Wednesday, May 22, 2024

Laura’s treatment regimen

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During the 18th month of hospitalization a psychological test called the Rorschach was administered to help clarify Lauras debilitating changes in mood attitude and behaviour

During the 18th month of hospitalization, a psychological test called the ‘Rorschach’ was administered to help clarify Laura’s debilitating changes in mood, attitude and behaviour. Four months later, and after the sub-personalities emerged in the treatment interview, Lori and Angel, the hypnotic influence behind the emergence of these two sub-personalities was observed.

Amy and Henry’s sub-personalities were not examined at the time due to their brief existence. The second Rorschach test was administered just prior to Laura’s discharge from the hospital, at 13 months. What was remarkable about Laura’s first Rorschach protocol was that her personality was overshadowed by obsessive and hysterical traits.

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In subsequent tests, presented with the same stimulus, Laura responds differently at different times, in different contexts, in different ways. Very soon the various entities are being exchanged again. This suggests the possibility of his multiple personality. Also, there was a huge lack of consistency between his various responses, as if everything was a blur. Many times it seemed like Laura was giving different answers from different entities for the same person, but the main character was still struggling to maintain her integrity.

Many who are aware of borderline personality are currently wondering about the possibility of this patient; But it is certain that no effect of fetal abnormalities or alcoholism has been confirmed in this case. Moreover, there was no indication of the child’s use during his hospital stay. Interestingly, the rapid changes in perception and the ever-changing boundaries of content revealed by Plate V are commonly regarded by clinicians as the “self-concept” or “reality” card (Brown, 1960), and contribute significantly to the diagnosis of multiple personality.

“I keep seeing different animals in the same thing,” Laura said. Laura’s responses to this card are paralleled in Rorschach investigations, where similar responses (eg, perceptual instability, emergence of multiple alternative perceptions, and lack of certainty about multiple objects) were observed among multiple personality individuals (Wagner & Hayes, 1974. (Laura’s full response). was: “They look like shoulders, a little bit. I guess they have wings like birds have wings. Shape–three animals in one. Four, actually. Because they have mouths like big gourds.

The agreement obtained from Lowry and Angell’s subjects was structurally similar to Laura’s, ie; They were also poor in quality, and the use of color was inadequate. However, there were also some notable contrasts, particularly in terms of perception. In particular, Lori’s records had the most references to aggressive and phobic images, such as “piranhas, tarantulas, dangerous weapons, claws,” etc.

Angel’s record, in contrast, used adjectives like “big, ugly, smoshed”. Although Laura’s protocol also showed aggressive and phobic content, these effects were complemented by more benign emotional experiences such as “bird kisses, light feathers, low, soft brown”. Thus, although the three records appear similar overall, there are clear differences between them in the dominant emotional experiences that parallel the clinical pictures of these personalities.

Overall, when the protagonist Laura was administered the Rorschach a second time, the change in her perception was less pronounced. In particular, Plate V responses reflect less impulsivity, less aggressive-phobic content, and stronger object boundaries than in the first Rorschach protocol.

treatment
Hospitalization provides Laura with a therapeutic and consistent, highly structured environment. The patient’s unacceptable behavior was handled in a firm but informal manner. Laura’s need for a certain amount of clinging, dependent relationships was arranged for her. However, he was encouraged to use proper, and properly self-assured. He was also occasionally given thioridazine or hydroxyzine hydrochloride to reduce anxiety.

Table 1
Percentage of Aggressive/Phobic References in Content

Laura I 26 Laurie 31
Angel 2
Laura Il 4

Throughout Laura’s hospitalization, her parents were actively involved in her casework. Naturally though they were very disheartened by Laura’s slow progress. The diagnosis of multiple personalities was frightening to them, especially because of their familiarity with the Sibyl book; The book mentioned that this disability carries over into the person’s adult life.

Initially psychotherapy focused on Laura’s distress over discovering her past background and her ambivalent feelings towards her stepmother. Talking to him about dissociative experiences had no effect on his amnesia. But, as these dissociative experiences gradually increase in intensity, in addition to the amount and intensity of damage upon oneself, occur more frequently; It becomes clear that the subpersonality Laurie is negatively controlling Laura’s behavior. It was then that the decision was made to use hypnosis on Laura.
Hypnosis was started on Laura on the 20th month of hospitalization and she was given a total of 30 sessions over 5 months.

Laura is said to be more active, assertive and independent during the hypnotherapy sessions. He is implied to resist Laurie’s attempts to take over. Amy and Angel, meanwhile, are encouraged to continue having meaningful conversations with Lori, and to convince her not to overwork Laura, to not be too angry with her.

Ultimately, the discussion with Laura emphasizes that she is actually one person and that the different entities or sub-personalities are actually just different perspectives or aspects of herself.

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