Case Study on Stress and Coping

Case Study #1

Jennifer is a 29-year-old administrative assistant married to Antonio, an Italian engineer, whom Jennifer met four years earlier while on a business trip for her marketing company. The couple now lives in Nebraska, where Antonio works for the county’s transportation department and Jennifer commutes an hour each way to her marketing office. They have been trying to start a family for over a year. Eight months ago, Jennifer miscarried in her second month of pregnancy. Antonio’s parents love Jennifer and often ask her if she is expecting again, hoping to encourage her to focus on her next baby. Jennifer’s mother passed away two years ago and her father’s health is rapidly deteriorating. Jennifer faces the probability of placing her father in a skilled nursing care facility within the next few months, against his wishes. At work, Jennifer runs a tight ship. She is organized and prepares lists to assure that everything is done according to schedule. Everyone counts on Jennifer and she takes pride in never letting people down.

Jennifer has visited her physician numerous times in the last six months, complaining of headaches, backaches, and indigestion. Jennifer insists that she is happy and is not feeling stressed, yet she finds herself making more mistakes at work, unable to keep up with housework, and feeling tired and overwhelmed; she has begun to question her effectiveness as an employee, wife, daughter, and potential mother. Her pains seem to be increasing, but her doctor cannot find a physical cause for her discomfort.


What are the causes of stress in Michael’s or Jennifer’s life? How is stress affecting Michael’s or Jennifer’s health?

Jennifer’s sources of stress are best expressed in a pyramidal fashion. Her most common source of stress seems to lie in daily hassles. Jennifer commutes every day for two hours which can take its toll. The noise pollution, air pollution, and traffic associated with this type of work-related commute can result in increases in heart rate and blood pressure, chest pain, and other signs of stress. Second on the way up the pyramid is Type A behavioral patterns. At work, she is described with the words: organized, prepares lists, and tight ship. In and of themselves these descriptions are not a stressor, but her drive for organization can work against her during stressful situations such as the one she finds herself in. She is questioning her effectiveness as an employee, and for someone who prides themselves on organization, this stress can act to reinforce other more obvious forms of stress. Second to the top of the pyramid would be the death of her mother and the upcoming placing of her father into a skilled nursing care facility against his will. It is important to maintain a stable support structure of family and friends. With the removal of her mother and father, she will have to adapt to the shift in this support structure. At the top of the pyramid are the attempted pregnancy and subsequent miscarriage. There are many stresses associated with the decision to bring children into the world including perceived financial inadequacy and fear of the unknown. Second, a miscarriage can sometimes bring with it the feeling of inadequacy or infirmity. Lastly, Jennifer now feels pressure to socially conform to the perceived expectations of her in-laws and herself. As to her health, Jennifer appears to be in the exhaustion phase of general adaption syndrome (GAS). The alarm reaction occurred during and after the miscarriage. Her body’s initial response to the stressor of her miscarriage was most likely to release energy and the stimulation of the sympathetic division of the autonomic nervous system. She has endured the resistance stage since the miscarriage by dealing with perceived social pressures and work-related stress. Finally, now her body has entered the exhaustion stage and is beginning to exhibit signs of deterioration. For instance, increased muscle tension from stress has lead to continual muscle-tension headaches.

How are these stressors impacting Michael’s or Jennifer’s self-concept and self-esteem?

The self-concept includes both the self-esteem and one’s ideal self. In the case of Jennifer the ideal self, the self we feel we ought to be is in conflict with her perceived self. A part of Jennifer’s self-concept is the perceived pressure to form a nuclear family in accordance with social conformity. Jennifer’s self-concept is also at play in her work performance. She has acquired a standard of fastidiousness which is at conflict with her actual or perceived job performance. To that end, Jennifer’s self-esteem suffers because of her shortfalls in measuring up to her ideal self. Furthermore, if Jennifer is not able to resolve this self-concept vs. actual self-conflict, then she might eventually enter an identity crisis. If she is not able to have children and therefore satisfy her ideal self-image, then she might have to re-evaluate her self-concept accordingly. If Jennifer was brought up by authoritative, rather than authoritarian or permissive parents, then she will be much more likely to be able to adapt to her perceived shortcomings and overcome this conflict of self-concept.

