Cutting, Binging, Drinking: A Case Study

An experienced psychologist helps a troubled young woman become “the captain of her own ship.”

cutting-bingeProblematic substance use rarely occurs in a vacuum. Much more frequently, clinicians are faced with a variety of presenting problems, both intrapsychic and behavioral, and are required to carefully balance safety concerns while at the same time working on deep underlying conflicts and unhealthy responses to life’s many challenges. In the past, it was common for clinicians, when confronted by substance misuse in a client, to refer the client for substance abuse counseling, but today many experienced clinicians realize the wisdom in continuing to work with clients who present with complex clinical presentations in which substance use is but one of a variety of significant clinical issues. Here, Dr. Jennifer Guttman skillfully balances several pressing problems in helping a young woman achieve a more autonomous and stable sense of self…Richard Juman, PsyD

What happens when a child isn’t taught the skills he or she needs to cope with the stress encountered in life? What if he or she doesn’t learn to express emotions verbally? What happens to a child who grows up in a family where everything is supposed to appear perfect to the outside world?

Despite having good intentions, in today’s world, parents make too many decisions for their children. When they do this, they backhandedly make two mistakes. First, they undermine their child’s ability to trust in his or her own decision-making skills, and second, they fail to allow their child to learn adaptive coping mechanisms for when the pain of not succeeding is experienced.

I met Chloe about two years ago. On the outside, she was a beautiful, intelligent, 16-year-old, living a seemingly perfect life. Behind closed doors; however, the need to live up to her parents’ high hopes for her had caused her to become depressed, cut herself, and start a conflicted relationship with food.

What she did not reveal at the time was that she had also been struggling with alcohol since she was 12. The drinking started with the consent of her parents on a family trip to Europe, and she was noticeably drinking quite a bit. Her behavior was the source of family jokes, but was not curtailed by the adults. From 12 onward, she continued to drink at family gatherings and hid secret indulgences in alcohol from family members.

A senior at a private high school, Chloe was going through the motions preparing to go to college; however, in my professional opinion, she was by no means emotionally ready. Her parents were overjoyed by her acceptance to one of the top 10 universities in the nation, and disregarded my urging to defer her admittance, permitting her matriculation.

Over the course of a mere six months of therapy before leaving for college, Chloe had begun a torrid love affair with a girl with whom she shared a passion for modern dance. The relationship was co-dependent and controlling for both parties; and depleted Chloe’s already scarce emotional resources. As college was looming, therapy was mainly focused on strategies to eliminate her cutting behaviors, as well as develop the coping mechanisms needed to separate from her girlfriend.  Read more “the fix”…

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