Clinically Speaking is a blog that will allow anyone to learn about Social Work, case presentations in psychotherapy, and the relationship of pop culture in psychology. Come one...come all!!!

Thursday, February 23, 2012

Case Presentation: Jack and Jill

Hey sorry for the recent lack of posts. I thought today would be a good day for a case presentation. Jack and Jill...

**PLEASE NOTE: This posting is in accordance with HIPAA rules and regulations. There are various parts of this case that are changed to protect the identity of the patient. Click here to learn more about HIPAA

Presenting Problem: Improve parenting skills.
Jack, a 40 y/o and Jill, a 39 y/o Caucasian couple who have been married for 15 years. They have 5 children ranging in ages of 14-5. When they entered therapy they wanted help to improve their parenting skills at home with their children. Jill reported "they sometimes just don't listen, when they don't listen I get angry and frustrated, and the kids start screaming and becoming slightly out of control". Jack reported "Its hard for my wife, often I am not home, so when I am home I might be a little more forceful, and then all the kids yell". It was clear from the beginning that Jack and Jill  needed to establish more effective ways in harnessing their frustration and anger. When they are able to do that, they will be in more control to parent more effectively. As a clinician though, I wanted to be able to understand how they as a married couple relate to each other. Jill reported "well overall I think we have a good marriage, but there are times when I feel we don't talk enough and when I need him he isn't there, whether he is working or doing charity work". Jack reported "I agree, but I think she down played when she gets angry and frustrated, she could explode in a matter of seconds".  What was clear after a further exploration was that the root of the problem was not necessarily due to the children not behaving and becoming out of control, but rather in the manner they become out of control. 

When it comes to parenting a large part of behaviors that children learn are adaptive from the parents, aka Modeling.  Both Jack and Jill were able to admit that they have spouse-to-spouse anger management problems. When the children see that this is how mommy and daddy act when they get mad, they interrupt that, as a productive or accepted manner to react, which obviously it is not. Myself and the couple decided to first work on better ways to, as I like to call "bringing the boiling point down". Meaning, it is unnatural to never get angry, but if your boiling point of anger before even becoming angry is at 100 degrees one can "explode" in anger in a matter of seconds. However, if you are able to bring that starting off point down, your tolerance and propensity for "high conflict situations" will be a lot more tolerable and calm which will allow a person to think more rational. 

How does one bring that point down? When it comes to a couple, it is very simple:Reliance/Trust and Communication.
Reliance/Trust: You need to be able to rely and trust your partner that they can step in when you feel that you are becoming angry and frustrated. 
Communication: is actually saying to your partner "I am becoming frustrated and angry, please help me". 

When these steps are implemented, being able to combat your anger and lower your boiling point to handle these situation will be easier. 

Fast fwd 3 months later: Jack and Jill reported to decrease their anger, how they relate when angry to each other and Jill reported "I started to see a real difference in the way i react to the children and how they are reacting to us at home". Jack reported "I feel myself not being as angry went the kids are going at it, which is good". 

Trust and Good communication can solve a lot of relationship issues. Jack and Jill were able to correct how to better model for their children by understanding and implementing these principals to help their won weaknesses.   
Trust and Good communication are the foundation of a good relationship, but if the foundation is made on quicksand you could never build a house.

On the horizon for the blog:
-PTSD and our veterans
-Bullying and Teens 
-...More Psychology 101.

Happy Thursday!

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