What defensive coping methods is Michael or Jennifer using? What active coping methods might be healthier for Michael or Jennifer to use? Explain why you would recommend these methods.

In Jennifer’s position, it is important for her to utilize the psychological tools of self-efficacy and optimism. Inherent in both of these coping methods is the belief that adjustment is obtainable whatever the circumstance. Jennifer must keep in mind that even though she is experiencing many forms of stress, resolution of those stressors is possible and even likely. Back to the idea of Jennifer’s social support structure, she must utilize those close to her in order to buffer against the effects of stress. At the present Jennifer is utilizing this support structure in the case of her in-laws, but a broader base of support is needed to deal with the many stressors she is experiencing. Furthermore, Jennifer should fall back on her commitment to her job, the challenge that it poses, and the control that it allows her to exert over her circumstances in the form of psychological hardiness. These forms of coping should be used because they all encourage healthy adjustment to the stresses that Jennifer faces rather than maladaptive responses such as substance abuse. By employing these coping methods Jennifer should be able to adjust and adapt to the stressors which currently face her.

Select one theory of personality and use this theory to tell Michael or Jennifer how this theory explains his or her situation.

Learning theory dictates that the headaches that Jennifer is experiencing could be linked through association to her work-related commute. Of course, further examination would have to take place in order to ascertain this information, but there is strong evidence notwithstanding. Furthermore, Jennifer could utilize a conditioned stimulus to overcome these associative responses. For instance, she could start going to get coffee before work at a restaurant that she likes. In that case, she could learn to associate more positive stimuli to the morning commute. It also appears that certain forms of operant conditioning are at work in regards to her miscarriage. Not only is she under significant real-world stress Jennifer has to offset the considerable negative reinforcer of the miscarriage itself. More than likely she experienced substantial mental and physical pain during and after the miscarriage. In order to offset the associated negativity to this painful event, Jennifer and her support structure should put several positive reinforcers in place. These could include buying things for the hopefully forthcoming baby or maybe talking about possible names. During these exercises, Jennifer would learn to associate more positive thought processes to the upcoming pregnancy, rather than the negative reinforcer of the past miscarriage.

In what stage of development is Michael or Jennifer and what factors about this stage might be impacting his or her perspective of this situation?

Jennifer is 29 years old so she is still in the young adult stage of development. She has not entered menopause so her reproductive organs should still be operating properly notwithstanding some medical problem. Jennifer is probably at her peak cognitive development or just after; therefore, crystallized intelligence and fluid intelligence are at an optimal balance. This level of psychological healthiness will help Jennifer’s adjustment to the stressors she is dealing with. It appears that Jennifer has overcome intimacy vs. isolation and chosen productive, intimate relationships over isolation. She has a well-adjusted support structure in place in the case of her husband and in-laws. The decision to try to have a baby might have been motivated by the age-30 transition. (i.e. her biological clock). At that age women tend to start asking questions like, where is my life going? Because of sources of social conformity and Jennifer’s self-concept she probably decided to include children in her family unit.

What relationship factors or considerations might be influencing Michael’s or Jennifer’s problems?

Jennifer and her husband are in the continuation stage of their relationship. The attraction stage of their relationship took place when they meet while she was on a business trip. The period of building was completed sometime during the ensuing three years before they starting trying for a child. During this time mutuality was reached and Jennifer and her husband started thinking about themselves as “we”. The continuation stage began some time before they started trying for a child and was probably only reinforced by the shared experience of the miscarriage. The miscarriage was a vital step in mutual cyclical growth because it increased the level of commitment and trust that Jennifer and her husband felt for each other. At this point in their relationship no signs of relational deterioration have occurred; therefore, the deterioration or ending phase of Levinger’s theory has not taken place. Feelings of equity are obviously present because no overt pressure for another pregnancy is mentioned from Antonio.

References

Nevid, J.S., Rathus, S.A. (2005). Psychology and the challenges of life: Adjustment in the new millennium. Danvers, M.A.: Wiley.

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