consideration for the eldest daughter’s position and became more responsible with self-consciousness about her own life. The client adapted to the new pattern of living alone, and the daughter also tried to distance herself from her mother and set clear boundaries.