A Psychological Assessment of “Ordinary People”

“Ordinary People” explores and expands the perspectives associated with experiences from a mental disorder. The novel’s author suggests that mental disorder does not just entail the diagnosis that is made but also has a focus on the experiences of individuals. The author uses the character's experiences to show that anyone can have a psychological disorder even when they may have things in control. Every individual in Jarrett’s family experience different challenges in their quest to come into reality after the death of one sibling (Guest, 1982). These challenges adversely affect the relationship between the family members and other people in their desperate clamor to handle the situation. The family systems theory can be used to assess the family's psychological issues. The theory is often applied to promote an understanding of how humans function and relate within their families (Haefner, 2014). The main characters in the book exhibit relational and emotional symptoms through their experiences and interactions. 

All family members have instrumental functions to fulfill. These functions are often determined by their position in the family along with other factors such as expectations, emotional demands, and personal beliefs (Haefner, 2014). From the start, Beth appears to have mental challenges. This occurs before the tragic accident and death of her son, and even afterwards, she appears mentally disturbed. Grief and bereavement can be at times complicated and make it highly difficult to diagnose separately during depressive episodes. Grief is displayed differently in different people and may even worsen an existing illness or be the factor that induces another. While the Jarrett family is grieving over the loss of a family member, Beth's grief is not typical. She is silent and is not able to connect with Conrad and other characters around her. Her conversations with her son feel awkward, and she does not actively weep like her husband her son. She repeatedly focuses on ensuring that her composure is maintained and establishing control despite the loss that she has experienced. This dismissive nature is seen to have an impact on the relationship she possesses with her family. 

Beth is described as having hysteria despite her cool composure. The mental burden on Beth can be observed in her life as she feels trapped; even her level of organization and cleanliness is affected (Guest, 1982). Due to her position in the family as a parental figure, Beth tries to initiate order in the family in spite of her grief; this further reduces her mental wellbeing. She always tries to establish control in the family's living environment while being disturbed psychologically and emotionally. Besides, Beth’s reactions affect her interaction with her husband, which makes the author describe him as feeling "trapped and hot" (Guest, 1982). Beth also appears to have challenges, especially when performing her parental responsibilities. 

Beth’s Diagnosis 

Beth has mental detachment, which is mainly a result of her antisocial personality disorder. The death of Beth’s son is very traumatic, which makes her depressed. Ertezaee et al. (2019), in their research about depression, notes that the major symptoms for major depression include being sad, changing patterns of sleep, guilt, hopelessness, and others. The symptoms of antisocial personality disorder are defined as including a disregard for right and wrong, being callous and cynical, a sense of arrogance, being impulsive, hostility and significant irritability, absence of empathy for others, poor or abusive relationships, and being consistently irresponsible. These signs and symptoms interfere with the daily living of a person and may often lead to social withdrawal. An individual with depression and antisocial personality disorder faces significant difficulty in social settings and establishing relationships with others. Additionally, having insomnia causes deprivation in sleep which affects an individual's ability to concentrate on their day-to-day tasks (Rice et al., 2020). Both antisocial personality disorder and depression have a negative effect on the way Beth interacts with her son and the others around her. 

Beth exhibits the symptoms of antisocial behavior in her life, as can be seen from her inability to form a relationship with her son and her husband. Beth Jarrett is cold and distant from the individuals around her. Once her son attempts suicide, she goes on vacation and does not attempt to talk to him or ask about his state of mind (Guest, 1982). People with depression find it difficult to have pleasure from activities that they initially seemed to enjoy while also having difficulties in making upright decisions. Beth loses interest in activities around her which results in her exclusion from the social environment. Beth appears to ignore everything happening around her, including, to a certain extent, the death of her son. She appears to have been emotionally detached for an extensive period of time. Her sister states that “emotion is her enemy” (Guest, 1982). Beth Jarett appears to struggle with the display and understanding of different emotions such as happiness, sadness, and anger. She seems to hold the belief that showing emotion exposes her flaws as her whole identity is based on being the perfect upper-middle-class wife. Her emotional detachment appears to highlight her antisocial personality disorder, which affects how she interacts with the others around her. 

