Reference no: EM132799274

Discuss the client's culture and identify his or her strengths

Case 1: Keisha Trauma Exposure Keisha is a 21-year-old African American female. She lives downtown in an apartment with her husband Mark. Keisha enjoys her job at a local coffee shop but has Mondays off. On this particular Monday, she was off and enjoying the evening alone since Mark works third shift. Keisha has a tendency to listen to her music rather loud so she almost didn't hear the door. Her neighbor from the apartment opposite hers was in the hallway with an exasperated look on his face and asked her to turn it down. She rolled her eyes and agreed then shut the door abruptly. A few minutes later there was another knock at the door. Keisha begrudgingly went to the door since she knew it was her fussy neighbor again. She swung the door open widely, ready to argue, only to find a large man she'd never seen before. He shoved his way past her and slammed the door behind them. Despite Keisha's best efforts to resist him, he was too strong. He raped her.

Victim's Response and Symptoms

Keisha feels ashamed and guilty about the attack. She wishes that she had not had the volume up so loud and that she had locked the door. She wonders whether she should have resisted more when the man was making his way into the apartment, when he had found her alone. She is also ashamed to have to explain to people what happened. She thinks the whole thing is her fault. She can no longer face her own reflection and feels dirty. She also feels stupid and is gradually withdrawing from others, even her husband and sister who are desperate to help her. Keisha is constantly thinking back to the scene of the rape and imagines various scenarios. She is unable to resume her normal life, because everything reminds her of the rape. She cannot bear her husband touching her and refuses any kind of sexual contact since the rape. She is sure that she will never be the same again, that she is destroyed and will never be able to have sex again. She has gained quite a bit of weight and only wears baggy clothing and no makeup, worried about arousing men. Even though the rapist has been arrested, Keisha wants to move. She no longer feels safe in her home and finds it unbearable to be home alone on Mondays. Keisha has lost all motivation, talks little, and has suicidal thoughts.

The Therapist's Observations

Rape is more common in women than in men. This traumatic event can leave deep emotional scars in its victims. As we can see from Keisha's behavior, this trauma can directly affect one's trust in others and all interactions with people can be seen as potentially dangerous. Women who have been sexually abused, like Keisha, tend to have more problems in their personal relationships which we do not tend to see in, for example, victims of natural disasters.

Traumatic Event and Traumatic Response

Even though rape does not necessarily imply a threat to one's life, Keisha has experienced a threat to her physical integrity. During the rape, she felt powerless and horrified. Keisha's experience can therefore be considered as traumatic. Post-Traumatic Stress Disorder Since the rape, Keisha is exhibiting post-traumatic stress symptoms: Intrusive thoughts: Images of the rape come over Keisha in the daytime. Hyperarousal: Keisha feels fearful most of the time and if afraid of being around anyone she does not know. Shame and guilt: These feelings are very common in victims of sexual abuse. Sexual problems: Rape victims may have sexual problems.

Other Problems

• Depression: Keisha is gradually refusing all contact with others, including her own family. She does not feel like doing anything at all and feels that the future does not hold anything for her. Many rape victims with post-traumatic stress will also develop depression.
• Suicidal thoughts: One needs to pay particular attention to people who express suicidal feelings after a traumatic experience. Keisha has hit an emotional 'wall' and wants to die, having no motivation or feeling that her situation will improve.
• Eating disorders: Keisha tries to make herself unattractive to men. To this end, she has gained weight and no longer dresses or cares for herself as she once did.