Working With Individuals: The Case of Mary

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Mary is a 47-year-old, single, heterosexual Caucasian female. She lives with her 52-year-old sister and 87-year-old father in the home in

which she was raised. She also has a 45-year-old sister who lives 10 minutes away and a 23-year-old daughter living on her own. Mary and her

family members do not maintain friendships outside the family. Mary has been unable to work for the past 3 years because she says she has felt

too frightened to go too far from her home. As a result, she has been financially reliant on her family members for these last few years. Prior to

this lapse in employment, she had been a school bus driver and an administrative assistant at a warehouse distribution center. Mary has no

history of drug or alcohol abuse. She is well groomed and physically fit with a diagnosis of hypoactive thyroid, for which she is treated with

Synthroid®. Mary was diagnosed with post-traumatic stress disorder (PTSD) and adjustment disorder, not otherwise specified (NOS) by the

clinic psychiatrist.

Before meeting with me, Mary saw a social worker in a private practice for 2 years. She entered treatment with that clinician because she said

she was traumatized by a romantic relationship with a married African American man she had met at work. Her trauma symptoms began 6

months after she ended the yearlong romantic relationship. Mary said the romance occurred because he had “brainwashed” her, as there could be

no other reason she would have slept with him. Mary believes that bad people are capable of “brainwashing” good people to perform bad deeds.

Mary was raised in a home that espoused racism, and she and her family members believe that African Americans and other people of color are

untrustworthy and bad. She said, “I take after my father, and he thinks black people are just evil.” Mary said she understands her feelings about

race are not right.

Mary considered her initial attempt at treatment unsuccessful for two reasons. First, she felt the therapist (a Caucasian woman) judged her and

her family harshly for their racial beliefs and this got in the way of the two of them building a trusting working

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