Aggression is a primary symptom of Beth’s mental illness. Following the death of her son, Beth's relationship with her husband is tumultuous as she seems agitated every time he is around her. Beth gets angry when her husband says good morning to their son. Eventually, Cal starts to recognize the significant distance that exists between him and his wife and even begins to question what is wrong with her (Guest, 1982). The deterioration of their relationship depicts a clear change in her reactions and behavior. Besides, the relationship with her son deteriorates as he tells his therapist that his mother appears to love his brother more than she loves him (Guest, 1982). Moreover, the reaction of his mother towards him, coupled with his grief, makes him feel less important or wanted in the family. The interactions between them are often characterized by anger and irrational outbursts. Beth fails to notice when her son distances herself, and this is worsened by her inability to communicate with him concerning her emotional struggles. 

Beth shows a refusal to talk about Conrad’s suicide attempt at all. When her husband mentions it, she aggressively snaps at him and states that she does not need to constantly have the subject hanging over her head (Guilt, 1982). Another reason that Beth will not speak about the attempted suicide of her son is because she feels guilty. His attempt to kill himself is a symptom of depression since depressed individuals often have thoughts of killing themselves. Despite the concern that her husband showcases for the mental health of their son, Beth attempts to make the situation about her. His suicide attempt resulted from feeling guilty following his brother’s death and his survival. Beth holds the belief that her son's suicide attempt was made with the view or attempt to hurt her. She also blames Conrad for being manipulative. In her outburst, she views the situation selfishly and makes Conrad's attempted suicide about her. She showcases a complete disregard for the emotions of others, along with the absence of remorse and empathy. Her image appears to be more important to her than the emotions of her family, but she does not appear to realize this. Beth showcases an ability to behave irresponsibly. Instead of getting help, Beth makes the decision to leave the family. Her behavior is described as going in circles and not ending. Due to her antisocial personality disorder, Beth is emotionally detached from the environment of grief around her. 

Journal/Article Review 

The journals that are reviewed in this paper had a focus on the treatment of depression and antisocial personality disorder. The first article, "The mediating role of pleasant activities in cognitive behavioral therapy for depressed adolescents," by Ertezaee et al. (2019), assesses the efficacy of CBT in dealing with depression among adolescents by alleviating pleasurable actions as a mediating factor. The population utilized within this research is adolescent females who are between 14 and 17 years old. The techniques applied involve an experimental framework with control and experimental groups. By using assessments, including pre and post tests, 60 girls were randomly directed into two categories. The results of the study indicated that cognitive-behavioral therapy has a high level of effectiveness in the treatment of depression. Ertezaee et al. (2019) conclude that pleasurable actions can act as a mediating factor in the connection between CBT and depression and may be applied within short-run treatments. Therefore, CBT with pleasant events could be applied in Beth's case in an attempt to reduce her depression. Since her antisocial behavior is instigated by depression. Since her antisocial behavior is instigated by depression, pleasurable activities, such as gardening and dancing, could be included in her treatment to improve her moods and reduce her depression. 

The second article, “Psychotherapy for children as a trauma-informed intervention by Rice et al. (2021), details the creation and establishment of a psychodynamic approach for the treatment of childhood trauma through the enhancement of the emotion regulation system. This article states that the difficulty associated with regulating emotions comes as a result of disruptions within the developing neural networks by interacting with different factors such as the links that a child has with those that provide them with care and the general environment. Rice et al. (2021) state that a therapeutic focus on the defenses of traumatized children is essential to overcome the adverse impact of trauma. An intervention to help children to address negative feelings within traumatic experiences is also presented by interpreting defenses. The content provided has a unique contribution to the extensive range of treatments for children who are exposed to trauma. Besides, the article provides important information about how individuals could deal with traumatizing events. Therefore, the information in the article could be utilized to help Beth deal with the traumatizing death of her son. The main aim of this technique is revealing the unconscious contents of a patient in the quest to reduce o remove psychic tension. Based on Beth’s assessment, she is suppressing most feelings about her son’s unfortunate death as she believes that being open will make her look weak. Therefore, this approach could be applied to help her reveal her unconscious content; this would reduce or remove her psychic tension. A reduction in psychic tension would result in reduced stress and depression. 

The third article is "Dialectical behavior therapy for men with borderline personality disorder and antisocial behavior: A clinical trial," by Wetterborg et al. (2020), conducts an analysis of the use of DBT for male adults who have borderline personality disorder and antisocial behaviors. The authors conducted a one-year assessment of DBT for men with antisocial behavior. The participants that completed the therapy reported elevated satisfaction with their treatment and continued to maintain their improvements. The article makes the conclusion that DBT can be utilized as an efficient treatment method for individuals with antisocial behavior. The findings obtained in this article could be utilized in Beth's treatment. Since she has an antisocial personality disorder, DBT could be utilized in her treatment. The main aim of DBT is to improve an individual's mental wellbeing by helping them to live in the present, develop methods of coping with stress, and manage to interact and develop relationships with others. Therefore, the application of this technique would help Beth to focus on today and not the past, develop ways to deal with her challenges, and develop and improve her relationship with others, especially her family members. 

