Reference no: EM132815508

It is Friday night. Hank is sitting in his apartment eating a pint of Ben & Jerry's Cherry Garcia ice cream and contemplating this past week, which had been stressful. He is 5'6" tall and weighs 250 pounds. Today, he saw a therapist about his weight for the first time, something he had been considering after yet another woman decided not to continue a relationship with him. After just two dates, Sally told Hank they should not see each other anymore because they were incompatible. Sally and Hank had met through a chat room in which they debated whether the iPad is the best tablet computer available today, and Hank became impressed with Sally's knowledge of computers and software. After chatting a few times on the computer, Sally and Hank found that they lived in the same city and both were single. Because they seemed to have their love of computers in common, they both thought it would be nice to get to know each other better. They met for drinks at a mutually agreed upon bar and then went on to dinner. The date did not go as well as Sally had hoped, and one could understand Sally's view. She tends to be a calm, friendly person with an aversion to conflict. Hank, however, tends to be quite sarcastic and often says things to others that offend them. For example, Hank made an unkind comment about Sally's occupation. She is an insurance saleswoman, and he implied that she tries to rip off other people by feasting on their insecurities and selling them insurance they do not need. Other examples of his verbal insensitivity include Hank berating the waiter at the restaurant because he was dissatisfied with the service. Hank became so loud that everyone at the restaurant stopped talking to watch Hank and Sally. Sally was mortified. Far from being occasional, these verbal outbursts seemed to be the norm because Hank engaged in similar behavior on their second date when they went to a computer show. Hank got into an argument with one of the exhibitors about which graphics software package was better.

Unfortunately, Hank has always been sarcastic, and his biting comments alienated him from his peers even as a child. When he was growing up, he had difficulty establishing relationships. Friendships were practically nonexistent for Hank. As a child, while all the other kids were hanging out with their best friends and interacting in groups, Hank was learning to use the computer, which now places him at an advantage in his line of work. Hank has other annoying habits that tend to alienate others, including Sally. For example, he often chews his fingernails when he is nervous. Although minor, this tendency repulsed Sally. In addition, he is a chain smoker, and Sally is a nonsmoker. Hank, however, thought that Sally broke up with him because of his weight problem and soothed his ego by telling himself that she was a very shallow person indeed if she could not see past his appearance and value his personality. After all, his weight was probably partly genetic: his whole family was somewhat overweight, including his father, mother, and siblings. He also suggested to others (and to himself) that he was about to break up with her. The week after his breakup with Sally, Hank started experiencing chest pains. After a trip to the emergency room, Hank found out that he had a heart condition. The doctor told him that he must stop smoking, lose weight, change his eating habits, and start an exercise program. Otherwise, he was headed for a heart attack that he might not survive. This was certainly good advice. Hank continuously had something in his mouth, either food or cigarettes. He especially ate and smoked a lot when he was nervous. This news about his health was especially disturbing to Hank because he is relatively young. He is a Caucasian man, only 33 years old.

And so Hank was scared into considering seeing a therapist to help him lose weight to improve his health. During his first visit to the therapist, the therapist described himself as psychodynamically oriented and then continued to describe the types of experiences that would occur in the therapy process. Hank felt confidence in his therapist by the end of the session and decided to continue so he would lose weight and become healthier. Hank also thought about the trying week he had at work. As an employee of an advertising firm, Hank works primarily with computers. He is the person others go to when they have a computer or software question. A whiz at computer graphics, Hank designed and now maintains the firm's Web page. Occasionally, he meets with clients or potential clients, but his boss usually assigns this duty to other members of the firm. This week, however, his boss asked Hank to meet with a potential client, primarily because the people who usually did so were too busy working to meet a deadline on a different advertising campaign and because other members of the firm were out with the flu. Apparently, the meeting did not go well because shortly afterward his boss called Hank in and chewed him out, stating that this potential client called Hank a loud-mouthed, belligerent cretin. Hank could not figure out where this opinion came from; he thought the meeting went well. Sure, he told the client that their health food products were tasteless and that the portions were too small, but the jerk kept self-righteously promoting weight loss and healthy eating. Someone had to put him in his place, Hank thought. His mother often described Hank in terms that implied that he had been loud even as a baby. His cries used to pierce the air, and his mother would often rush to make a bottle for Hank or give him a cookie to regain some peace and quiet, even when she could not understand why he was hungry because he had eaten so recently. She laughs about it now, but it was stressful at the time. The ice cream started to make Hank feel better and more relaxed. Once he finished off the pint, he pulled out a cigarette and lit it. The first inhale also helped to reduce the tension he was feeling. He hoped that the next week would be better. Hank wished that his coworkers would appreciate him and offer him friendship. When he was younger, he thought that by becoming good at computers (which he thought were cool) and being able to answer other people's questions about computers, he would be able to make contact with others and form the close relationships that other people do, but so far, this strategy has been unsuccessful. More than anything, Hank wishes a woman would fall in love with him. He thinks that love will solve all his problems: He would not be lonely anymore, and he would be able to lose weight and quit smoking, too, if he just had the love of a woman.

Use Freud's states of consciousness and stages of psychosexual development to help explain Hank's behavior by answering the following questions.

-At what stage is Hank fixated, according to the Freudian perspective? Find evidence of fixation in the case study. What would have caused this fixation?

-Find an example of a Freudian defense mechanism that Hank uses in this case (other than regression). Explain it.

-Find an example of regression in the case study. Explain it.

-Would a Freudian therapist view Hank's weight problem as a behavioral problem in and of itself or as a symptom of another problem? Explain.

-What is an alternate explanation (besides Freud's) for Hank's eating and argumentative behaviors?