Treatment Plan 

This plan was designed and assessed on 17/5/2021 for Beth. 

Time of Consultation: 2.00 PM—4.00 PM. 

Plan Developers 

Therapist. 

Beth Jarrett (patient). 

Diagnosis 

Depression. 

Antisocial behavior disorder. 

Current Medications : There are no medications assigned to the patient. 

Problems/Needs : 

Depression. 

Antisocial behavior disorder. 

Problem/Need : Major Depressive Mood Disorder (F32) 

Beth’s depression has been recognized as an illness that needs proper treatment. In Beth, this illness can be seen through symptoms such as; 

Depressed mood that is consistently present. 

Withdrawal from social situations. 

Change in moods. 

Poor sleeping habits. 

Feeling guilty. 

An inability to experience pleasure. 

Long Term Objective : 

Reduced (less than 4 times a month) on no depressive moods. 

Targeted Date: 14/9/2021 

Short Term Objective 

Objective 1 

Beth will have the ability to describe the causes and triggers for her illness and moods. 

Frequency: Bi-weekly 

Target Date: 15/6/2021 Date of Completion: Status: 

Objective 2 

Beth will manage to develop positive interactions with people around her. 

Duration: Three weeks 

Target date: 15/7/2021 Date of Completion: Status: 

Intervention: 

To achieve these objectives, the CBT intervention will be utilized. 

Problem : Antisocial Personality Disorder (DSM 301.7) 

Beth’s antisocial personality disorder is an active challenge that calls for treatment. It can be observed through symptoms such as; 

The disregard for right and wrong. 

Being callous and disrespectful to others. 

Being mentally detached. 

Agitation and significant irritability. 

The lack of remorse or empathy for other individuals. 

Poor relationship with her son and husband. 

Consistently behaving in an irresponsible manner. 

Long Term Objective: 

Improved relationship with others. 

Targeted Date: 28/4/2021 

Short Term Objectives: 

Objective 1 

Beth will have knowledge of management approach. 

Duration: 3 weeks 

Target Date: 3/9/2021 Date of Completion: Status: 

Intervention: 

The counselor will support Beth in learning and utilizing behavioral strategies to assist in the management of her symptoms. 

Short Term Goal 2 

Beth will be able to develop relationships with those around her and be empathetic. 

Frequency: Bi-weekly Duration: 20 min per session 

Target Date: 15/5/2021 Date of Completion: Status: 

Intervention: 

The counselor will utilize psychoanalysis therapy to help Beth in minimizing and mitigating callousness and levels of aggression. 

Status 

Beth identified several strengths and capabilities, along with competencies that he would like to develop during treatment. The information will be utilized in guiding the treatment approaches and interventions identified as appropriate for Beth. 

Strengths: 

A supportive family. 

Desire for further improvement. 

Needs: 

A proper outline of the diagnosis. 

Support in managing her feelings. 

Abilities: 

I have the ability to ask for assistance from others. 

Preferences: 

Personal therapy. 

Expected Outcomes: 

I will have the ability to be empathetic towards the feelings of others 

I can express my feelings to those around me. 

Barriers: 

Emotional challenges may act as a barrier to the treatment. These challenges can be solved by using personal/individual therapy. 

References 

Ertezaee, B., Asghari, K., Oreizi, H., & Ghasemi, N. (2019). The mediating role of pleasant activities in cognitive behavioral therapy for depressed adolescents. International Journal of Behavioral Sciences , 13 (1), 33-39. 

Guest, J. (1982). Ordinary People . Penguin Books. 

Haefner, J. (2014). An application of Bowen family systems theory.  Issues in Mental Health Nursing ,  35 (11), 835-841. 

Rice, T. R., Prout, T., Cohen, J., Russo, M., Clements, T., Kufferath-Lin, T., ... & Hoffman, L. (2021). Psychodynamic psychotherapy for children as a trauma-informed intervention. Psychodynamic Psychiatry, 49 (1), 73-85. 

Wetterborg, D., Dehlbom, P., Långström, N., Andersson, G., Fruzzetti, A. E., & Enebrink, P. (2020). Dialectical behavior therapy for men with borderline personality disorder and antisocial behavior: A clinical trial.  Journal of Personality Disorders ,  34 (1), 22-39.